chronic subclinical hypothyroidism yet somehow have elevated T4 levels — where do i even go from here?

no doctor will treat my subclinical hypothyroidism, despite having it for years, because it’s “not bad enough”. my levels have ranged between 5.2-9.5 for 4 years, except for February this year when it randomly went into normal range (& we never figured out why). per my most recent bloods, my TSH is 5.23 mIU/L & my FT4 is 24 pmol/L. i realise it’s unusual for T4 to be elevated alongside TSH.

i’m confused, overwhelmed, & frankly afraid that something my doctors haven’t caught is wrecking havoc on my body. i am incredibly unwell. i’ve had severe hair loss & dryness for years, attributed to my PCOS diagnosis, but no PCOS / hormonal medication has ever helped; i am constantly exhausted & frequently have to lay down during the day; i feel ‘dumb’ & like everything’s hazy; i am in near constant severe musculoskeletal pain — & received a fibromyalgia diagnosis for it because we haven’t been able to find a cause. i struggled to lose weight for years & kept gaining (even when i was essentially starving myself) before i went on Wegovy for my insulin resistance.

my current GP is amazing, but i have a grocery list of issues, & consequently some things get forgotten about. the subclinical hypothyroidism is one of those things we keep an eye on, but never really discuss. what do i do? is it time for another endocrinologist referral? i already require referrals for rheumatologists, specialist physicians, sleep specialists ect so it wouldn’t be hard to request an endo referral, i’m just hesitant because my last endocrinologist was genuinely traumatising. i don’t think i can handle somebody listening to my concerns & telling me to eat >800 calories a day again.

does anyone have any advice, any tests they’d recommend i pursue, or even words of encouragement? 😕