weak legs, feeling of high cortisol on NDT reduction

[Crankyoldbag]

Three weeks ago i started getting severe insomnia so after consultation with endo he agreed i could reduce my dose from 1gr morning to 1/2 gr and continue with 1/2 grain p.m

Insomnia did not improve so i then started missing out the p.m. dose. I have also had intermittent symptoms of high evening cortisol, weak legs and the insomnia continues. Would missing out the p.m. dose give these symptoms?

I posted my initial 2023 labs TSH FT4 and FT3 a few weeks ago and some questioned why i was being medicated at all. I did a 4-point cortisol test in 2022 which was slightly upregulated in the evening.

My uk endo (i’m in France) maintains that initial 2023 FT3 (3.67) was in the lower range of normal, TSH (1.36) FT4 (14.2) which is why he wanted to medicate.

Lowering my dose has not improved insomnia, if anything it has worsened. Recently found French endo and she thinks i do not need NDT and advised to lower dose and see how i felt.

I do have quite a few gut issues going on that i’m trying to get on top of but the severe insomnia is making everything complicated. I cannot work out if i’m over or undermedicated or the problem is arising from not taking the p.m. dose? Or even an unresolved adrenal issue.

I feel worse if i take 1gr in the morning, less bad if i take 1/2 grain morning and a tiny bit better if i take 1/2 gr p.m.

waiting for results of 4-point cortisol test. Sorry for the confusing post. Several weeks of severe insomnia have addled my brain.

Most recent labs (25.02.25) after a slight dosage reduction were TSH ( 0.82)FT4 (9.91)FT3 (3.73).

[greygoose]

This sounds like one huge guessing game where nobody has all the facts and everybody is groping around blindly. Why they think reducing your tiny dose of NDT is going to reduce your evening cortisol I cannot imagine.

What you need to look at is your morning cortisol. If that is low it explains why your bedtime cortisol is high - if it is still high, but you don't even really know that. But the solution is not to reduce your NDT, nor to try and reduce your evening cortisol, it's to raise your early morning cortisol, then everything will fall into place.

But, before you do anything, go back on your original dose of NDT, wait six weeks and retest. And do another 24 hour saliva cortisol test so that you know where you are now, not three years ago.

[serenfach]

Love your name! Just a thought - my legs go to jelly if my Vit D is low, so it is worth checking this out.