Levothyroxine over-replacement — SCE Endocrinology MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: E — Reduce levothyroxine dose and treat atrial fibrillation risk
Suppressed TSH with high free T4 indicates over-replacement, which contributes to atrial fibrillation and bone loss. Carbimazole is not the solution when the excess is exogenous levothyroxine. The pearl is that TSH suppression is not benign outside selected thyroid cancer contexts.
Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal-nutritional-and-metabolic-conditions