Hypothyroidism – Clinical


  • Pursue ICPI
  • 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


ICPi: Immune Checkpoint Blockade Inhibition
TSH: Thyroid-Stimulating Hormone
FT4: Free Thyroxin