Cortisol fluctuations on raising thyroid meds - Thyroid UK

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Cortisol fluctuations on raising thyroid meds

24 Replies

Hello!

I have a quick question on changes when you raise thyroid meds.

I know that when you increase levo or t3, cortisol goes up and many recover from low cortisol symptoms. My situation is, I change my dose, I sleep okay the first few weeks, then week 3 or 4 I can't fall asleep, my heart is pounding, anxiety kicks in, but pulse is only 72 maybe 78. I wake up after a few hours completely rested. Around afternoon, I am tired of course. Could this be cortisol changes? I have a blood test booked at 5 weeks just to check the progress of thyroid meds. Currently on 112 t4 and 17.5 t3

Again, it could be too early, right? I have been on it for 30 days only.

Previously, my ft4 was midrange, ft3 around 60-70%.

Thanks :)

Cuppa

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24 Replies
humanbean profile image
humanbean

Based on my own personal experiences, so take this as just anecdote :

1) Changes in cortisol which lag behind the changes in your thyroid hormone levels and might sort themselves out eventually - but how you would know if and when it will sort itself out, I have no idea.

2) Low iron and/or ferritin

3) High blood sugar

4) Low magnesium

5) Low potassium

Bear in mind that the heart is a muscle. So anything that could affect, for example, your leg muscles will probably also have an effect on your heart.

in reply tohumanbean

Thanks humanbean, this is very helpful!

I think after the elimination process it is no 1 - cortisol, hopefully will settle...I used to change my dose too often and I think this had impact on my cortisol etc. My iron is top range, ferritin mid range, blood sugar within ranges, potassium fine, serum magnesium fine, but not sure how reliable this one is!

If issues will sort themselves out, hopefully I will know by sleeping soundly and not having adrenaline rushes, I hope :)

SlowDragon profile image
SlowDragonAdministrator

Personally I always feel worse from roughly weeks 4-8 after any dose increase

I have always suspected that it’s adrenals rebalancing that causes this

If you can bear to hang on to at least week 8 before testing you might get better view (and might be starting to feel better)

Making sure to do some physical exercise for 15-20mins twice a day might help....even just a walk around the block

in reply toSlowDragon

Hey SlowDragon, thank you so much! I thought it was so strange to feel worse after 4 weeks, but you put me at ease!

I feel that it is cortisol up and down, you are right, adrenal glands must be catching up.

I have another blood test at 8 weeks, I have good access to cheap bloods so I do it to calm my mind :) I am not intending to change the dose at 5 weeks, just helps my anxiety.

I think I can bear it, it is so uncomfortable, but it is fine, I dont work now so it is easier.

Thank you, I will go for a walk today for sure!

in reply toSlowDragon

Hey SlowDragon hope you are well! Quick question, how bad and what are your symptoms between 4-8 weeks? For the past 9 days I have been having palpitations, mostly and the worst ones at night, so even I am tired can't fall asleep until 3 or 4. Anxiety I can deal with, but I think that is just caused by my heat racing. Pulse is about 80 resting, temps 36.6-36.7 at night, 36.8 during the day in case it is helpful. This fast pulse seems to make me tired and I have muscle weakness. Thank you!

SlowDragon profile image
SlowDragonAdministrator in reply to

Sorry no experience of fast heart rate...mines always too low ...before T3 added resting heart rate was under 50...even now usually 54-58 max

in reply toSlowDragon

I see, mine is normally around 66, anything more and I feel exhausted and anxious. I went through thyrotoxicosis years ago, had a lot of heart racing, no sleep for many months, so my anxiety starts to kick in that I could be overmedicated.

SlowDragon profile image
SlowDragonAdministrator in reply to

Previous post

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Personally I would try splitting the dose

in reply toSlowDragon

I have tried and felt worse. Before toxicosis, I have been taking t4 and t3 for 3 years, was feeling great and took it all at once in the morning. After thyrotoxicosis I was splitting my t3 dose into 3 for about 6 months, sleep was worse andnhad peaks and throughs, then I tried to split into 2, same issues, but a bit better, then realised that when taking less in my second dose I would feel better so that would bring me back to taking it once daily.

SlowDragon profile image
SlowDragonAdministrator in reply to

Have you done Regenerus cortisol and DHEA test?

in reply toSlowDragon

Not recently, no, I am convinced my cortisol is high by my symptoms, I just wanted to know if it is temporary when adjusting, after 4-5 weeks and how long should I wait with these symptoms, it has been 9 days now. Personally, my ft3 doesn't need to go largely over range to feel overmedicated. My cut off is somewhere around 70-80% of range. Recently, my bloods showed ft3 at 70% of range at the same dose, but I didnt hold it for long enough, maybe couple of weeks. I test after 24 hrs and it is 70-80%.

SlowDragon profile image
SlowDragonAdministrator in reply to

I find a walk is best for suspect high Cortisol..gentle exercise

Or yoga would be good

in reply toSlowDragon

Totally, I took your advice the other day and went for a walk, I felt better. I did yoga up until last week, have to resume, was too exhausted, but previously yoga saved my life when I was coming out of the big overdose! Thank you SD, I guess the advice is as previously, try to last until week 8 (of course, if resting pulse goes over 100 I will drop by 2.5, that was my endos advice)? I have bloods this Friday, a bit early at 5 weeks, but I might post them here for your comment, if that is okay! :)

in reply to

Hi SlowDragon , I have received my blood results:

FT4 40%, 16 (12 - 22)

FT3 59.46%, 5.3 (3.1 - 6.8)

So I am definitely not overmedicated it seems. I have another blood test at 8 weeks (this one was done at 5 weeks).

I think the best is to wait, what do you think? Thank you :)

SlowDragon profile image
SlowDragonAdministrator in reply to

Yes carry on as you are

in reply toSlowDragon

Thank you SlowDragon! I will put a new post up in 3 weeks. Really appreciate you helping me. take care!

in reply toSlowDragon

Hi SlowDragon before I go :) I forgot to say, I was on 112 levo for 8 weeks actually and on 17.5 t3 for 5 weeks. Ft4 has dropped from 55% to 40%:

FT4 40%, 16 (12 - 22)

FT3 59.46%, 5.3 (3.1 - 6.8) previously 70%

I am feeling quite hypo now, should I still wait beyond 8 weeks on 112? Also, I would assume with dropping t4, I would need levo, not t3 going up? Thanks!

Edit: I am swelling up a lot now, back to being dizzy, spaced out, dry skin, thirsty, have pain in my whole body now.

SlowDragon profile image
SlowDragonAdministrator in reply to

So you were on 100mcg levothyroxine ........now you had been on 112mcg levothyroxine for 8 weeks that’s a realistic result on Ft4

So you could try increase in levothyroxine back to 125mcg ...retest in 6-8 weeks

Make sure all vitamins remain optimal

Are you strictly gluten free ?

in reply toSlowDragon

Hey SlowDragon, yes, correct, it is now over 8 weeks on 112 levo and 5 weeks on 17.5 t3.

I will increase levo to 125 and test.

I will check my vitamins as well in 6/8 weeks, I am supplementing as always.

I am mostly gluten free, but unfortunately being gf for a few years earlier didn't give me any results :( selenium did however, need to start supplementing again

SlowDragon profile image
SlowDragonAdministrator in reply to

What are your antibodies levels roughly?

in reply toSlowDragon

They hover around 700, but haven't checked them the last 5 months. They used to be over 1,000 😳 I can check in 6 weeks.

SlowDragon profile image
SlowDragonAdministrator in reply to

Sometimes the only noticeable improvement on strictly gluten free diet is slow dropping of TPO antibodies

in reply toSlowDragon

Unfortunately when I was on strictly gluten and dairy free diet for about 2 years, there was no improvement, they were always around 1,000 back then :( I think I will try selenium again, 200 a day

in reply toSlowDragon

Thank you for jumping in and your advice :)

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