One of the most frustrating experiences for thyroid patients is being told that their thyroid is normal while they still feel exhausted, foggy, cold, constipated, and unable to lose weight. In many of these cases, the issue is not that the thyroid has been fully evaluated. It is that the evaluation was too limited. TSH is often the main, and sometimes only, lab marker used in standard thyroid screening. While it can be useful, TSH is not the full story.