First thyroid treatment guide

Review your first hypothyroidism treatment online

For adults 18 to 64 who have never taken thyroid medicine and have recent blood tests showing an underactive thyroid, with no heart disease.

Start online

Start a $59 online review for First hypothyroidism treatment.

Hypothyroidism means your thyroid is underactive. This visit is for a first treatment review based on blood tests from the last 8 weeks showing high TSH and low free T4, two thyroid test results. The physician reviews the report and your health before deciding whether starting levothyroxine is appropriate.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response times

Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

A recent blood test with high TSH and low free T4
Fatigue with blood tests showing an underactive thyroid
Feeling cold with blood tests showing an underactive thyroid
A new thyroid diagnosis and questions about a first prescription

May fit online care

Adults 18 to 64
You are 18 to 64 with a new diagnosis of an underactive thyroid
Your blood test is from the last 8 weeks
Your TSH is above the lab range and your free T4 is below it
You have never taken thyroid medicine
You have no heart disease and can upload the lab report

Look for another care setting

Severe confusion, extreme sleepiness or being hard to wake, a body temperature below 95°F (35°C), a very slow pulse with fainting, chest pain or pressure, or severe swelling of the face, tongue or throat with trouble breathing or swallowing (call 911).
Pregnancy, or a birth, miscarriage or ended pregnancy in the last 12 months.
Age 65 or older.
Heart disease, an irregular heartbeat, heart failure, a past heart attack or stroke, or taking digoxin.
A new neck lump, goiter, trouble swallowing, or a painful, tender neck.
Pituitary or adrenal disease, steroid tablets or injections now or in the last year, or unexplained weight loss, salt craving, dizziness on standing or darkening skin.
Thyroid cancer, prior thyroid surgery or radioactive iodine, hyperthyroidism, or amiodarone, lithium or cancer immunotherapy.
Warfarin or another blood thinner taken by mouth.
Having taken thyroid medicine before.
No free T4 result, or a normal free T4.

What to have ready

Your lab report from the last 8 weeks with TSH and free T4 results
Your current weight
Your health history, including heart disease and any prior thyroid treatment

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

Verify Virginia medical license Verify West Virginia medical license Verify board certification

Can I start thyroid medicine based on symptoms alone?

No. For this option you need a recent report of your thyroid blood tests showing a TSH above the normal range listed on the report and a free T4 below it. The doctor checks that your results fit before deciding whether to start medicine.

What if my TSH is high but free T4 is normal?

That pattern is rechecked and discussed in person rather than treated through this option. Uploading a report does not guarantee treatment.

What happens after I start treatment?

We plan to repeat your TSH and free T4 tests about 6 weeks after you start. After that, dose changes are handled through the Thyroid dose adjustment option, and steady refills through the Thyroid medication refill option.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

High blood pressure (home-monitoring program)Iron, vitamin D & B12 deficiency Prediabetes (metformin)Weight management (non-incretin-based)