Do I have hypothyroidism or something else?

[mrrhacker]

Here are my results

TSH: 7.4 mIU/L Abnormal (general reference range 0.35 - 4.94)
T3 Free: 5.8 pmol/L Abnormal (general reference range 2.6 - 5.7)
T4 Free: 11 pmol/L Normal (general reference range 9 - 19)
Thyroid Peroxidase Antibody:
Value:< 10
Unit:IU/mL
Flag:Normal
Range:<=34
Testerone Level: 1.9 nmol/L (general reference range 8 - 32)

I have iron overload which causes my organs not to work properly (im guessing my pituitary was affected along with testosterone/hormones) , ferritin currently at 900 and slowly going down with chelation.
The issue that I'm having is the hormonal side.
3 years ago, ever since I was placed in TRT, my first shot (100mg a month), I gained 30lbs in 3-4 weeks. My endo and hematologist didn't know what was wrong. Over the years, each time the dosage was adjusted (200mg a month, 300mg a month, 150mg every 2 weeks, 75 once a week, etc) my weight would sky rocket. I was 140lbs before TRT and currently sitting at 240lbs (currently off of TRT for about 3 months and my weight hasn't moved). I knew deep inside that I had a hormone imbalance and thought it was my estrogen, turns it, it was 23.5 (normal range). I've recently found out that my TSH was off the roof but my hemo doc says appears stable... After some research, it appears that TSH plays an important role with metabolism because it didn't matter if I ate 1k calories or exercised 6 days a week, I didn't lose a single pound. Turns out my endo specializes in diabetes...
So can anyone give me their opinion with this case who at least dealt with this before or specialize in thyorid/hormonal therapies? Do I have hypo? Do I have another problem? I've been struggling for 3 years and I may have finally found an answer to it.

[Red_Star]

There is nothing apparently wrong with your pituitary gland in regards to thyroid hormone. Your TSH has risen in response to lowering free T4 levels. My result was something similar; TSH 6 mU/L, free T4 13 pmol/L.

Your labs indicated early stage hypothyroidism. In the earlier stages the body increases the rate of conversion from T4 to T3 so it's not uncommon to see normal or even slightly elevated T3 levels. I can't say whether your hypothyroidism is a temporary or permanent condition though. It's possible that stopping TRT may see thyroid hormone levels go back to normal.

[gimel]

As I read your test results and experience with TRT, a couple of things came to mind.  Your TSH is high enough to be a possible indicator of Hashimoto's Thyroiditis.  To assess this possibility, two tests are required, TPO ab and also TG ab.  Your TPO ab test was okay, but you need to run the Thyroglobulin Antibodies test also, to be sure.  

Your Free T4 is also low in the range, which is another indicator of possible hypothyroidism.  Free T4 should be at the middle of the range, at minimum, for best results.  I expect that your Free T3 being very high in the range, would be enough evidence for most doctors to decide you could not be hypothyroid; however, that overlooks the possibility of pooling of T3 in your blood.  You can read about that problem here.

"T3 Pooling

What is Thyroid pooling? This is when the thyroid hormone T-3 collects or pools in the blood and does not get into the cells.

How does T3 Pool? The cause of T-3 pooling can be any one of the following or a combination of the following:

    High cortisol
    Low cortisol
    High iron
    Low iron
    Medications
        beta blockers
        Amiodarone
        Iodinated contrast media
        Lithium"

Obviously from what you have mentioned, the high ferritin would be the likely cause for pooling.  If the T3 is not getting into your cells, you are hypothyroid, regardless of what the tests results show.  

Low thyroid function is also associated with low testosterone levels.  So I expect that fixing your iron overload problem will help with both your thyroid issue and your testosterone problem.  I would go ahead and request testing for the Thyroglobulin antibodies (TG ab) test.