I would ask that anyone reading this post to please bear with me while I first provide what may appear to be quite a bit of background.
This question is on behalf of my wife. She is 52 years old & a lifelong athlete. Approximately 12 years ago, for no apparent reason, she began putting on excess body fat, became lethargic, developed sleep problems, mental fogginess, forgetfulness, hair falling out, brittle finger nails, etc. After a few years of this, she discovered that hypothyroidism runs in her family. She saw her GP about it, had her TSH levels tested, which were sky high, so she was put on synthetic T4 (thyroxine). Over the past eight years or so it has been an endless cycle of a few weeks of improvement, then a return of all her symptoms, followed by another test showing high TSH levels, followed by an increase in her T4 dose. Her GP got to the point where she refused to increase her T4 dose any further because she was afraid she would make her hyperthryroidic. In spite of continued high TSH levels, she was told by this doctor that she was getting old and would have to get used to feeling like this.
My wife has been to see an endocrinologist about her problem and his very scientific diagnosis was to calculate her body mass index, which is within the normal range, and tell her that she looks far better than most women her age and that there’s nothing wrong with her.
I should note that we live in Canada, with it’s mistakenly lauded public health care system, where health care and access to doctors is for all practical purposes, rationed.
In frustration, she looked into other possible causes of and solutions to how she was feeling. She read extensively that testosterone replacement therapy is now being used increasingly to treat symptoms like hers in women at or near menopause. Until recently, we had a centre here in our community that was supposed to specialize in hormone replacement therapy for women her age. She gave them a try and asked to be put on a trial of TRT to see if it would help. Given their reaction, you would have thought she had requested physician prescribed heroin. Instead, they loaded her up on progesterone, estrogen, and a tiny little dose of Testim 1% gel. Long story short, the high doses of estrogen and progesterone made all of her symptoms even worse. When she requested that they monitor her thyroid function in conjunction with the HRT, they refused. “Not interested” was the response from the attending doctor. So much for publicly funded health care. She stopped going to this supposed “centre of excellence” in frustration, which was closed shortly thereafter when its government funding was pulled. If any of our American friends reading this are longing for a Canadian-style, single provider, government healthcare system, be careful what you wish for 
In the process of looking for some help for my wife, we stumbled across a video on Youtube of a medical conference lecture given by an anti-aging doctor who operates a private clinic outside of the public system in another Canadian province (private, for profit clinics in our home province are illegal and don’t exist). She contacted this fellow and flew out to see him. For the first time since her health problems started, it appears that she is now being cared for by a very knowledgeable, caring, highly qualified doctor.
He conducted extensive panels of blood tests and has discovered that her thyroid condition has never been properly treated because she cannot metabolize synthetic T4 into T3. He has also found that her bioavailable testosterone is so low that it is almost immeasurable. He is currently in the process of carefully adjusting her thyroid medications, which are now a combination of synthetic T4 and T3. He has also put her on low dose estradiol, as well as a different kind of progesterone replacement that has not had any of the nasty side effects of the form previously prescribed by the women’s clinic I referred to above. This doctor is also a big advocate of TRT for menopausal women. As he puts it, he is open to using “every tool in the toolbox” to restore optimal health.
Since she started seeing him a few months ago, he has progressively increased her dose of TRT, but her bioavailable T barely budges. She is now on 0.83333 grams of Androgel 1% per day. I have every confidence that this fellow will get the dials all finely tuned eventually so to speak. He has told her that the sex hormone replacement therapy can’t be optimized until he dials in her thyroid medications properly, so she will need to be patient while they do that.
The question I have for the forum is, does anyone feel that my wife’s thyroid condition is having a detrimental effect on her ability to transdermally absorb the TRT she is being prescribed?
She has read everything she can get her hands on regarding the subject and is doing everything she can to help ensure she gets good absorption. She applies the gel each morning to her shoulders and upper arms after a hot shower and washing with soap and water. She also read about the T-Gel hack whereby she applies moisturizer to the application site after applying the Androgel, which we’ve read should improve absorption by up to 15% to 20%.
Like I said, the doctor she is seeing feels like the first healthcare practitioner that she’s seen who actually cares about making her healthy again. However, given the cost and the fact that we are in different cities, her opportunities to pose these types of questions to him are infrequent.
If anyone can shed any light on this situation for us, we’d greatly appreciate it.