Hi everyone. I’m having lots of night sweats. Is it possible my NDT is too much. I’m taking 2 grains in the morning. T3 in higher range

[Papillon2011]

Night sweats

[Lalatoot]

Without seeing blood results we cannot comment.

[Papillon2011 in reply to Lalatoot]

Hi sorry didn’t seem to have room to put results in

TSH 0.64. (0.35-4.94) T4 9.30. (9.01-19.05). T3 4.90 (2.63-5.70)

All the other blood tests were normal.

[humanbean]

TSH 0.64. (0.35-4.94)

T4 9.30. (9.01-19.05) 2.9% of the way through the range

T3 4.90 (2.63-5.70) 74% of the way through the range

I'm going to assume that your T4 is actually a Free T4 result rather than a Total T4 result, and ditto with the T3 result. I'm going to assume that is a Free T3 result not a Total T3 result.

I can think of several scenarios causing your night sweats but I can't say which scenario might apply to you.

1) Some people do very well with very low levels of Free T4 and a good level of Free T3 but some people don't. You might want to try taking some Levo (say, 25mcg to start with?) with your NDT to see if it increases your Free T4, and see whether it helps you feel better. You currently appear to be a super-converter - but that sometimes happens when T4 is too low - the body converts all the T4 (into T3) it gets given which keeps it low, and it isn't always good news. You'd have to pay attention to what your Free T4 AND your Free T3 is doing if you added some Levo.

2) When the body is short of thyroid hormones one of the coping mechanisms the body uses is to create more cortisol, one of the stress hormones. Cortisol production has a circadian rhythm. In a healthy person cortisol production reaches a peak at about 8am - 9am then reduces throughout the day. It reaches a minimum during the night and then when the body starts preparing for the day (at roughly 3am - 4am ) it starts to increase cortisol production to help you wake up and get your body moving.

This image of the cortisol circadian rhythm is a bit cartoonish but it will give you a rough idea of what happens :

data.integrativepro.com/ima...

People often get night sweats when the cortisol production starts to ramp up at around 3am - 4am, but there are timing differences between individuals depending on sleep and work patterns.

3) Low nutrients cause physical stress to the body which can mess up cortisol. I saw in one of your earlier posts that you have a good level of ferritin (iron stores), your vitamin D level was good, and so was your calcium. It would help if you had results for folate, vitamin B12, and serum iron as well.

4) I don't know what effect your HRT will have on you, your thyroid, or your cortisol or whether it helps with night sweats.

[Papillon2011 in reply to humanbean]

Hi. Thankyou so much for your reply. My results for B12, and ferritin we’re good, in fact my B12 was a bit high so I’ve had to stop taking the high supplements for a while. I think you may be right in trying a bit of Levo to see if that helps.

[Hidden]

I guess the only way to know is to reduce your dose by a quarter and see if it makes a difference. It did for me, as within a few days, I hardly get any hot flushes now and find I can snuggle under the duvet without having to throw off the covers within minutes 😁 (Downside is I have cold feet again at times)

[Papillon2011 in reply to Hidden]

Thankyou for replying. Yes I am going to try and cut one grain in half and add a small dose of Levo. Hoping I don’t feel more tired from cutting down.

Would love to be snug under the duvet instead of no covers with fan on !!!!😆

[pennyannie]

Hello Papillon

My understanding is that when on NDT your TSH will be low/suppressed :

Your T3 will present higher in the range whilst your T4 will be proportionately lower in the range :

but then these ranges and guidelines were written to be used alongside Levothyroxine, and all introduced to replace NDT medications.

So your blood tests reflect this but maybe you are not on the right dose yet :

How long have you been on 2 grains, when did these symptoms occur and have you introduced anything else into your medication regime ?

[Papillon2011 in reply to pennyannie]

Hi. Thankyou got your reply. I have been on 2 grains for about 4 months now. I went from 1 1/2 to 2 hoping it would give me some much needed energy. That doesn’t seem to have worked. So as suggested by others I’m going to try cutting down again and adding Levo. But I’m not sure what exactly the FT4 does, what difference the levels make in your body.

[pennyannie in reply to Papillon2011]

Hey there :

T4 is a storage hormone that needs to be converted by your body into T3 the active hormone that the body runs on.

T3 is said to be about 4 times more powerful then T4 and the average person uses about 50 T3 daily, just to function.

Your body needs to convert the T4 thyroid hormone into T3 and this can be compromised if you vitamins and minerals, especially ferritin, folate, B12 and vitamin D are not maintained at optimal levels in the ranges.

Your conversion can also be compromised if you suffer other health issues, physiological stress ( emotional or physical ) inflammations, depression, ageing, dieting, to name a few.

If you have been on 2 grains NDT for 4 months and are only just getting these symptoms I doubt the cause is NDT and when you adjust a dose of NDT it should be only by a 1/4 grain and then reassess your if symptoms diminish/increase.

Some people are unable to convert T4 effectively and so some people try a T3 + T4 combination to find their wellness, whilst others try NDT and others try T3 only as find they can't tolerate T4 at all.

Unfortunately It's all a bit trial and error, trying to find your best health with limited knowledge from most medical professionals.

[humanbean]

I don't think you need to cut your NDT before adding a small dose of Levo. Your Free T3 isn't too high.

[Papillon2011 in reply to humanbean]

Do I take the NDT and Levo at the same time?

[humanbean in reply to Papillon2011]

You could do if you wanted to. I would take them together if I was taking both.

[Papillon2011 in reply to humanbean]

Thankyou so much for your help. I wonder how quickly it will make a difference.