Dr. Debashis Chatterjee (Internal Medicine) needs a second opinion on this medical case.
I saw a 17 year old girl 165 cm tall weighing 55 kg (BMI 20.2) - reasonably fit and energetic - doing well academically. She was diagnosed to have a subclinical hypothyroid state in 2017 (see reports) and was observed.
Interim, she was diagnosed to have PCOD with minor menstrual irregularities. She has atopy with high IgE and sensitivity to dust and cold.
A follow up TSH and FT4 done recently (see reports) showed slight worsening of values and anti-TPO came out to be rather high. She has a lowish Hb 12.3 of normocytic normochromic type.
Does this girl need to be treated with replacement LT4? If no, how frequently should her TFT's be monitored? If yes, what dose of LT4 would you start with?