Hypo/Hashi's. Having trouble with palps, need advice please!!

[unfrogettable]

Sorry this is long...2010 November, started having extreme 2-3 day long migraines that Relpax would not relieve.  Extreme "waves of dizziness" again, major brain fog, exhaustion, dry skin and noticed hair starting to 'shed', had 10bl weight gain over past 2 years.  Didn't think any connection to thyroid as TSH was never high on any past bloodwork. Thought weight gain was due to exhaustion and not feeling like going to the gym. Figured hair loss was due to change in seasons and getting older/ menopause.   Went to Neurologist in May 2011, all tests were negative….except bloodwork showed a high TSH of 5.24 (range .45-4.5), Thyroxine(T4) --7.2 (range 4.5-12.0), Triiodthyronine (T3)-- 101 (range 71-180).  Vitamin D, 13.4 (range 32-100).   I thought it strange that only 8 months prior during yearly physical (9-2010), TSH tested at 2.45 --range (0.35 - 5.5).   Before going on topamax, I wanted to follow up with MD.  I remembered my Dad had thyroid issues and he took a tiny pill called "Thyrolar".   So after doing some prior research before my appt. with my MD (and wow is there a lot of confusing info on the internet about thyroid disease), I was hoping MD was open minded to prescribing Armour.  And I didn't even have to ask for it, she just gave me script for 30mg of Armour.  Also told me to take 5,000 VitD a day and to come back in 6 weeks for a re-check.  I was hopeful to think that this might be the reason for why I felt so bad for so long and that maybe I had undiagnosed thyroid issues for many years. Took the meds and didn't have a headache for 6 weeks! No TMJ pain, no elbow/ hand pain either! Still a little dizzy now & then and still brain foggy…but I was optimistic!  Recheck on Monday July 25, 2011. New labs from 7-9-11 showed TSH at 2.45 (range .45-4.5), freeT3 -- 2.6 (range 2.0-4.4), T4 not reported,  Reverse T3 --148 (range 90-350), DHEA--36.1 (range 35.4-256.0),  VitD-- 30.3 (range 32.0-100.0).  MD said she'd like levels a little lower and increased Armour to 60mg, told me to take DHEA 25mg, keep up with the VitD and sent me on my way.  I took the 60mg Tues, Wed Thurs and Friday…by Friday afternoon I thought I was dying.  Dizzyness, nausea, palpitations, pounding pulse, chest pain, difficulty breathing---called MD office and was told she had left for the weekend at noon. Her nurse said to call the pharmacist. Pharmacist said 60mg shouldn't give me those reactions and if I was having chest pain, to go to the ER. (Somehow I knew I wasn't having a heart attack so I didn't panic).  Made it through the rest of the work day, got home took BP--135/85, pulse 95 (which is actually high for me).  Normal BP for me is 110/65, resting pulse 70.   Took 30mg on Sat & Sun but felt sick with chest pain and shortness of breath all weekend.  On Monday, 8/1, called MD, was told to reduce meds back to 30mg. (duh, already did that).  Couldn't get in to see reg MD, so I went to friend's holistic MD around the corner from my work on Tues 8/2, who drew more blood for a nutrition panel and gave me saliva cortisol test to take home.  Follow up 8/30. Considering the 60mg was still in my system, the lab results from 8/2 were TSH 1.42 (range .40-4.50), Free T3--3.2 (range 2.3-4.2). Free T4 not reported (again), but thyroid peroxidase antibodies tested high at 61 (range <35).  New doc's diagnosis was "mild hashimoto's".   Saliva test said cortisol was Morning 6.7 (3.7-9.5), Noon 1.9 (1.2-3.0), Evening 1.3 (0.6-1.9) and Night 16.2 (0.4-1.0).  Night was very high.  Told me to stay on the 30mg of Armour and the nutrition study showed I was deficient in B1, Selenium and VitE.  She didn't say anything about my chest pains other than "I can't treat your heart as I haven't done any tests, but if you take the vitamins you'll have a lot more energy in two weeks".    (Since 8/30 I've been taking DHEA 25mg, VitE 400mg, VitD 5,000, VitC 250mg, B-Complex, Selenium 50mg Magnesium 250mg, Calcium 1500mg, Zinc 25mg and 100mg phosphatidylserine for the high night cortisol).  
So, after 5 days of the 60mg and the horrible reaction, I have tried to go back to my original dosage of 30mg Armour, but the chest pains return if I take the 30mg for more than 2 days. The calcium & DHEA kinda help soften the pains but don't eliminate them. I've tried cutting the 30mg pills in half and taking half in the morning and half later on. Thinking maybe the new 30mg bottle was bad, I tried cutting the 60mg in half.  I still get pains. I tried taking 30 every other day. I just wany to be able to breathe normally and have no chest pains and pounding pulse again!   I didn't take the thyroid meds at all on 9/3 or 9/4. (I was really getting sick of the chest pains and shortness of breath). 9/5 I took 1/2 a pill in the morning, but in the afternoon, I got a 5 hour dizzy spell (this was new, usually it's just a 'wave' of a vertigo-like sensation) and chest pains returned.   Since it was a holiday, I was home from work so I went to bed for the rest of the afternoon.  Went back to my regular MD on Tues 9/6 and discussed options --she said she wouldn't change Armour to anything else and gave me propranolol to help ease the chest pains-- 10mg 'as needed' and told me I could take up to 80mg, stay on the 30mg Armour and follow up with new bloodwork in 4 weeks.  Said heart is strong and fine as indicated by the ultrasound from 9/2010.
I've been on 30mg for the last 5 days and have taken the propranolol each day, but the dizziness won't go away and I just feel terrible.  I'm shaky and nervous and needless to say I'm becoming very emotional over this.  
1. What is causing the "heart issues"?
2. Will I now have to take a beta blocker forever to tolerate thyroid medication?  
3. Would switching to another brand of medication cause the same symptons?
4. Is my heart sustaining any damaged from this? (doc doesn't "think" so)
5. Should I go see an Endo?
I could use some good advice!!

[unfrogettable]

Thank you for your reply!
What I did not write in my first post was :
1988 pre-mature ovarian failure ("pre-mature menopause"--I was 28). Was given birth-control pills to 'regulate period'.  Stayed on them for a few years. Developed terrible migraines.
1992 New Gyno finally said 'you're in menopause' and prescribed hormone replacement. Periods stopped.
1994 Developed terrible bouts of sudden abdominal pain, bloating, nausea, and constipation alternating with diarrhea. Diagnosed with spastic colon/ IBS.
2000--started experiencing migraines again & cramping and back/ leg aches.  Stopped hormone replacement. Periods did not come back.
2002 --started to experience severe migraines again (but wasn't on any hormones) 'waves of dizziness', 'brain fog', & migraines and odd 'burning tongue/ mouth' sensation, joint pain, dizziness, fatigue, TMJ, light sensitivity, hyper sensitive to odors, tender skin-- Diagnosed by neurologist with 'migraine aura' and prescribed 10mg of nortryptaline "to prevent migraines" at bedtime.  Relpax as needed. Was never officially diagnosed with fibromyalgia (Internist said "IF that is what you have, I wouldn't put you on anything other than the nortryptaline anyway").  Also developed stomach pain on right side with nausea that would cause me to wake me up in the middle of the night to throw up.  This occurred once every two to three months. MD said it was stress and told me to take Tagamet.
2004 Gallbladder removed ("full of stones & inflamed").  Stomach trouble over past 2 years was evidently due to gallbladder. (fired MD)
2006 Went to MD to have a bump on wrist checked. Cyst was only a ganglion, but she noticed loss of pigment on both of my hands, diagnosed as Vitiligo.  Also, childhood heart murmur was now called "mitral valve prolapse" and was told to get a baseline ultrasound, which turned out fine.  
2007 pain in elbow radiating to fingers. Pinky and ring finger go numb and lose feeling. After seeing neurologist and orthopedist, had MRI, nerve conductivity test, all testing was negative. Diagnosed with cubital tunnel nerve irritation. Got elbow brace from orthopedist.
2008 started having TMJ issues and sinus pain. Had allergy testing. Saw TMJ specialist. Nothing was found except that I'm allergic to grass and I grind my teeth at night.
2010 begins first post.....
So I've had a long history of nothing really bad (thank goodness) but just a bunch of symptoms which no one can seem to find the cause, just treat the symptoms.  After so many years of "chasing ghosts" and not ever really finding a root cause, I suppose it can all be chalked up to a bunch of auto-immune issues I inherited courtesy of Dad.

Doc did give me script for more lab work for next visit. Includes all hormones, iron, cbc, T3, T4, TSH, DHEA and VitD.  We'll see if the lab actually reports the T4 this time!  It's been ordered twice before and just not reported. Frustrating to say the least, especially when the doc says "weird they didn't include it , but oh it's not really necessary, the T3 and TSH are there". Hopefully third time's the charm.  Doc is open to me coming in with my "reseach". She also tolerates my need to self-diagnose *g*.   She didn't want to switch meds as I think she firmly believes in Armour but I think I will ask for just the T4 next time.  Problem is that the "ideal" lab values occurred when I was on the 60mg but had the worst reactions, although I think I felt better on the 30mg with tsh at 2.45 and t3 at 2.6 and just need to find balance with my other hormones.  Before I got the beta blocker, I read calcium helped with muscle spasms and DHEA is like a 'mother hormone' and also affects adrenals. So perhaps it was in my head, but when my chest felt tight, I took 1/2 the dhea and a calcium pill after breakfast and the other 1/2 dhea and another calcium after dinner and pain seemed less, not gone, but less. Of course the beta blocker stops it completely.  I'm hoping by increasing the VitD (originally was 13 in May...30 in July) along with adding bio identical creams for estrogen/ testerone replacement I can get back in balance and stop the beta blockers. Stopping the "background" headaches would be nice too as they've come back.
And that is my total tale of "woe".  I beginning to think that since the thyroid is failing,  it threw all the other hormones out of whatever 'balance' they were in.  Thank you for your support!

[Barb135]

Your TSH looks good, and at 3.2 your FT3 is almost at mid range, so there's no indication that you are hyper.  It would be nice if there were an FT4, though.  Of course, everyone reacts differently to medications, so you might just be overly sensitive, or you could be one who would be more comfortable with your FT3 a bit lower; however, it would seem to me that thyroid is not wholly responsible for the way you feel. Also, it's possible that you are having a reaction to the fillers in the Armour, rather than the actual medication.

There's really  no such thing as "mild Hashimoto's" -- you either have it or you don't and it certainly appears that you do; that means that as the antibodies destroy your thyroid and it produces less hormones, you will need higher amounts of medication to keep the hypo symptoms away.  

There are a few of us on beta blockers to keep palps at bay, and there's a good chance you might eventually be able to get off them once you get your thyroid medication stabilized.  Quite often when we get a dosage change, we get symptoms of being hyper, or worse hypo symptoms because it takes a while for our body to adjust to hormones we haven't had for a while. I have similar "heart issues" - I take atenolol to keep the palps down; I've had extensive tests on my heart and aside from leaky valves, which are not an issue at this point, there's nothing wrong with  my heart. I get a pounding feeling and it feels like my heart is going 90 miles/hr, but when I check my pulse rate, it's usually very low, so the "issues" really aren't issues at all, they are merely "sensations".  In my case, it's been determined that these sensations are caused by anxiety.

Did your doctor say why she won't consider another medication?  Some people don't do well on dessicated meds, like Armour, because of the T3, while others do best on them. I don't understand what level your doctor would like to see lower; everything but your TSH is already rock bottom, and those are the ones we'd like to see higher, so she must be talking about TSH.  Apparently, even though she's testing FT3, she must be dosing, based on TSH, which is almost always a recipe for disaster.

Vitamin D deficiency can cause symptoms you're having as well, so you might want to have that tested again to make sure it's coming up adequately, with the supplements. Even the 30.3 you had in July, yours is still WAY too low.

With the various supplements you are taking, what makes you think the "calcium and DHEA soften the pain"?  I don't know your age, but you mentioned "getting older/menopause", so is it safe to think you have either gone through menopause or are getting close?  It's normal for DHEA to decline as we age; I wonder if the DHEA you're taking could actually be causing some of your symptoms, or making them worse.

You should talk to your doctor about trying a straight T4 medication. A good thyroid doctor should be willing to try various medications in an effort to alleviate symptoms.  The other thing is to make sure you get tested for Free T4, along with the TSH and FT3.