TSH 4.74 (fluctuates between 2.5 to 4.5 in last 2-3 years) fatigue, not well rested even after 10hrs sleep (0.3mg melatonin for delayed) Hypothyroid?

May be. Your TSH is at the borderline of normal. You may wish to consult an endocrinologist to ascertain if you are prone to becoming hypothyroid, in which case you may be prescribed thyroid medication. In the mean time, for good health - Have a diet rich in fresh vegetables, fruits, whole grains, low fat milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco, alcohol, weed or street drugs in any form. Practice safe sex.