A 42-year-old woman presents with a 3-month history of fatigue, weight gain, cold intolerance, and constipation. Vital signs show HR 52 bpm, BP 128/82 mmHg, temperature 36.2°C. Physical examination reveals dry skin, bradycardia, and delayed deep tendon reflexes. TSH is elevated at 8.5 mIU/L (normal 0.4-4.0) with free T4 of 0.8 ng/dL (normal 0.8-1.8). She denies recent medication changes. Which of the following is the most appropriate initial treatment?
- A)Liothyronine monotherapy
- B)Levothyroxine monotherapyGABARITO
- C)Levothyroxine plus liothyronine combination
- D)Observation with reassessment in 6 months
- E)Propranolol and methimazole
Explicação
Primary hypothyroidism with elevated TSH and low-normal free T4 is best treated with levothyroxine monotherapy. Levothyroxine has a long half-life, is peripherally converted to T3 as needed, and allows TSH-based dose titration. Ver explicação completa e trilha adaptativa →