Newly Diagnosed Hashimotos, struggling with insomnia, night sweats and Tinnitus

[MissMonty]

Hi there. Any tips and advice for my symptoms would be really appreciated.

I started with a whole heap of symptoms 6 months ago: hairloss, tinnitus, intense night sweats, low mood, muscle twitching, sore joints etc. My mum has hashimotos, so I got it checked with woth the GP.. Tested TSH (3.8) only and told me I was fine. However a friend who has graves advised to get a medichecks blood test:

9.15 AM test

TSH 2.46 (0.27-4.2)

T3 4 (3.1 -6.8)

Free Thyroxine 15.7 (12-22)

TPO 226 (0-34)

Low end of scale vit D and B12 but others fine

I had lots of conflicting advice from GPS and endos on whether I was hypothyroid or not, all said that I was fine and to go away and watch and wait, apart from one GP who started me on x2 half grains NDT 6 weeks ago.

I felt an immediate reduction in symptoms, especially the ones that were bothering me most being tinnitus and intense night sweats and waking every hour with a racing heart and extremely dry eye sockets. However this only lasted a week or 2 and the symptoms have slowly started to creep back up. My latest blood results (6 weeks post starting NDT) are confusing as they look worse that when I started as everything much the same apart from my free thyroxine has decreased:

8am blood draw, Fasting, before medication

TSH 2.12 (0.27-4.2)

T3 3.98 (3.1-6.8)

Free Thyroxine 12 (12-22)

Vit D and B12 now in middle/high endof range after supplements. All others still fine

Any advice on how to manage the insomnia and night sweats greatly appreciated. And does it sound as though I'm on the right track taking thyrpid medication? I have another month to wait for a follow up appointment with the prescribing doctor. Had an endo frighten me half to death saying that if I took I would end up in her office having had a stroke in a few years time, however didn't offer amy other alternative hypothesis or tests for why I was having the symptoms I was having other than "stress" from the tinnitus.

I have 2 small children at home and am really struggling with the exhaustion of unrefreshing sleep and the torment of tinnitus slowly creeping up in volume each day. Could the night sweats and dry eyes be perimenopause perhaps?

Thank you so much for any help/advice

[csj113]

Hi, I’ll let someone else comment on your thyroid blood results (apart from agreeing with you that you had a case for medication as your TSH was creeping up and you have antibodies) because I know nothing about NDT.

I would say though, that your symptoms could be peri-menopause too, and sometimes for women it can be difficult to untangle the two things. Do you have a GP you can speak to about that? Increasing numbers are going for menopause training. You can also check out the Balance website.

[MissMonty in reply to csj113]

Thank you csj113, interestingly the GP who is helping me with my throid has just emailed to say she thinks it could also be peri-menopause and we can discuss HRT at my next meeting in a month. I would love to hear from anyone having gone though similar experiences. I think perhaps my 2 pregnancies (I have a 4 Yr old and a 2 Yr old) may have triggered both the thyroid and hormone issues? ... I miss sleep so much my 2 Yr old has just stated sleeping through the night so now I finally have the opportunity after 4 yrs of being kept up by the little ones ..my body isn't playing ball and still no sleep with this awful tinnitus and night sweats 😴🤦‍♀️

[tattybogle]

it is quite common for fT4 levels to decrease a bit when starting on low doses of thyroid hormone replacement.

As dose is increase this will balance itself out , and 4 will rise as dose is increased .

The reason is probably because when we add a bit of T4 to what we are already making, the pituitary notices this and in response it lowers the TSH a bit. TSH (Thyroid Stimulating Hormone) is made by the pituitary and is just a 'message' asking the thyroid to make more T4 / T3. (the higher the TSH is , the louder it is shouting for more)

When the TSH is lowered ,the thyroid is asked to make a bit less T4/T3.

So until you have added 'enough' T4 to fully compensate for this lower T4 production from the thyroid .. you can initially end up with less T4 than you started with.

over -simplified example ..there is more going on than this , but:

say your body needs '100', but your thyroid is struggling and can now only make '75' no matter how hard it tries.

you add '25 ' (from tablet) ...and briefly (for a week or so) you have '100'.

But then the pituitary notices the T4 went up, (it's a bit thick, so it doesn't realise the thyroid didn't do this and the T4 actually came from a tablet).. so it still lowers the TSH because it thinks "oh good, the thyroid is making enough now , so i'll stop 'shouting' at it to make more."

So then the thyroid stops trying so hard and only makes '25'.

So then you have 25( from thyroid) + 25 (from tablet) = '50' (ie. less than you started with)

Dose is increase to 50 .... and briefly you have 50 +25 ='75'

Then pituitary notices and lowers TSH,, so thyroid then only makes eg. '10'

Then you have 10 (from thyroid) +50 = '60'

Dose is increased to 75.. etc. etc .

This continues until the amount you get from tablet is more than you started with and TSH stays stable.

[MissMonty]

Thank you tattybogle. A really good description... it makes sense with how I felt with the symptoms subsiding and then ramping back up! Hopefully some fine tuning on the dose will help me along side some HRT.

[Hidden]

How old are you MissMonty?

[MissMonty]

I'm 42. My mum went through the menopause at 50ish without any symptoms (she has hashimotos also) ... I remember a dr somewhere along the way told me you tend to follow the same path as your mum with the menopause.

[Hidden in reply to MissMonty]

Your mum got lucky there then! I only ask because I'm struggling to get any medic to take me seriously that something is amuck with my hormones outside of thyroid because I'm only 36 (birthday soon! 🥳).

[MissMonty]

I'm not an expert, as its all really new to me, but I'm sure I've read it can happen a lot earlier than 50s for some women. I'm sure a dr who is knowledgeable in the area would discuss this with you in more depth rather than just dismiss your concerns... keep asking until you find someone's expertise you feel confident with.... Good luck xx

[MissMonty]

No, I don't wear a fitness device unfortunately. I do have a blood pressure monitor at home that measures heart rate that I can use. I don't take any other medication other than my NDT for thyroid.