Question

A 49-year-old woman presents with fatigue and weight gain. TSH is 7.8 mIU/L (elevated) and free T4 is normal. She has no goitre, no pregnancy, and no clear hypothyroid symptoms. According to the Canadian Task Force and endocrine guidance, what is the most appropriate management?

Accepted Answer

Repeat thyroid function tests in 6-12 months and consider treatment only if symptoms or TSH rise

Answer

Immediately start levothyroxine at full replacement dose

Answer

Start liothyronine therapy

Answer

Order routine thyroid ultrasound and fine-needle aspiration

Answer

Start empiric combination levothyroxine and liothyronine therapy

Practice question

A 49-year-old woman presents with fatigue and weight gain. TSH is 7.8 mIU/L (elevated) and free T4 is normal. She has no goitre, no pregnancy, and no clear hypothyroid symptoms. According to the Canadian Task Force and endocrine guidance, what is the most appropriate management?