Hypothyroidism – Subclinical


  • Pursue ICPI
  • Start standard thyroid hormone replacement therapy if TSH > 10 mIU/L with normal free T4

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