25th August 2020

A 26-year-old lady presented to the GP with symptoms of lethargy, menorrhagia and unintentional weight gain

A 26-year-old lady presented to the GP with symptoms of lethargy, menorrhagia and unintentional weight gain. The GP noticed the lady was wearing a thick winter jacket despite the hot weather day. On examination, the GP also noticed bradycardia and hyporeflexia. A blood test was done which came back with the following results:

• TSH: High
• Serum-free T4: Low
• TSH-receptor antibodies: Negative
• Anti-TPO antibodies: Positive

Based on the clinical findings above, which medication would be first-line in managing this diagnosis?

Select the SINGLE most appropriate option from the list below.