Start standard thyroid hormone replacement therapy: initial dose can be the full dose (1.6 mcg/kg) in young, healthy patients, but a reduced dose of 25 -50 mcg should be initiated in elderly patients or known cardiovascular disease.
Assessment and Investigations
Repeat TSH and free T4 testing after 6-8 weeks and adjust thyroid hormone dose accordingly.
If TSH is above reference range, increase thyroid hormone dose by 12.5 mcg to 25 mcg
After identification of the appropriate maintenance dose, further evaluation is required every year, or sooner if patient’s status changes