Table 1 Societal Recommendations for the Management of Primary Hypothyroidism
| Primary Hypothyroidism | ||
|---|---|---|
| Category | ATA/AACE | Endocrine Society |
| Laboratory testing | • Recommends measuring TSH, free T4 | • Recommends against measuring free T3 |
| Antibody testing | • Consider when diagnosing subclinical hypothyroidism, nodular thyroid disease, pregnant patients, and patients with miscarriages | • No recommendations |
| Ultrasound | • No recommendations | • Recommends against obtaining an ultrasound, unless a nodule is palpated |
| Treatment choice |
• Recommends levothyroxine monotherapy as standard of care • Recommends against treatment with desiccated thyroid hormone, compounded thyroid hormones, or combination levothyroxine and liothyronine | • No recommendations |
| Follow up interval |
• Laboratory assessment at 4–8 weeks after any dosage change • Laboratory assessment at 6 months, then at 12 month intervals, once on adequate replacement dose | • No recommendations |