How often should you follow up on a patient with newly diagnosed hypothyroidism?

Wirsing, Nellie MD
Hamilton, Andrew MLS

¹Oregon Health and Science University/Cascades East Family Medicine Residency, Klamath Falls
²Oregon Health and Science University, Portland

The Journal of Family Practice 58(1):p 40-41, January 2009.

Evidence-based answer

Six to 8 weeks after the start of levothyroxine therapy you should reexamine patients and measure their serum thyroid-stimulating hormone (TSH) (strength of recommendation [SOR]: C, common practice and expert opinion). If thyroid function is normal at that time, examine the patient and measure serum TSH again in 4 to 6 months because clearance of levothyroxine increases in the euthyroid (normal) state (SOR: C, expert opinion).

Once the proper maintenance dose of levothyroxine is achieved, evaluate the patient and obtain a serum TSH at least annually, or as clinically indicated (SOR: C, expert opinion).