Question

A 50-year-old woman has a TSH of 7.0 mIU/L (elevated) with normal free T4 on two occasions. She has no symptoms, normal lipids and negative thyroid peroxidase antibodies. According to the Canadian Task Force guideline on asymptomatic thyroid dysfunction, what is the most appropriate management?

Accepted Answer

Repeat thyroid function tests in 6-12 months without starting therapy

Answer

Start levothyroxine to normalise TSH

Answer

Start levothyroxine only if TSH exceeds 2.5 mIU/L

Answer

Order thyroid ultrasound and fine-needle aspiration

Answer

Refer urgently to endocrinology for radioiodine therapy

Practice question

A 50-year-old woman has a TSH of 7.0 mIU/L (elevated) with normal free T4 on two occasions. She has no symptoms, normal lipids and negative thyroid peroxidase antibodies. According to the Canadian Task Force guideline on asymptomatic thyroid dysfunction, what is the most appropriate management?