Hormone Replacement Therapy · NCLEX Exam

What is the recommended approach for treating central hypothyroidism (due to pituitary deficiency)?

  1. Titrate the levothyroxine dose to a strictly normal serum TSH level
  2. Target free thyroxine (FT4) in the upper half of its reference range
  3. Withhold thyroid hormone replacement and monitor clinically instead
  4. Use the serum TSH measurement alone to guide all dose adjustments
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Correct answer: Target free thyroxine (FT4) in the upper half of its reference range

In central (secondary) hypothyroidism, TSH may not be reliable, so levothyroxine dosing is guided to raise free T4 into upper half of normal rather than focusing on TSH.

Difficulty: Hard Question 8 of 18

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