How can elevated tsh be involved in hypothyroidism?

In the typical person with an under-active thyroid gland, the blood level of T4 (the main thyroid hormone) will be low, while the TSH level will be high. ... Since the pituitary is not making enough TSH, then the thyroid will never make enough T4. Hypothyroidism is usually quite easy to treat (for most people)! The easiest and most effective treatment is simply taking a thyroid hormone pill (Levothyroxine) once a day, preferably in the morning. This medication is a pure synthetic form of T4 which is made in a laboratory to be an exact replacement for the T4 that the human thyroid gland normally secretes. It comes in multiple strengths, which means that an appropriate dosage can almost always be found for each patient. The dosage should be re-evaluated and possibly adjusted monthly until the proper level is established.