A 19 year old female came to your OPD for follow up for medical management of panhypopituitarism after resection of brain tumor. In her recent repo, you found that TSH is below the limits of detection of the assay. What will be your next step in management of this patient?
Her plasma TSH level is low as she has panhypopituitarism and is unable to make TSH Free T4 level- determine her plasma level of thyroid hormone Free T4 level & clinical picture will determine dose of levothyroxine MRI brain- not useful as there is no clinical evidence of recurrent disease Thyroid uptake scan- not indicated as she is unlikely to have primary thyroid disease, and T4 level is unknown
Decrease levothyroxine dose to half of current dose
Order free T4 level
Order MRI of her brain
Order thyroid uptake scan
Diseases of Thyroid