This is a great question. To summarize, I'm not sure exactly. Below are the results from my most recent Thyroid Panel. I was taking 200 mcg of T4 daily leading up to this test. I have since switched to 2 grains of Armour Thyroid daily in an effort to reduce free T4 to mid range and increase free T3 to the upper quartile. I am under the impression that this will likely reduce reverse T3 production and make my treatment more effective.
As for symptoms, I've eliminated the symptoms that are most important to me: fatigue and the need for long afternoon naps, difficulty waking up, very slow digestion and all the problems accompanying that, and significant water retention. These problems have pretty much vanished. I still have a scalloped tongue and vertical ridges on my fingernails which have both been linked to hypothyroidism. I also have a pretty low heart rate, that is often in the low 50 BPMs, sometimes in the 40s. However, I am very fit and exercise religiously, so my low heart rate could be from that I guess.
I just took my temperature at 7:55 am, about an hour and a half after waking up, after breakfast and coffee. I took three readings: 96.4, 96.1, 96.5 (I used a typical digital thermometer). So, as you can see, my body temp is still very low despite the improvement in TSH and symptoms. I do not take iodine supplements. However, I use iodized salt on my food at least once per day... not too much though.
I'm already on a pretty high dose of Thyroid medication, so I'm kind of baffled.
I've always been somewhat confused about the interactions between Thyroid hormone and Testosterone. As I increased my Thyroid dosage, my testosterone blood levels increased, and I've had to subsequently reduce my testosterone dosage. Conversely, when I introduced exogenous Testosterone, my TSH increased, and I had to increase my Thyroid dosage. I'm wondering if my T levels are so high that my body needs super high levels of Thyroid hormone to balance everything out. Is it possible that high levels of testosterone are blocking the thyroid hormone from getting into certain tissues. Do they share receptor sites?? Should I keep increasing my Thyroid hormone until the scalloped tongue goes away, or should I decrease my testosterone dosage?? Or am I totally off track here. Below is a more detailed breakout of my T Levels
Total T - 1076 (250 - 1100)
Free T = 245.9 (35 - 155) High??
E2 = 23 (<= 39) Damn near perfect!