Hello Sharan, I will try to answer your concerns as best as I can. I would also appreciate if you can answer a couple of questions that I will ask. It is good that you were able to manage your hypothyroidism quite well over the last 3 years. It is unfortunate that your TSH levels have risen lately. Kindly don t despair, get upset or get anxious. Your TSH level will again come to acceptable levels over the next few months. All you need is a bit of patience and some management suggestions. What ever has happened now in the past cant be undone, so the only option you have is to look to the future. Thyroid replacement medication/tablet should always be taken in the morning on an empty stomach. Take the tablet with water. Do not eat anything or consume any tea or coffee for about 45 minutes afterwards. This way the absorption of thyroxine is enhanced. You are only partly right about the high fiber diet and thyroxine replacement medication. You can have high fiber diet, infact I normally advise overweight/obese hypothyroid patients to go on a high fiber diet which includes plenty of vegetables as that will help them with their weight loss. High fiber diet can be taken, but the timing is very very important. Wait for several hours (like about 4-5 hours) after taking your thyroid medication before consuming a high fiber diet. Further, I do not think that your high fiber diet has anything to do with your thyroid levels. All these 3 years , your thyroid levels were normal. Infact if high fiber diet was interfering with your thyroid hormone levels, then you would have noticed an increase in your TSH rather than your TSH reducing to 0.3. So I am fairly certain your diet is ok (unless you have changed to a different diet altogether recently). So, you must be wondering what should you do regarding the Eltroxin dose. Before advising you further on the dose, I would be grateful if can answer a few of my questions; 1) What were your recent T4 and T3 levels? 2) What were your TSH, T4 and T3 levels over the past 1 year? I am assuming you must have done them a couple of times at least?Or you could send me all the results over the past 3 years. 3) Can you remember since how long you have been on 50 micrograms Eltroxin? I look forward to hear from you. Best wishes and regards Dr Sunita Sayammagaru