Thyroid UK
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Feel the Worst in the Morning

Almost everyday, I wake up early morning around 4AM and at first I will feel fresh and ready to go then gradually feel tired, exhausted and short of breath. This gets worst in 9-10AM and disappear after 12:00 noon and feel good the rest of the day.

What I notice that this correlates to cortisol daily trend, but not sure what is the exact problem. Doctors will not lessen to me!! When I convinced them to test cortisol in AM and PM they looked within range.

Here is summary of my treatment:

Before medications:

TSH: 0.015L (ref. 0.460 - 4.680).

FT4: 18.10 (ref. 10.00-28.00).

FT3: 7.48 (ref. 4.28-8.1).

Radioactive Iodine Uptake very low 0.1% (N 0.4-4%).


Anti TPO <10 (ref. up to 34)

Thyreoglobulin abs 233H (ref. up to 115).

After 6 weeks on 50 mcg Levothyroxine:

TSH: 4.690H (ref. 0.460 - 4.680).

FT4: 9.93L (ref. 10.00-28.00).

FT3: 4.17L (ref. 4.28-8.1).

I have taken 75 mcg for a month then 100 mcg for another month, here is the latest results:

TSH: 0.371L (ref. 0.460 - 4.680).

FT4: 15.80 (ref. 10.00-28.00).

FT3: 5.61 (ref. 4.28-8.1).

B12 Vitamin: 264 (ref. 239-931)

Currently I'm taking 150 mcg Levothyroxine and will test in two weeks.

4 Replies

Ali1101, FT4 and FT3 were low in range on 100mcg and should be considerably higher on 150mcg. Symptoms can lag behind good biochemistry by a couple of months.

Thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's) and this has caused your hypothyroidism. 100% gluten-free diet can reduce Hashi flares, antibodies and symptoms.

B12 is very low, 1,000 is optimal. Supplement 5,000mcg methylcobalamin for 6-8 weeks then reduce to 1,000mcg, and take a B Complex vitamin to keep the other B vitamins balanced.


I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

1 like


On 150 mcg since two weeks now, I have some improvements but mornings are not my good time at all! At noon, I will be a different person.

I expected you to comment on my TSH, it is strange, I cannot understand why it is low when my T4 & T3 is low!!

Thank you Clutter.


I'm confused, your TSH was low and the others were normal and they prescribed LEVO?

My results are similar, but my docs say it's sub clinical hyperthyroidism and prescribed me methimazole.

Also, why are you upping your dose when your latest numbers are all optimal?



My TSH was even lower when I started medication. My T3 and T4 always normal, only once they went below range. One doctor told exactly like you (subclinical Hyperthyroid). It didn't make sense as all my symptoms indicate my thyroid is low not high!

I went to another doctor and he ordered Radioactive Iodine Uptake Test and my results were very low confirming I'm not subclinical hyperthyroid. He ordered Levo based on my symptoms and the strange TSH. His theory is that I might have dysfunctioning pituitary gland and giving enough TSH to thyroid gland and that is why I need the supplement hormone.

More than 4 months and my dose reached 150 Mcg, I feel better (may be 50% improvement) than before, I will do blood work end of this week.

In fact I'm confused too! but I clearly have hypo symptoms. I feel cold easily one people feeling normal sometimes, my heart rate is mostly affected and drops to 47-50 when sleeping causing apneas and disturbed sleep, slightly constipated most of the times low energy, short of breath .. these symptoms appear in the morning and 90% of them disappear afternoon and feel good at night!

What about you, what are your symptoms? what did you feel after taking anti-thyroid medications?


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