You need to know your entire patient hx, including any surgeries, meds, co-morbid dz processess, etc. so you can get the overall clinical presentation.
Elevated TSH is reason to start Thyroid preparations such as Synthroid in primary hypothyroidism.
Just supposition here, your pt. could
have had a sub-total thyroidectomy with surgery for hyperparathyroidism as pointed out. Normally, these individuals are not
treated with Thyroid meds postop for they still retain the ability to produce thyroid.
Another supposition; the primary dx could
possbily be hyperthyroidism treated with Synthroid. The elevated TSH
(16.77) just proves pt. is now hypothyroid
, which is a secondary dx. Up to the healthcare provider how/if he/she wants to address this (new?) finding.