Follow up ? initially titrated up to 175mcg of t4 and tsh was still 7ish. had to add in t3 (liothyronine) @50mcg to supress tsh to normal. 6 months ago tsh @1.0, now 8.53. i'm compliant with meds. i am 100kg. 40 y/o

Thyroid titration: There are many things that can interfere with the metabolism and uptake of thyroid medications. It is usually advised to avoid taking thyroid medication within 2 hours of eating. Your doctor should check you for anti-thyroid antibodies to determine if there is an autoimmune issue associated with your thyroid disease. This could describe the great fluctuations that you're seeing in the tsh.

Thyroiditis.: Get a thyroid scan . A short course of steroids might help. Best see a good endocrinologist if possible.

Inconsistent dose: Usually T4 alone will treat low thyroid problems. On occasion t3 (liothyronine) needs to be added, as in your case. It seems that you had adequate levels previously since your TSH suppressed nicely. Sometimes a change in medication brand or even lot number with the same brand will result in inadequate T4 being provided to you. Check with your doctor.