I am struggling to fine tune the timing of my Levothyroxine dose and just wondered whether my low (but not low enough for HC) morning cortisol is the cause.
If I take the dose at night, I have poor sleep, and feel groggy in the morning. Energy is then poor during the day, and I am exhausted by 7pm.
If I take it in the middle of the night, I wake up a lot earlier than usual but with a heavy, foggy head and energy is poor. This lasts until after lunchtime, but I could then work until midnight.
And, if I take it first thing in the morning, I am ok for an hour or so but then get a foggy head (when the levo kicks on??) and feel exhausted. This lasts until after lunchtime, and I get tired again around 8pm.
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BreifneKing
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How much levo are you taking? It sounds more like you're not taking enough, rather than the time you're taking it. When did you last have a blood test, and what were the results?
I don't think levo has any direct effect on cortisol, because it is basically a storage hormone that doesn't do much until it is converted into T3. And that is far from instantaneous! What's more, it doesn't 'kick in'. It is slowly absorbed into the blood, through the gut wall, and floats around in the blood for some time before anything happens.
But, if taking it at night affects your sleep, don't take it at night, because you need a good night's rest to have decent levels of cortisol in the morning. Are you getting plenty of B vits and vit C for your adrenals? Do you ingest a fair amount of salt? Adrenals should improve as FT3 levels rise, but maybe you have a conversion problem, so the levo you're taking isn't helping them. What you need is full thyroid testing to find out these things.
Well, you probably won't get enough vit C just eating fruit for sick adrenals. I cup of kiwi is only 167 mg. 1 cup of orange is only 95 mg. I was thinking more in the 1000s mg.
So, are you on a low salt diet? Do you use salt in cooking? Adrenals need salt.
Unfortunately I have heterozygous hemochromatosis so was advised by my haematologist to not take vit c or iron supplements, hence the reliance on fruit.
Sorry GG I’m needlessly splitting hairs - I do occasionally use Himalayan pink salt but I don’t use cooking or table salt (which I refer to as ‘salt’) and I’m not on a low salt diet.
Yes, you are splitting hairs, aren't you! lol Salt is salt. Qualify it if you like by saying 'table', 'sea' or 'pink Himalayan', but it's all salt. In any case, sounds to me like you're not getting enough, so your adrenals are suffering.
I too have haemochromotosis, and supplementing Vit C isn’t advised with food as aids absorption of iron but you can take it in between meals. I take up to 3g daily for adrenals. I also use plentiful salt at any time.
Aldosterone (another adrenal hormone) tells our kidneys to retain salt but with adrenal issues we frequently pee too much salt out. If you find salt isn't tasting very salty, then you need more. If your ankles swell, then you have taken too much (Dr P tip, I think 🤔). Have you had electrolytes tested?
I’m sorry that nobody answered your question and you were asked to make a new thread. It’s very normal for most threads to have some questions posted to those answering and they do normally go off on a bit of a tangent at times it can’t be helped ! So please don’t be put off posting due to this. The important part is you were reading the post (which means you were intending to help).
Beau55 Thank you, Yes I often see others asking different Qs on different threads - I like that we all chip in to help one another along and I certainly have zero qualms if anyone wants to ask a Q that could help them on my own threads… some people just don’t like sharing I guess 😂 2000mg actually is what I’ve been researching might be best! My adrenals thank you for your advice 😊
Low GFR is more likely linked to slow metabolism resulting from either inadequate amounts of thyroid hormones replacement meds or the right amount that are not working on a cellular level, so inflicting hypothyroid symptoms. The amount depicted in our labs is only what is in blood circulation (either free or bound) and doesn’t necessarily imply what is active on a cellular level.
187.5 mcg of levothyroxine
FT4 - 16.6 (09.00 - 19.00) 76% through range
FT3 - 5.0 (2.4 - 6.0) 72.22% through range
Your labs are good. In reply to your original question I would split thyroxine to get a better spread, particularly with adrenal issues. Any elevation or trough will be another stress for the adrenal glands and often why people can’t introduce T3 in one dose as the body starts secreting adrenaline in response.
Because T4 is a storage hormone to be slowly converted, for years it was said it doesn’t matter if you take a large amount in one go. There are even papers evidencing whole weeks worth in one dose but some members have found less of a bump when it is daily split dosed. I medicate both NDT & T4 and split both am & pm, as believe it's not a natural bodily response to have a whole daily amount of hormone dumped into the body in one go.
Many micro nutrients such as zinc, magnesium, iodine are required for good conversion but the one encouraged best is selenium 100mcg daily to improve conversion and reduce thyroid antibodies (should you have elevated). I also supplement Optimal Minus One by Seeking Health as contains all the nutrients essential for conversion and no iron. You may find other members against multivitamin pills but my take is they are fine (we don't split nutrients gained from our foods!), as long as they aren't expected to address a large deficiency as wouldn't be adequate.
Regarding the Vit C, yes start slowly as it can give some people upset tummys. I use Biotics Research Mixed Ascorbate Powder 3g and Seeking Health Magnesium Glycinate 200mg taken daily when I remember 😁.
We are also told not to eat red meats, drink alcohol, etc but if you time things right we can manage ok ie never have a steak with a glass of red!😬
Thank you; that is quite possibly the most ‘tailored’ response / advice I have ever received (and from reading other posts I’ve noted that that’s something both you and greygoose do strive to provide, which is greatly appreciated).
Is there a cutoff time for the second thyroxine dose or should the two doses be 12 hours apart?
Regarding vitamin supplements: I will start the vit c between meals today but is there any reason for not also starting selenium, multivit, and possibly magnesium as well? I only ask because I’ve tended to follow the ‘change one thing at a time’ rule (although I’d quite welcome going full on rock ‘n’ roll tbh🥳).
That’s dependant upon if you are treating a nutrient deficiency with high supplemental doses or just keeping optimal levels topped up with a multivitamin.
When making large adjustments to any levels it is always best to introduce one thing at a time, and take any supplemented magnesium separately or it will bind everything else.
There is no rule for split dose timings of thyroid hormone meds as people find their own preferences through trial and error. I take mine upon waking between 6 -7am and again mid afternoon around 3pm which helps me avoid that afternoon slump.
It’s funny you compare greygoose and myself because we tend to suggest opposites 😂, but the beauty of the forum is you receive every experience, opinion and angle.
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Read member Hashihouseman's experience regarding splitting Levo (about 3/4 way down page).
is there any reason for not also starting selenium, multivit, and possibly magnesium as well?
The reason is that if you start several things at the same time, you won't know what is doing what - what is helping and what really doesn't suit you - because not everyone gets on with all supplements.
And there are many, many reasons for never starting a multivit! They really are the biggest con on the planet. I can go into minute detail, if you wish, about why, but they are never, ever recommended on here. You might just as well throw your money down the drain!
Levothyroxine (T4) doesn’t affect cortisol directly, T3 does. Without your results it’s impossible to know how levothyroxine as a precursor to T3 is affecting your cortisol because we can’t see how well you convert T4 into T3. Levo doesn’t “kick in,” it’s a storage hormone, the timeline between its conversion into T3 is far longer than the one you’re suggesting that you experience.
”my low morning cortisol” - is this a guess that you have low morning cortisol or have you actually tested this? They can present very similarly. Testing is not optional for any cofactors or hormones involved in managing thyroid disease. If you have low morning cortisol on T4 monotherapy then adding T3 and/or adrenal cortex can be the answer.
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