Cortisol fluctuations on raising thyroid meds

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

[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.

[Hidden in reply to humanbean]

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 Administrator]

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

[Hidden in reply to SlowDragon]

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!

[Hidden in reply to SlowDragon]

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 Administrator in reply to Hidden]

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

[Hidden in reply to SlowDragon]

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 Administrator in reply to Hidden]

Previous post

healthunlocked.com/thyroidu...

Personally I would try splitting the dose

[Hidden in reply to SlowDragon]

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 Administrator in reply to Hidden]

Have you done Regenerus cortisol and DHEA test?

[Hidden in reply to SlowDragon]

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 Administrator in reply to Hidden]

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

Or yoga would be good

[Hidden in reply to SlowDragon]

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!

[Hidden in reply to Hidden]

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 Administrator in reply to Hidden]

Yes carry on as you are

[Hidden in reply to SlowDragon]

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

[Hidden in reply to SlowDragon]

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 Administrator in reply to Hidden]

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 ?

[Hidden in reply to SlowDragon]

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 Administrator in reply to Hidden]

What are your antibodies levels roughly?

[Hidden in reply to SlowDragon]

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 Administrator in reply to Hidden]

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

[Hidden in reply to SlowDragon]

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

[Hidden in reply to SlowDragon]

Thank you for jumping in and your advice