What is the first-line treatment for a patient with elevated TSH indicative of hypothyroidism?

Levothyroxine is the first-line treatment for patients with elevated TSH levels indicative of hypothyroidism. This synthetic form of the thyroid hormone thyroxine (T4) effectively raises serum T4 levels, which in turn helps to normalize TSH levels. The primary goal of treatment is to restore the normal hormonal balance, alleviating symptoms of hypothyroidism, which can include fatigue, weight gain, and depression, among others.

Levothyroxine is widely preferred due to its predictable pharmacokinetics and long half-life, allowing for once-daily dosing that enhances patient compliance. Additionally, it undergoes conversion in the body to the more active form, triiodothyronine (T3), providing a balanced approach to thyroid hormone replacement.

Other options, such as liothyronine (a synthetic T3) or liotrix (a combination of T4 and T3), do not have the same level of endorsement as first-line therapies for hypothyroidism. While they can be used in specific cases or for certain patients, they are not routinely recommended as primary treatments due to concerns regarding dosing complexity and potential for adverse effects. Propylthiouracil is an antithyroid medication used primarily in hyperthy