What is wrong when tsh is elevated and you are on thryoid replacement already

What is wrong when TSH is elevated and you are already on thyroid replacement therapy?

This depends a lot on some factors like health status, sex, age etc.

For your information, I interpreted your results on MedSipo and I found that "Higher levels of TSH are seen in the following situations: Infants; Pregnant women; Elderly people; Underactive thyroid gland (primary hypothyroidism); Rarely, due to excessive TSH secretion from the brain (TSHoma); Drug effects from amiodarone or lithium."
Source: http://medsipo.com/details/tshmlu-lwoman4-201-1000

General medical information derived from trusted sources on the Internet can be beneficial for learning about medical issues however, NEVER rely on medical advice specific to your case that you get online. That should come from the medical professional that prescribed the test or conducted it.