why do i get irritable and get morning nausea

[ali2341]

hi everyone i have been struggling for a long time since being hashi. hypo for 2 years, im on 100 mcg of t4 and have dont some test where t3 and t4 are around 55% through range i cant go any higher than 100mcg as i get hyper symtoms, but why i this happening to me when i eat a meal im ok for a few ours then i get really angry and have to eat again, also sometimes i wake up after a few hours of sleeping and if i somehow get 7+ hours i am feeling nauseas in the morning and cant even brush my teeth without eating first ? is it a blood sugar issue or adrenals there is something wrong with me. Its really affecting my mental health as i have anger issues and this problem is the last thing i need.

[SlowDragon Administrator]

previous post shows you were likely not on high enough dose levothyroxine

healthunlocked.com/thyroidu...

Which brand of levothyroxine is your 100mcg tablets

Do you always get same brand levothyroxine at each prescription

Common to need to increase dose very slowly

Eg is going from 100mcg to 125mcg

Initially only increase by 25mcg per week (as 2 days at 12.5mcg extra) …..after 4-6 weeks….increase by another 25mcg per week……so then on 112.5mcg 4 days week

Then increase to 112.5mcg every day

Retest after 6-8 weeks

Approx how much do you weigh in kilo?

Approx age?

[ali2341 in reply to SlowDragon]

32 , 120 kg i cant tolerate 112,5 i get hyper symptoms insomnia hungry all day

[SlowDragon Administrator in reply to ali2341]

Common initially to feel a bit over replaced initially when first dose is first increased

Waiting at least 12 weeks on higher dose

What were results after 6-8 weeks at 125mcg (or 112.5mcg)

Always test early morning and last dose levothyroxine 24 hours before test

Are all four vitamins at good levels

Have you tried splitting levothyroxine…..half waking and half bedtime

ALWAYS worth trying gluten free diet with Hashimoto’s

[ali2341 in reply to SlowDragon]

i could take 125 mcg before last summer when my vitamin d was super low, now after replacement of vit d i cant even tolerate 112.5 mcg, wont be able to as i cant even sleep more than a few hours on it. not tried splitting the dose, been researching and might be adrenal problem too ?

[SlowDragon Administrator in reply to ali2341]

How much vitamin D are you taking

Have you retested vitamin D levels

Are you also taking magnesium supplements afternoon or bedtime (must be four hours away from levothyroxine)

Improving low vitamin D can result in needing to improve B12 and folate

Are you taking good quality vitamin B complex with folate in

[ali2341 in reply to SlowDragon]

not taking mag, taking d3 1000 iu a day now to maintain levels after pills from doctor vit was in range, other vits are fine done tests. this is not a vit problem something is wrong and i need to possibly get cortisol test

[SlowDragon Administrator in reply to ali2341]

i could take 125 mcg before last summer when my vitamin d was super low, now after replacement of vit d i cant even tolerate 112.5 mcg

Do you always get same brand levothyroxine?

Many people find different brands are not interchangeable

Teva especially upsets many people

[ali2341 in reply to SlowDragon]

Yes but tried different brands to no difference

[Jaydee1507 Administrator]

This sounds like you're:

1. horribly under replaced

2. very likely have low vitamin levels caused by poor absorption. Hypo's get low stomach acid which causes the poor absorption. Low vitamins cause intolerance of thyroid hormones.

3. Possibly intolerant of gluten, dairy and soy. Worth cutting them out of your diet one by one to see if it helps.

What were you latest thyroid results with ranges, also vitamin test results - ferritin, folate, B12 & D3?

[ali2341 in reply to Jaydee1507]

all vitamins were fine been taking them for months and tests ok, t3 and t4 are around 50% through range

[Jaydee1507 Administrator in reply to ali2341]

It sounds like you're a sensitive one. Have you tried lactose free levo? No guarantees but could help.

As far as diet goes you may need a low carbohydrate/sugar diet. Try eggs for breakfast and if that helps it's a good indicator. Also removing gluten & dairy can be very beneficial.

[ali2341 in reply to Jaydee1507]

allergic to eggs , there something wrong hormonally might be high or low cortisol i know that regulates blood sugar need to get it tested, or i hear t3 can help in that too

[Jaydee1507 Administrator in reply to ali2341]

If you're struggling with Levo then T3 may not be the answer. Up your protein intake and lower carbs. Whatever food suits.

[SlowDragon Administrator in reply to ali2341]

Most people when adequately treated will have Ft3 and Ft4 at least 60-70% through range

Vitamin D was too low recently

If your Weight is 120kg you’re probably not on high enough dose levothyroxine

Guidelines suggest 1.6mcg per kilo of your weight per day

That’s around 190mcg levothyroxine per day

[ali2341 in reply to SlowDragon]

theres no way i would be ablt to take that much will try small amount of t3 with 100 mcg of t4

[SlowDragon Administrator in reply to ali2341]

So first thing is probably adding magnesium

The trouble with adding T3 before levothyroxine dose is high enough is as soon as you add T3 your TSH drops significantly often becomes suppressed and then your own thyroid output shuts down and stops

Suggest you get Regenerus cortisol and DHEA test next

regeneruslabs.com/products/...

Then try splitting levothyroxine as 2 doses but not until AFTER done cortisol test

When adding T3 need to do so EXTREMELY slowly

2.5mcg or 5mcg maximum initially

Start with adding T3 alongside levothyroxine waking up

Assuming that’s ok

Wait at least a week before adding 2nd 5mcg dose mid afternoon

Wait another week before adding 3rd 5mcg dose at bedtime

Wait 6-8 weeks before retesting

Optimal vitamin levels essential

Serum B12 at least over 500

Active B12 at least over 70

Folate and ferritin at least half way through range

Gluten Free diet can improve absorption of levothyroxine and may help with cortisol issues too

Similarly dairy free often beneficial too

[Hidden]

this sounds adrenal to me. Low morning appetite/nausea is a sign of high stress hormones which you might have if you are badly replaced. It might also be why you have hyper symptoms when raising. Likelihood is that you need to raise incredibly slowly x

[ali2341 in reply to Hidden]

thanks for the reply i think its high stress hormones too as i had mental health issues before being hypo and its similar symptoms, when i eat i feel better i cant even do 112.5 mcg as it casues insomnia and seems like high adrenaline, i will try around 3mcg of t3 with my 100 mcg of t4 as i hear t3 can lower stress.

[LucyYoga in reply to ali2341]

Yes I agree with relentlesssearch- sounds very adrenal to me too. In your shoes I would do regenerus 5 point cortisol test as suggested earlier in thread, and work at balancing blood sugar levels / hypoglycaemia. In my experience so far with raising doses, aside from obvious ones like optimal D, B12, ferritin and folate (as SlowDragon has talked about), I think addressing adrenals through diet , correct supplementation (vit c, b vits, adaptogens/ potentially adrenal cortex) and lifestyle (stress management - eg yoga/meditation/ breathwork or whatever works for you) is crucial. Also as we know inflammation is it the root of all diseases- particularly an issue with hashimotos - and the single biggest driver of inflammation in the body is blood sugar dysregulation. A sure sign of blood sugar dysregulstion is feeling ‘hangry’ during the day then better after food. Going on a blood sugar roller coaster then just puts more stress on already stressed adrenals. And from my own experience, my own opinion and the dearth is material I have read- adrenal dysfunction and hypothyroidism go hand in hand.

Good luck

[Hidden in reply to ali2341]

That sounds tough! As LucyYoga says, your blood sugar regulation is quite important. I’ve found the best way to avoid these hangry episodes is to eat protein with carbohydrate, and eat little and often. Other opinions may vary. I did Keto and it made my blood sugar regulation worse so I find the longer I go without, the worse off I feel. Re. Raising your dose, I completely understand - I thought I was intolerant to thyroid meds for 2 years. Awful misery every time I tried to raise, these three things have meant I now tolerate thyroid meds without any side effects anymore - 

Raise EXTREMELY slowly. If it’s T4 you don’t have to take it every day as it’s storage, so you could actually start with 100mcg 6 days a week, 112.5mcg one day a week. Or you could even get a pill cutter and reduce that one day a week increase even more. 

Raise your dose, go back down and then raise again. I’m not sure why this works but it seems to reduce the side effects. 

Support adrenals! It does sound like your adrenals are making it hard for your raise your dose. A saliva adrenal test will help to confirm whether it’s high or low and the appropriate support can then help you. There is an interesting article here that explains the role of cortisol & thyroid hormone: paulrobinsonthyroid.com/hig...

[Mccrae]

have you had a complete female hormone panel?

[SlowDragon Administrator in reply to Mccrae]

ali2341 is male

[Rhannii7]

Hey, im the same, I had to get on NDT but its stopped working now also. I personally have conversion issues but when I tried to add t3 to the ndt I get anxiety and rage issues. Cant breath properly either, cant raise the ndt either without issues, I saw on my blood test that my cortisol is high as well, im getting those sugar spikes too. Have you checked reverse t3 ? Might be worth a look. Mine us also a bit hogh . You might might need to add t3 and reduce the t4 a bit . They all say go low and slow when adding t3

[dazzaman]

Hi Ali,

My name is Darren and I'm hypo like yourself and had the same problems as you but seemed to sort then out

I might be able to help you if you would like a chat on the phone

[ali2341]

Thanks for the replies everyone , going to do cortisol test soon and i will try ashwaganda as i seen studies where it lowers cortisol levels and tsh