Hypothyroidism management
What the major U.S. guidelines recommend, with a link to verify each at the source. A quick-reference summary for clinicians, not medical advice.
ATA · 2014
Levothyroxine is first-line (strong rec, preparation of choice). Full replacement roughly 1.6 mcg/kg/day; start low (12.5 to 25 mcg) in older adults or known CAD. Take 60 min before breakfast or at bedtime 3+ hr after the evening meal. Steady state in about 6 weeks; recheck TSH 4 to 6 weeks after any dose change. Target TSH within reference range, about 0.4 to 4.0 mIU/L.
Verify at ATA →USPSTF · 2015 · Grade I
Insufficient evidence to assess benefits vs harms of screening for thyroid dysfunction in nonpregnant, asymptomatic adults. No routine TSH screening recommended in this group; test based on signs, symptoms, or risk factors.
Verify at USPSTF →