Thyroid UK
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My body Cycles between Good Times and Bad Times

I go through cycles of good times "warm, calm, sleepy, sharp" and bad times "cold, anxious, alert-insomnia, fogy" This cycle takes around a week and mostly the bad side last longer.

I couldn't find out the cause by consulting doctors. I think it is related to thyroid or adrenals which needs time to recharge and pump adrenaline all over my body. By the way I have low cortisol at night.

I have central hypothyroidism (TSH is always suppressed) and I take levo 100 mcg and I tried to increase it but didn't help to rise T4/T3 to the upper level in the range.

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'I tried to increase it but didn't help to rise T4/T3 to the upper level in the range.'

That sounds like you have an absorption problem. How do you take your levo? On an empty stomach, leaving one hour before eating or drinking anything but water? Are you taking any other form of medication? Have you had your vit D, vit B12, folate and ferritin tested?

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Hi greygoose (:

I meant I did take more levo (150 mcg) to rise T4/T3 and I was successful and I didn't gain any benefit by having T4/T3 in the upper range. So I went back 100 mcg and now T4/T3 in mid-range. I take it on empty stomach and wait ~1 hour.

Vit D is low and I was working on rising it too, I was also successful in rising it to normal range (above 30) however stopped as I have difficulty taking medications or supplements; whenever take Vit D I will enter into pee/thirst many times and cannot sleep. Vit D might help but not the main issue. I dd also rise B12, didn't help.

I don't know what else can I do. I'm thinking trying NDT and working to source it.

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Well, perhaps you didn't give it long enough. Nothing happens instantly, it all takes time.

You need to have your vit D, vit B12, folate and ferritin all optimal, and keep them optimal. Then raise your levo slowly until your Frees are in a place you feel comfortable with. If you then decide it's not helping and lower your dose again, it never will help.

But talking in a vacuum isn't helpful, either. Can you give us some numbers (and ranges!). What were your results when you were on 150 mcg, and what are your numbers now? Just saying 'mid-range', isn't helpful. :)

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I will get the latest tonight and post them along with historical numbers when my Vit D and B12 were tested. So you assume that thyroid is the cause not adrenals?

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"I go through cycles of good times 'warm, calm, sleepy, sharp' and bad times 'cold, anxious, alert-insomnia, fogy' This cycle takes around a week and mostly the bad side last longer. "

1. When you say sleepy, does that mean tired all day, or just sleeping well?

2. Does the goode side come on a partiuclar day of the week or at a particular time in your shift pattern?

3. You said you have low Cortisol at night, what are the levels like for each time it was tested. What method was used - spital or blood draws. Give the results of any tests you can please.

4. If you have 'central hyptohyroidism' then I would very much like to know what your ACTH is like if its been tested.

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Hi leoopard,

1. Both sleeping well but also stay tired and sleepy the rest of the day. I used to think it is a good thing because I can sleep much better then drink lots of coffee to stay awake and function. In the other days I wake up with something like adrenaline surge after 4 hours of sleep and cannot go back to sleep.

2. It is not particular day of the week it is pattern not associated with any lifestyle factor such as food or habits. It happens in my vacation with no change.

3. Cortisol:

Morning (blood)

7.2 ng/ml range (4.45-22.7) (10:30am)

Night 8:00pm (Blood) 1.46 ng/ml range (1.66-14)

Cortisol (saliva)

(mid-night): <.55 ng/ml (reference is up to 2.1 ng/ml).

4. ACTH was done only once and it was afternoon 1:30pm:

30 ng/ml (normal range 10-48) cortisol was not taken at that time.

Also, I forgot to mention that I start to feel well afternoon everyday and best at night.

I hope you can give some insights.

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Okay, then you have an Adrenal issue (I suspected as much). ACTH and morning Cortisol really should have been done much earlier (Closer to waking time), wasn it done fasting? Your Thyroxine is likely to be exacerbating this adrenal issue.

I was trying to find out whether your symptoms were better after rest. From what you say it sounds like your cycle has no pattern, not fixed days, as well as no link shifts/rest?

Are you on Hyrdocortisone normally?

On an anxious, foggy day I would like to do at least one of:

1. Get Genova to do four spital samples in one bad day with all your medications normal (though take samples BEFORE any meds) make sure you follow the collection intructions exactly.

2. Get yourself a blood glucose meter and take readings on waking, before each meal, and before bed.

Option 1 wil be a little more costly but better by far.

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"ACTH and morning Cortisol really should have been done much earlier (Closer to waking time), wasn it done fasting? "

Yes the morning tests I was fasting. I have one cortisol done earlier at 8:00am and it is the highest I have ever seen it was 13 ng/mol. It will be difficult to take a sample at 4:00am unless I go for private spital test.

"Your Thyroxine is likely to be exacerbating this adrenal issue."

I don't see that. I felt better after starting levo 3 years ago. I have less frequent bad days. Symptoms improved in general I cannot imagine not taking levo!

"Are you on Hyrdocortisone normally?"

No. The only medication available here is predinsolone and I tried it; I thought it will help me, it didn't and I stopped it. I still think Hyrdocortisone/predinsolone should benefit me, I don't understand why it didn't. I took 5 mg of predinsolone for a week then stopped.

"On an anxious, foggy day I would like to do at least one of:

1. Get Genova to do four spital samples in one bad day with all your medications normal (though take samples BEFORE any meds) make sure you follow the collection intructions exactly."

It will be interesting to me to see such graph. I need to research it and see if possible to do it as I'm in middle east and will need to mail it overseas.

"2. Get yourself a blood glucose meter and take readings on waking, before each meal, and before bed."

I used to do blood glucose. All sample looked normal and in the low side. By the way, One doctor did GTT (drink glucose while fasting then measure blood glucose) the doctor diagnosed me with hypoglycemia. My glucose reached 3 mmol/L (54 mg/dl) after 3 hours. Some other doctors said that is normal and even normal people will get similar results.

If you think option 2 is useful I can do it while researching option 1.

Thanks you so much.

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