Abstract
Answer B. Initiate levothyroxine
This man has evidence of subclinical hypothyroidism. His tiredness is not affecting him and he is therefore asymptomatic. For people aged 70 years or younger, if the thyroid stimulating hormone is above 10 mIU/L, they should be started on treatment even if asymptomatic. Carbimazole is used to treat hyperthyroidism. Serum lipids need to be checked owing to the link with dyslipidaemia. Patients over the age of 80 should usually be monitored rather than treated. This person does not meet the criteria for referral to an endocrinologist.
InnovAiT article: Subclinical hypothyroidism. DOI: 10.1177/1755738018815525.