fT3 is the only active hormone, there is no receptor for T4.
T4 is a reservoir for fT4–>fT3 conversion.
fT3 regulates your body temperature by acting on mitochondria inside your cells. Mitochondria cholesterol–>pregnenolone and make ATP, the energy source that allows your cells to function.
Mid-range fT3 should deliver good thyroid function and you are hypo. Our first reaction to that is to suspect elevated rT3 is interfering with fT3 at T3 receptors. While your rT3 is withing range, you need to know that some lab companies have a lab range where you would be over-range.
There are variations in how we function. Perhaps rT3 has a larger impact on you than others.
You need less T4 to have less fT4 for fT4–>rT3 and that is done with ~25mg T3 medication per day, depressing TSH to reduce T4 production. There is fast acting pharma T3, better to get [in USA] time release or sustained release T3 from a compounding pharmacy.
So no simple fix.
Why is rT3 elevated? Read the thyroid basics sticky noting references to rT3, stress, over training, accidents, surgeries, infections, inflammation, chronic, acute, adrenal fatigue and Wilson’s Book.
Low CoQ10 can have some related effects. But we typically only see that in relatively rare cases where cholesterol reducing ‘statin’ drugs reduce CoQ10.
What has been your history of using iodized salt?
You need to have a known source of selenium when taking high dose iodine. This is not a trivial concern/risk.
Taking larger doses of iodine will increase TSH, harmless. But that then makes TSH labs results of no use. Were you taking iodine for those labs?
Your energy levels, libido and mood are low?
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.