Question

A 36-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation. Her TSH is 12 mIU/L (elevated) and free T4 is low. She is otherwise healthy and not pregnant. According to Canadian thyroid management principles, what is the most appropriate initial treatment?

Accepted Answer

Start levothyroxine at approximately 1.6 µg/kg/day and recheck TSH in 6-8 weeks

Answer

Start levothyroxine at 25 µg daily and recheck TSH in 2 weeks

Answer

Observe without treatment and repeat TSH in 12 months

Answer

Begin liothyronine (T3) monotherapy

Answer

Start combination levothyroxine-liothyronine therapy immediately

Practice question

A 36-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation. Her TSH is 12 mIU/L (elevated) and free T4 is low. She is otherwise healthy and not pregnant. According to Canadian thyroid management principles, what is the most appropriate initial treatment?