Thyroid UK
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I'm always hot and sweaty - It seems to be no thyroid issue

I am a Male, 24, 75 kg.

Whenever I am outside I get hot and sweaty. I am not out of breath easily because I go to the gym. I'm just HOT. This has been an issue since I was a child. I never wore jackets in the winter. I am most comfortable around 16-18°C. Everything above 21°C is really uncomfortably hot for me. My metabolism seems to be slow. I was always skinny and barely had any appetite. I feel weak and tired most of the time. Also, I've been suffering from depression for the past three years. But it is not the cause of the sweating. I keep thinking: maybe what causes the sweating (out of balance hormones) also causes the depression?

Recent thyroid blood test shows:

FT3: 3.5pg/ml (normal 2.0-4.2)

FT4 1.2ng/dl (normal 0.8-1.7)

TSH 3.18mlU/l (normal 0.35-4.50)

TPO < 1.0 (normal < 5.6) (Thyroperoxidase Antibodies)

So it seems like my thyroid is actually slower than usual which should make me cold, right? Either way, I have started taking L-Thyroxin 25mg to lower the TSH.

I don't get it. I'm grateful for any kind of advice of what to do next.

Current medication:

Amineurin 25mg

Bupropion 150mg

Cetirizin 20mg

4 Replies
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With a TSH over 3 you would be classed as hypothyroid by doctors in some countries and would receive proper treatment. A dose of 25mcg is unlikely to make you well, you will need your dose increasing.

Which country are you from?

When the body has too little thyroid hormone for optimal functioning then one way the body attempts to compensate is by increasing levels of the stress hormones, cortisol and adrenaline (called epinephrine in the US), both of which are produced by the adrenal glands. If you are sweating a lot then the chances are you have high levels of these two hormones.

Cortisol comes in two forms :

Bound cortisol - the cortisol is attached to transport proteins which allow the cortisol to be carried around in the bloodstream. For the body to use this it has to be detached from its transport proteins first.

Unbound cortisol - this is cortisol in the form that the body can use immediately.

For testing purposes, either blood or saliva can be used :

Blood - contains bound and unbound cortisol, and standard blood tests measure the total of the two.

Saliva - contains unbound cortisol only.

Cortisol production follows a circadian rhythm. Maximum output occurs at around 7am - 9am. Minimum output occurs at around bedtime. Output stays low during the night until about 3am - 4am when the level start to rise towards maximum again.

alpineintegratedmedicineblo...

The best test of cortisol production you can do is a saliva test where you produce a spit sample at 4 - 6 specified times throughout the day.

These are the kind of graphs you might expect from such testing :

evewomensmedical.com/antiag...

hypothyroidmom.com/wp-conte...

drsaulmarcus.com/img/ASI_hi...

If you are lucky then treating your hypothyroidism will cause your cortisol and adrenaline production to return to normal by themselves. You're young, and your hypothyroidism isn't yet severe, so you have a good chance I would think. But if you have been hypothyroid and untreated all your life or for a substantial chunk of your life then your cortisol might not return to optimal by itself and you would need to treat the problem.

One thing that will help is getting nutrients optimised - the basics are iron, ferritin, and other iron-related levels, vitamin B12, folate, vitamin D. If you got these tested, and typed the results into a new post we could tell you how to supplement to get them optimised.

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Which country are you from? I am from Germany.

I agree, 25mg is a small dose. I will talk to my GP and we'll probably raise the dosage soon.

If you are sweating a lot then the chances are you have high levels of these two hormones.

That's very interesting. Would this fit some of my other symptoms aswell? Ever since I was a child I had trouble sleeping at night. While still in school I would lay awake in bed until 2-3am. For some reason, I am tired throughout the day and wide awake at evening to night. Also, I've been super nervous in the past years. When I was child, I had some "tics" (like chewing fingernails) that calmed me down. I've stopped those tics, but my hands are still shaky and I feel very nervous.

If you got these tested, and typed the results into a new post we could tell you how to supplement to get them optimised.

I have a slight iron deficiency (69ug/dl, normal 70-180) and recently started taking a supplement. I also take B12 (5000ug) and Vit-D supplements (4000 IU) since I am very pale and do not get enough Vit-D from the sun.

Another issue I have are MAJOR dark circles under the eyes. No bag, just a dark bit of skin even though I am pale white. I just to think it's due to a messed up sleep schedule, but I get my 8-9 hours per night so that's out. Any deficiencies that cause something like that?

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Yes, incorrect levels of cortisol (too low or too high), and excessive production of adrenaline will cause anxiety, and a poor response to stress. They will also often cause insomnia - difficulties in getting to sleep at all or waking up at times when you should be asleep.

For labs that do testing for patients in Germany without a doctor, search for the reference to "Germany" on this page :

stopthethyroidmadness.com/r...

For ideal levels of iron related measures :

rt3-adrenals.org/Iron_test_...

I can't tell if that result you've given is for serum iron or ferritin (iron stores).

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Sorry, I don't know anything about the causes of dark circles under the eyes, but I'm sure they've been mentioned on this site many times. The search function on this site is dreadful, but you might find something useful if you search for "circles"

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