Thyroid UK
84,229 members99,229 posts

OAT ovarian thyroid adrenal axis?

I'm having a bit of a nightmare and not sure what to do. So thank you for any suggestions.

I've been on levothyroxine 25mcg between end of Jan and end of March. Then 50mcg between end of March and now. This after about 25 years of hypothyroid symptoms but "normal" levels, so untreated till now. I'm nearly 40 now.

Levo has helped clear some brain fog but since being on the 50mcg particularly my periods have gone nuts :( late plus mega awful pms bloating and very painful breasts... :( spots too... or boils rather!

Still exhausted. Anger and anxiety up, even when not pms.

I'm feeling abandoned by my new dr (3rd different surgery in 6 months....) :(

I've read about the OAT axis and feel I'm causing more imbalance by taking levo!! Which is heartbreaking as I just want to feel better. I'm so sick of being so exhausted I can't live even close to a normal life.

I've read that to repair the ovarian, thyroid adrenal axis, it's best to just heal the adrenals. That thyroid meds increase metabolism that then puts more strain on adrenals if they were already struggling. And pushing the thyroid point on the axis with thyroid meds may upset the ovarian part of the balance if there are issues there (eg increasing oestrogen dominance). Given I still feel awful, and my periods are driving me crazy now, is levo making me worse?

My mum and I are extremely similar in our health. She was diagnosed hypothyroid when she was around 40 and not that long after starting levo (within a few years?) She ended up having a hysterectomy as her ovarian part of the axis worsened significantly it seems..?. So if I continue on levo could I end up in this direction? My poor mum has never felt right, never got to the bottom of her/our illness. Perhaps adrenal fatigue is at the root?

Anyone got any suggestions?

Thanks xx

3 Replies

I get what you're saying. But - have you considered that the reason the axis was tipped is more to do with continued undermedication (both for you and your mother)? 50mcg levo is a starter dose. It is a very low dose. I would lay money on you being undermedicated. When you first start levo, it does indeed mess up the status quo - but only because your body was, if you like, forced into a dormant position by the untreated hypothyroidism.

Do you know what your blood test results are on that dose? Would be worth getting them from your doctor (you have a right to know). Also, when you've been under active for a while, you tend to be low in iron, B12 and Vit D. Everything works in harmony but unfortunately many doctors don't consider bodies from a holistic viewpoint.

Start with your blood test results. It's far better to be tested for hypothyroidism than not treated - untreated and undertreated hypothyroidism has huge effects on health. If you consider that thyroid hormone is needed for every cell in the body, you can see how important it is when the body doesn't have enough.


Thank you Jazzw

I really don't know what to think... just I can't stand another pmt time like this! It just goes on and on and is soooo nasty.

Here are my most recent test results after being on 25mcg, just before the increase to 50mcg. This test result was a month ago.

TSH 2.8 mu/L (range 0.4-5.5)

Free T4: 16.1 pmol/L (range 11.5-22.7)

B12: 390 ng/L (range 210-910)

Folate 11 ug/L (range 5.4-24)

Ferritin 42 ug/L (range 10-307)

Vit D 62.6 nmol/L (range 50-150 adequate, below 50 not enough)

Before these test results, my TSH was 7.0 mu/L at the end of January this year, before i started any Levothyroxine or any thyroid treatment ever. And free T4 was 14.9 pmol/L end of January too.

My B12, vit D and folate are steadily rising. I used to be bottoming out in B12 and vit D but in range, and deficient in folate apparently for 7 years! So this is good progress over the space of 3 months.

But my ferritin is Stuck! I had a test for this in November and it was 50 ug/L. I supplemented a little bit and retested end of January and my ferritin went Down not up! Unlike my other vits. It went down to 42 ug/L where it has stayed since then, despite upping my supplements and dietary iron... and yes I always have vitamin C with iron. So I'm confused on this.

For reference I'm Mega sensitive to pretty much any medication, supplements, herbs anything really. I saw Dr Peatfield in December and he suggested my adrenals are the root of the problem. I started on an adrenal glandular in December but can only take a quarter of a normal dose otherwise my brain goes hyper. I tried natural desiccated thyroid in January and this also sent my brain hyper, even just a crumb of it. I then read on Stop The Thyroid Madness that this hyper brain reaction could be a reaction to T3, because of low iron and/or adrenal problems. I think I have both these issues. It's like crazy head speedy hyper brain, but still physically exhausted. This reaction is only triggered by a few things. Too much vitamin C or any co q10 does it too.

I also have a lot of trouble sleeping. I sleep a max of 6 hrs at night then try for extra during the day. This has been going on a long time and have only just realised this could be the drain on my adrenals.

Thank you for your time


I feel for you x When you've been untreated for a while, everything goes a bit wrong! When you tried to raise your ferritin levels, what did you try? The amount of iron in multivits etc won't be enough - it'll need hitting with something more. Your B12 is still much too low - it should be at least 500. That folate could be higher too.

When did your doctor ask to see you again - or didn't he/she? When finding your levo dose, you should be having blood tests every 6-8 weeks, so you'll ideally be having your bloods tested again in the next month. Most find they don't feel better on levo until their TSH is below 1.0 and their FT4 is up at the top of the range (so with your range, much nearer 22). TSH becomes a bit useless once you're medicated - it's the FT4 that starts to provide more clues (and if you can get it FT3 - that's the test that so many doctors seem to deem irrelevant, yet that's what you need to know - whether you can convert FT4 to FT3. Again, you'll likely feel best with an FT3 at the top of its range).

So, if you haven't got an appointment - make one and get those bloods done again.

I know the PMT thing is awful to have to deal with, but I think you're not going to get far with sorting that until you're on the right dose of thyroid hormone replacement.


You may also like...