AKT-4784

AKT-4784

A 70-year-old man with a history of hypothyroidism is admitted to the Emergency Department after experiencing chest pain. He is diagnosed with acute coronary syndrome and iron-deficiency anemia. A percutaneous coronary intervention is performed, and a coronary artery stent is inserted. Endoscopies of the upper and lower gastrointestinal tract are performed and reported as normal. Upon discharge, he is prescribed aspirin, clopidogrel, ramipril, lansoprazole, simvastatin, and ferrous sulfate in addition to his regular levothyroxine. Six weeks later, he reports feeling constantly fatigued to his GP, who orders routine blood tests:

Hb 11.9 g/dl
Platelets 155 * 109/l
WBC 5.2 * 109/l

Free T4 8.1 pmol/l
TSH 8.2 mu/l

The patient’s TSH had been within range for the past two years prior to his recent admission. Which of the newly prescribed drugs is most likely responsible for the elevated TSH?