A 20-year-old woman overdoses on levothyroxine but appears euthyroid after 24 hours. What is the most appropriate treatment?

In cases of levothyroxine overdose, the patient's presentation and clinical condition play a crucial role in determining the appropriate treatment. When a 20-year-old woman presents after an overdose on levothyroxine and appears euthyroid 24 hours later, this suggests that her thyroid hormone levels are within the normal range and that she is not exhibiting the symptoms of hyperthyroidism, which can include tachycardia, anxiety, tremors, and hyperthermia.

Levothyroxine has a long half-life and may cause hyperthyroid symptoms if the overdose is significant enough. However, if the patient is euthyroid at the time of assessment and not showing any signs of significant toxicity, the immediate concern for acute treatment diminishes.

In such a scenario, observation and supportive care may be sufficient, as the body may adequately handle the excess levothyroxine without intervention. Other treatments, such as beta-adrenoceptor blockade, can be used to manage symptoms if they are present, but in the absence of symptoms, this is not necessary. Similarly, forced alkaline diuresis and haemodialysis are not effective methods for managing levothyroxine overdose because levothyroxine is highly protein-bound and not effectively removed via these