Is it usual to get hot flushes and night sweats with hypothyroidism?

[Nerynoo]

My TSH is currently 11. I’ve been experiencing lots of hypothyroid symptoms, such as hair lose, very brittle nails, fungal toenails, extremely heavy periods (now no period?!), dry skin,... I’ve never had trouble sleeping but for the past couple of months I feel very hot at night and wake up several times a night sweating profusely. I read that this is a sign of an overactive thyroid so I’m very confused? I’m on T3 only which I’ve always used without issue and the sweats started before I began medicating. Any advice would be greatly appreciated x

[greygoose]

That's the problem with symptoms. They're never clear-cut. So many of them cross over from hypo to hyper and back again. So, you cannot rely entirely on symptoms to tell you your thyroid hormone status, you need labs for back-up. Over-heating and night sweats can be hypo as well as hyper, so don't let them fool you.

And, of course, it is perfectly possible to have hypo and hyper symptoms at the same time. That hormone you swallow every day is not distributed evenly to every cell in the body. Some may be getting too much and others none at all. You have to know your body very, very well to go by symptoms alone.

[Nerynoo in reply to greygoose]

Thanks for your reply. I wasn’t aware you could flip flop between hypo and hyper? It is all very confusing, especially with severe brain fog too! I’m currently off work and not sure how I’ll manage full time going forward. I shall definitely look into further testing and report back!

Many thanks x

[greygoose in reply to Nerynoo]

No, that's not what I said. I said you can have hypo and hyper symptoms at the same time. That is not 'flipping between hypo and hyper'. I explained why it happens.

But, if you still haver hypo symptoms, you probably need an increase in dose. Doctors usually keep their patients under-medicated.

In fact, with a TSH of 11, you're absolutely under-medicated. How much T3 are you taking? And when did you have your last increase in dose?

[Nerynoo in reply to greygoose]

Apologies, I misunderstood.

I only started on T3 2 weeks ago, hence why I’m currently only at a 25mcg dosage per day.

I’ve ordered the thyroid testing from Medichecks today, which arrive tomorrow. Will the T3 skew my results if I haven’t been taking it for long?

[greygoose in reply to Nerynoo]

If you only started on T3 two weeks ago, you should be on 10 mcg, not 25. You've increased too quickly, and that could account for your symptoms.

You should really wait six weeks on a steady dose before testing. The results won't exactly be skewed, but they won't be much use.

[Nerynoo in reply to greygoose]

That being the case, would you advice I wait 4 weeks on my current dose before testing? I’ve ordered the Medichecks Thyroid Check Ultra Vit..Thanks

[greygoose in reply to Nerynoo]

I would suggest you wait the full six weeks - especially as you've increased too fast and your body will be struggling to acclimatise to the unaccustomed T3 influx.

[Nerynoo in reply to greygoose]

Ok, I’ll do that. Thanks for all your advice.

[greygoose in reply to Nerynoo]

You're welcome.

[MaisieGray]

I have been hypothyroid for 40 years and suffer severe overheating and sweating. Even when my 20 mcg T3 was summarily withdrawn after 10 years and my T4 reduced by almost half such that I became very undermedicated and my FT3 plummeted (I have tested heterozygous positive for a DIO2 polymorphism so have a particular need for T3) I continued to overheat and sweat, and even back on my T3, I continue to do so...... It is misleading and confusing to label symptoms as either hypo or hyper, they are just symptoms which in totality may indicate this medical condition or that medical condition, or as if often the case, any number of different medical conditions. I don't know how old you are, but your overheating and sweating may, as in my case, simply be indicative of your hypothyroidism, or may be related to your sex hormones and/or being peri menopausal for instance. Only blood testing will show if levels are askew.

[Nerynoo in reply to MaisieGray]

Yes I was sweating before the T3 but it does seem to be getting worse. I’m only on 25mcg T3 a day at the moment. I’ve always tolerated it well and been on a lot more but want to raise it very gradually. I have an endocrinologist appointment on 8th August where they’ll be running tests.. I’ll post my results on here, I’ve lost total faith in the nhs to be perfectly honest. Thanks for your reply x

[SlowDragon Administrator]

Why are you on T3 only and how much T3 are you taking?

How long been on T3?

Do you have Hashimoto's?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.

So it's important to get TPO and TG thyroid antibodies tested at least once .

Low B12 is often cause of night sweats and low B12 is extremely common when hypothyroid

What vitamin supplements do you currently take?

Obviously your TSH is far too high. On T3 it's often suppressed. Are you sure your T3 is genuine

[Nerynoo in reply to SlowDragon]

Thanks for your response. I’m seeing my endocrinologist on 8th August but I have little faith in his testing/treatment, going on past experience.

I’ve been hypothyroid for almost 10 years. My ‘normal’ TSH was around 7 for years so my endo just monitored me and let me self administer T3 (following ‘recovery with T3’ protocol).

I’ve been told I have no antibodies but not entirely sure what tests they did to rule this out.

I have been under immense stress for the past few years hence my TSH rising to 11.

I take sublingual B12, selenium, kelp, zinc, omega 3, iron and a multi. Oh and the T3 I purchase was recommended through here.

I will most probably go private for all the tests you mention and take it from there...

Thanks for your help x

[SlowDragon Administrator in reply to Nerynoo]

Kelp is not recommended for anyone hypothyroid, but especially if Hashimoto's.

Multivitamins are not usually recommended on here either, too little of what we do need and usually cheap ingredients, frequently contains iodine again not recommended if hypo

iron in multivitamins binds to most other nutrients anyway so is waste of money

Yes most popular test is Thyroid plus ultra vitamin. Opinion to pay extra for private blood draw at local to you private clinic or DIY finger prick test

£99 or £79 if on offer

[Nerynoo in reply to SlowDragon]

There’s an offer on Medichecks for the Thyroid Check Ultra Vit, which appears to tests thyroid levels, antibodies and nutrients... I think I’ll order it today unless you or anyone would recommend a better alternative?

[SlowDragon Administrator in reply to Nerynoo]

Make sure to get blood test done as early as possible in morning and fasting. Last dose of T3 eight to twelve hours prior to blood test

How much T3 are you taking?

Do you split the dose ?

[Nerynoo in reply to SlowDragon]

I take 25mcg a day, splits into 4 doses throughout the day. Whenever I’ve tried T4 in the past it makes me feel really ill within a few days.

The iron I at night alongside vitamin C as I’ve always struggled with my iron stores. Is this wrong?

Many thanks

[SlowDragon Administrator in reply to Nerynoo]

Surprised you are functioning at all on such a small amount

Which brands of Levothyroxine have you tried?

Many people can only tolerate one or two brands

Most people take 20mcg (or 25mcg) T3 per day alongside Levothyroxine

Personally I take 125mcg Levothyroxine and 20mcg T3 as 3 split doses 8 hours apart

On just T3 a more typical dose is 40mcg - 60mcg

Suggest you get FULL Thyroid and vitamin testing first.

Absolutely essential to have optimal vitamin D, folate, ferritin and B12

Come back with new post once you get results and ranges

Then trial increase in dose of T3 by just 5mcg. Hold for 6-8 weeks and retest

Have you considered DIO2 gene test?

If test positive it's a good scientific reason for NHS to prescribe T3

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

Make sure to stop any supplements that contain biotin a week before any blood tests

Biotin can falsely affect test results

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Recommend stopping kelp and multivitamins anyway

[Nerynoo]

I’be been sign off work these past few weeks as I feel so ill and my endo appointment isn’t until 8th August. I’ve been at a loss as to what to do in the meantime, with the nights sweats so bad and affecting my sleep I’m barely functional during the day.

I used to take Cynomel but can no longer get it, so I’m on Tiromel now, which I have tolerated before. My night sweats and hot flushes have been getting worse though, so I’ll stop it for now and see if anything improves..

I’ll order the thyroid tests today and hopefully I’ll have a clearer picture of what’s going on when the results come back.

Thyroid problems run in my family on both my dad and mums sides. My great grandmother died young from complications and my Aunty had hers removed. My grandad was also hypothyroid, as is my sister. Probably worth getting the gene test done I think!

Thanks for all your advice, I’ll post my results when they come back.

[SlowDragon Administrator in reply to Nerynoo]

There's absolutely no point doing blood testing, if not on constant unchanging dose of T3 (or Levothyroxine) for minimum of 6-8 weeks

So you need to continue taking exactly same dose T3 until you do blood test. Making absolutely sure to take last dose T3 between 8-12 hours prior to blood test

The trouble with taking T3 is its difficult to asses what dose you need (one of the reasons medics don't like using it )

If on T3, an adequate dose would normally suppress TSH down to near zero