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.