American Board of Internal Medicine (ABIM) Certification Practice Exam

How frequently should TSH levels be checked when starting treatment for hypothyroidism until the goal is reached?

1. Every month

2. Every 3 months

3. Every 6 weeks

4. Every year

The correct answer is: Every 6 weeks

When initiating treatment for hypothyroidism, it is essential to monitor thyroid-stimulating hormone (TSH) levels closely to assess the adequacy of therapy and to reach the target level effectively. Checking TSH levels every 6 weeks is recommended because it allows for timely adjustments in medication dosage based on the patient's response. Hypothyroidism treatment typically begins with a levothyroxine regimen, and the effects of this hormone can take several weeks to stabilize. By checking TSH levels at 6-week intervals, healthcare providers can ensure that they are not waiting too long to modify the dosage if the TSH is not within the desired range. This approach minimizes the risk of prolonged symptoms of hypothyroidism and helps to achieve the target TSH level more efficiently. Once the desired TSH levels are achieved and the patient is stable, monitoring can be extended to every 3-12 months, depending on individual patient factors, considering that dose adjustments usually become less frequent after the initial treatment phase.