Question

A 52-year-old woman complains of fatigue, weight gain and cold intolerance. Examination reveals dry skin and bradycardia. TSH is 18 mIU/L (normal 0.4-4.0) and free T4 is low. She is otherwise healthy with no cardiac disease. What is the most appropriate initial levothyroxine dosing strategy?

Accepted Answer

Start levothyroxine 50-75 µg daily and adjust based on TSH

Answer

Start levothyroxine 25 µg daily and titrate slowly over 12 months

Answer

Start levothyroxine 200 µg daily immediately

Answer

Withhold levothyroxine and repeat thyroid tests in 6 months

Answer

Treat with liothyronine (T3) alone

Practice question

A 52-year-old woman complains of fatigue, weight gain and cold intolerance. Examination reveals dry skin and bradycardia. TSH is 18 mIU/L (normal 0.4-4.0) and free T4 is low. She is otherwise healthy with no cardiac disease. What is the most appropriate initial levothyroxine dosing strategy?