I am a26yo f who recently started lactating for no reason. i am also experiencing extreme fatigue and lack of motivation. prolactin 2.3, tsh 0.945, t4 6.0, t3 uptake 25% and free thyroxine index 1.5 any ideas?

Hyperprolacteinemia is ruled out so breast disease needs to be ruled out, especially if you have unilateral nipple discharge. However, transient idiopathic galactorrhea (with normal prolactin level) can also occur, usually in premenopausal women so your condition may fall in this category if you truly have bilateral galactorrhea and breast exam + radiology tests are normal. Good luck.