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Thyroid replacement monitoring — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsThyroid replacement monitoringGPhC CRA

A 61-year-old woman has her levothyroxine increased from 75 micrograms to 100 micrograms daily. Which monitoring plan most closely follows UK guidance?

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

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Correct answer: D — Check TSH from six weeks and repeat every three months until stable

TSH does not equilibrate immediately after a levothyroxine dose change. SPS advises checking TSH from six weeks after initiation or dose change and repeating about every three months until stable. A two-week TSH is premature; free T4 is not adjusted against a 24-hour peak; waiting six months despite instability is too late; and total T3 is not the routine dose-adjustment test for primary hypothyroidism.

Reference: NHS SPS levothyroxine monitoring: https://www.sps.nhs.uk/monitorings/levothyroxine-monitoring/