“…In the young age thyroid problems are latent stage or asymptomatic & Symptoms come out according to their age increased. Probable cause of elevated thyroid-stimulating hormone/SCH are Autoimmune (Hashimoto) thyroiditis, Suboptimal treatment of overt hypothyroidism, Partial thyroidectomy, Radioactive iodine ablation, External beam radiation of head and neck, Infiltrative diseases of the thyroid (amyloidosis, sarcoidosis, hemochromatosis, Riedel thyroiditis, scleroderma), Drugs, iodine contrast, amiodarone, lithium, tyrosine kinase inhibitors (sunitinib, sorafenib), interferon alpha, or immune response modulators (ipilimumab, alemtuzumab, pembrolizumab), Iodine deficiency, Excess iodine, Thyroid dysgenesis [6,7,8,9] . Diurnal variation, Recovery phase of euthyroid sick syndrome, Recovery phase of subacute, painless, or postpartum thyroiditis this are the physiological cause & others are Assay variability, Substances that interfere with TSH assays (heterophile antibodies, rheumatoid factor, biotin, macro-TSH or abnormal TSH isoforms), Central hypothyroidism or hyperthyroidism, Thyroid hormone resistance, Impaired renal function, Adrenal insufficiency, Obesity, Older age etc [10,11,12,13,14] .…”