Labs seem ok, I'm not.

[Pearlrose210]

I am a 39 year old female that feels I have symptoms of an underactive thyroid cold feet, brain fog, weight gain, and sore muscles etc. My labs came back at  F TSH 1.23 and  F T4 1.3. After doing a little research myself it doesn't look like that's my issue. Are there any other tests to have done to get to the bottom of why I feel like this if it's not an underactive thyroid issue? I had a cbc panel, a cmp panel, and hormonal labs drawn. There were a few slight red flags, but I really thought the thyroid was going to be further off than what it is. Can anyone give me some advice?

[gimel]

You need to always be tested for Free T3. Free T3 is the biologically active thyroid hormone that is largely responsible for the metabolic activity throughout your body.  The main value for Free T4 is to be available for conversion to Free T3.   Doctors like to tell us that T4 always converts to T3 as needed.  That is not the case.
With all those symptoms you cannot rule out having hypothyroidism without knowing your Free T3.  Since it affects the cellular response to thyroid hormone, it is also important to know your Vitamin D level (should be at least 50 ng/ml), ferritin  level (should be at least 100 to enable adequate conversion of T4 to T3 and to avoid low iron symptoms that sometimes mimic hypothyroidism), and also B12 (should be in the upper part of its range).

If you have trouble getting your doctor to consider diagnosing and treating you I suggest that you give a copy of my paper from this link and ask to be diagnosed and treated clinically as described in the paper.  If the doctor still refuses, then you will need to find another doctor who will do so.

https://thyroiduk.org/further-reading/managing-the-total-thyroid-process/