Question

A 65-year-old woman is found to have a thyroid-stimulating hormone (TSH) level of 8.5 mU/L (normal 0.4-4.0) and a normal free T4 (fT4). She has no symptoms of hypothyroidism. What is the most appropriate next step?

Accepted Answer

Repeat TSH and fT4 in 3 months

Answer

Start levothyroxine 50 micrograms daily

Answer

Check thyroid peroxidase (TPO) antibodies

Answer

Refer to an endocrinologist

Answer

Reassure and discharge

Practice question

A 65-year-old woman is found to have a thyroid-stimulating hormone (TSH) level of 8.5 mU/L (normal 0.4-4.0) and a normal free T4 (fT4). She has no symptoms of hypothyroidism. What is the most appropriate next step?