any opinion ?

one of my patients have always very high TSH level / above inspite of receiving eltroxine 100mcg/od.
she is a female , b.wt 70kgm without any other remarkable clinical problems.

[AR-10]

Have you tested her Free T4 and Free T3?

The Free T4 has room to vary within lab limits. As long as it is not at the bottom of the lab limit, it will provide enough Free T4 for conversion to T3.

The Free T3 must be above midrange of lab limits, about two thirds up the scale on the range your lab uses. There is very little room for variation. A little higher and she will be hyper, a little lower and she will be hypo.