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Medication advice

I was diagnosed with hypothyroidism 2 years ago.  I was on levothyroxine for a year and a half.  In the first 9 months I gained 22 lbs and had severe belly issues as well as muscle weakness, shortness of breath, foggy headed etc.  Last July my doctor switched me to Armour thyroid 125mg which seemed to help the belly problem but not much else.  My TSH at that time was 0.02. Then end of that month he changed it to 90mg.  Since October I have lost 15 lbs have had some tremors and still the muscle aches and very irritable in general not feeling well.  Just had labs done last week and my TSH is still 0.02.  My doctor seems to just blow it off.  He said he doesn't go by the numbers he goes by how you feel.  My question is since my TSH is low do I need more or less Armour thyroid?  I can't afford to lose more weight I only weigh 112 now.  Any help would be greatly appreciated.  I'm trying to understand all of this
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Avatar universal
Unfortunately, that's a total T4 test, which doesn't yield the same quality of information as FREE T4 does.  It's at 36% of range, which is a little low of the 50% guideline.  Your doctor didn't test FT3, which is inexcusable once you are taking meds with T3 in them, like your Armour.  It's your FT3 level that's most likely to be the cause of nervousness and heart palps.  

If you can, it would be really good to have labs redrawn and make sure that FT3, FT4 and TSH are ordered this time.  Those tests are available online without a doctor's order if that would be easier.  Self-ordered tests are also self pay.  With those, we'd be able to see what your FT3 is doing.

It could well be that the T3 in Armour is too much for you.  The ratio of T3:T4 in Armour is quite high.  It's possible that you'd do better with a synthetic T4 med (levo) with a little synthetic t3 (Cytomel and generics) added to it.  The advantage of the synthetic approach is that T3 and T4 meds can be manipulated separately for more of a custom fit.

I strongly suggest getting FT3 tested first, so we know where we're starting from before any meds changes.  
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Avatar universal
This is what he had tested according to my lab report
TSH 0.02      Ref Range 0-04-4.50 mlU/L
T4 Total 8-2   Ref Range 4.5- 12.0 mcgldL
I have nervous and heart palpations and I'm wondering If the armour thyroid is too much for me.  I feel lousy
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Avatar universal
Is your doctor testing only TSH?  FREE T3 and FREE T4, too?  If so, please post those with the reference ranges from your own lab report.  Low TSH indicates the need for less meds.  However, you have to be very, very careful, because once on meds, TSH often goes down very low and it no longer reflects FT3 and FT4 levels accurately.  .  
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