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Thyroxine over-replacement — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsThyroxine over-replacementGPhC CRA

A patient taking levothyroxine 150 micrograms daily reports palpitations, weight loss and tremor. Her last thyroid function test was more than a year ago. What monitoring is required?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Arrange thyroid function review and advise prescriber assessment for possible over-replacement

Palpitations, tremor and weight loss can indicate excessive thyroid hormone replacement. Thyroid function tests and prescriber review are needed before changing the dose. Interacting products such as iron should not be used deliberately to reduce exposure. Abrupt long-term discontinuation is not appropriate without clinical assessment.

Reference: BNF; NICE CKS