Question

A 42-year-old woman presents with fatigue, cold intolerance and weight gain. Her TSH is 18 mIU/L (reference 0.4-4.0) and free T4 is low. She is otherwise healthy and not pregnant. According to Australian practice, what is the most appropriate initial dosing strategy for levothyroxine?

Accepted Answer

Start levothyroxine 50 micrograms daily and titrate according to TSH

Answer

Start levothyroxine 200 micrograms daily immediately

Answer

Start levothyroxine 25 micrograms on alternate days only

Answer

Observe without treatment and repeat thyroid function tests in 12 months

Answer

Start liothyronine (T3) alone as first-line therapy

Practice question

A 42-year-old woman presents with fatigue, cold intolerance and weight gain. Her TSH is 18 mIU/L (reference 0.4-4.0) and free T4 is low. She is otherwise healthy and not pregnant. According to Australian practice, what is the most appropriate initial dosing strategy for levothyroxine?