Hi! Good evening. I am Dr Shareef answering your query. Your TSH is elevated, signifying that your thyroid gland is not functioning properly making you hypothyroid. Your symptoms of feeling lethergic and development of cracks could be due to hypothyroidism. I would advise you to get yourself clinically assessed by a medical specialist in your area, who depending on the findings, might start synthetic thyroid hormone (levo-thyroxine) from a low dose to a higher dose if need be after titration. This treatment would relieve you of your symptom soon. An ESR of 30 might not have much consequence. A serial testing would be more helpful. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.