Question

A 49-year-old woman complains of tiredness, weight gain and constipation. TSH is elevated and free T₄ is low, consistent with primary hypothyroidism. She has no cardiovascular disease and is otherwise healthy. What is the most appropriate initial treatment?

Accepted Answer

Start Levothyroxine 50–100 micrograms once daily and titrate according to TSH

Answer

Start Levothyroxine 25 micrograms once daily and review in 5 years

Answer

Start Liothyronine

Answer

Start Carbimazole

Answer

Start Levothyroxine only if she becomes symptomatic

Practice question

A 49-year-old woman complains of tiredness, weight gain and constipation. TSH is elevated and free T₄ is low, consistent with primary hypothyroidism. She has no cardiovascular disease and is otherwise healthy. What is the most appropriate initial treatment?