Kimberly was started on Levothyroxine, and had her dose increased at her 4 week check up, she's still hypothyroid at her next check up (4-8 weeks later). What do you do?
Increase in the same increment as before (by 25mcg/day for >50yr &/or known cardiac disease OR by 50mcg/day for young & healthy) and repeat TSH in another 4-8weeks.
If she's STILL hypothyroid then refer to endocrinologist.(aka, start dose, increase 2x and then refer!)