Brain fog in the morning

[Den1987UK]

Anyone on this forum have brain fog in the morning. I have bad brain fog in the mornings lately. Started on a new regime of going to bed at 23:00 11 at night and waking up at 10:00 in the morning. Also increased the Levothyroxine to 100mg instead of 75 mg because I was not feeling right on just 75 mg I felt horrible and had bad brain fog but now it’s a little better.

[Cooper27]

If it's specifically in the morning, it there are a few possibilities besides thyroid. Itmight be an adrenal issue. Potentially also related to any medication you take. Do you drink coffee, and does the fog lift after you have a cup?

[Den1987UK in reply to Cooper27]

Good afternoon Cooper27 No no coffee just tea With decaf tea bags don’t drink alcohol and don’t smoke quit last year. Do take propranolol for high blood pressure 20 mg and Paroxetine 20 mg both one a day the propranolol can’t be raised because of Raynauds But I think where I was under active for a while two years and the new dose increase of 100 mg instead of 75 mg might be the cause that and not getting adequate sleep but could be wrong. As for adrenal glands never had them checked because my doctor is like oh you don’t need it done which in itself strange. Might ask to be referred to a endocrinologist just to check it out.

[Cooper27 in reply to Den1987UK]

For me, I used to take a medication before bed that caused brain fog in the morning, but if all you're on is thyroxine, I don't know if that would be it.

Definitely work on sleep quality & consider a little meditation session before bed to see if that helps. B vitamins help support the adrenals too, and thyroid sufferers tend to be a bit low on them. I found a b vitamin complex helped me, so it could be worth trying.

It could be something else entirely, we all experience different symptoms, so hopefully someone else has some ideas

[Den1987UK in reply to Cooper27]

Thank you Cooper27 I am currently just started taking B12 and D3 with zinc for bone pain doctor did a test on marrow that was fine. So could be low on B12 and D3.

[SlowDragon Administrator in reply to Den1987UK]

Propranolol slows uptake and conversion of FT4 to FT3

High blood pressure is a hypothyroid symptom

You can NOT suddenly stop propranolol. It must be weened off incredibly slowly. 5mcg max per day .....wait 2-3 weeks and then drop a further 5mcg

Quitting smoking is often a catalyst for thyroid problems to start or get worse

ncbi.nlm.nih.gov/pmc/articl...

thyroid.org/professionals/a...

Bloods should be retested more frequently in 2 years after stopping smoking

Bloods should be retested 6-8 weeks after each dose increase (or change in brand) of Levothyroxine

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Do you have high thyroid antibodies?

Ask GP to test vitamin levels

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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)

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

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

For thyroid including antibodies and vitamins

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

Cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

Hypothyroid patients often have low vitamin D. Low vitamin D and low magnesium are often linked

Propranolol affects parathyroid hormone level

labtestsonline.org.uk/tests...

See

"Is there anything else I should know"

Drugs that may decrease PTH include cimetidine and propranolol.

This may be why Propranolol might also lower magnesium

Get vitamin D tested AsAP

I was stuck on propranolol for almost 20 years. More on my profile

[Lora7again in reply to SlowDragon]

My husband was given propranolol for anxiety and ended up in hospital because his heart rate was too low. He is a runner and has always had a low heart rate and this drug did not suit him at all.

[humanbean in reply to Lora7again]

That sounds a bit like me. My heart rate and blood pressure dropped dramatically on a low dose of beta-blocker. I live on a small hill and the nearest bus stop is at the top of the hill. I got to the point where I couldn't make it to the top of the hill because HR and BP were just too low.

I was originally given the beta-blocker because I developed tachycardia (very fast heart rate). I like being able to control my heart rate if it went too fast, but I couldn't tolerate it all the time. Much to my doctor's horror I started taking the beta-blocker just when I needed it, and kept my dosing to the absolute minimum so I didn't become dependent on it. It works for me, even if it isn't standard medical practice.

[Den1987UK in reply to humanbean]

Exactly the same as me Tachycardia and high blood pressure and like yourself not agreeing with me . I feel like I ran 45 streets when I do physical exertion and yet ECG was done and the heart is fine apparently.

[SlowDragon Administrator in reply to Den1987UK]

Sounds like you might have low FT3

[Den1987UK in reply to SlowDragon]

Could be but my gp won’t tell me unfortunately so getting my medical records on Monday and will post them up as soon as I can. Also getting a ultrasound done on my thyroid and MRI brain scan done. My NHS doctor will not pay for either so have to have the scans done myself at £400.00 pounds total

[Lora7again in reply to Den1987UK]

Why are you not getting an ultrasound on the NHS? I have had two and I didn't have to pay.

[Den1987UK in reply to Lora7again]

I think it’s because my NHS gp is pardon the pun a ass unfortunately. Can never get anything done with my gp they are like oh you don’t need this done or that done everything is normal lol that’s why I am changing doctors surgery soon. Where I live in Bromley it’s hard to get anywhere most gp in my area are not good. My previous gp surgery was very good where I lived before this one.

[SlowDragon Administrator in reply to humanbean]

I had a bit of a funny turn up top of Mount Etna few years ago ......it's pretty high and very thin oxygen... ...usual response is for heart rate to speed up with lack of oxygen ....obviously on propranolol that's not possible. ...I was struggling to breathe, I felt I was wading through treacle

Even before starting on propranolol I always had incredibly slow heart rate and very low blood pressure. Actually blood pressure improved slightly on propranolol (adrenals were able to recover)

[Den1987UK in reply to SlowDragon]

Good evening slowdragon Okay thank you been on propranolol for 14 years and paroxetine SSRI for about the same time. I know the Levothyroxine I am taking Eltroxin Levothyroxine Sodium is causing some side effects like arythmias and high blood pressure problems so might get it changed. Also I have Raynauds poor circulation so yes something probably not agreeing might change the propranolol to something more better suited for my needs. I am trying to get my medication checked and or changed and also trying to get a copy of my medical records because my gp is being evasive at the moment. Having a MRI brain scan done because my mum Arnold Chiari Malformation pressure in the head and low brain in the skull pushing on spine and wanted to check the gland on the base of the brain perpituary gland and also having a Ultrasound on my thyroid done. My gp won’t fund it even though an NHS gp and will cost me £400 to get it done but I need to know so got to have it done.

[SlowDragon Administrator in reply to Den1987UK]

I had a lot of Raynauds type symptoms just before Hashimoto's was diagnosed, this continued until on a decent amount of Levothyroxine

Extremely important to regularly test vitamin D, folate, ferritin and B12

Strictly gluten free diet helps many/majority with autoimmune thyroid disease (Hashimoto's)

Always worth trying this

Get Coeliac blood test FIRST, before going strictly gluten free

Magnesium supplements can help steady heart rate. Ask GP to test magnesium levels.....though it's a poor test and rarely comes back with out of range results. But many people find magnesium supplements help

The Magnesium Miracle by Carolyn Dean is an Interesting read

[Den1987UK in reply to SlowDragon]

Thank you slow dragon. I know that if you smoke you get Raynauds and propranolol can cause Raynauds. I used to smoke a year ago and if I go out in cold weather not good at all. I am only 32. Told my doctor who was very unsupportive and couldn’t care less to be honest. I am thinking of trying a different doctor and gp surgery there is another further down the same road but don’t know if they are any better. I asked to be referred to a endocrinologist without success. All I hear is everything is normal lol

[SlowDragon Administrator in reply to Den1987UK]

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 primary hypothyroidism in Uk is due to Hashimoto's.

20% of Hashimoto's patients never have raised antibodies. So if BOTH TPO and TG thyroid antibodies are not raised then a thyroid ultrasound scan can be helpful

healthunlocked.com/thyroidu...

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 .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many people need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

FT4 and FT3 should be roughly similar % through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

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

[Den1987UK in reply to SlowDragon]

Thank you slowdragon very helpful information I will have a read and will post results on medical records once I get them only had a full TFT panel plus FT3 FT4 done a week ago but won’t tell me the results.

[SlowDragon Administrator in reply to Den1987UK]

The receptionist are not allowed to release results to patients until the results have been seen by GP

You are legally entitled to printed copies of your blood test results and ranges after that

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

[Den1987UK in reply to SlowDragon]

Thank you slowdragon my gp has read the results but won’t tell me as for online access have that but no results posted online ever not even medical records. You have to request at reception I think. Even then they are padantic about handing them out.

[SlowDragon Administrator in reply to Den1987UK]

You may have to fill in extra paperwork to get blood test results online

[Den1987UK in reply to SlowDragon]

Good evening Okay thank you slowdragon that’s good to know. Hopefully can get things sorted out and feel better for once.

[Lora7again in reply to SlowDragon]

I didn't they just sent me details of how to log in and I made my own password. As I said before this is when I found out they had put delusional on my records. I am still very annoyed about his because they knew I had Graves' which can make you paranoid if you have been left untreated for a couple of years. I blame them for letting me get so ill and sending me away with hormone patches and a referral letter for a dermatologist instead of spotting my TSH was suppressed at 0.002. I am hoping my MP will put this to Matt Hancocks because I have emailed her my story and how I think the TSH should not be used to diagnose thyroid disease. Whether anything will come it I don't know but I will keep emailing her until she does something to help our cause.

[Den1987UK in reply to Lora7again]

It’s a huge problem I am thinking about doing the same contacting Bob Neil MP for my area in Bromley

[TSH110 in reply to Lora7again]

As I understand it, TSH is supposed to be the best measure for diagnosing thyroid disorder. If it is autoimmune, antibody tests will confirm it, but only if they are positive.

It is not the best for determining the correct dose of thyroid hormones if you are hypothyroid and being treated for it, free T3 is a better measure of reaching a euthyroid state. You say the TSH result was missed but it clearly indicates a problem. It is not the test at fault here, but the idiots failing to interpret it.

I am not so well up on Graves and what tests they do for it but I would think TSH is pretty important. They thought I had it initially but were not sure and did more blood tests which showed I was hypothyroid, as I had long suspected but told it was just the menopause 🙄

Bad scene they wrote that on your records, unless it was just describing a symptom you actually had due to the Graves.

[Den1987UK in reply to TSH110]

Hello TSH110 good evening yes I agree with you I know my Free T4 is at 18.46 I thought that was supposed to be lower than that. As for TSH definitely not the golden standard for diagnosed hypothyroidism or hyperthyroidism. I agree the real gold standard is Free T3 and Free T4 and antibodies TG and TPO also ferritin and B12 and D3 vitamin levels from blood tests and scan of the thyroid as well as TFT thyroid function. But I also agree you need someone with years of knowledge on thyroid disease disorders and conditions to interpret the results properly and not like my doctor who is I’m afraid to say wet behind the ears and has not got a clue about the endocrine system or immune system or adrenal system because they all linked very closely as I know. I know you have the perpituary gland at the base of the brain then the thyroid then the gland in your chest in the breast bone and the then the testicles in men or ovaries in women and adrenal glands on top of the kidneys and that the hormones control nerve function heart rate blood pressure pulse brain function and metabolism and the gut urine function and much more . Small gland the thyroid but mighty power.

[Lora7again in reply to TSH110]

When my TSH was 0.77 and I felt hypothyroid and I had symptoms I had a medichecks blood test and my T4 was 15.6 pmol/L - 12.00 - 22.00 and my T3 was 4.25pmol/L 3.10 - 6.80 and my Thyroglobulin antibodies were lower at 2576.000 IU/ml 0.00 115.00 and Thyroid Peroxide Antibodies were the same at *600 IU/ml 0.00 - 34.00. My folate was low at 3.71 ug/L 2.91 - 50.00 and my vitamin D was 67.90 nmol/L 50.00 - 200.00. According to the medichecks Doctor those results were perfect so why was my hair dropping out and my nails lifting and I lay in bed all day ??? The TSH means nothing in my honest opinion! This was January 2018 btw. What a difference a year makes!

[TSH110 in reply to Lora7again]

Yeah the free T3 was too low so you still felt ill. My endo did go for a much lower TSH 0.2 - 0.5 and tested the others but I never felt good I had to have NDT to feel better. My free T3 remained low. I have the DIO2 gene combination for poor conversion of T4 to T3 which could explain it. I was never tested or offered T3 on the NHS but I should have been.