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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