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Thyroid, pituitary, blood glucose?
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Thyroid, pituitary, blood glucose?

Hi,
There isn't an endocrinology forum - I apologize for hijacking this one. For the last 15 years I have experienced headaches & extreme fatigue on waking.  I never have a restful sleep.   I am female, 39, non-smoker, non-drinker, 5'8", 150lbs.  I don't drink much caffeine - just a small cup of coffee in the morning.  

I have undergone several tests to find the root of my fatigue.  Sleep test ruled out sleep apnea.  Most blood tests are normal.  One thyroid test pointed to the pituitary: TSH was not raised (0.86 mIU/L) in conjunction with a low FT4 (8.2 pmol/L).  ACTH, prolactin, FSH & LH tests at that time were normal so my doc didn't follow up.  B12 & ferritin have both been low in the past, but supplementation didn't help my morning exhaustion. I have benign nodular hyperplasia (based on thyroid ultrasounds).

I've noticed an odd pattern for me... if I wake around 4am or 5am (which I do often), I am tired, but the bad headache isn't there.  I often wake sweating.  Then 2 or 3 hours later when I wake at my normal time, I have a headache in my temples & eyes which feels like my temples are being sucked into my head.  It takes a couple of hours for that headache to subside.

I've read about dawn phenomenon and somogyi effect, so I have been trying to monitor my blood sugar.  There have been a few low-ish fasting blood glucose results (from a home monitor), for example 3.5 mmol/L.  I had one AM cortisol blood test about 5 years ago, which was normal (280 nmol/L). One GH test was normal.

This morning my glucose at 4:24am when I woke as usual was 4.6 mmol/L, & again I was sweating, but no severe headache.  At 7:44am when I got out of bed, it was 4.1 mmol/L & the temple headache was BAD.  I'm not sure what's waking me early in the morning (4-5am).  I'm wondering if it's low blood sugar & the sweating & waking are a result.  I thought blood sugar is supposed to rise in that 4am to 8am time period, but mine doesn't.

Thoughts?
Thanks for your time,
A
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97953_tn?1193367871
As you mentioned, this is a thyroid forum
Would recommend general endocrine consultation.
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Thyroid & Endocrine Center of Florida
Sarasota, FL
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