When do you consider changing a patient's levothyroxine dose during hospitalization due to abnormal TFTs, but without clinical evidence of thyrotoxicosis or hypothyroidism?

Thank you for your question. I think this is something we commonly get in the hospital, and we often overreact to it. This was a "Things We Do For No Reason" some time back, and I think they outline the issues well.

When people are acutely ill, TSH testing is unreliable. The times when TSH testing is...

In general, unless I can attribute some aspect of their acute illness to the abnormality and/or it's at the true extremes, I do not make changes. I always make sure that it's ordered for follow-up testing in 3-4 weeks and that PCP is aware of the need to follow up.