High TSH - fT3 High, Low-Normal FT4. Advice? KSMan?

Hope KSMan reads this as you know your stuff man! I’ve read the thyroid sticky over a few times.

I’ve recently been put on TRT (started July 2018). First few weeks I felt awesome, then started to feel shit. Came across the thyroid sticky and read over it. I looked over the bloodwork my doctor had done pre-TRT and noticed my TSH was 3.07 but he didn’t bring this up as an issue. He didn’t test for FT3 or FT4.

So, I checked temps, noticed I was SLIGHTLY cold in the afternoon but not by much - hitting about 98.2 / 98.3 in the afternoon. So I tired IR. 25mg Iodoral every day for a week. I then started consistently hitting 97.6 every day, sometimes even by 11am and would maintain this most of the day. Stopped IR for 3 days and got my levels checked again yesterday morning, they came back as follows:

FT4 15.9 (pmol/L) Ref 9.0 - 25.0
FT3 5.7 (mIU/L) Ref 3.5 - 6.5
TSH 3.72 (pmol/L) Ref 0.5 - 5.00 (as we now know, this reference is bullshit)

Got cortisol checked to rule out adrenal fatigue and all looks good to me:

Cortisol 326 (pmol/L) Ref 110 - 550

Any ideas? Advice? I still feel foggy headed, lethargic, just all around below average and TRT has not helped in the way I thought it would. Don’t feel any better since IR either.

What about Reverse T3? If elevated Reverse T3 blocks Free T3 and then a certain potion of Free T3 become useless as it floats right by the T3 receptor.

Another thing you need to understand is it takes 1-3 weeks for the pituitary gland to take notice of the exogenous testosterone, when this happens the pituitary gland is fooled into thinking the testicles are producing testosterone and so the pituitary gland shuts down.

So before all of this happened you have your natural production and the injectable testosterone where now you only have the injectable testosterone. You’re going to have to wait for your body to adapt.

Doctors see TSH in range and believe there’s no problem, time and time again this is proven wrong and the TSH range has too many people in range with undiagnosed hypothyroidism.

Yeah, I considered reverese T3, however the labs I got my bloods done though couldn’t test for reverse T3.

If it WAS reverse T3 - how do I lower this? As my T3 levels look healthy, would supplementing with synthetic T3 lower reverse T3? Also, synthetic T3 should lower TSH, correct? I’m sure the high TSH is responsible for my current foggy head and lethargy.

I know T4 alone is not good for reverse T3 levels and same with NDT. I have no idea what my reverse levels are, so would I be best starting on trying to lower my TSH?

Thanks in advance guys

The cause for high Reverse T3 could be many, insulin resistance, being chronically sick and stress to name a few. Ferritin is needed for thyroid hormones.

My ferritin levels are good, normal range. I have slightly high iron and transferrin saturation.

Would synthetic T3 lower TSH, and would it lower reverse T3?

Anyone have any ideas? Will T3 lower TSH?