adrenaline rush wakes me every morning

[Ilovegreenolives]

I wake up early every morning with a rush of adrenaline..which feels very uncomfortable, it completely prevents me from going back to sleep, and my legs and feet ache and burn, so I end up just getting up early to make it all stop. I have low thyroid and am on 50 mcg. of levo, but still quite tired most of the day, low mood etc..and then every evening seem to feel a lot better in mood and energy. Is this related to low thyroid hormones or to a problem with my adrenals? I am thinking of also seeing functional medicine to see what they have to say.

[greygoose]

How long have you been on 50 mcg levo? That is just a starter dose and should have been increased to 75 mcg six weeks after you started it. You probably just need an increase in dose.

[Ilovegreenolives in reply to greygoose]

I have only been on the 50 mcg for only a week. hopefully she will increase it after next bloodwork.

[greygoose in reply to Ilovegreenolives]

Ah, ok, so it's far too soon to draw any conclusions of any sort. You need to stay on the 50 mcg for at least 6 weeks before the retest.

[Ilovegreenolives in reply to greygoose]

true..before that I was on 30mg. of armour for six weeks..was switched to levo because on armour my tsh and t3 improved but t4 still low, it did not bring that up at all.

[helvella Administrator in reply to Ilovegreenolives]

It is expected that T4 does rise much (or at all) on Armour Thyroid. Especially on a low dose.

30 milligrams of Armour Thyroid has just 19 micrograms of T4. That is, less than the lowest dosage of common levothyroxine tablets.

I suspect your doctor/prescriber is not as aware of Armour Thyroid and the expected results as needed.

[greygoose in reply to Ilovegreenolives]

Well, it wouldn't, would it. 30 mg is only a tiny dose. It's only about 19 mcg T4 and 4.5 mcg T3. And taking T3 in any form is going to reduce the FT4. Why didn't you just increase the dose rather than stop it altogether?

[SlowDragon Ambassador]

typical symptom when on inadequate dose of Levo

Please add most recent thyroid and vitamin results

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

[Ilovegreenolives in reply to SlowDragon]

thank you for your advice. waking up like that is pretty miserable and I've not heard anyone else that I know ever mention that symptom..hoping with increases it eventually goes away.

[SlowDragon Ambassador]

Burning feet can be low B12

Aching bones/joints low vitamin D

Have you had vitamin levels tested

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

thyroid levels should be retested 2-3 months after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements are you taking

Also VERY important to test TSH, Ft4 and Ft3 together

What is reason for your hypothyroidism

Autoimmune?

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Post all about what time of day to test

healthunlocked.com/thyroidu...

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

[Ilovegreenolives in reply to SlowDragon]

my vitamin levels have been tested, some were a bit low,so I am taking d, b vitamins and iron/folate. It is not autoimmune, but it all started about a year ago due to an extremely stressful year or two of two significant losses and a personal medical crisis.

Does improving thyroid levels also help the adrenals function better? I'm thinking they are shoving out way too much adrenaline into my system early in the morning.

[SlowDragon Ambassador in reply to Ilovegreenolives]

Adrenals try to compensate for lack of thyroid hormone

Adrenal levels should slowly improve as each dose levothyroxine settles

You will need several increases in levothyroxine over coming 12-18 months

Guidelines of dose Levo by weight

approx how much do you weigh in kilo

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)

cks.nice.org.uk/topics/hypo...

bnf.nice.org.uk/drugs/levot...

Some people need a bit less than guidelines, some a bit more

[Ilovegreenolives in reply to SlowDragon]

I weigh about 130lbs..not sure what that is in kilo

[SlowDragon Ambassador in reply to Ilovegreenolives]

Approx 58kg x 1.6mcg = 92mcg

So eventual dose likely to be around 87.5mcg per day

Important to maintain GOOD vitamin levels

Many thyroid patients need to supplement continuously to do so

[birkie]

I had this very thing it would wake me out of a deep sleep around 3, 3.30 sometimes earlier 😔 and try as I might I couldn't get back to sleep, I walked around my flat felling tied but just couldn't get back to sleep. This happened when I was taking t4 and t3 unfortunately these synthetic thyroid meds did nothing for me because of absorption and gut issues, it's only since starting on ndt around 9wks ago this sensation is definitely ebbing 🙌 I'm finding my sleep pattern is improving, but as members have mentioned 50mcg level is a starter dose and as you've only been on them a week you won't find any change yet...although many wish we could just take our medication and feel well right away🤷‍♀️ it takes time , 9wks and counting for me, and I'm not yet out of the thyroid woods.

[Ilovegreenolives in reply to birkie]

it is a miserable way to wake up every morning..I haven't been sure if its anxiety due to a very stressful past year or my low thyroid hormones...things have calmed down a lot so hoping part of the solution is my thyroid.

I'm glad things are slowly improving for you.

[arTistapple]

I have found that rushes of adrenaline are a ‘safety net’ whilst under medicated. It’s extremely unpleasant. I have a low HR and my adrenaline immediately, pushes up my oxygen levels and increases my HR, which wakes me up in no uncertain terms! Really it’s my body’s own first aid. Obviously you want to correct this but it’s extremely unlikely 50mcg is going to manage that!

As everyone is saying, it needs time (about six weeks) until you will most likely get your meds increased. Then it will be on to a new part of the process.

[Galadrie]

This is not going to be a clinical perspective, just one based on personal experiences. I used to wake up in a similar state, it was never confirmed as an adrenaline rush but I deduced it to be, recognised it as the sensations of “stage fright” I used to get as a child performing. All the pressures of my daily life immediately pressing down on me, and some disturbing nightmares just before waking that wouldn’t leave my mind. I used to take medication after waking but it would be hours before I felt settled. So I decided to flip it round, medicate at bedtime so I would wake more ready for the day. It made a big difference. The other thing that I did was get some talking therapy to provide strategies for dealing with symptoms of stress (excess adrenaline is a symptom) which was also very helpful. I seldom get that morning disturbance now.

[Ilovegreenolives in reply to Galadrie]

thank you for taking the time to reply to me! I do have low thyroid isssues, but also had a very stressful 2023, which I believe really took a physical toll on me, thyroid wise and my heart issues got a lot worse, which have been fixed with an ablation. Is your medication some type of anxiety medicine? I do have a presciption for ativan that I don't use much.

[Galadrie in reply to Ilovegreenolives]

I take levothyroxine for the thyroid issues. I don’t know if the early morning anxious feelings were connected to the thyroid situation or to the daily stress I was under from external sources. But changing to night time dosage and having talking therapy made the difference. I have never had medication for anxiety