We have case , femal patien , age 60 years, the tsh less than 0.05 while t4 in normal range , and she has not any symptom of thyroidism , is it ok ?

Subclinical hyperthy: A low TSH with a normal T4 and no symptoms is usually subclinical hyperthyroidism. She may have a multinodular goiter that is autonomously functioning, or very early graves disease. A T3 (liothyronine) level and free T4 level should be checked. There is a higher risk of developing atrial fibrillation despite the normal T4 level, but many endocrinologists would just follow her levels for progression.