Hypothyroid and Still Having Symptoms

[marcyb291]

I was diagnosed with Hashi's 2 years ago. At the time of dx my lab values were:
TSH: 11
Free T4: .61 (.82-1.77)
TPO: 1800 (0-34)
No T3 done at time of diagnosis.

I have been taking 75-88mcg of Levothyroxine but have been feeling horrible. After not seeing improvement, an Endo agreed to try me on Armour. He said that I have a very mild case of hypothyroid and the symptoms I am describing cannot be due from hypo. I have had multiple other tests to rule out other causes but always come up empty. I am at a loss.

I have been on Armour 90mcg for 6 weeks. I felt great the first week or so...no more brain fog, more energetic, clear headed. Felt like I did when in high school. I thought this was too good to be true. Well...I started feeling worse and the symptoms were just as bad or worse from when taking the Levo. I am always tired, brain fog where it is difficult to do my job, decreased memory, blurry vision, dizzy, shakey, basal body temp in the 96's, hands and feet so cold they feel like they are burning, hair falls out easily in the shower. These are most of the same symptoms I felt on Levo but maybe a tad worse.

My lab results from 90mcg of Armour are:
TSH: .021 (.450-4.50)
Total T4:7.4 (4.5-12.5)
Total T3: 109 (71-180)

I have always had Free T4 & T3 tests done so I do not know how to interpret these.
When on Levo, my labs were pretty normal, with T4 and T3 being in low/normal range, and TSH either normal or suppressed. However, none of my symptoms ever went away.

I also had a miscarriage 2 months ago, which may or may not be related to thyroid.

Can you please tell me what these lab values mean? Am I being medicated properly on Armour? I am feeling so bad, I am thinking of switching back to Levo but know I will still feel aweful.

[marcyb291]

Thank you for your response. I have heard varying idealogies about TSH and T3, T4. I have heard that if you have hypothyroid, and especially Hashimoto's, since it will attack your thyroid and TSH can show up as suppressed, that the only real indicative measure of how a thyroid is functioning is the FT3 and FT4, which should be in the 50-80% of normal for someone to feel well. I have heard of people who's TSH has been suppressed but their T's are in the ideal range, and their hypothyroid symptoms have subsided. Do you think this theory is accruate? I am just trying to figure out why if my TSH is normal and T3 and T4 are not "ideal", I still have all the classic symptoms of hypo, especially fatigue and an all day temp in the 96's.

[Mark Lupo, M.D.]

If you are planning pregnancy again, current guidelines recommend against use of T4/T3 combo products such as Armour.  Would recommend re-stabilizing TSH in the 0.3-2.0 range with branded levothyroxine product before attempting pregnancy again.  Also work with your doctor to determine other (non-thyroid) causes of your symptoms.