The last 4-6 weeks very cold weather in North Wales / North of England (temps of 4c down to -2c), have been a challenge. My PMR is in remission and "replaced" or is it "supplemented" with adrenal insufficiency. I take 25-35 mg of Hyrdrocortisone daily, also a tiny dose (30mcg) of levothyroxine for underactive thyroid.
When I get cold after a dog walk or even just in the house, I become super-sleepy and dose off for anything between 30 and 60 mins. When I waken I take 5-10mg of hydrocortisone and begin to 'waken up'.
What causes me to react to the cold with this incredible sleepiness? Anybody else experienced this symptom?
Best Wishes - Conrad
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Cyclo5
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Levothyroxine doesn’t “top up” your own thyroid output
It replaces it
25mcg in only half the standard starter dose
Because of Addison’s you were probably started slowly but dose still should be increased SLOWLY upwards
How long have you been on just 25mcg and which brand
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
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)
NHS only tests TG antibodies if TPO are high
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)
I had PMR (Polymyalgia Rheumatica) and was on a high dose of Prednisolone for 2.5 years. That went into remission but left me with Adrenal Insufficiency/ Addison's and slight hypothyroidism. I produce almost zero cortisol, and have very low vit D, have injections for that.
Hi Cyclo5, Addison's is an autoimmune condition whereas adrenal insufficiency can be caused by Addison's or for other reasons. If yours is autoimmune (Addison's) most people with Addison's also need fludrocortisone, are you receiving that?Walking in the cold will cause physiological strain and therefore will also use up additional cortsol, depleting what you have from your hydrocortisone and depending on time of day, it will make you feel more tired. Do you split your hydrocortisone intake over the day? It is generally recommended to split into 3 doses with having the slightly higher dose when you wake in the morning.
Have you got any thyroid blood test tesults you can share? T3 is important one and not often measured by NHS. TSH can be ok ish in a few but T3 not. T3 is active hormone.
Temperature under your tongue (core temp) worth tracking as you wake in the morning.
I am fairly new to all this but I think the recommendation is to sort adrenals then start levo/thyroid problem solving.
Probably undermedicated. Great advice here Do keep a track of your early morning temperature ( BEFORE you get out of bed), also your temperature when you're feeling noticably cold and sleepy. The results may be enlightening. Good luck. And Spring is on its way....
I live in Canada, where right now temperatures are around -40C with the wind chill. I have to increase my thyroid meds in winter or I don't even make it out of bed. Anything that makes the body work harder, like extensive exercise or trying to keep warm, depletes T3 as it is the "power source" for the cells, responsible for energy and metabolism. Under normal circumstances the body just makes what it needs, but if the thyroid is shot, it can't. So I have to help it out by giving it more "fuel that keeps the engine running". In summer I reduce the dose again.
I think I too have a hibernation gene! The dark cold evenings mean I doze off without meaning to, much to the delight of my cat. My 10 minute "power nap" has now grown to 40 minutes totally zonked out sleep. I have poor circulation anyway, have done since a child, but I just hate the cold!
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Cold, tearful, tired in afternoon
Melting in the cold.
Cold weather and winter
I feel the cold. 
Does cold weather affect hypo?
