How do you counsel a patient with hypothyroidism who complains of persistent hypothyroid symptoms despite achieving normal TSH values with levothyroxine?  

This is a complicated question without an easy answer. Many patients express dissatisfaction with their health status despite normal thyroid function (Peterson et al., PMID 29620972). Obviously, causes of symptoms other than hypothyroidism need to be ruled out such as anemia, autoimmune diseases, sl...