Hi, I have high morning cortisol and exercise vigorously each morning. I take 125mcg of T4 at 6am and then 15mcg of t3 at 9am, another dose of T3 of 15mcg at 12pm and another T3 of 10mcg at 3pm (total t3 is 40mcg). I keep gaining weight (and have done so since being put on t3 in Oct last year). My dr increased my t4 from 100 to 125mcg two weeks ago and raised my t3 by 10mcg to 40mcg. I’m not seeing any change (but maybe I’m being impatient!)
Could anyone offer any thoughts about reducing cortisol and also whether there is hope to loose weight? I am ceoliac and eat very well. My tsh is suppressed I don’t have rT3 issues and my t4 is not in the top quarter nor is t3 hence dr wanting to raise meds to get optimum. Many thanks
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DaisyJones1
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High cortisol levels will results in Cushings like symptoms, which includes weight gain and loss of bone density. So that's a plausible explanation for your weight gain.
There is a strong link between Thyroid hormone levels and cortisol levels. Indeed there is a strong link between Cushings and (low) thyroid hormone levels:
When people dose exclusively on Levo thyroxine they often end up with low Cortisol (I did). Those that take Liothyronine or NDT find their cortisol recovers. So can too much Liothyronine cause high Cortisol?
Your dose of Liothyronine seems particularly high. For example I'm on 100mcg Levo + 15mcg Liothyronine. (But I have a normal gut and obviously if your gut is not absorbing the Liothyronine well then you will naturally have to take more)
Normally when people take a lot of T3 they become hyper and that results in weight loss. However, after being though the mincer myself for the last two years it's certainly not as black and white as that. We all respond differently to thyroid hormone levels.
If this problem started when your Liothronine was increased then my instinct tells me that the net effect of increasing T3 for you is weight gain. This could be explained as follows:
Just as too little fT3 causes low Cortisol, too much could cause high cortisol. The net effect of that on your body would depend on how strongly your adrenal glands increase their cortisol output in response to increasing T3 and how strongly your body responds to the elevated cortisol. If that strength of those effect exceeds the usual increase in metabolic rate from increased T3 then you would get weight gain instead of weight loss.
This is not to say that the Liothyronine is causing the problem by itself. You may well have an underlying cushings disease or other adrenal gland problem that is less active when fT3 is low and more active when fT3 is high. I've not found any research to suggest that this would happen, all the research that comes up is to do with Cushings resulting in low thyroid hormone levels. But anything's possible.
My advice would be to get to an endocrinologist and see if they can identify whether something else is going on here.
Note also that not every one has to be in the top quarter of the reference range. It's called a reference range because 50% of all people are below the mid range. So don't aim for the top quarter for the sake of it... Always use how you feel as the guide.
Hi do you know if there are foods which might raise cortisol. I have low cortisol and was disappointed to see many of my favorite foods on the list of foods which lower cortisol!
I've tried Grapefruit and Licorice. In fact I still eat the grapefruit. Neither seemed to make much of a difference in before and after cortisol tests.
Careful with grapefruit as it can react with certain medications.
Thank you for your thoughtful and comprehensive reply. I am under an endo who raised my Levo to 125 and t3 to 40as she though that the high morning cortisol was linked to my body working so hard because I’m under medicated. I’m at a loss to know what to think. I do wonder about the intensity of exercise and whether this is increasing the cortisol in the morning. The cortisol test was done on a lower dose of 100 t4 and 30 t3. I have now moved my timing of t3 taking it now at 11am and then at 3pm in case it is raising my morning cortisol (my cortisol levels are fine in the afternoon). I’m just experimenting as don’t know what to do here or think! Thank you.
The normal rhythm of cortisol is to start high in the morning and drop rapidly the first half of the day and then more gradually to a very low level in the evening. So being low in the evening is good. Stress causes cortisol to go high and not drop so gracefully (a more irregular pattern throughout the day, which a seven point saliva test would show up). After prolonged stress the adrenal glands get tired (adrenal fatigue sets in) and the pattern switches to being low in the morning and relatively flat in nature ending higher than normal in the evening.
The cortisol rhythm is linked to your circadian rhythm, which in turn is linked to your T3 rhythm. So if your T3 rhythm is out, your cortisol rhythm will struggle.
There is a follow up article on the same website about dosing which describes how to take T3 to optimise your circadian rhythm. The peak of syrum fT3 should be 2:00am and the lowest level should be about 4:00pm with a rapid rise between 6:00pm and midnight.
Essentially the answer may be to take more T3 in the evening than in the morning. Noting that I personally find absorption is 25% less on a full stomach than an empty one.
I take 1/3 of mine my liothyronine dose when I wake and 2/3 when I go to sleep. I find this makes a big difference.
Some people don't tolerate taking large amounts oral T3 when they go to sleep, others love it and sleep like logs, so it's very much a matter of suck it and see.
If sleep is affected then an alternate suggestion would be to take 1/4 of you dose when you wake. 1/4 at about 5-6:00pm, 1/4 at 8-9:00pm and 1/4 at 11-12pm. This is also more in line with what thyroidpatients.ca recommend. Unfortunately I can't cut my pills that small.
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