19
Start levothyroxine
25–50 mcg/day
Recheck TSH
every 3–6 months
No follow-up,
contact if symptoms
Check TPOAb status
a
Subclinical
hypothyroidism
Euthyroid
For women with infertility
and a time-constraint
c
or low
likelihood of normalization
d
TPOAb positive TPOAb negative
Confirmation TSH and
FT4 after 4–6 weeks
b
Or alternatives as described in the thyroid function testing subsection of this guideline.
c
For example when fertility is already planned or when the chance of successful pregnancy due to age
or comorbidities would be further limited by postponing treatment.
d
Based on expert opinion, this could be defined for example as a TSH concentration >6 mU/L or in
case of subclinical hypothyroidism with concomitant TPOAb positivity.
