Data
Clinical presentation: A 49-year-old woman requested a second opinion. She has been treated with levothyroxine for 6 months but her original complaints remained the same. The TSH level was 5.68 mIU/L before starting with the replacement therapy.
Palpation: no abnormality.
Laboratory test: TSH 4.01, FT4 14.1 pM/l on daily 50 microgram levothyroxine.
Diagnosis. Adequate replacement therapy for hypothyroidism. Lymphocytic thyroiditis.
Summary. The complaints could not be and cannot be explained by a thyroid problem. Continue with the daily 50 microgram levothyroxine replacement therapy. TSH check in a year. Ultrasound in 3 years.