Low cortisol: will it improve when I'm on HRT? - Thyroid UK

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Low cortisol: will it improve when I'm on HRT?

ā€¢19 Replies

I think I just keep asking the same question but in various different ways. šŸ˜‚

I work term time only and every half term I'm full of optimism about what me and the kids can do and how much I'll get done in the house and inevitably I spend all week on the sofa. It's the same every time.

I recognise this is probably because I push myself a bit too hard during term time but this morning I felt so dreadful that I was pretty close to trialling hydrocortisone cream. Despite 8+hours sleep last night I still struggled to get out of bed and have been flopping around all day.

So as thyroid is almost there and I'm hopefully starting HRT in the not-too-distant future will the cortisol issue resolve itself?

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HeartWoman profile image
HeartWoman

I am on estrogen and now trying to optomize my thyroid. I did not find the estrogen to help with cortisol. I am hoping that when my T3 and T4 are higher in the range, then my energy comes back. BTW, you will definitely need to watch your thyroid if you go on estrogen. Often women need higher doses of thyroid when also on estrogen.

ā€¢ in reply toHeartWoman

I often think getting well is one of those sliding squares puzzles.

I just don't know if I've got it in me to try and fix another problem. šŸ¤Ŗ

I hope your energy comes back when your thyroid hormones are better. šŸ€

FancyPants54 profile image
FancyPants54ā€¢ in reply to

Definitely try HRT. It can be a game changer for the mind and mood. And topical oestrogen, patch, gel, spray has much less, perhaps no effect, on thyroid levels. Just avoid using oestrogen in pill form.

All the hormones work together in conjunction. We can't just fix one and expect improvement sadly.

ā€¢ in reply toFancyPants54

I'm going to push hard for it at my next endo appointment.

Good to know topical oestrogen is fairly benign in terms of thyroid levels. Thank you!

I donā€™t think that your thyroid would ā€˜almost thereā€™ if your cortisol were as low as you think it is. Itā€™s more likely that cellular uptake of thyroid hormones is hindered by adrenal fatigue.

In summary, your blood levels may be showing reasonable levels which are not the reality

ā€¢ in reply to

It's not a case of 'thinking' my cortisol is low; it is low.

ā€¢ in reply to

I realise that. My point - not well made / sorry /brain fog - is that your cortisol is so low that itā€™s preventing absorption of thyroid hormone at cellular level. So when you say thyroid levels are ā€˜almost thereā€™ - they probably arenā€™t.

Bean101 profile image
Bean101ā€¢ in reply to

I tried progesterone with low cortisol and I crashed badly! Be careful

london81 profile image
london81ā€¢ in reply toBean101

me too my ft4 crashed to 4 percent so strange

ā€¢ in reply toBean101

Oh cripes.

Were you on oestrogen to??

Bean101 profile image
Bean101ā€¢ in reply to

No I wanted to start progesterone first.. Iā€™m going to work on Adrenals then try again

Alanna012 profile image
Alanna012

I have found Natpro progesterone cream helpful with energy.

During a particularly awful time when I had to take a 6 hour round trip to my son's university (get him settled, spend the day shopping, cinema etc etc) I applied the cream several days before and it gave me the energy (and the warmth) I needed to make it through the day.

I later ended up dropping it though as (just as with taking thyroid hormone) I hit a wall with it and trying to get so much right (thyroid, vits) at once is difficult.

I recently returned to trialing it, but rang a representative this time to talk through how exactly best to use it. Early days, but one thing I found I'm less dead in the afternoon and late evening. The downside is my sleep is actually worse - previously before it made me sleep. I'll have to see if that continuesšŸ˜¬

I hear testosterone is useful in bringing energy levels up and it is often overlooked.

You can get testosterone through Superdrug

onlinedoctor.superdrug.com/...

There's a clinic I think it's the Newson clinic that gives a specific testosterone formula for women that's licensed in Australia.

newsonhealth.co.uk/

HeartWoman profile image
HeartWomanā€¢ in reply toAlanna012

I was on testosterone for about a year. Unfortunately, it didn't help.

Alanna012 profile image
Alanna012ā€¢ in reply toHeartWoman

Oh nošŸ˜” I keep hearing it's the 'key' for so many! It's always the case that what works for some doesn't always work for others. It's disappointing when you hear about how great something is, but you are just not responding to it. Happens to me often.

HeartWoman profile image
HeartWomanā€¢ in reply toAlanna012

Exactly! I think i have it figured out and nope! Right now I am trying to adjust raising my T4 from 50mcg to 75mcg. I did fine until I hit the end of week 3. Now i am jittery anf sick at my stomach. I hope it is just settling end and I feel more normal soon. This hormone stuff is such a nightmare.

Alanna012 profile image
Alanna012ā€¢ in reply toHeartWoman

I don't know your history. But 75mcg is usually not enough levo. It's a dose at which for many TSH drops far enough within the magic range that people can end up being stuck on it. What brand of levo are you taking?

Some don't get on well with Teva (though personally I don't take well to any of them by themselves without some T3 and Teva is slightly stronger than the rest in my personal opinion) so maybe a different brand may not give you the same problems

HeartWoman profile image
HeartWomanā€¢ in reply toAlanna012

I just increased from 50mcg to 75mcg 3 weeks ago, so planning to test in 3 weeks. I take brand name Synthoid. I am in the states, so I don't know if that is available to you. I take 5mcg of T3 as well and wonder if i would feel better on more. I see a new endo in the morning. I just hope my body calms down soon. I was on generic T4, but requested name brand for consistency. So when i increased to 75mcg, i also switched to Synthroid.

I waa diagnosed about 10 years ago abd crashed bad after a year or so. I didn't know anything about thyroid and trusted my doctors. I looked back at labs and now realize i was way under treated. Plus, my estrogen was in the pit even though i was on it. Of course i waa diagnosed with anxiety and depression, which had never been an issue before the crash.

In 2017, I was on NatureThroid and did great. It went out production and i crashed again. I tried NP Thyroid and felt like i was on a rollercoaster. Now, trying a T3-T4 combo.

I hope i get back to my fun-loving self soon. I am just trying to fight through these jitters and hope they settle soon. The jitters just started yesterday and i figured it was because i am getting more thyroid in my system and my body is adjusting. I sure hope that is all.

ā€¢ in reply toHeartWoman

consider possibility of low cortisol

Alanna012 profile image
Alanna012ā€¢ in reply toHeartWoman

Yeah I mourned for NT. Absolutely brilliant NDT now gone foreveršŸ˜„ I keep an empty bottle in my cupboard, I can't seem to throw it out.

5mcg T3 is not a lot. I don't tolerate levo well and find I must raise my T3 higher and take the levo and T3 at the same time, each time spread throughout the day in order to tolerate the T4.

If I was to raise my T4 at a ratio considerably much higher to the T3, I get the nasty symptoms that come with taking levo.

It is normal to experience symptoms when raising levo dosage, so see how it goes. If things don't settle down after 6 weeks though, you have to consider if either the levo dose is high enough (75 is usually no where near enough) and raise it, or whether you ought to be raising your T3.

It is worth experimenting with raising the T4 first to work out whether that is the issue first.

It may even be possible for you to have a bit of NDT plus T4+T3.....

It can take time, even years to figure out what works for you personally. But if you can get along with levo with just a bit of T3 that would be ideal.

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