Question

A 35-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation. TSH is 12 mIU/L (elevated) and free T4 is low. Anti-thyroid peroxidase antibodies are positive. She is not pregnant. What is the most appropriate management?

Accepted Answer

Start levothyroxine replacement therapy

Answer

Reassure and repeat thyroid function tests in 12 months

Answer

Start liothyronine (T3) monotherapy

Answer

Start antithyroid drugs such as methimazole

Answer

Refer urgently for thyroidectomy

Practice question

A 35-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation. TSH is 12 mIU/L (elevated) and free T4 is low. Anti-thyroid peroxidase antibodies are positive. She is not pregnant. What is the most appropriate management?