Question

A 44-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation. Examination shows dry skin and delayed relaxation of deep tendon reflexes. TSH is 12 mIU/L (normal 0.4-4.0) and free T4 is low. What is the most appropriate management?

Accepted Answer

Start Levothyroxine and titrate to normalise TSH

Answer

Observe and repeat thyroid tests in 6 months

Answer

Start Liothyronine (T3) monotherapy

Answer

Start combined T3/T4 therapy immediately

Answer

Order thyroid ultrasound and defer treatment until imaging is available

Practice question

A 44-year-old woman presents with fatigue, weight gain, cold intolerance, and constipation. Examination shows dry skin and delayed relaxation of deep tendon reflexes. TSH is 12 mIU/L (normal 0.4-4.0) and free T4 is low. What is the most appropriate management?