Primary Hypothyroidism | ||
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Category | ATA/AACE | Endocrine Society |
Laboratory testing | • Recommends measuring TSH, free T4 | • Recommends against measuring free T3 |
Antibody testing | • Consider when diagnosing subclinical hypothyroidism, nodular thyroid disease, pregnant patients, and patients with miscarriages | • No recommendations |
Ultrasound | • No recommendations | • Recommends against obtaining an ultrasound, unless a nodule is palpated |
Treatment choice | • Recommends levothyroxine monotherapy as standard of care • Recommends against treatment with desiccated thyroid hormone, compounded thyroid hormones, or combination levothyroxine and liothyronine | • No recommendations |
Follow up interval | • Laboratory assessment at 4–8 weeks after any dosage change • Laboratory assessment at 6 months, then at 12 month intervals, once on adequate replacement dose | • No recommendations |