Follow-up strategies for patients recovering from De Quervain's thyroiditis should focus on monitoring thyroid function tests periodically to detect transient hypothyroidism or hyperthyroidism phases.
Initially, thyroid function tests (TSH, free T4, and free T3) should be measured every 4 to 6 weeks during the acute phase and early recovery to monitor for thyrotoxicosis and subsequent hypothyroidism.
Once thyroid function stabilizes, typically within 6 months, TSH and free T4 should be measured at 6 and 12 months post-recovery to ensure return to euthyroid status or identify persistent hypothyroidism requiring levothyroxine therapy.
If hypothyroidism develops, levothyroxine treatment should be initiated and monitored according to standard hypothyroidism guidelines, with TSH and free T4 measured 6 to 8 weeks after starting treatment and then periodically as clinically indicated.
Long-term monitoring beyond 12 months may be considered annually if there are features suggesting underlying thyroid disease or persistent thyroid dysfunction.