switch thyroid meds and dosage

[ZENmommy]

Hi there,  I am a 54 yr old woman  in menopause.
I've been on Armour 0.5GR once a day for over a year.
Recently my TSH was .50 and free T4 was .61.  My Dr.  felt both were on the low side so he upped my Armour  to 0.5GR twice in the AM and once at night.  Does this sound  like the correct thing to do based on my blood test ?

In addition, there has been a shortage of Armour lately and the formula has changed in the pill, so my DR wrote me an RX  for cytomel 5mcg  twice in the AM and levothyroxine 0.05MG one in the AM as a back up ( in case I cant get my Armour RX filled )    Is it OK to switch from  Armour to the cytomel/levothyroxine and is the dosage  equivalent ?  I notice when I take my Armour, I feel very hot/warm and somewhat irritable afterwards for a few hours. Is that a normal side effect?
I  have an enlarged pituitary and enlarged pituitary stalk , which is monitored by MRI yearly. My cortisol tends to be on the very low side in the AM and  I've had cortisol stimulation tests in which I was borderline low response ,however, my cortisol does spike around 5 PM  when I've had saliva tests done.  I have read  that taking throid meds and having low cortisol is not a good thing but my Dr doesnt seem concerned.  
I also take ambianCR  12.5 mg  for insomnia , xanax .5 MG  nightly,  I just started celebrex for severe joint/bone  pain  which I have developed over the past few weeks, also been using  estrogen patch and prometrium 100 mg nightly to help with menopausal symptoms.  I have been taking Diovan 80 MG  for HBP for a few years now.
My Dr recently prescribed Savella for my all over body pain which gets much worse at night while I am sleeping , My Dr.  says the pain  is most like caused by  Fibromyalga(?) as he ruled out Rhumatoid arthritis with a blood test.   I hesitate to take it as I am on so many drugs already . Could the pain becaused by low thyroid?
  Do you think I am on the right path with my thyroid meds based on my blood tests?

[Mark Lupo, M.D.]

The only caveat is the TSH must be interpreted knowing you have normal pituitary function which seems to be the case with the history provided, but a general endocrine evaluation may be needed to verify this.

[Mark Lupo, M.D.]

The TSH and T4 you posted suggested that 0.5g of armour once a day was adequate.  Armour has less T4 than human thyroid gland - so the T4 tends to run low.  
0.5mg of armour would be like 0.05mg of levothyroxine alone.  So if you take cytomel as well there would be a need to decrease the dose.   The T3 in the armour makes some people irritable.  May be wortwhile trying levothyroxine alone.  The pain is not likely caused by low thyroid.