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Table 1 Societal Recommendations for the Management of Primary Hypothyroidism

From: Endocrinology practice patterns of hypothyroidism and osteoporosis management in a U.S. tertiary academic medical center

Primary Hypothyroidism
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