Hi everyone, just looking for some advice. I have hypothyroidism diagnosed about two years ago. On Levothyroxine 100mg. This has recently been increased from 75mg a couple of months ago as my TSH had started to rise again. I’ve recently been suffering very badly with night sweats. Most nights now, completely soaked from head to toe. Just wondering if this could be a side effect of the increased dose of meds? Has anyone else experienced this symptom?
Thanks
Low B12 is frequently cause of night sweats
bmj.com/content/349/bmj.g52...
Low vitamin levels are extremely common when hypothyroid
Ask GP to test vitamin D, folate, B12 and ferritin
ncbi.nlm.nih.gov/pubmed/186...
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,
Your post from 2 years ago showed extremely hypothyroid
healthunlocked.com/thyroidu...
This showed extremely low folate, low B12 and low vitamin D and low ferritin levels
GP should have tested for Pernicious Anaemia before prescribing folic acid for extremely low folate result
Should have prescribed 1600iu vitamin D daily for 6 months and retested at end of prescription.
Local CCG guidelines
clinox.info/clinical-suppor...
Government recommends everyone supplement October to April
gov.uk/government/news/phe-...
These should have been retested at least annually
Can't imagine how you were managing on just 75mcg Levothyroxine
I had a lot of bloods done a little while back which is when they increased my thyroxine. Results below:
TSH 6.9
T4 15.4 (11-23)
Hb 125 (117-149)
B12 425 (197-771)
Folate 3.1 (2-18.7)
Ferritin 23 (20-130)
No vitamin d tested.
I’m concerned by these night sweats because they are so severe. Got a gp appointment next Monday but don’t want to be fobbed off again! Feel like I’ve turned into a right moaner since diagnosis but just had endless horrible symptoms. Kind of assumed once I was medicated everything would be better again. Also, I’m a worrier so tend to automatically assume the worst (eg cancer) thanks google 😩
So you were left woefully under medicated
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
nhs.uk/medicines/levothyrox...
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
Functional B12 deficiency can be a hypo problem
Levels of B12 appear normal.....but you have symptoms of B12 deficiencies
As explained here
nhs.uk/conditions/vitamin-b...
Folate is still very low and needs improving by self supplementing
Do NOT start any B vitamins until had further testing for B12 deficiency/Pernicious Anaemia
Ask GP to consider giving B12 injection to see if symptoms improve
Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.
chriskresser.com/folate-vs-...
B vitamins best taken in the morning after breakfast
Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks
Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
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...
Ferritin very low too. You need full iron panel testing for Anaemia.
Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption
Links about iron and ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
drhedberg.com/ferritin-hypo...
restartmed.com/hypothyroidi...
Vitamin D needs testing.
GP should test
Alternatively NHS postal kit £29
FT4 only 36% through range
Useful calculator for working out % through range
Thyroid levels should be retested 6-8 weeks after each dose increase
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.
Wonderful post slow dragon. Hard to follow! But I just wanted to say that I had the same problem. My B12 is carefully monitored and is ok. My vit.D is now ok. However, when my ferritin was checked it was very VERY low normal. Doctor started me on chelated iron 3 times a week. Went from 30 to 50. Since my doctor says that she's aiming for at least 70 as test result for proper thyroid function, I am now trying every other day. I'm having much less of the sweating and look forward to finding out my test numbers next month. It's a process as you really have to be careful to not have too high ferritin with suplimentaion as one can damage your self so you really need to be tested and monitered.
I know, like myself, that we all want to feel better right now. Especially when most of us have been feeling poorly for years before finally getting a diagnosis. I've learned that there are so many symtoms and medical problems that are connected with thyroid disease. I've also had to learn to be patient with myself and pragmatically take on things one at a time. It's hard and often goes slowly but you can feel better. But it often takes time.
Most people that are healthy don't understand what it feels like to often feel so cold but wake up night after night soaked. It's exhausting and frustrating.
But I think you are getting very good advice about "the four" and defincencies. I hope you pursue them. It may take time to get things balanced again, but I believe it is possible. I've been working on it for three years which if you read the posts is not very long pertain to thryroid ussues. Every little victory towards feeling better helps you carry on.
Also, have you had your cortisol levels checked? Adrenal Fatigue is very real and also is a reason for night sweats.
I wish you well and good luck. There is simply wonderful people and good advice on this site so have a good read. You'll find many have or had symtoms like yourself.
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