I am Mysticdoc, experienced Internal Medicine Specialist.
I am here to help you with your concerns.
I assume you are talking about TSH level.
TSH of 200 does mean severe hypothyroidism or low thyroid.
Sometimes, symptoms may not be experienced since you are already taking some amount of liothyronine
However, you likely have levothyroxine ( T4) deficiency.
Liothyronine ( T3) may not meet that deficiency.
You should see your doctor to start on levothyroxine.
The dose can be started at 50 mcg daily and then gradually increased till TSH level falls below 2.5
Usually this takes about 6 to 8 weeks.
Your fatigue symptoms will improve with levothyroxine.
This type of lab results are commonly seen with autoimmune thyroid disorder also known as Hashimoto's.
The normal thyroid gland gets destroyed by the body's immune system requiring more thyroid hormone treatment over time.
Usually, the treatment is life long.
Please reply here if you have any further question.
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