Hypothyroidism – Clinical

Management

• Pursue ICPI
• Start standard thyroid hormone replacement therapy: initial dose can be the full dose (1.6 mcg/kg) in young, healthy patients, but a reduced dose of 25 -50 mcg should be initiated in elderly patients or known cardiovascular disease.

Assessment and Investigations

• Repeat TSH and free T4 testing after 6-8 weeks and adjust thyroid hormone dose accordingly.
• If TSH is above reference range, increase thyroid hormone dose by 12.5 mcg to 25 mcg
• After identification of the appropriate maintenance dose, further evaluation is required every year, or sooner if patient’s status changes