I’m in the process of being investigated for hypothyroidism, after a couple of private blood tests, most recent showing TSH of 5.06 mIU/l, free T3 of 3.9 pmol/l, free T4 14.3 pmol/l, TPO Ab 41.7 kIU/l
My GP has been very supportive and has me booked for these tests to be repeated on the NHS to confirm the diagnosis. She is prepared to prescribe thyroxine for me, even if I am sub clinical.
The reason for this post is to ask whether anyone can confirm that hot flushes are associated with hypothyroidism! I’m well and truly post menopause, but have had a return of hot flushes for the last several weeks. I have one as regular as clockwork in the morning, just after I’m aware I’m awake. And then several more at odd times of the day. I’ve read online that hot flushes can be associated with hypothyroid issues, but only on general sites, I can’t find any research or papers or more reputable sources.
My GP says she hasn’t heard of them being part of hypo symptoms and as well as the TFT tests has asked for “blood disorder” tests. Of course now I’m much more worried - especially as one of the tests is for multiple myeloma. I have zero symptoms that would fit this.
So, my question - can any of you wise and well read people point me in the direction of any reputable sources of further information?
Thank you
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Many symptoms of hypothyroidism and hyperthyroidism overlap & I for one have symptoms on both lists:thyroiduk.org/signs-and-sym...
Your recent flushing may well be linked to your thyroid health.
Can you please provide ranges for your test results (in brackets after results) as these can vary between laboratories. TSH should always be under 2, with many members reporting they feel best when it falls under 1.
Thanks very much for your reply. The NR for my results as follows:
TSH of 5.06 (NR 0.27 - 4.2 mIU/L)
Free T3 of 3.9 (NR 3.1 - 6.8 pmol/l)
free T4 14.3 (NR 12 - 22 pmol/l)
TPO Ab 41.7 (NR 0- 34 kIU/l)
It’s such a complex area - but I suppose it reflects the importance of these hormones as core to general health. I do feel like I’m at the beginning of something quite intimidating, but this site has been so helpful. Thanks so much to you and the other admins and contributors, who have helped me start the journey. I hope it leads to better health.
So your TPO antibodies are over range confirming autoimmune thyroid disease aka Hashimoto’s
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Hot flushes and especially night sweats have been the bane of my life ever since my hypo symptoms made themselves known. That’s 30 years ago now! The ‘when you wake up’ one is every single morning without fail.
I am trialing gluten free. To my astonishment the flushes and night sweats have reduced significantly. Some nights to zero! The waking one is now short and minor too. I hate being gluten free but sadly the benefits outweigh even a Belgian bun!
Thanks so, so much for your answer! It’s reassuring to know that at least someone else has been having this odd and very unwelcome symptom. I’m really sorry you’ve had to cope with it for so long, but if, as you say, giving up gluten is helping, then that’s great news. Pity about the Belgian buns though.
Can you tell me whether your GP took you seriously on hot flushes as a symptom of being hypo? I’ve been really worried since seeing my GP, who said she’d never heard of it as one, and is checking me for much more sinister causes.
Sorry but most GP’s don’t have a clue. Even if they did it seems that symptoms relating to menopause are acceptable for treatment and the same symptoms related to thyroid are not. My symptoms started immediately following my hysterectomy. Doctors were determined that everything was related to that so gave me every form of HRT ever invented. None of them made a scrap of difference but no other suggestions were made. Years later, when I had become quite ill, they told me my symptoms were consistent with thyroid disease but that everything was normal and didn’t need treating! I was then lucky to see the late, lovely Dr Peatfield and have treated myself privately ever since.
Good luck, listen to your GP but listen even closer to what the wise people on this forum tell you. They know far more.
Your T3 and T4 levels are very low which is reflected in your TSH being over range. My endocrinologist explained to me that a TSH above 2.5 will give you hypothyroidism symptoms even though the top of the range is around 5. So you definitely need some levothyroxine T4 to help you. T4 levothyroxine sits in your body and waits to be converted to the most important hormone T3. T3 is the driver within every single cell in your body. It gives you energy. It’s your metabolic rate. It lifts your mood. As your T3 is very low once you start on the T4 levothyroxine you need to ensure your T3 is checked routinely to ensure you are converting to T4 properly. I know for sure I had sudden sweats and over heating when my thyroid failed and I wasn’t optimally medicated. I take levothyroxine plus T3 liothyronine daily for my Hashimoto’s and I’m a very poor converter hence why I take T3 Liothyronine also. My sister who also has a thyroid condition ( cancer) has constant over heating. We are both way past the menopause. We both started the menopause aged 42. We are now in our 60’s. My over heating disappeared when I was finally optimally medicated. So getting the correct dose for yourself is very important.
It’s also very important to optimal vitamins D, B12, folate and ferritin. Check these and make sure they are not scraping in at the bottom of ranges they should be good and optimal for good t4 to t3 conversion.
Thanks McPammy - I hope I have less of a journey toward a bit of recovery than you - just read your bio. Goodness me you’ve had to be your own advocate all the way!
I don’t know the answer to your question but I thought I’d just mention that I started having frequent hot flushes again whilst eating a low carb diet in an effort to reduce the likelihood of diabetes. I’m 65 & well past menopause. Now I’ve abandoned the low carb diet the flushes have stopped.
I’m hypothyroid & take both T4 & T3. It’s possible that we’re predisposed to hot flushes as our hormones are already disrupted by poor thyroid hormone levels. Flushes are not listed as I side effect of low carb eating that I could find. Your chosen TUK name suggests that you’re not a low carb dieter so it’s probably not that!
I found that wheat and oats both cause me hot flushes, I've now gone gluten free and they've pretty much gone away, although I do still flush if I have to do something immediately stressful that makes me panic a bit, so I presume there's a cortisol link there somewhere.
Hi Titaniumfox - this is exactly what I'm realising. If there's something a bit stressy, I have a flush - the cortisol link is interesting. No idea what to do about it except hope I get some treatment soon.
The gluten free aspect seems quite established too - from what I've read here
For me, there are 2 situations that cause hot flushes. The first is eating too much white carbs during a meal: white rice, potato, pasta. A couple of hours later I'll get a hot flush. My body obviously can't deal well with a sudden rise in blood sugar. The second is waking middle of the night to a racing heart, anxiety and a flush. I believe this is due to low ft3 which leads to low blood sugar, which the body tries to compensate by releasing cortisol and adrenalin - to try to raise blood sugar again. Obviously a complex interconnected situation, but basically all initially down to not having 'optimal' thyroid hormones. Quite keen for it not to progress to full blown diabetes, so am generally very careful with my carb intake.
For me, there are two kinds of this. One is when my face gets hot (what I call "flushed"). The other I call a hot "flash" - that's when I start sweating a lot all at once.
First - The hot face has happened all through my early under-replaced days. Pre-hypo diagnosis, hot face was sometimes correlated to my rosacea acting up. All of this - including the rosacea - got 95% better when I started Levo. Still happens when I feel particularly under-replaced and made worse when I drink too much coffee.
Incidentally, I can say one of the surprise upsides of starting Levo was realizing my rosacea was actually a symptom... and what a joy that it has cleared up in the past year while I get my Ts up.
Second - hot flashes. BRAND NEW! Started a couple months ago at the same time as my monthly cycle jumping around for three months in a row. I went from 28 days to 25 days about 5?? years ago (both steady and consistent) UNTIL about 3 months ago and then I think I had like a 15 day then a 29 day cycle. Something like that. Pretty sure I'm moving from peri to menopause and it's creating so much mixing up of causes and symptoms between that variable and my thryoid. Not sure if it's the same in the UK, but in the US there is high awareness that hot flashes (the sweaty kind) are menopause related, and recently there have been TV commercials repeated ad nauseum for a drug that treats those hot flashes for menopausal women.
So that's my experience. I am trying to hold on for dear life as I "low and slow" my thyroid replacement, and wait for these menopause symptoms to come out of left field and wreak havoc!
Oh Fallinginreverse, I do hope you can get some support if it is menopause related. I had dreadful hot flushes (flashes) - the whole body type after a surgically induced menopause. HRT was very helpful, but the hot flushes I’ve had for the last month are like going through it all again.
yes, hot flashes are associated with hyperthyroidism and hypothyroidism. When my TSH is off, I have them a lot. I am 64 yrs of age and have having them as we speak. Trying to get my levels up. My TSH is low right now. COVID messed them up
thanks so much for this - it was worrying me so much, as I haven’t been able to find definitive connections online between hypo and hot flushes. So to have had the responses I’ve had from other people in the same position has been very reassuring
You've had great replies already so another is probably not really necessary! but yes, definitely correlated for me, as they start and stop with changes in my meds (I'm still trying to find my optimal dose and type of meds). I also think they're linked to low cortisol for me (probably). Sounds like you have a GP that listens which is great news, hope you can get some treatment soon
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