I don't have any personal knowledge about thyroid but there are some links in this post that you might find helpful.
I noticed at the end @KnitOrMiss linked a documentary series available for a limited time.
https://community.myfitnesspal.com/en/discussion/10525994/anyone-with-hashis-or-any-auto-immune-condition#latest

I have hashimotos which lead to being hypo. I also got thyroid cancer which lead to complete removal of my thyroid. So... I go back and forth between hyper and hypo until my dose gets set.
Don't settle for 4.8. Find the number in the range that is optimal for you. I still have hypo symptoms at 3.
Take your Meds consistently. There are some foods/drinks that effect absorption. Coffee and calcium affect it, but Since I always have the same amount of it followed by 30 mins and then Meds, the same amount of medicine gets absorbed and then we adjusted until I leveled out to 1. Consistency is the key.

I'm bumping this. It seems like there should have been more response....

@KnitOrMiss ?

Hi I have an under active thyroid and am starting keto, please add me

I have hypothyroidism, too. My doctor started me on levothyroxine, but later when my symptoms got worse she sent me to endocrinologist who switched me to the name brand Synthroid and increased the dosage. As others have noted, it was not until my TSH level got down to almost 1.0, that I began to feel better and could eat a reasonable amount of calories without gaining weight. MFP has a Hypothyroidism and Hyperthyroidism group. It's not as active as this group but there are some very knowledgeable members who are great about responding to questions. I'll send you a friend request.

Sorry, for everyone who tagged me. I'm not on much over the weekends, and I don't get notifications for the forums on my phone at all, which is all I have access to on weekends. (PM on here is fabulous, email or text is better, if you have those ways to contact me...)

The information you've gotten above is brilliant. At this point, with a TSH that far out of the norm, I personally would request more tests in addition to what has already been done. You're going to want to rule out whether or not it's auto-immune, and if it is auto-immune, which type it is. This will be CRUCIAL to your treatment plan. Things that work well for some types are anathema to other types - and can actually trigger them to ramp up and worsen badly.

stopthethyroidmadness.com does a great job suggesting the additional tests. mariamindbodyhealth.com/thyroid-madness/ along side her book, "Keto Adapted," is another awesome resource. I could probably list a page of just good ideas. Specifically antibodies tests and the in depth thyroid panels I would consider absolutely essential.

I would also suggest, just for your own clarity, writing down every symptom of not feeling well, like yourself, etc. that you have EVER had. And I do mean EVER. Just in listening to that forum that was linked above initially, I've discovered that some of my history includes some concerning symptoms I'd not realized were related, but that DESPITE THE PRESENCE OF NO POSITIVE ANTIBODIES FOR HASHIMOTO'S, that I could still have Hastimoto's Auto-Immune Thyroiditis. Until this weekend, I had not known that this was an issue in any regard. I'd falsely and blithely thought, "My results were negative, I can make this concern off the checklist!" I was so wrong. I think it was up to 15% (or something, I don't recall the exact number) of patient suffering from Hashimoto's actually have no presence of antibodies. And they've no real reason to understand why yet, though it's being studied. This is not intended to scare you, as this is relatively rare. I just wanted to share a jumping off point for down the road, if you still don't get back to feeling right...and to make sure you write it all out... I've gone several years now, thinking I was good and in the clear...only to have the rug yanked from under me...

So, I'm back to being concerned, because with any untreated auto-immune issue, it can trigger other reactions. Which means that my insulin resistance could actually be a deeper issue... But that's for another discussion.

If anyone is wondering what issue raised this concern for me specifically, it was a combination of concerns about vertigo and about migraines/eye-ears issues. Sometime around my heaviest weight in 2009, through a series of tests, I was diagnosed with Benign Positional Vertigo, also known as shopping cart syndrome, where movement in my periphery would actually make me motion sick. So as a driver in a car, I was okay, but motion on the TV screen could make me sick, or being a passenger in a car triggered it, too, etc. Further testing lead me to finding out that another related issue was that my brain did not seem to be receiving proper input from my feet, ears, and eyes as far as maintaining balance. It typically only happened when I was stationary and with my eyes closed...unless I was attempting a non-normal balance stance. Also, I've always been sensitive to bright lights, and that points to a adrenal side to this issue. With my insulin resistance seeming to present itself more as a whole "cellular energy resistance" to all macros, my stuff is a little wacky and out there. I am FAR from the common thyroid patient.

I'm blessed to have a great PCP (whom I'm now having to transition away from, as I can't drive 45 minutes each way to see, now that I've moved) and a great Endocrinologist willing to treat my symptoms, even when the labs don't point clearly to an issue, because he said with women in particular, so many issues are interrelated, symptoms tend to hide, be mirrored, or get confused amongst other more "vocal" issues.

Also, know that your dose is pretty low considering your TSH, but that seems to be a fairly standard starting type dose, so as not to adjust you too quickly. However, long term you may not want to be on a synthetic medication. There is more info on that in those links above. I'm still taking the synthetic medication, but I'm having a really hard time getting level, despite having increased my T4 medicine (levo, like what you are being prescribed) 3 separate times, plus adding a separate T3 medication in and and adjusting it 3-4 times already as well, usually at 3-6 month markers in between... When starting medication, you may have a 2 week honeymoon period of feeling fantastic, then feeling worse somewhat for a few weeks before feeling better again - due to the initial reduction in inflammation...

So please, as 1,000,000 questions if you have them. @805_blondie Even if the question has been asked before, it can always be asked again. And you just might ask a question in a way that teaches us ALL something new! It's happened before, and I'm sure it will happen again. There are so many comorbid conditions to this... So please, don't stop fighting as an advocate for your own health until you feel good being yourself again. I can and will happen eventually if you don't give up... There is so much knowledge in this forum, and while most of us are not medically trained (some are, but this may not be their specialty), many of us have been on this journey through Hades right along side others just like you! So any information should be used as the basis of your own research to be addressed with your medical team to test and find the best program to address your own personal set of issues and conditions.

Best of luck to finding the Best You underneath all the health mess! (hugs)