Hypothyroidism is due to deficiency of secretion of thyroid hormone from thyroid gland. Levothyroxine is the treatment of choice for hypothyroidism. You need to take levothyroxine for life-long. Any interruption in treatment will cause symptoms of hypothyroidism. The possible side effects of levothyroxine are nervousness, excitability, tremor, muscle weakness, fatigue, cramps, sweating, flushing, heat intolerance, headache, insomnia, tachycardia, palpitations, restlessness, depression, difficulty in sleeping, excessive weight loss; menstrual irregularities, agitation and reduced bone mineral density, especially in post-menopausal women. But these side effects are seen in those who are taking high dose. Fifty microgram is a very minimal dose. You will tolerate it easily without any side effects. Even if any side effects occur, this is seen in early stage of treatment and often resolves with progress of time once you achieve a stable dose of levothyroxine. So monitoring of treatment is essential. Serum TSH should be measured to monitor for adequate replacement. TSH can take up to 4 months to normalize. TSH is measured 6–8 weeks after initiation of levothyroxine and then annually once you are on a stable dose of levothyroxine. Advice 1. Continue with 50 mcg of levothyroxine 2. Measure your serum TSH after 6 weeks; take the report to your doctor. Doctor will titrate the dose of levothyroxine as per serum TSH level 3. Regularly check your blood pressure and pulse rate 4. Avoid smoking, coffee and alcohol Thanks