###Human: Is it good to reduce the dosage of Levothyroxine for high TSH level? ###Assistant: Hi. I have gone through the attachment (attachment removed to protect patient identity). Your TSH (thyroid stimulating hormone) is in the lower normal range, just near the border. The dosage of Levothyroxine has to be reduced. Try to maintain TSH around 2 mIU/L. Please test your FT4 (free thyroxine) levels. I believe that you experience fatigue due a secondary cause. Ask your doctor to get anemia workup done, get vitamin D, and calcium levels. Sjogren syndrome itself is a cause of fatigue, and get ESR (erythrocyte sedimentation rate) and CRP (c-reactive protein) done to check for disease activity. If your results have not shown any abnormalities, then it is better to consult a rheumatologist rather than seeing an endocrinologist in my opinion.