Thyroid UK
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What Happens to Me Every Morning

Every morning I wake up early after only 4 hours of sleep with heart pounding and then feel extremely low in thyroid so I cannot get up from my bed. My levothyroxine at 100 mcg makes my levels optimal and increasing it didn't help. The doctor thinks I have deficiency in TSH (pituitary is low in TSH). I do feel much better afternoons.

It is clearly something related to cortisol and adrenaline rushes wakes me up early but I cannot figure it out! neither my doctors were helpful! I don't have any blood sugar issues, as I checked so many times never been abnormal.

Any idea, what is going with me? should I consider any tests?

24 Replies

Hello Ali1

A common reason for waking in the early hours of morning is not enough glycogen required for liver regeneration. If you are low in cortisol (probably through thyroid problems) your body may not have enough glycogen and compensate by releasing adrenalin making you wide awake and unable to get back to sleep.

A healthy bedtime snack might be peanut butter on g/f crackers which contains protein and also a little carb required for glucose to get into the brain ensuring healthy levels of serotonin & melatonin encouraging you into REM sleep. Sufficient and balanced thyroid hormones are also required for proper serotonin and melatonin metabolism.

I supplement 5-HTP, an amino acid that is a precursor to serotonin. Other members have posted about success supplementing melotonin, GABA or magnesium.

Some members have found drinking the "Adrenal Cocktail" before bed or upon waking helps. See link below.


Adrenal Cocktail


Disclaimer: 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.



This is a link which has good information which may be helpful to you:-


Hi Ali1, Have a look at Wilsons Syndrome basically means T3 can't get into your cells causing low body temp, so what you do to fix it is take t3 to get your body temp up then ween of it, sometimes you may need to do it a few times.

I am low thyroid so tied lethargic and have a low body temp my blood test show normal TSH, T4, T3 ect

Good luck and keep learning, the reality is it doesn't take much to know more than the doctor know or can remember on thyroid.


How much low is your temp? I'm going to try T3 soon.


My temps averaged about 97.4 F pre T3, Dr Wilson recommends sustained release which you have to get compounded.

I am 5 days into starting T3 sustained release, my temp initially went up 98.6 F now it has gone down to 97 I'm continually raising my dose trying to get it higher.


Hi Ali1,

I have this problem too but only when I go to bed feeling VERY depleted. Ie I've done too much in the day!

When thyroxine levels drop too low it is nigh on impossible to maintain blood glucose. Have a snack before you go to bed. A glass of milk would help enormously.

Are you sure you're optimally medicated??


I tried snacks but it is clearly not sugar, when I wake up and check blood sugar it is very normal, my doctor ordered a test to fast 48 hours to see if my blood glucose will drop below normal but it didn't.

Yes, At 100 mcg and T3/T4 in normal range, at 150 mcg still normal range but they were close to high and didn't feel better.


It would help if you posted your 'normal' blood results. 100mcgsmay not be enough and 150mcgs may be too much.


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)

My last result of T4 after a month on 150 mcg increased to 24.2 normal is 10-28 but didn't change my symptoms! SO I went back to 100mcg.


Sorry Ali, which of these blood results are your latest ones?

The top set where it says before medication?

Or the bottom set?


Sorry Ali, ignore the last post I made, I've just looked at your previous posts so I now realise the top results were BEFORE any meds at all.

Your latest blood results suggest that you need an increase. Neither your FT4 or FT3 are optimal. They are both low in the range.

Have you had a pituitary scan?

You seem to have a pituitary or hypothalamus problem, hence the originally very low TSH?

This can be caused by any number of reasons and should be investigated.

I am central hypothyroid and had to push to get my pituitary scanned.

It has taken years to finally get the correct diagnosis but my dose increases have had to be very slow otherwise my reactions are terrible.

Central can cause other hormone deficiencies.

With Central hypothyroidism the aim is to ignore TSH blood results and aim for an FT4 at the upper end of the reference range.

You did a mighty big jump from 100mcgs levo to 150mcgs levo. That in itself could have made you feel dreadful. Perhaps that is why you felt no improvement. I think most people would struggle with an increase of that size.

Increasing by 25mcgs would have been more sensible.

In my humble opinion you need to raise your dosage but please consult your GP and push to have a pituitary scan.

I am currently taking 100mcgs levo and 10 mcgs T3. I am by no means levelled off yet and still get horrific adrenaline surges in the night if I over do it.

But remember I have NO TSH to signal for back up troops so when all the T4 has gone it has truly GONE!!!

Your bloods would also suggest this and that is why your getting these surges.

Central hypothyroidism is a bit more complicated and the symptoms can be far more severe.

I'm not a the way!!!xx


If you have central hypothyroidism, do you have to take T3 along with T4?


Hi Ali,

No you don't have to take T3 too but I was a painfully slow converter and they seemed to be able to get T3 into me quicker than T4. It was necessary so that I could go back to work. When I raise my T4 I can only do it by 12.5 mcgs every 4/5 weeks, which is a vast improvement on 6.25 every 6 weeks which is what is was initially. Dose increases any larger than that had horrific side effects.

13 months on I have now hit 100mcgs which is a minor miracle but am still raising slowly. I should be about levelled off by the summer!


1 like

I didn't get any side effects going from 100 mcg to 150 mcg , to be honest, I was scared to try it but I did despite my GP warning me not to add any more. I didn't get benefit either having my T4 at 24 (10-28), I came back to 100 mcg.

With Levo, I got something like 55% improvement in my symptoms, I still feel something is missing, may be T3!

I also want to do well in my job! so tired!!

Thanks Joesmum


Have a read of Wisons syndrome on the net, it can help with blood sugar, fatigue depressing and many other health problems. I'm just starting on the Wilsons protocol so not cured yet but I hope it is the answer. It has been a bit difficult to get my doctor to understand, I printed out and high lighted pages from the Wilsons web site. My Doctor openly says he doesn't know much about thyroid, he is going to read this and I see him tomorrow. Also as I need to raise my dose, so don't want to run out, he wanted me to stay on 2.5 mcg but I need to keep increasing depending on my temps and symptoms to a max of 180mcg per day then ween of and start a new cycle until my temps are normal or optimal. For me this battle started 12 months ago with doctors they are cautious to the point they rarely fix anyone with fatigue, depression and lethargy. Fatigue is the number one complaint a doctor gets this is how you fix it, well hopefully anyway. I have read many patient stories on people cured with Wilsons protocol.

I hope this helps you and any advise or ideas welcome from me


I take NDT and found taking a small dose in the evening stopped this happening for me. Not sure how this would work with Levo but have heard some people take it at night though I am sure others on here are more knowledgeable about that. I sympathise as it is horrible.


What is NDT?


Natural Dessicated Thyroid eg Armour Thyroid to name but one. I see below others have suggested some things to try with your T4. I take my first dose of Armour at 4.30am and last at 5pm which seems to have more or less resolved the problem for me. It sometimes returns if I have a particularly busy day and feel I have 'run out' at bed time.


Could you try splitting your dose of T4 and take half in the morning and half at night.

I actually take T3 and take 10mcg around 2 - 3 a.m. Worth a try with the split dose.


a good idea, I think I tried it but will consider another trial! 2-3am! sounds like a perfect time to get T3!!


Worth a try! Fingers crossed it works this time.


How did you reach to 2-3AM time to take your T3?


It's the time that T3 is at it's lowest and perfect for me as I always wake around that time. Get back to sleep a short while after taking it, half an hour or so.


after researching, I found that T3 is at its highest after mid-night?


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