Thyroid UK
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Shaky and trembly in the morning, anyone else?

Having massive problems getting endo or GPs to believe there is anything wrong with me other than 'leftover' symptoms from being hyper earlier in the year and then being made really hypo on Carbimazole way back in March/April. I started feeling very ill again in August, all of a sudden, within five minutes, all the energy drained out of me and I've never felt right again since. My current thyroid bloods are 'normal' with TSH at 1.56, free T4 at 17.6 (12-22) and free T3 4.6 (3.1-6.8). I am not on any medication.

I wake up every morning feeling weak and shaky and trembly. Like incredibly bad low blood sugar. Does anyone else with a thyroid problem get this? I ask so as to see if I'm still dealing with a thyroid issue or whether I should be looking at adrenal problems.

Sorry no blood results to post yet, I will get them from the doctor's surgery. I am told recent morning cortisol is 'normal' and 24 hour urine metanephrines are 'normal' and diabetes check 'normal'. Now I'm getting the mutterings about 'anxiety' which is offensive, especially given how they threw that at me several times last year and were completely wrong.

But does anyone else get really bad shaky trembly feelings in the morning and if so, would you say they were a thyroid symptom or related adrenal symptom? Thanks.

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Other patients report this and i think it is more adrenal / blood sugar.

Do you know if you have hashimotoes disease ? You would have some thyroid antibody tests done in the past to confirm this. Quite often hashi's patients can get this issue.

Someone who has this going on has found waking in the middle of the night to eat really helps. I think you set your alarm for say 4am and have a snack at the side of the bed and this seems to really help.

If you have been through hyper/hypo it is often an issue with the adrenal system. Your body is going into fight mode and the thyroid reacts accordingly. Hence you go hyper. They treat the thyroid, but it is really the adrenal system which needs help.

Thyroid is made in the first part of the night and in the second part we make cortisol. The two hormones work together and so match each other closely in production. If you are low in thyroid, adrenal will be lower as well. Being in balance is the key to good health.

Your bloods do look ok, but there is something going on.

Another thing to look at may be the early morning T3 usage routine. This is where you use a small amount of T3 at around 4am to specifically boost adrenal output. It maybe you just need a small amount. I use 3mcg T3 which is 1/8th of a 25mcg tablet. It really makes a difference.

There are many protocols to look into, so it is often a case of trying some to see what reactions you get.

I would try the food one first because it is simple and if it helps then you know it will be related to improving the sugar / cortisol area. See how this goes and then maybe look at some stronger adrenal support. After that you may need to look at some thyroid hormones.

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Thank you Marsaday! You have given me lots to think about. Yes i am positive for TPO antibodies which I understand means Hashimoto's. So that fits in. I am worried if it's my adrenals making me feel so bad. Can you have adrenal problems without full blown Addison's Disease? So does T3 aid the adrenals, not stress them? Thanks again.

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Hi there just to say i still am being treated fir hyperthyroid and i have hashis, i still get the trembles slightly in the morning but not has bad since being on carbi but i also think it is also connected with hashis aswell. Mine disappear as soon as im up and walking around but a goid suggestion from marsady its worth trying the little snack suggestion it may do the trick.x😊

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Thanks Rmichelle! That's really interesting that you also have Hashi's and have had this, thanks for sharing your experience. I will try the night time snack first (though I'm a bit concerned I won't fall back to sleep and then I generally feel awful for the day).

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Ok so hashis is the cause really. The adrenal system struggles to cope with the erratic thyroid output.

Yes you can have adrenal issues without it fully collapsing or going into over drive.

T3 and cortisol work together. So t3 will help generate cortisol and cortisol will use the t3. However when out of balance the system struggles. So if you provide too much t3 thecortisol will get used up to fast. This is why we try small amounts first and try and let the body build naturally. If I use much t3 I become hypo so I only use 3 mcg am and sometimes 3 in the afternoon. If I go over I become hypo probably because my body doesn't have the cortisol making abilities needed. I am generally well though so all is ok.

This cortisol/ thyroid relationship is the key to good health and with hashis it is harder to get it right.

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Thanks very much again for your reply. Well it wouldn't surprise me if my adrenals might be struggling then: thyroid numbers have been all over the place: first hyper (free T4 of 41) then hypo (down to 5 on inappropriate Carbimazole). Struggled back up to about 13, then - at the same time I got ill - the free T4 shot up to 19. Latest was 17. My poor adrenals.

I am gluten free and eating pretty healthily. I will try the early snack (though I worry about failing to go back to sleep). Maybe I do need the small dose of T3 already though as I feel pretty ill. But that is going to be difficult to get from a GP or endo when my thyroid bloods are now in the 'normal' range, even if they are up and down. I suppose I could order it myself and go solo, which will alienate me from the medics and I'm a bit scared about that. Perhaps it's time to find a thyroid and adrenal-friendly private endo. I think there is someone who has a list of names on here isn't there?

Thanks for the reassurance that the adrenals don't have to fall to pieces, though i am getting increasingly anxious the longer these wretched doctors leave me feeling like this that I will suddenly fall off another cliff adrenal-wise.

I am glad you are feeling well in general. I like to read that as it gives me hope.

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Have you had vitamin D, folate, ferritin and B12 checked. If these are too low you can't use thyroid hormones. Your bloods can appear fine, but actually you are hypo. These symptoms definitely sound hypo.

If you can't get full thyroid and vitamin testing from GP

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw or

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

Healing gut is key too.

Bone broth, probiotics, fermented foods like kefir.

Daily vitamin C would support your adrenals

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Hi SlowDragon, So sorry for my late reply. Thank you for yours, it's very helpful. Thank you for the test ordering links. The GP surgery adds the odd test in here and there alongside my thyroid ones, sometimes they will, sometimes they won't when I ask. So I think I might order a panel of them as I'm fed up of going begging at the GP and only have one or two useful ones coming back. I think I might also order a 24 hour salivary cortisol test

Ferritin was recently 95 ug/L (30-470). My iron has always been on the low side ever since pregnancy (or is iron different?) Having a daily supplement but maybe I need more - will have to find out what a safe loading dose (is that the phrase?) might be.

B12 in March was 641 (180-900)

VitD in March was low, around 40 I recall but I have had plenty of sun since then and now supplementing about 2000iU a day.

Folate in March was 7.3 (2.5-19.5)

Thanks again.

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Personally I would try strictly gluten free diet

Presumably you had Graves' disease?

chriskresser.com/the-gluten...

Supplementing selenium may help improve conversion

Ferritin looks low, should be half way through range. Eating liver once a week should help boost

Yes I'm not sure about differences between iron and ferritin either

Vitamin D, I would recheck to see how much 2000iu has helped

Vitamindtest.org.uk £28 postal kit

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Thank you! I did have a diagnosis of Graves but it was changed to 'thyroiditis', type not specified, because after only three weeks on Carbimazole I plummeted from hyper to hypo on that and I haven't gone over the top of normal since. i also had high TPO antibodies so presume it is Hashi's. I do wonder if that medically induced hypo crash put such a strain on my adrenals (thanks, doctors) that they crashed in August which is when I started feeling terrible.

I have been gluten free since coming on this board and have been supplementing with selenium or brazil nuts also thanks to this board. Yes perhaps it is time to work on that ferritin. And maybe that folate. I will ask GPs once more to repeat Vit D.

I am also looking into Wilson's temperature syndrome. I am starting to realise I feel unwell when I get cold. I am not sweating very much. Also in the evenings I sometimes get hot/cold chills where I find it very hard to get my temperature right. On Dr Wilson's website, he says he treats with T3, which is what Marsaday upthread takes. I have had amazing temporary healing with acupuncture recently but it only lasts for a while (though stretching out a bit now) but that is expensive and I can't afford it every day!

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