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Thyroid UK
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Help with new results please - relationship between thyroid and sex hormones?


I have been titrating NDT for a while now for Hashi's. Started very low and am now up to 1.5 grains. I took the Medichecks test early November when I was on 1 grain - so it looks like I am underdosed.

I am 48 years old- so likely pre-menopausal.

Last night the same pattern appeared - woke up at 4am (blood sugar / cortisol?). Didn't doze off again until 5.30am in which time I had a very vivid nightmare.

Could this be related to being underdosed? My mood, when my period started also dropped significantly, I just couldn't shift that feeling of being 'down'. 4 days into my period and it seems to have lifted a bit.

Can someone please explain the relationship between underactive thyroid and sex hormones? I can't figure it and am looking for a pattern.

I also went for an interview last week (the first in 2 years!), so it could be that which has triggered something with my adrenals - although last cortisol readings didn't indicate a problem (whereas it has been high for all readings a few months prior).

Or - I had a crown replaced at the dentist - another stress for my body.

It's so hard unpicking it all....

Many thanks


6 Replies


You were undermedicated on 1 grain. Most people optimally dosed on NDT will have TSH below 0.27 and FT3 in the upper third of range ie >5.5. FT4 will usually be low in range, sometimes below range. You can probably increase to 2 grains without overmedicating. Hold at 2 grains for 6 weeks before retesting.

I think it is overcomplicating things to look at interview and dentist stressors causing problems. If you were optimally dosed symptoms should improve.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.



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Are you strictly gluten free?

How about vitamin D, folate, ferritin and B12?

Have these been tested recently, and do you supplement.


Yes, strictly gluten free and have been for nearly a year now.

Supplement everything - as listed, but haven't been tested for a while. Also take Magesium, K2, Selenium.


All hormones are intertwined.

If one is lacking body is trying to recoup with another putting strain on all.

You may be peri. Because of your age and also because of your strained thyroid.

Peri symptoms are same as full menopause I.e

Crushing fatigue

Back pain

Muscle joint pain stiffness

Sleep problem

Skewed periods



To name just a few. I had over 30. And all are similar to underactive thyroid - right?

If you're peri, your bloods won't show so you have to go by symptoms.

The only way to fix it and find out is to try HRT/ combined pill for few months to see if it makes you feel better.

But if your thyroid is lacking at the same time you need to address it quickly and see if there is improvement.

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I should add - bloods they do in NHS for meno won't show peri.

You can do egg reserve test which will show if your peri but you'll have to do it privately. Not sure if worth money if you're not trying for a baby. But if you want to and have money - go for it.


Waking up at 4am I very much associate with adrenals. When I have this I am hungry, and I think it has something to do with the adrenals role to cover for low blood sugar late at night when all the food of the day has been used up. I now keep oatcakes by the bed and have a couple as soon as I wake up like this. I also have a snack just before bed so there's something in my stomach. Some people take an adrenal support drink before bed, of orange juice and salt.

I also feel being hypo really related to menstrual cycle. Sometimes my hypo symptoms are much much worse during periods. The two sets of symptoms blend into each other.

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