A 36-year-old woman presents with 6 months of fatigue, weight gain, cold intolerance, and low mood. TSH is 6.8 mIU/L (slightly elevated) and free T4 i...

Question

A 36-year-old woman presents with 6 months of fatigue, weight gain, cold intolerance, and low mood. TSH is 6.8 mIU/L (slightly elevated) and free T4 is normal. Anti-thyroid peroxidase antibodies are positive. She is not pregnant and has no significant comorbidities. What is the most appropriate management?

Accepted Answer

Start levothyroxine because she is symptomatic with subclinical hypothyroidism and positive antibodies

Answer

Observe and repeat thyroid function in 3 years

Answer

Start antithyroid drugs

Answer

Arrange urgent thyroid ultrasound and biopsy

Answer

Recommend iodine supplementation only

ca-mccqe1 MCQ (SBA): Subclinical hypothyroidism