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Levothyroxine is the standard initial medication prescribed for hypothyroidism because it is a synthetic form of the thyroid hormone thyroxine (T4), which is typically deficient in individuals with this condition. The goal of treatment is to restore normal thyroid hormone levels, thereby alleviating symptoms associated with hypothyroidism, such as fatigue, weight gain, and cold intolerance.

Levothyroxine is preferred due to its effectiveness, predictability, and safety profile. It acts to normalize metabolic processes and has a long half-life, which allows for once-daily dosing and stable hormone levels.

In contrast, the other medications listed are not appropriate for treating hypothyroidism. Propylthiouracil and methimazole are antithyroid agents used to manage hyperthyroidism, which involves excessive production of thyroid hormones. Propranolol, a beta-blocker, is used primarily for controlling symptoms such as tachycardia and anxiety but does not address the underlying hormonal deficiency in hypothyroidism. Therefore, levothyroxine is the correct choice as it directly targets the deficiency in thyroid hormone.