Thyroid UK

Thyroid roller coaster hypo but meds make me hyper can’t tollerate small amounts

Hello, I’m new here but have been on the not able to get the right thyroid treatment roller coaster ride for over 20 years. I am hoping to get some answers since all of my doctors end up saying the same thing, “I don’t know what to try next.”

Recent results: On a VERY minimal dose of NP thyroid my TSH was 5.9. Switching to 43mcg compounded T4 only brought it down to 4.6. I still feel extremely hypo with all the symptoms. My reverse T3 was a little high. My doc switch dose to 37.5 mcg T4 with 5 mcg t3 and I couldn’t tollerate it. Massive headaches, face pain, pain up and down my spine. Stopping the headaches and pain are almost gone. Can anyone shed light on why what I need so badly to function makes me sick?

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If your TSH was 5.9 on minimal NP Thyroid, why on earth didn't they increase the NP Thyroid, instead of changing you to something else?

I think, in order to help you, we need some kind of time-line here - how long were you on what? Sounds as if there's been too much chopping and changing going on. And, we need some comprehensive blood test results, with ranges. However, if your doctors have just been dosing by the TSH, then they are never going to find the right dose.

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Hi, it is almost impossible for me to list a comprehensive history because it goes back over 20 years, multiple docs, non of which found the answer. I’ll try to fill in some blanks and answer your questions to add clarity the best I can.

When taking only NP Thyroid, even the tiniest amount (crumb) caused me to have an extreme hyper-like reaction. Headaches, face-eye pain, anxiety, neck and back pain, much higher pulse rate, etc. I had really hoped it would be the magic answer because it was natural and contains no milk (I’m allergic) but no matter how tiny I made the crumb, I still reacted to it ending up with both hypo and hyper symptoms.

The very first endo who diagnosed me said I didn’t convert T4 to t3. Put me on cytomel only 3x a day. I belueve it was 5mcg ea. I felt better. Never terrific. After abt 3 years started having extreme ups and downs like thyroid hormones blasting into my system ramping me up then crashing. Original endo passed away.

New doc added 50mcg of t4 without reducing t3. I felt like a million bucks. For abt 3 months. I was also given small amount of testisterone. This was 2009. Then ended up with such hyper symptoms I ended up in emergency room and that doc said stop all thyroid meds. Said it was toxic.

Next doc said I dont need thyroid meds. All meds stopped. I then struggked for over a year barely beng able to function.

Since then I’ve been on a roller coaster of diff meds that includes compounded combinations made with no dairy fillers, tirosint that caused severe constipation, no thyroid meds at all, and a natural oriented doc who kept upping my dose until I was taking 285 t4 and 35 t3 even though I kept complaining of screaming headaches and neck face pain and anxiety. I couldn’t sleep it hurt so bad. I was exhausted from the pain and aggitation. I lost a tooth from bleading gums. She wanted to increase again and I stopped seeing her.

Fast forward to my latest doc who wanted to be more conservative in her approach. She has been testing all nutrients related to thyroid and helping me take supplements to get them to optimum levels.

We tried boosting nutrients w no meds - with no luck - i felt like the walking dead.

Then we tried NP Thyroid at my insistence but I could not tollerate the smallest amount.

Then we started with t4 only 43mcg. My tsh moved down a little. Reverse t3 went up. So then she changed it to 37.5 t4 with 5mcg t3. This gave me the extreme headaches, face pain, some anxiety (but not as bad as when taking the mega dose before). I recognize it as the same type of pain. I could only handle this for 2 days and stopped. I have now been off meds for 3 days and feel really good today with most of the pain gone. However, I know it won’t last and soon with no meds I won’t be able to think straight, get out of bed in the morning without extreme effort, will be severely depressed, constipated, and all the other hypo symptoms. I’ve been through this sooooo many times!

I do not show hoshimoto’s antibodies. But my doc only ordered one of the tests.

With minimal meds my heart rate was 55. I have low blood pressure. High total cholesterol 260, fasting glucose 71, body temp abt 97.6 I think?

I can copy the exact numbers with ranges for you from my last two tests. Let me know if you want that.

Thank you so much for helping!


It would help if you posted your last nutrient numbers, with ranges. And, of course, your last thyroid labs. And said what exactly you're taking, in the way of nutritional supplements.

Have you ever had your cortisol tested?


I will post them later. Yes, I had cortisol tested 4x in a day via saliva and afternoon number was elevated more than others which were a little high above baseline.

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Last night I took 1/6 of my previous thyroid meds 37.5 t4 with 5mcg T3 because I’ve been without it now long enough to start dragging. I was so tired Saturday I didn’t make it to the pharmacy to get my new prescription. I woke yp in pain with headaches, face pain, neck and shoulder pain, burning sensation along my arms, eyes... The same thing that happens no matter how small of an amiunt I take. But I need it, but I can’t tollerate it...

I was looking at earlier labs from when I was on a much higher dose and the numbers looked more normal. But I remember I was in excrutiating pain and had to stop.

I don’t know what to do. I’ll be picking up my new combo of meds today but I’m afraid to take them. This last time it took abt 3 days for the pain to go away.

This makes me feel like a hypochondriac to keep complaining. My docs just look at me like I’m crazy and say it doesn’t make sense. They’ e never seen this.

I’m going to drink the adrenal coctail and take a hot shower. Eat breakfast... what is this? What can I try? I do think I felt better the 2 days I drank the adrenal coctail.


I really don't know what it is. I've never heard of anyone having such a bad reaction, before. I can only think that you are having a reaction to one of the fillers. The hormone itself wouldn't do that, I'm pretty sure.


It has happened with pretty much e ery thyroid med I’ve tried to take. One doc said, “maybe your heart can’t take the T3.” One pharmascist says, “even if there is some lactose, it wouldn’t effect someone with an allergy because the amount is so small.” Another says, “well I only used vegitarian filler, mostly cellulose. I’m not exactly sure what filler is already in the thyroid hormone when I get it.” When I called the company that makes NatureThroid they said, “we all get our base hormone from the same few places and it has lactose in it before we get it. We don’t add any to it and can’t control the base thyroid fillers.” Ugh!!! This pain I get is similar to the pain I get from eating almonds and not milk anyway. If I get milk my nose starts running and won’t stop. And I feel achey. Not headaches or arm tingling pain. This is so hard to figure out when the experts don’t know.


Can you get liquid thyroxine where you live? That doesn't have any fillers.


I never knew that existed. I’ll ask. On my way to pick up meds now.


Well, it exists in some countries, I don't know if it's universal. Definitely worth asking.


I was told “we don’t have it”. Then I asked because you don’t offer it or because you can’t get it? She said well in all the years I’ve been a pharmasist I’ve never seen it. It doesn’t exist.” Wait, there is more- I specifically asked the head pharmacist Brad who wasn’t there today to split my prescription and give me cytomel for the t3. I took it many years ago and didnt have that pain then and I know it didn’t have lactose monohydrate. When I got there, the t3 was compounded with the same fillers as the t4. I adked fir a detailed list of EVERYTHING in the compounding and was told only Brad can give me what he put in it. So I asked if they could switch tge t3 for cytomel and she says yes. Then I ask to please give me the insert that comes in the package from the manufacturer and was then told, well we don’t actually have the brand name cytomel. We only carry the generic but it is exactly the same. Ugh! I checked the insert and at least there is no lactose monohydrate. I don’t know if the fillers are exactly the same or if any of the others could be causing my sensitivity. At least I know what is in The t3 so I guess that is the first one I will try to take. Pathetic!!!


Not very professional at all! But, don't let them off the hook that easily! Insist on getting the full list of fillers when Brad comes back, so that you can compare.

And, liquid thyroxine most certainly does exist!


She took my email address yesterday and promised to ask Brad to send the list of ingredients. I researched liquid thyroxine and found one this morning Tirosint-SOL, I double checked the ingredients of brand name cytomel and compared to the generic they gave me and the list is different. That woman outright gave me in orrect info on multiple questions and that is NOT ok. I will be telling her and Brad that is not acceptable. If she doesn’t know the answer or is too lazy to check she needs to say so. How in the world can someone with sensitivities and allergies figure this out when pharmacists could care less about the accuracy of info they give out!!! I’m more than a little mad about this.

Btw, I took just half of the generic t3 this morning and no bad reaction and I felt better. Felt so good I created an excel spreadsheet with all the inactive ingredients of my recent meds so I can look for a pattern.


Wow! That's fantastic! I'm so pleased to hear that. Let's hope it lasts!

You are right to be mad at the pharmacist. These people play Russian roulet with our lives! They need to be more responsible. But, I have always found pharmacists here in France, to be a pretty ignorant, irresponsible bunch. Although I know they have to study for many years before qualifying. Can't help wondering what exactly they study, though!

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Ha ha ha! How to be a muppeteer?


Yesterday was day 2 taking t3 only (half of a 5 mcg pill). I still felt sluggish all morning and hadn’t drank my adrenaline cocktail (A drink) yet cause I didn’t know how long I should wait after meds. By about noon I did the A drinktook a vit C 1000 and ate lunch. An hour later I decided to take another half of the t3 (remembering that when I took it over 20 years ago the dose was 5mcg 3x a day. Within about 20 min I felt fantastic and it stayed with me all day. I love how clear my thinking feels. No brain fog! So here is the rest of the story... I went to bed about 12:30 woke up aroun 3:30am unable to get back to sleep. Around 4:30 I got up and washed the dishes, cleaned my stove top, and counters, microwave put a load of laundry in the wash and retouched a piece of art I scanned. I think maybe I needed that extra t3 but took it too late in the day? I didn’t feel anxious just really good with energy. Since I knew I hadn’t gotten enough sleep I took a Holy Basil and went back to bed just as I saw a slight glimmer of sunlight. I slept very soundly until 9:30 when a Happy Thanksgiving text woke me up. Felt a little drowsy and dragged myself to the shower - but here is the good news - I still feel way better than I did just 3 days ago!!!

What are your recommendations of timing my t3 and the A drink? And taking extra vit C? I take vit D with dinner.

Oh another thing, I noticed that I got really hungry yesterday bef dinner. I think I haven’t had much of an appetite being hypo. Ever hear of that?

I only took half a pill this am and feel kinda normal so far.

2.5 mcg seems like so little to be making me feel so much better. Probably haven’t found the exact right dose and timing yet.

I’m excited at the possibilities.


Oh yes, it's bound to have an effect on your appetite. But, that's good!

Well, as I said before, it's usually recommended to take the adrenal cocktail in the evening. It's just that it doesn't suit me, in the evening. But you could try it and see how it goes.

Anyway, that's all very encouraging, isn't it! Let's hope it keeps up!

So, you're on 5 mcg, now, right? Stick with it for at least two weeks before trying to increase again. You don't want to go too quickly. :)


I thought the Adrenal drink was suppose to raise my early morning cortisol that is too low. My 2nd and third were too high. 4th low where it should be. If I take it at night wont it keep me awake?


No, it won't instantly raise your cortisol, but it might help with raising your cortisol the next morning. Takes time to get into your system.


Ok will try that tonight! Thanks!!!!!


You're welcome. :)


LABS (taken abt 2 months after taking minimal amount of NP Thyroid - was having difficulty tollerating just a small crumb of smallest dose)

eGFR 64. Ref > OR = 60

Sodium 141 ref 135-146 mmol/L

Potassium 4.7 ref 3.5-5.3 mmol/L

Chloride 102 ref 98-110 mmol/L

Carbon Dioxide 25 ref 20-31 mmol/L

Calcium 10.7 ref 8.6-10.4 mg/dL (?)

Doc did follow upon calcium

Protein total 7.2 ref 6.1-8.1 g/dL

Albumin 4.6 ref 3.6-5.1 g/dL

Globulin 2.6 ref 1.9-3.7 g/dL (calc)

Albumin/Glibulin ratio 1.8 ref 1.0-2.5 (calc)

Bilirubin total 0.6 ref 0.2-1.2 mg/dL

Alkaline Phosphatase 92 ref ref 33_130 U/L

AST 20 ref 10-35 U/L

ALT 17 ref 6-29 U/L

TSH 5.94 ref .40-4.50 U/L

T3 Reverse LC/MS/MS 22 ref 8-25 ng/dL

Iodine serum plasma 108 ref 52-109 mcg/L

(Was taking suppliment doc asked me to stop. I noticed I felt better taking iodine.)

Selenium 155 ref 63-160 mcg/L

(Was taking suppliment)

HS CRP 1.6 ref < 1.0 low risk, 1-3 average risk, 3.1-10 high risk

Vit D ,25-OH, total, IA 54 ref 30-100 ng/mL

(D was low around 20 previously. Have been taking 5,000 mcg daily)

T4, free 1.2 ref 0.8-1.8 ng/dL

T3, free 2.3 ref 2.3-4.2 pg/mL

Thyroid peroxidase antibodies 2 ref < 9 IU/mL

Vit B12 756 ref 200-1100 pg/mL

(Have been supplimenting this)

Zinc 69 ref 63-130 mcg/dL

Cholesterol total 267 ref < 200 mg/dL

HDL 82 ref > 50 mg/dL

Triglicerides 93 < 150 mg/dL

LDL 165 ref < 100

Chol/HDLC ratio 3.3 < 5.0 (calc)

LDL/HDL ratio 2.0 ref < 2.34 av risk

Non HDL cholesterol 185 ref <130 mg/dL (calc)

Glucose fasting 71 ref 65-99 mg/dL

Urea nitrogen 12 ref 7-25 mg/dL

Creatine 0.97 ref 0.50 - 1.05 mg/dL

After this test my doc switched me to 43 mcg of T4 only. I don’t have a copy of those labs yet and only saw them at my docs. Will try to get them tomorrow.

Thank you.


I can't see a folate result in there. Not a good thing to supplement your B12 without knowing your folate level.

Supplementing iodine was a bad thing to do. You may have felt better, but it was because the iodine was stimulating your thyroid to make more hormone, which wouldn't have gone on long before you crashed. Stimulating a sick gland just causes it to burn out faster.

Your TSH was much too high, there, you were under-medicated and converting badly. Stupid of your doctor to think that T4 only was the answer! I would imagine your FT3 is under-range, by now. Which is why your cholesterol is so high.

Your zinc is very low - have you been supplementing that?

So, what is the doctor doing about your high cortisol?


Found Folate with older labs:


Vit B-12 497 ref 200 - 1100 pg/mL

Folate serum > 24 ref normal > 5.4


Vit B12 458

Folate serum 18.8

(Same lab and ref ranges)


Vit B12 438


Vit B12 756


Vit B12 644

QUESTION: should folate always be tested w B12? What does it mean?


Previously my doc also tested iron/ferritin (I can look for this if you want it.) and did the cortisol saliva test.


Iron levels are important, yes.


I will post iron levels when I get them.



Dec 2016

Iron Bind Cap (TIBC) 354 ug/dL ref 250-450

UIBC 273 ug/dL 131-425

Iron, serum 81 ug/dL ref 27-159

Iron saturation 23% ref 15-55

Reverse T3, serum 20.4 ng/dL ref 9.2 - 24.1

Ferritin, serum 124 ng/mL ref 15-150

Triiodothyronine, Free, serum 2.8 pg/mL ref 2.0 - 4.4


OK, so your iron/ferritin appears to be good.

Reverse T3 is pretty irrelevant.

FT3 is much too low. It's well below mid-range, when most people need it up the top of the range to feel well.

Have you ever considered trying T3 only?


I have just started taking zinc. Stopped the iodine and noticed my horse sounding voice came back. Staying away from it though. I just barely got access to lab results through the lab directly and all the previous labs weren’t there for the past year. I need to call them or my doc to get that info. I’ll look for a folate number. My doc gave me two different suppliments for adrenal support for the high cortisol and I think they made me feel anxious and agitated and couldn’t sleep. She also said to make sure I eat every 3 hours and not go a ling time without eating. That is it. So I’m not doing much for the high cortisol. As for taking t4 only, every time I take t3 I can’t handle the pain it causes. Headaches and face pain and a burning sensation. I need it and can’t tollerate it. What is wrong?!!!!!!!

Yesterday I took 1/3 of the t4/t3 capsule because I’m waiting for the pharmascist to make the new prescription and it gave me a slight headache face pressure and I felt weak and couldn’’t think all day. It feels like I’m terribly hypo but taking the meds make me feel sick. I don’t know what to do.

I’ve had high cholesterol for a long time. And my thyroid hasn’t been treated properly for a ling time as well.

I shoukd be able to get newest results today and will try to get previous ones to look to see if folate was tested.


OK, so maybe T3 only isn't such a good idea. Do you know what fillers go into the capsules your pharmacist is making for you? It's very often the fillers that cause the problems.


The reason I go to a compounding pharmascist is because I’m extremely allergic to milk. I can’t take any pills with lactose monohydrate in them. The pharmacist says that the filler he uses for me is all cellulise plant based. The casule that contains it is as well. When I pick up my prescriptions today I am going to ask for a printout that lists everything in detail. I have to know. Also, my prev doc gave me tirosint. I could not have a bowel movement for 6 weeks and got so sick I ended up getting an emergency colonoscopy, tests for everything else which all came back normal. I stopped the tirosint and was fine two days later. The fillers were gelatin and glycerin. I’m now avoiding both of those in everything.


The reason I go to a compounding pharmascist is because I’m extremely allergic to milk. I can’t take any pills with lactose monohydrate in them. The pharmacist says that the filler he uses for me is all cellulise plant based. The casule that contains it is as well. When I pick up my prescriptions today I am going to ask for a printout that lists everything in detail. I have to know. Also, my prev doc gave me tirosint. I could not have a bowel movement for 6 weeks and got so sick I ended up getting an emergency colonoscopy, tests for everything else which all came back normal. I stopped the tirosint and was fine two days later. The fillers were gelatin and glycerin. I’m now avoiding both of those in everything.


It's good to know what's in it, then you can research for possible problems.

I've never heard of gelatin or glycerin causing constipation, but if you get constipated, you can just increase your vit C and magnesium. They will help.

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I tried both of those plus many over the counter solutions, prunes, everything I could think of and nothing worked except the triple prep they gave me before the colonoscopy. It was really scary. I got so sick I looked green in the face. I’m sure that didn’t help my stress level and cirtisol levels!


Did the colonoscopy not find anything?


All looked good. Only comment was that my colon is a little long. I can go 10 years before I need another one. No other advice or follow up wS given to give me any clarity on the issue. I was still taking the tirosint and the constipation started to come back so I stopped it and changed doctors.


I can only think that you must have low stomach acid, and that is slowing down your transit. Have a look at this article :

Can't remember if I've asked before on this thread, but have you tried gluten-free?


Back when I was having so many problems I found articles about low stomach acid and bought the supplement for that as well as digestive enzymes and probiotics. Nothing helped. I’m only taking the probiotics right now in the interest of trying to narrow down my problems and not confuse things. So taking HCL is still a possibility too.

GLUTEN: I’ve brought this up to docs many times and was tested 4 times for celiac and was told I can eat gluten. I doughted that and always kept it at a minimum. With my new diet I mentioned in another post I completely eliminated gluten. I think it has helped. I’m certainly not super bloated anymore and managed to lose 20 lbs. prior to that I was steadily gaining with no hope in sight. I also completely eliminated soy. The only grain I am allowing myself to eat right now is an ocasional small amount of brown rice. Most all of my carbs now come from veggies.

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Coeliac testing is notoriously unreliable - too many false negatives AND too many false positives!

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Just read this article. One thing I can say is that I never get heart burn nor have I taken antacids. I can try the eat meat test. :-) A nice steak that my doc doesn't want me to eat should work nicely. :-) fyi, I started buying only grass fed beef.

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Oh, also I had one good idea yesterday. I asked my pharmacist if he coukd separate my prescription into two different pills. Instead of adding the t3 into the sane capsule as the t4. To just give me cytomel separately. I won’t be stuck with only that ratio if it doesn’t work.

I’m tired when I wake up and feel tired all day. I finally feel a little better for awhile at night. I feel like I have to push myself all day. Drank a second cup of coffee just to function which I usually do not do. I’m trying to not get too discouraged but it is difficult.


That's a very good idea! I don't like combined pills of anything.



After a month and a half of t4 only 43mcg 1x daily

T3 Reverse 26 ref 8-25 ng/dL (went up)

Iodine, serum plasma 353 ref 52-109 mcg/L (went way up)

(It was after this tesult that my dic said to stop iodine. Not the last one.)

Selenium 131 ref 63-160 mcg/L

Vit D, 25-OH, total, IA 42 ref 30-100 ng/mL (went down)

(I had actually cut back on D. Now making sure I take every day. Doc said take with dinner fattiest meal of the day.)

The D I take is D3 5,000 IU with K2 45 mcg

TSH 4.34 ref 0.40-4.50 mlU/L (went down)

Thyroid peroxidase antibodies 1 (went down)

Ref <9 IU/mL

Vit B12 644 ref 200-110 pg/mL

The B12 I’ve been taking is methyl B12 1,000 mcg sublingual lozenge - 1x after breakfast

Zinc 80 ref 60-130 mcg/dL (went up)

The zinc I’m taking is (450 mg1;s. Cerevisiae) 22.5 mg with organic spinach, beet root, parsley, carrot 25 mcg; s. Cerevisiae (source of naturally occuringbeta glucans & glutathione, broccoli (sulforaphane)- 1x at breakfast

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I'm not impressed with that zinc you're taking. For a start, you should only take about 15 mg a day. And glutathione doesn't suit everybody. How long have you been taking that?

I can't see an FT4 in that list. High rT3 often means that your FT4 is too high, and you're not converting well.


ZINC: I have another bottle of zinc lozenges I can switch to.

Vit A 500 IU

Vit C 60 mg

Zinc (from Zinc Gluconate) 12.5 mg

Slippery Elm 25 mg

Bee propolis 5 mg

It also has fructose and sorbitol.

Is this ok until I use it up? Then when I buy a nee bottle what type of zinc is best?


This site will tell you all about zinc :


Ok got it! My zync sucks. Gonna get a better one! Hugs to you!

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I heard that sulforaphane is not good for us-hypo people


I have heard that too. That eating raw broccolli, cauliflower, cabbage is goitragenic and supresses thyroid function but cooked is ok. Anyone care to comment on this?


Yup. You'd need to eat a hell of a lot of broccoli to get a goitre! You'd have to practically live on the stuff.

Goitrogens impede the uptake of iodine by the thyroid, which is why function is supressed - i.e. less hormone is made. But the list of goitrogens is far longer than just broccoli and cabbage (cauliflower is not a goitrogen), and you probably eat a lot of them without even realising that you're eating goitrogens.

The good news is, that goitrogens don't affect everybody, and even if they do, not all goitrogens affect everybody - if you see what I mean. So, don't even think about things being goitrogenic, just stop eating anything that affects you badly - it might be a goitrogen, it might not. Just eat what agrees with you, and stop eating what doesn't. It's as simple as that. :)


I didn’t realize that it was because it impedes iodine. Still find that interesting. Btw, I got my earlier labs and can see that the reason I started taking iodine was becUse it was low. 48 ref 52 - 109

51 in another test.

Obviously, I was taking way too much to end up with those high numbers but maybe after it settles down, a little iodine now and then wouldn’t hurt - since I’m typically low without supplimenting.


Except that raising iodine levels isn't as simple as just taking a pill. There are protocols to follow, and cofactors to think about, and you really shouldn't be doing it without a doctor experienced in iodine therapy. As you have seen, your doctor has allowed you to go over-range, and who knows what effect that might have had. Excess iodine can cause hypothyroidism, as well as hyperthyroidism if it isn't done properly.


Well at least it was just for a short period of time. Will stay away from iodine for now. Thank you for sharing your wisdom.

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Regarding cholesterol: my doc gave me a do and don’ts food list. I eat better than what is allowed on her list. The only thing left to adjust is no more red meat. No egg yolks, only whites.

I did not take any of the thyroid meds today and feel much better. I don’t feel that druggy can’t think weak feeling with slight headache. However, was very hard to get up this morning and I’m tired. ???


High cholesterol is not dangerous. Being hypothyroid and having not found the right kind or right level of treatment for you will keep your cholesterol high.

It has been known for years that cholesterol in food does nothing to increase your risk of any kind of cardiovascular disease. Keep eating eggs including the yolks, and keep eating meat if you want to.

A poor diet is going to give you headaches, and make you feel weak and tired. And most of the dietary advice coming from the US and UK governments over the last 40 years has been dreadful.

I'm speaking from personal experience here...

I couldn't tolerate sufficient thyroid meds for my needs, no matter what I tried. I had high cortisol. Both high and low cortisol are known to make thyroid meds hard to tolerate.

I tried lots of things to lower my cortisol - various adaptogens, phosphatidyl serine (PS), phosphorylated serine (brand name = Seriphos). Different things work for different people. What has worked for me is Holy Basil. I was able to double my dose of thyroid meds, and in fact I tolerated it so well for a while that I found out I was taking too much and had to reduce again. Some links for you :

If you want to post your cortisol results, plus DHEA if you have it, I can have a look through them and analyse them compared to suggested optimal results.

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Oh my goodness, this site and all of you are amazing. How can it be that I have described that I can’t tollerate thyroid meds to sooooooo many docs and they had no clue what I was talking about. I have the stopthethyroidmadness book and it is what has guided me to push my doc for certain tests.


February, 2017

Morning, 1 hour after rising (7-9am)

0.273 ref 0.097-0.337 mcg/dL

11am - 1pm

0.137 ref 0.027 - 0.106 mcg/dL

3 - 5 pm

0.152 ref 0.013 - 0.068 mcg/dL

10pm - 12 am

0.010 ref < = 0.034 mcg/dL

DHEA 7-9am 102 ref 71-640 pg/mL

DHEA/CORTISOL RATIO 374 ref 358-2,538

I can’t wait to see what you suggest!

Thank you!

I will read all your links!


Well, I know what I'll suggest...

You said, above, that your cortisol was over-range all day. But, that's not true. In the morning, first thing, your cortisol is just a little over mid-range, which isn't too bad. But, it goes high in the next reading, which probably means that your adrenals are beginning to struggle. If you support your adrenals first thing in the morning, then they might be able to make more first thing, so will make less later on. I would not suggest your try lowering your cortisol at any point, just try raising it first thing.

And, by supporting your adrenals I do not mean all that gunk your doctor has given you! I mean plenty of vit C - especially last thing at night - and plenty of B vits. Have a high protein breakfast as soon as you get up - and that's a full egg, not just the white - your doctor is a muppet and knows nothing about nutrition! And make sure you get plenty of salt!

In fact, you could even try what we call an adrenal cocktail : half a tspn sea salt, half a tspn cream of tartar in orange juice, first thing in the morning. That gives you sodium, potassium and vit C, all in one go. Then have your high protein breakfast.

That will mean, of course, that you have to take your thyroid hormone last thing at night - 2 to 3 hours after eating. You can take vit C with that, which will also help you absorb the hormone.

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Silly me, my doc told me all three day levels were too high and that is what the visual chart looks like from the lab. - and I believed her. Thank you so much for educating me.

ADRENAL COCTAIL: tried one this morning with just 1/4 tsp cream of tartar and 1/4 hymalain salt in 4 oz of fresh tangerine juice. Wanted to start small and work my way up.

Questions: should I also get some sea salt and alternate in order to get a broader mix of minerals? Can I modify this to reduce the sugar? I never drink anything with sugar. Just water, sparkling water, herbal teas, black coffee. What if I dilute the oj and drink it with 1000 mg vit c cap? Will that work? Will it taste awful? The version I tried today was fine with me. The article I read about it said to drink more later in the day if you beed to. Is that a bad idea with my high afternoon cortisol?


Personally, I do use both sea salt and pink Himalayan. I mix them together in my salt jar, so that I always get a bit of both when I take a pinch. Not sure that has any benefits, but it can't do any harm.

Some times I take my adrenal cocktail with lemon juice, in water. I'm not sure what it would taste like if you dissolved a vit C cap in water! lol

I've only ever tried taking the adrenal cocktail in the morning, or before bed - of course, it would have to be well away from levo - but I found it more effective in the morning. I've never tried taking it in the afternoon. But, then again, I've never had high cortisol. Mine has always been low.

We do have to experiment with things for ourselves, to see what suits us personally. We're all different, and it's all trial and error. :)


Thank you. I’m going to get some sea salt just for fun :-)

When I suggested diluting the oj, I meant using 2 oz of orange juice with 2 oz of water and just swalliwing one of my 1000 vit c caps with the coctail.

Today I tried only 1/4 tsp of tartar and salt. Tomorrow I’ll try 1/2. Any opinion on keeping the tartar to 1/4 because I have low blood pressure?


I don't see any problem in keeping the tartar at 1/4 teaspoon. Whatever works for you.


Cholesterol is made in the liver. And, it is made in the liver for a reason : we need it! It is a very important nutrient. The brain is made mostly of cholesterol, so are the walls of our cells. And, the adrenals need it to make hormones!

The amount of cholesterol that is made in the liver is so vast that the cholesterol found in an egg yolk is just a drop in the ocean, in comparison. But, doctors know little or nothing about nutrition. They get their education from Big Pharma sales reps, and Big Pharma sales reps want to sell statins, so they've put the fear of god into doctors about the dangers of cholesterol. And, it's all rubbish! It's far more dangerous to have low cholesterol than high cholesterol, you're in far greater risk of having a heart attack with low cholesterol. So, keep eating the food you enjoy, and know is good for you, and just ignore your doctor's pathetic spoutings about eggs and red meat. lol

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Ok, I’ve read sbout that before and the dangers of statin drugs. One other suggestion my doc made was to eat no more than 1 tablespoon of nuts per day. I like raw cashew, pistachio meats, macadamias and pumpkin seeds. I prefer more like 3 - 4 tablespoons a day of a mix of them. What is your opinion on that?


Why did she suggest that? What's the connection with cholesterol?

Nuts are good for getting some good fat into your diet, but I don't know a lot about them. Aren't you supposed to soak them before eating, or something? I'm not a great nut eater, myself.


Maybe because she is a “muppet” and knows nothing about nutrition?!!

Her approved list included a bunch of oils I will not eat and deserts like ice cream etc. which I never eat.

I heard soaking almonds helps with digesting them. I found I am sensitive to almonds and can’t eat them. I get headaches and neck pain from them. I never used to like nuts at all but have grown to like them after reading so often they are good for you. I never liked avacado either but eat it regularly now and love it especially in a green spinach smoothie.

All my research on digestive problems I found that fats slow down digestion. I don’t think I eat too much. Just a nice proportional amount to the rest of what I eat. Maybe a tblsp at a time 3x a day. Only one tblsp in a day seems small though.


Which is why eating fat stops you getting too hungry, is more satisfying. Who suggested you should only have one tbsp of fat a day?


My doc said limit nuts to 1 tbsp a day. Not all fats.


OK, well, as I said, I don't know much about nuts. :)



#1. from doc, contains ashwaganda root extract 250 mg, skullcap root extract 250 mcg, eleuthero root extract 200 mg, rhodiola rosea root extract 200 mg, L-Theanine 100 mg, phosphalidylserine (from soy) 100mg.

Taking this one caused me anxiety and I couldn’t sleep. Is there a stimulant of some kind in it? Also, I have stopped eating soy of all kinds. Stopped trying to take this.

NOTE: I tend to be sensitive to everything. A small amount is always better for me.

#2. Recomended at health food store: contains B1 8mg, B2 8mg, B3 20mg, B5 200mg, B6 8mg, B12 8mcg, biotin 400 mcg, herbal complex of eleuthero root, asian ginseng root, schizandra fruit, suma root, astragalas root, american ginseng root - 710 mcg / L-Theanine 200 mg, Taurine 50 mg/ ayurvedic conplex of ashwaganda root 62.5 mg and leaf extract 62.5mg holy basil extract40 mg / sichan pepper, ginger root, black pepper, habenero pepper 10 mg.

I felt better on this and dont remember having side effects. Just decided to simplify and to not confuse the issue of whether thyroid meds were causing pain. Gets too confusing when taking so many different things. Have not been taking this.


#1 Yes, they're all stimulants. Not surprised it gave you anxiety. They are adaptogens, which are supposed to be miracle workers, according to some! But, they don't suit everybody. They don't suit me. They obviously don't suit you.

#2 Oh dear! They've thrown everything in there but the kitchen sink! Bound to be stuff that doesn't agree with you. Adaptogens and all sorts. B vitamins are good, but I would just take a B complex, and drop all the rest.

However, as it contains Biotin, stop taking it a couple of days before any blood tests, because it can skew results.

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Ok, will continue to look for folate test results and get a good B complex. Will not take those two kitchen sink supplements.




The rhodiola works as a stimulant in some people.


Your results :

Sample 1 : 0.273 ref 0.097-0.337 mcg/dL

Sample 2 : 0.137 ref 0.027 - 0.106 mcg/dL

Sample 3 : 0.152 ref 0.013 - 0.068 mcg/dL

Sample 4 : 0.010 ref < = 0.034 mcg/dL

DHEA 7-9am 102 ref 71-640 pg/mL


Optimal results for cortisol are described in Example 1 in this link :

• Morning at the top of the range

• Noon approximately 75% of the range

• Evening close to 50% of the range

• Nighttime at the bottom of the range


Comparing your results to the optimal results we get :

1 : Optimal = 0.337 --- Yours = 0.273 --- You produce 81% of the cortisol that you should.

2 : Optimal = 0.08625 --- Yours = 0.137 --- You produce 158% of the cortisol that you should.

3 : Optimal = 0.0405 --- Yours = 0.152 --- You produce 338% of the cortisol that you should.

4 : Optimal = 0.00 --- Yours = 0.010 --- I'm not happy with the reference range, but I'll carry on anyway.

Totals : Optimal = 0.46375 --- Yours = 0.572 --- You produce 123% of the cortisol that you should.

DHEA : I don't know what is optimal, but your result is 5.5% of the way through the range which is very low.

Sample 4 has a reference range of <= 0.034 mcg/dL. This reference range includes 0. This is clearly nonsense. Having a cortisol level of zero would only be healthy for a corpse. Despite this I've seen reference ranges including zero for saliva test results in many cases during the last year or so, usually for the bedtime sample, but I've also seen a few results including zero in the reference range even for a late afternoon sample. Clearly the body produces very little cortisol at bedtime but it should not be a zero amount, so I'm not impressed by the testing companies including this in the reference range. It suggests that they haven't excluded sick people from their data when determining the ranges.

Overall you are producing too much cortisol each day. The pattern of your results, with the first sample being too low and later samples getting further and further from optimal is a typical pattern that occurs often.

As thyroid dysfunction worsens, cortisol starts to rise. It may rise very high indeed. It may stay high all day for years. I think you have probably been in this state for a while, but you have now started going downhill from this high cortisol state.

Eventually the body can no longer keep on producing high levels of cortisol, and levels start to fall. A common pattern is what has started happening with yours - the earliest one starts to fall, then later in the day the adrenal glands try to make up the slack, but over time the fall in levels gets worse and starts affecting cortisol levels later in the day. This is referred to as "adrenal fatigue", but the mainstream medical profession doesn't acknowledge that this condition exists. They only believe in "adrenal insufficiency" - Addison's Disease - where the body can't produce cortisol at all or produces almost none. But that is as far as they will go.

People who have succeeded in improving their pattern of cortisol output and adrenal health have found that by increasing the first sample result then the results later in the day fall by themselves.

So, some suggestions :

A couple of useful links :

I think you should try an adrenal glandular fairly early in the morning. Don't take glandulars after 1pm. The most popular ones I know of are Nutri-Adrenal and Nutri-Adrenal Extra (NAX), and Adrenavive glandulars, but I don't know which one you ought to take. And of course there are other brands, but I don't know which ones are good. Look at Amazon for adrenal glandulars and read the reviews. One thing to be aware of is that some glandulars may contain adrenaline which causes a problem for some people. Taking just adrenal cortex should avoid the adrenaline (epinephrine) issue. Look for reviews of adrenal products on Amazon or similar sites.

Be aware that some people don't do well with adrenal supplements of this type i.e. made out of bits of the adrenal glands of other animals. If they don't agree with you stop taking them.


You definitely need some vitamins and minerals to support your adrenal glands. Avoid multi-vitamins and multi-minerals (although a good B Complex is essential). Look for links on the subject of adrenal fatigue supplements.

You really need to take a substantial amount of vitamin C per day, preferably a minimum of 2 g per day, but more if you can cope with it.


It is essential to reduce stress as much as possible and that includes physiological stress. So, keep nutrients optimal, but also work on getting your gut working as well as possible. Probiotics in high doses are good. You can make your own probiotics with food - things like kefir and sauerkraut, for example.

Eat regularly, don't miss breakfast, eat enough protein and enough healthy fats, and drink an adrenal cocktail every day (if you can). Do a search for "adrenal cocktail" recipes and pick the one that appeals to you. I couldn't stomach the salt myself, but do try to get some down you.

Avoid big spikes and drops in your blood sugar, if at all possible.

Some info on healthy eating - I don't think very low carb or fasting help with adrenal fatigue, so don't go extreme in any diet :

You have to register for above program but it's free. There is also loads on healthy eating at this link :

The above links may be for diabetics, but are healthy for anyone.


Go to this link :

scroll down to the section on "Adrenal Information" and read the links.


When you do another saliva test, be aware that various supplements can affect the results - some things lower cortisol, and some will raise it - you have to research and find out which is which from the following lists.


The Dr Lam website has a lot on adrenal fatigue :

Click on each of the blue boxes to the right of the phone number.


I also wrote a post for someone else on the subject of their adrenals - you may find some of it helpful :


One thing that should help is getting enough sleep, but if cortisol is too high at bedtime and getting to sleep is difficult then do some research on the following which may help with lowering cortisol :

Seriphos -

Phosphatidyl serine - lots of brands available - google for more info.

Adaptogens - I've already mentioned these in an earlier post I think. Different ones help in different ways. For example Rhodiola Rosea perks people up. Holy Basil calms them down. So, experiment with timing and dose and do lots of research.


Should I consider taking DHEA? If so, what time of day/circumstances and about how much? I bought some Holy Basil today and took one this evening. Am planning on making an Adrenal cocktail tomorrow morning. I’ve heard that potassium lowers blood pressure. Looking at my labs my potassium and sodium levels look nornal and I have liw blood pressure already. Should I keep the potassium portion on the smaller side?


Not if you're taking lots of B vits, no.

DHEA is a sticky one. It can help, or it can all convert to testosterone and give you raging acne! If you can help your adrenals without taking it, that would be best.

Whilst I'm with humanbean on 99% of what she says - in fact, she says much the same as me, above (although I didn't read her comments before I wrote it! lol) I'm not sure about the Holy Basil. I think it will get very complicated and confusing if you start trying to raise cortisol here, and lower it there. If you can raise it first thing in the morning, with the measures out-lined here, the rest of the day will sort itself out naturally.


The only reason that I suggested Holy Basil for evening is to give Joy a chance of getting some sleep if insomnia is an issue.

I agree that trying to increase cortisol in the morning and lower it later in the day/evening seems like overkill and sounds a bit dubious. But if you were to Google "How do I lower cortisol" I can guarantee that 95% of the links you come across will tell you to meditate and get plenty of sleep.

When I was struggling with high cortisol that prevented me sleeping I would sometimes just shout at my monitor "HOW can I get plenty of sleep when I've been suffering from insomnia for nearly 50 years?" These links on the web always made it sound like I'd just been choosing to have insomnia because I was an idiot.


lol Doctors make it sound the same.

But, Joy's cortisol is not high at 10 pm, so it's probably not that causing her sleeping problems. Does Holy Basil help with sleep in general? I thought it was just when you have high cortisol. Could be just her hypothyroidal state that's causing insomnia.


I don't know if Holy Basil helps with sleep generally to be honest. I've honestly never given it a thought. It's the kind of thing that I would only expect to be taken by someone with high cortisol, all or part of the day.


OK. Well, perhaps we'll find out. :)


In reality, my main problem has been sleeping too long and having difficulty waking up and still being tired the first half of the day. For a lot of years. I typically sleep through the night with no problems at all. But when I start taking thyroid hormone to correct my hypo state all hell breaks loose and then I get the headaches, face pain, anxiety and start waking up in the middle of the night. Even on the smallest doses. The waking up part is new for me and I don’t like it! As well as the foot cramps and a feeling in my legs like - hard to explain- like they are percolating? Stopping thyroid meds usually resolves the pain and then I go right back to being a zombie. I’ve been off for about 4 days and headaches are gone but waking up still persists. I’m now starting to feel achey and tired, like I’m in slow motion, brain fog starting to come back. Ugh!


Sorry, my above response sounds bad tempered, I didn't mean it to.

Whenever I'm reminded of my years and years and years of insomnia, being told by lots of glib authors of websites that I should get more sleep to reduce cortisol makes me want to punch my monitor.

When I was working and suffering from permanent insomnia I had to do everything in my power to organise my life around the insomnia - but I was never important so I often failed. My body actually preferred to sleep from 6am (sometimes later) up to about 3pm or 4pm. Doing an office job under those conditions was like being tortured every week day. I had to try and organise meetings for as late in the day as possible. I slept most of my weekends away.

And of course, anyone who struggles to get up in the morning is judged and deemed to be lazy and stupid.

And then high cortisol makes many people overweight. So as well as being thought lazy and stupid I was assumed to be greedy as well.

Sorry again. :D My interest in cortisol developed when I realised it was responsible for a lot of the problems I had to live with throughout life, and discussing it makes me twitchy. :D


No, you didn't sound bad tempered at all! I understand. I also understand your preferred sleeping patterns! I also sleep much better in the day than at night. I don't like the dark! How pathetic is that at 72? lol


I appreciate your open candor on the subject. Your frustrationnand feelings about how hard it is make a lit of sense. I have struggled with getting up in the morning most my life which creates a general feeling of shame. Why can’t I function the way the rest of the world does?

I was thin my whole life until after having kids which is when my thyroid problems started. I’ve struggled with my weight ever since. I was steadily gaining weight and scared as can be abt it. A friend told me about “Dr. Kelly Ann’s bone broth diet” I tried it and lost 20 lbs. It is like a miracle for me because even though I ate very well it wasn’t good enough for my sluggish metabolism.

I could still lose abt 5 - 10 lbs but in light of my cortisol issue, I’m just going to try and maintain and work on healing adrenals.

I eat no dairy, gluten, soy, sugar is very minimal, only healthy fats like olive oil, coconut and avacado. Some nuts. No packaged preservative chemical filled foods. Try to stay as pure as possible. Lots of veggies, lean hormone free meats. No deserts. No junk food ever.


Ok. I’ll hold off on the Holy Basil for now. Should I consider it on only a high stress day? Fyi, I think I got this way because I was under an extreme amount of stress for too long AND not being treated properly for my hypothyroid condition. Most of what caused my stress has been resolved but there are still days I might get triggered - like if I try taking my new thyroid meds today and they cause me pain. I feel trapped in a catch 22 there.


I think Holy Basil is like so many things that affect cortisol - people just have to experiment and see what works and what doesn't.

I take this :

You could try taking a couple when you wake up first thing in the morning, and just see what happens?

Edit : Ignore this post!


Isn’t holy basil the one that lowers cortisol? If so, shouldn’t I take it in the afternoon? Of couse late afternoon is usually when I finally feel better so I hate to do anything to sliw me back down. I’m thinking if I have a stressful day it might be good to add???


Aaaagh! Sorry, yes! Brain must have gone AWOL.

Sorry, ignore my post.


No problem. I’m learning so much and am soooo grateful.


Thank you so much. I read all the previous links last night and am still processing. I’m feeling a little overwhelmed so would like to implement just one or two things at a time. Regarding diet, I feel like I have that covered. Honestly, I’ve studied it for years and already eat VERY healthy. Balanced, lots of organic veggies, lean organic meats, healthy fats, very low sugar, avoid packaged, preservatives, additives etc. I think I need to focus on cortisol first. Would I be correct in saying a good place for me to start would be to add an adrenal glandular in the morning, an adaptogent like holy basil in the afternoon early evening, then maybe again before bed time? I’ve started waking in the middle of the night around 4am lately. This is new with trying to take thyroid meds again. Without them, I crash and sleep through the night and still can’t get up and could stay in bed til noon if I didn’t force myself.

Along with this, I am currently waiting to get my new thyroid prescription later today. Do I stay off it for a short period of time while I try to get adrenals recovered and cortisol under control? Or take a very small amount to keep me functioning?

Because I am so sensitive to so many things, I’d like to start one step at a time. If I try too many things at once, if I react badly I won’t know what causes it. What is my best next step?

(And of course I will continue to read all your helpful links. And when it is time to retest adrenal function I’ll try a different lab, perhaps the one recommended on stop the thyroid madness.)

I will still work on hunting down folate and ferritin lab results and post them.



You need to click on the Reply button and the person you are responding to will then be notified by email and on-site notification that you responded to their post.

I have tagged humanbean to notify her of your reply.


Thank you. I always hit reply but probably the wrong one. I’ll try to reply in the right place from now on.

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First I think you should introduce some of the recommended vitamins and minerals for good adrenal and thyroid health, (see Dr Lam, Izabella Wentz, Dr Axe, Chris Kresser, the advice you've been given by greygoose above, read posts by SeasideSusie on this forum about the basic nutrients). I would also suggest the adrenal cocktail early on (if you can tolerate it, that is). Bear in mind that what ever you try has to fit in with your existing supplements, medicines, and thyroid hormones, so do your own research on any possible conflicts. If you research something and you don't like the look of it because of existing health problems, then just leave it out. Taking absolutely everything that people suggest will be too much.

I find useful for supplements info.

One of the most important things for good adrenal health is good quality sleep, but for people with high cortisol later in the day this is in short supply. Dealing with this should be one of the earliest things you try. I would suggest looking up Julia Ross regarding sleep and high cortisol - I linked to her website in one of my earlier replies.

Once you've decided on which nutrients you want to try, and you tolerate what you are taking, and you've tried the adrenal cocktail and decided whether or not you want to continue it, then about a month later try adding a low dose adrenal cortex supplement. It could raise your basal temperature, so take your early morning temperature for a while. Adrenal (glandular or cortex) supplements must be taken in the morning, and no later than 1pm, because they can disturb sleep later on.

You asked the following in one of your earlier posts :

#1. from doc, contains ashwaganda root extract 250 mg, skullcap root extract 250 mcg, eleuthero root extract 200 mg, rhodiola rosea root extract 200 mg, L-Theanine 100 mg, phosphalidylserine (from soy) 100mg.

Taking this one caused me anxiety and I couldn’t sleep. Is there a stimulant of some kind in it? Also, I have stopped eating soy of all kinds. Stopped trying to take this.

Yes - rhodiola rosea is stimulating. I have used it and got some benefit from it a few years ago, but it should be taken no later than 1pm, and for many people taking it fairly early in the day is best. I found it very helpful for a year or 18 months, but then it started making me feel jittery so I stopped taking it.

Skullcap - I know nothing about this.

Ashwaghanda is very popular and many people seem to find it very helpful, but it made me feel very nauseous so I don't use it and don't know how it should be used.

L-Theanine - Very expensive, and it did very little for me, so I've not tried it again, but I know it is popular.

Phosphatidylserine - I've never taken this specifically. Instead I've taken Seriphos which is chemically related. I was very ill before and during the time I took it, and I felt like I had flu while taking it. Despite this it did help reduce my insomnia issues for a few months, even after I stopped taking it.

Your difficulties with the combo of things you were taking is why I prefer taking individual things in most cases (B Complex is an exception) because identifying what doesn't agree with you is so much easier.


Ok, just read wait to introduce adrenal glandular until after syarting the nutrients/ adaptogens.

Haven’t found adrenal cocktail yet. Which link has that? I’ve been watching Isabella Wentz youtube videos recently and have learned a lot. I feel like everything goid is coming together.

ZINC: one of the links I read last night suggested taking zinc before bed and not staying on long term. For now, do you agree that I should take it at night instead of the morning?


Just put "adrenal cocktail" into Google. There are many, many links on the subject and they tend to be very similar. Compare a few and pick the simplest one that appeals to you and give it a try. The ingredients should be found in any supermarket.


Regarding zinc - I would agree that late afternoon/evening/night time is best for minerals. Vitamins are best taken in the morning/lunchtime.

Remember to keep a big gap between taking supplements and your thyroid meds because so many supplements interfere with absorption.


QUESTION vit C: I’m thinking the best way to take C based on my cortisol would be 1,000 with breakfast and 1,000 with lunch. Sound good?

QUESTION probiotics: I’ve been taking them before bed. Is it better to take with food? Earlier in the day? Not with other suppliments? Your advice is appreciated.


If you are taking iron then take some vitamin C with the iron to help it get absorbed. Alternatively just split the dosage any way you want. I think vitamin C is helpful at any time, so your suggestion of breakfast and lunch sounds fine.

Probiotics - I have seen arguments that probiotics should be taken with food, without food, in the morning, just before bed. I have no idea which is the "right" answer. I take two probiotics per day. I'll take a lower dose/cheaper one in the morning and a more expensive/higher dose one last thing before going to sleep. I swap brands of probiotics regularly, to maximise the variety I get. It works for me. I suggest experimenting to see if you notice a difference.


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