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Thyroid UK
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From hypo to hyper?

Hi I would appreciate any advise please.

I had a blood test one month ago for TSH

Which was 1.534 range 0.550-4.780

I was feeling pretty rubbish, really tired, quite depressed, tingling in hands, low' pulse rate, dizziness and just no energy, so I persuaded the endocrinologist to increase my dose of levo from 62.5g to 75g.

Now 4 weeks later I'm having really hot sweats, I smell! I can't sleep even though I'm exhausted - I wake at around 4 ever night and I have lost 3kg ( weight i don't want to lose)

Do you think I should cut back the levo to 62.5g again? I think I was hyper last year ( chronic night sweats) until I had a horrible incident of vertigo and vomiting after which I went hypo.

I don't see the doctor again until the end of September but I feel confused as to what is going on.

17 Replies

Sounds to me like you have Hashi's. Have your antibodies been tested?

You cannot jump from hypo to hyper and back again. It's a physical impossibility. You can, on the other hand, be over-medicated. But, that sounds very unlikely on 62.5 mcg levo! That's a tiny dose - not much more than a starter dose. And, four weeks is not long enough for the increase in dose to have taken effect.

However, if you have high antibodies, you can have 'hyper' swings - aka Hashi's flares - where the dying cells dump their hormone into the blood, temporarily increasing blood levels of thyroid hormone. Did you have a blood test when you felt 'hyper' last year? Were you on the same dose - 62.5 mcg?


Thanks for replying- I wrote a long response last night but hadn't hit the reply button🙄. I would be grateful if you could advise me. I took my 75g this morning- should I keep up with this - is the sweating and hot flushes a hyper swing? Does this mean my TSH would be high at the moment?


If it were a hyper swing, your TSH would be very low at the moment. Sweating and hot flushes are non-specific. They could be cause by many things - a reaction to something you ate, for example. Very often, people don't have hyper symptoms when they have a hyper swing. Myself, all I felt was exceptionally well! Suddenly, I lost weight, my hair began to grow very fast - my swings usually lasted a long time, only of course, I didn't know they were hyper swings because I hadn't been diagnosed. Just, suddenly, I had plenty of energy, and felt good.

You would have to have a blood test to be sure that it was a swing.


Have you been tested for autoimmune thryoid antibodies? Have a look at your blood tests. They would be TPO and TgAb otherwise known as Thyroid peroxidase antibodies and Thyroglobulin antibodies.


Sorry I'm having a techno melt down - brain not functioning this morning! I had replied to your question last night but hadn't pressed reply. Any advise you have would be much appreciated- having mad sweats and hot flushes this morning after little sleep last night..


I had a problem for a couple of years - since 2014 - light irregular periods, chronic sweats( very unusual for me as I have never sweated and it smells), not munch energy, depressed, and mood swings, hair loss and feeling rubbish. I saw a doctor who said it was early menopause- I was 45yrs. By the way I still am not menopausal but at the time I assumed she was right.

February 2017 I had a horrible vertigo episode - I was sick for four hours every time I moved a muscle - in bed for 3 days and then ill for 10days. I saw a doctor who ran some tests- everything pretty in range except for TSH which was 12.7 range 0.550-4.780- I was then t4 tested which was 10.36 range 11.50-22.70 and TPO which was 433.3. <60. Since then referred to endocrinologist who started me on 25mg in February with gradual increases now and I'm on 75mg as mentioned. It's just after the vertigo incident I had no more sweats but was freezing cold all the time and basically lay in the sofa all afternoon and terrible brain fog. It was awful, since being on the medication I have felt gradually better although I had a 20 day blip in June when I felt really rubbish again. Anyway I just assumed because I have started the sweating again like last year, I thought I had flipped to hyper I didn't realize you couldn't do that....


When you respond to a reply you have to press the green reply button otherwise they're not notified. If more than one you can also add in the others by putting an @ before their name and a list will pop up below and choose the one you want.

i.e. Nanaedake greygoose.


Ah thanks for that - will try again!


I've done it for you but in future you will be able to. :)


Thank you!

1 like

Thank you! Second time round I remembered to hit the reply 😃


A lot of doctors don't realise you can't do that! lol They're always talking about 'flipping over into hyper'.

Just sweating heavily doesn't automatically mean that you have too much thyroid hormone in your system. It's too vague a symptom to base a diagnosis on. You would need to have blood tests done at the time, to see.

Your FT4 was very low, so it was no wonder you felt ill. But your doctor is over cautious. He should have started you on 50 mcg - unless you are very old, very young, or have a heart condition. He should also be increasing your dose by 25 mcg at a time, not these fiddling little doses he's dishing out, like a medical Scrooge!

And, your antibodies were high. So, you do have Hashi's, as I suspected. So, there are things you can do to help yourself. You could try a 100% gluten-free diet. This often makes people feel a lot better, because their bodies are reacting to the gluten and making them feel bad. It can also lower antibodies, because it's possible that the antibodies are causing symptoms, themselves.

You can also try taking selenium. Selenium is known to reduce antibodies, and can also help with conversion - we don't know how well you convert because we haven't seen an FT3 test. When did you have your last blood test? Do you have results for FT4 and FT3? If not, you need to get them.

You also need your nutrients tested : vit D, vit B12, folate, ferritin. These are often low in hypos, and need to be optimal for your body to be able to use thyroid hormone.

I think your problem at the moment is likely to be under-medication - you are still hypo. So, try to stick with the 75 mcg dose. You could try taking 1000 mg vit C with it, to help absorption. You probably have low stomach acid, and the vit C helps with that. :)


Thank you so much for your informative reply. I shall stick with the 75mg and try and ride the sweats and hot flushes- I am absolutely boiling at the moment!!!

I haven't had f3 tested ever and f4 not since February. I'm looking for a new endocrinologist who knows something about hashimoto's - if anyone knows of one near Montpellier that would be amazing!

In the meantime i am not gluten free at the moment - but contemplating going that way and I have been 2 organic Brazil nuts a day (they are from Brazil) to help with selenium. Will start on the vitamin c as suggested. I had vitamin tests done and I have a doctors appointment to go through them but I did a previous post in my vit results which clutter helpfully answered.

Can I just ask as I am trying to get grips with this thing - if I'm having a hashi flare would my TSH result read high or low?


My undertanding is that if you were having a Hashi flare your TSH would be lower than usual. So, for example, if your TSH is usually 1.0 it might go down to 0.01 but more importantly your FT3 would be high and likely over range. Maybe someone else can verify this?

Have you checked your vitamin B12 and folate? Some people say they've had hot sweats with vitamin B12 deficiency although I don't know if it's a common symptom or not.


Hi, thanks for replying - i did have vitamin b12 checked and it was 310 - range 182-625). So I'm in range... it's just weird cos it's the last three/four days that I've been having these hot flushes and just not sleeping - feeling sort of wired...


Well, check it out on the HealthUnlocked Pernicious Anaemia website because you can be deficient anywhere in range and it might help to be nearer the top of the range but they're the experts.

You might also need to check vitamin D, folate and ferritin.


Ok will do thanks


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