Tsh 1.02 swollen thyroid nodules fatigue weight gain 45 years old muscle aches insomnia. blood work came back normal. help?

Hashimoto's: It sure sounds like hashimoto's thyroiditis low TSH an enlarged thyroid with feelings and symptoms of hypothyroidism with fatigue and weight gain is a classic presentation in a women your age you should get the antibody test and perhaps a biopsy it is benign but can sometimes cause the throat to close around the vocal chords and cause breathing difficulties.

Not thyroid: If the TSH is normal then the other symptoms are not from a thyroid problem. If thyroid ultrasound shows nodules >10 mm then needs biopsy. Suggest more blood work looking for autoimmune disease.

Need more blood work: Tsh range is .5 to 5.0 miu/ml so TSH is wnl. With nodules, ultrasound of thyroid may be prudent. Blood work normal so i asume you are not anemic or diabetic. If overweight, may have sleep apnea causing fatigue. I believe more specialized blood work may be necessary as in the adrenal axis-estradiol, dhea, testosterone etc. This problem is difficult and you may need referred to sub-specialist.