I would recommend testing for thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb). Some men with hypothyroidism may complain of ED. Also, vitamin E is known as the "sex" vitamin and shown to help with ED. Gynecomastia may be due to lifestyle factors which include alcohol abuse, amphetamine or heroin use, marijuana use and steroid use.
"There is also the difficulty of interpreting a serum of concentration of TSH in isolation. A concentration at or near the upper limit of the reference range, particularly if associated with a normal T4, may indicate autoimmune thyroid disease. A consensus exists for early treatment of such patients with thyroxine if anti thyroid peroxidase antibodies are present in the serum, because the risk of overt thyroid failure in future years is high, and it makes sense to anticipate morbidity rather than risk loss of follow up."
Drs Anthony D Toft and Geoffrey J Beckett, "Thyroid function tests and hypothyroidism", British Medical Journal, 8 February 2003, 326:296-7.
I don't see a "classic" primary hypothyroidism in your labs. FT4 is close to midrange, and FT3 is way up in the top of the range. TSH is a little on the high side, but TSH is a very unreliable indicator of thyroid dysfunction, and you must remember that TSH, per se, causes NO symptoms.
Low cortisol and low ferritin can both contribute to high RT3 levels. Many theories on RT3 dominance...you can do some reading. In a nutshell, T4 is converted to both T3 and RT3. RT3 is inert, and it's the body's way of stopping T3 levels from getting too high in times of trauma, starvation, etc. High RT3 levels are thought by some to prevent T3 from getting into cells. You can request RT3 testing, but many mainstream doctors don't "believe in" it, so be prepared to be insistent.
Have you had a thyroid ultrasound? Do you have nodules? An autonymously functioning nodule (toxic nodule, toxic adenoma are other names for the same thing) can raise FT3 levels.
What about a pituitary connection? The whole endocrine system, including adrenals , thyroid and sex hormones, etc is controlled by the master gland, the pituitary. If all are off, perhaps they are due to pituitary dysfunction.
Hashi's? Wouldn't be my first guess with your FT4 and FT3, but as pointed out, TPOab and TGab would rule it out.
I appreciate the responses! I've made notes and will take this to my Endo shortly. I'm going to have the antibodies checked out along with a pituitary MRi, cortisol, iodine, ferritin levels checked, and have a thyroid ultrasound. Sounds like I'm getting somewhere. I'll keep you guys posted.