1. Do not change the dose on your own today. First fix the technique: take Thyrox on an empty stomach, with plain water only, and wait 45-60 minutes before tea, coffee or food. Keep calcium, iron, antacids and multivitamins at least 4 hours away. 2. Take it daily, same time, same brand - do not switch brands, as bioavailability differs. 3. If you are already doing all this correctly and TSH is 5.1 with symptoms, the usual step is a small increase - for example 62.5 mcg daily, or 50 mcg on most days with 75 mcg on two days a week. This must be prescribed after your treating doctor sees the actual report; do not self-escalate. 4. Repeat TSH (with free T4) after 6-8 weeks of any change - testing earlier gives a misleading value. Always do the test fasting, in the morning, and before taking that day's tablet. 5. Since you are 50 and weigh 85 kg, also get lipid profile, fasting sugar/HbA1c, haemoglobin and vitamin D and B12 checked - these often explain fatigue that people wrongly attribute to thyroid. 6. Keep a simple record of your TSH values with dates so the trend is visible over time. 7. You can send me the report images through a Practo online consult and I will tell you exactly whether to hold or step up the dose; if an in-person review with examination of the neck and full workup suits you better, I see patients at Synergy Multispeciality Hospital, Miraj.

Caution: never double the dose to "correct" a high TSH quickly - over-treatment at 50 can cause palpitations, atrial fibrillation, anxiety and bone loss. Never stop thyroxine because the report looks near normal. See a doctor sooner if you develop chest palpitations, tremor, marked weight change, severe fatigue or a new swelling in the neck.