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Subclinical hypothyroidism — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareSubclinical hypothyroidismUSMLE Step 3

A 47-year-old woman has fatigue and a TSH of 6.8 mIU/L on routine testing. Free T4 is normal. She has no goiter, is not pregnant, and has no infertility concerns. Which of the following is the most appropriate at this time?

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

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Correct answer: C — Repeat TSH and free T4 before starting treatment

Mild subclinical hypothyroidism is often confirmed with repeat testing before treatment decisions, especially without pregnancy or marked TSH elevation.

Reference: American Thyroid Association hypothyroidism guidance