If you have unexplained symptoms that are suspicious for thyroid disease such as fatigue, weight gain, hair loss, depression, or muscle pain – you may have thyroid disease even if your thyroid antibodies are negative and your TSH is above 1.9 or below 0.4. Studies have also shown that a TSH on the higher side of the normal range is more common in obese populations than in healthy populations. Ref
In these cases, it can be worth evaluating your thyroid with an ultrasound study and considering thyroid replacement. Ref
