Conclusion
Idiopathic refractory hypothyroidism is diagnosed by exclusion. The
literature has shown various administrative methods for managing such
cases. This case exemplifies the difficulties in diagnosing refractory
hypothyroidism, particularly the idiopathic form, and it should always
be considered in the differential when encountering a patient who is
struggling to return to normal status after being prescribed oral
levothyroxine, such patients may be treated with parenteral doses of
levothyroxine.