Question

A 49-year-old woman complains of fatigue and weight gain. Examination shows dry skin and bradycardia. TSH is elevated and free T4 is low. She has no cardiac disease and is otherwise healthy. What is the most appropriate starting dose of Levothyroxine?

Accepted Answer

Start a full replacement dose and titrate according to TSH

Answer

Give no treatment unless symptomatic heart disease is present

Answer

Start Carbimazole and monitor TSH

Answer

Start low-dose Levothyroxine only if T3 is low

Answer

Give high-dose steroids before Levothyroxine

Practice question

A 49-year-old woman complains of fatigue and weight gain. Examination shows dry skin and bradycardia. TSH is elevated and free T4 is low. She has no cardiac disease and is otherwise healthy. What is the most appropriate starting dose of Levothyroxine?