Actually it’s not, and here is his full statement below. The reason some people do better on high dosages of TRT is because it can mask other issues with the immune system and/or thyroid/adrenal axises. It can also cause an up-regulation of thyroid function that can help with existing issues.
Here are the statements:
When interpreting thyroid function, it is very important to obtain a Total T4.
T4 is about 98 percent of circulating thyroid hormone.
If one is treated with t3 (Liothyronine, Triiodotyronine), then Total T3 will also be important to determine what is occurring.
Assuming there are no significant major health problems and nutrition is optimized,
use T4 or Armour Thyroid, and/or T3 to gradually achieve the following:
First: Total T4 between 8-12. Generally midway is better to avoid over-conversion to T3 when the adrenals are working well.
Second: Free T3 between 3.4 to 4.2. Generally midway is better to avoid adrenal fatigue from high free T3). Avoid high Free T3 - backing off the T4 target if T4 to T3 conversion is too strong.
Once this is achieved, then any remaining problems associated with thyroid are due to conversion problems from T4 to T3, e.g. such as due to adrenal fatigue, excessive stress, end-organ thyroid resistance, the other signaling systems, etc.. In this case, address adrenals, address nutrition, address stress, improve sleep, psychological problems, see specialist, etc.
Nutrition absolutely has to be optimized to avoid serious health problems with thyroid.
Of course, consult with your physician before undergoing any thyroid treatment.
Levothyroxine has an advantage here since it can increase Total T4 to its target most easily, without overly stressing the adrenal glands.
This is analogous to Total testosterone as a target for testosterone replacement - as I have posted before.
The adrenal glands give out not only cortisol, but also pregnenolone, DHEA, progesterone, testosterone, aldosterone, estrogen, etc.
As the adrenal glands fatigue, they will try to keep cortisol production up while progressively sacrificing production of the other signals. Thus, cortisol alone is NOT a good measure. The other signals also have to be monitored to determine what state of fatigue one has.
Cortisol can be "normal" yet the adrenal glands can be fatigued as shown by deficiencies in the other signals. This is why in some, Cortisol is still necessary for supportive treatment.
This is why I don't advocate monitoring Cortisol alone. The spectrum of signals needs to be measured to determine its status.
This is analogous to using only fasting blood sugar or hemoglobin A1c alone as a monitor for insulin resistance or diabetes. This doesn't tell much unless it is seriously off. One has to monitor fasting insulin, cortisol, lipids, thyroid, etc. etc. to get a better picture of what is happening. For example, one can have a "normal" blood sugar but have an insulin level of 200. This indicates severe insulin resistance and a pancreas that is working very hard to control blood sugar. When the pancreas fails to do this, then glucose goes out of control and diabetes may occur. This would not be shown by only testing hemoglobin A1c or fasting glucose.