Question

A 42-year-old woman presents with fatigue, weight gain, cold intolerance and constipation. TSH is 18 mIU/L (elevated) and free T4 is low. She is not pregnant. What is the most appropriate initial management?

Accepted Answer

Start levothyroxine and titrate dose according to TSH

Answer

Observe and repeat TFTs in 12 months

Answer

Start carbimazole

Answer

Give high-dose iodine

Answer

Refer immediately for thyroidectomy

Practice question

A 42-year-old woman presents with fatigue, weight gain, cold intolerance and constipation. TSH is 18 mIU/L (elevated) and free T4 is low. She is not pregnant. What is the most appropriate initial management?