### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am currently on levothyroxine 50mcg. I have been experiencing very acute episodes of extreme fatigue. Also, I have phases of hair loss, palpitaions, headaches and episodes of eye discomfort where I feel as though my eyes are being squeezed ( sounds strange, but it is the best way to describe it). My last TSH was 6 weeks ago and it was 1.93. Lately, I also have developed a very salty taste in my mouth. Everything tastes salty, even water. Over the past 3 years I have lost 200 lbs. I weigh 135 now. I eat very healthy and I exercise regularly. What is going on?

### output:

Hello and very pleased to answer you. There are three types of hypothyroidism: primary, secondary and tertiary. In secondary hypothyroidism, the pituitary gland does not control sufficient production of hormones by the thyroid. In other words, the problem does not come from the thyroid. The same applies to tertiary hypothyroidism (the hypothalamus does not produce enough TRH, thyroid stimulating hormone). TRH plays an important role in stimulation of the pituitary gland for the production of thyroid stimulating hormone (TSH). In your case, with a low dose of levothyroxine (50), your TSH level do not change, and clinically, you are always suffering from hypothyroidism, and normally as your levothyroxine is low TSH should be very high, but your nervous system does not interact with the problem, and the TSH do not change.Then you have a secondary hypothyroidism or a tertiary hypothyroidism, and you need to consult an endocrinologist to make all the things in theirs way. Time to see the endocrinologist, I propose you to take 100 mcg day of levothyroxine. May this answer help you and best wishes.