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Many people feel unwell with a TSH of 4.0 to 5.0, even though it’s technically “normal.” Optimal thyroid function involves: TSH is between 0.5–2.5 mIU/L (some doctors and patients prefer a level below 2.0) Free T4 is in the upper half of the reference range Free T3 is in the upper half of the reference range Low or absent symptoms of hypothyroidism, such as fatigue, hair thinning, constipation, cold intolerance, or depression In autoimmune thyroid disease (Hashimoto’s), it’s also helpful to monitor thyroid peroxidase (TPO) antibodies and support the immune system with selenium, vitamin D, and lifestyle changes to reduce inflammation