A 45-year-old woman presents to the clinic with a 6-month history of fatigue, weight gain, and feeling cold all the time. She also reports hair loss and constipation. On examination, her skin is dry, and her reflexes are delayed. Her blood pressure is 110/70 mmHg, and her heart rate is 60 bpm. Laboratory tests reveal a low free T4 and elevated TSH. What is the most likely diagnosis?