A 44-year-old woman has fatigue, constipation, TSH 12 mIU/L, and low free thyroxine on repeat testing. She is not pregnant and has no cardiac

Question

A 44-year-old woman has fatigue, constipation, TSH 12 mIU/L, and low free thyroxine on repeat testing. She is not pregnant and has no cardiac disease. Examination shows delayed relaxation of ankle reflexes. Which of the following is the most appropriate next step in management?

Accepted Answer

Start levothyroxine and recheck TSH in 6 to 8 weeks

Answer

Start liothyronine monotherapy

Answer

Treat with methimazole

Answer

Order thyroid radioiodine uptake testing

Answer

Repeat thyroid tests in 1 year

Primary hypothyroidism — USMLE Step 3 MCQ

A 44-year-old woman has fatigue, constipation, TSH 12 mIU/L, and low free thyroxine on repeat testing. She is not pregnant and has no cardiac disease. Examination shows delayed relaxation of ankle reflexes. Which of the following is the most appropriate next step in management?