A 52-year-old woman presents with fatigue, weight gain, and cold intolerance for 3 months. On examination, she has dry skin, bradycardia (52 bpm), and delayed relaxation of deep tendon reflexes. Serum TSH is 8.5 mIU/L (normal 0.5–5.0) and free T4 is 0.8 ng/dL (normal 0.8–1.8). What is the most appropriate next step in management?

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