Night sweats

[missdee172]

I have been on levothyroxine for a little over 2 years.  When I started, I was also taking bioidentical progesterone, estrogen mix and DHEA to control hot flashes and night sweats, which it was doing very well.  Once levothyroxine came in, the flashes and night sweats came back with a vengeance and I had trouble sleeping.  When I sought relief, I was caught in the crossfire between my compounding pharmacist (who abhors the medical community) and my endocrinologist (who was only interested in doing ultrasounds, biopsies and prescribing rather than asking me how the medication made me feel).  Soon after, I started experiencing post menopausal bleeding and was advised by my gynecologist to drop the hormones.  I did, but the bleeding continued.  So I dropped the levothyroxine for a couple months and slept like a baby!  But the bleeding continued, my thyroid levels were down and I went back on the levothyroxine, which stopped the bleeding but brought back the night sweats.  I wake up every couple of hours and am exhausted all day long.  So what's the solution?  Continue on the medication prescribed by medical docs who aim to please the pharmaceutical industry, or find some natural alternative?  Have any other women here had similar experience?  Have you found relief?  Sorry for the long post, I'm so frustrated and exhausted.

[Barb135]

You need to find a different pcp.  Your TSH level is too high, even if the lab report says it's normal.  And your FT4 is way too low.  Did you happen to get the reference range for the FT4?  

Are you in the U.S?  If so, your doctor is required, by law, to provide you with a copy of your lab reports.  

Reading back over this thread, I also noticed that Thyroid Peroxidase Antibodies were tested twice, but there was no Thyroglobulin Antibody (TGab) done.  Either one, or both, can be present with Hashimoto's, so you need to ask for that test, as well.  

Are you asking to have the Free T3 done each time?  If so, what is the response?

You should call the doctor's office back and ask about the levo.  I realize that your FT4 is "normal", but just being "in range" isn't good enough.  I do think it's a good idea to see a Gyn, regarding the hot flashes and night sweats.  Be sure to tell them about your thyroid issue, so that can be factored into any diagnosis they might make.

[missdee172]

Results after 6 weeks off levo:

TSH = 2.56 (up from 1.33)
Free T4 = 0.82 (down from 1.03)

Office called and said "your bloodwork was normal" but didn't say anything about getting back on levo.  

Still having hot flashes and night sweats,not as frequently, but some pretty intense.  Found a gyne group specializing in menopause and have an appt at the end of January (first available).

[missdee172]

Had bloodwork on Friday.  Cholesterol was 213 and LDL was 132.  Told me to watch my diet and get some exercise.  Had to catch the nurse before she hung up to ask about thyroid as she was only reporting on cholesterol.  TSH was 1.3.  They did T3 & T4 but said they were all in normal range.  I said I am having night sweats and can't sleep, what can we do about that?  Doc just called back and said to go off levo for six weeks then come and get my levels checked mid-November.  

[Barb135]

I had nigh sweats long before I knew what thyroid medication was, so for me, the sweats are, for sure, not a side effect of the thyroid med.  

For over 12 yrs, my doctor kept telling me they were menopause -- sorry, no way I could buy that; I had a hysterectomy in 1996, which meant instant menopause and I know effects don't last for 12 yrs.  My previous doctor finally acknowledged that, but wasn't interested enough to try to find a cause.  Since my thyroid levels have come up to something I can be comfortable with, I usually, only wake up once during the night, with a sweat, and all I have to do is throw back the covers to cool down; whereas before I used to have to get up, shower and change clothes, and often bedding, as well. .

[Totie]

I had RAI & TT almost 20yrs ago. I was 24 and I have always had the night sweats, I thought they were normal for women. I think it is the side effect of the thyroid medication.

I also had a hysterectomy about 6 months ago, I am on HRT patch, but I still and always had night sweats.

At lest this is my theory. I have been hyper & hypo in the last 20yrs and still the night sweats continue. I just lay a towel down on my side of the bed and have a towel by my bed to dry myself off, then I get the chills..

It never ends, but used to them after 20yrs, my husband says "I need to quit dreaming so much about him"...LOL...

[Barb135]

What's the range for the FT4 and FT3? Ranges vary lab to lab and have to come from your own report.

Your TSH, in 12/10 was actually over range, even though your report might show it "in range".  Over 10 yrs ago, AACE recommended that the range for TSH be changed to 0.3-3.0, but most labs are still using old ranges. Because of this, and the fact that too many doctors go only by TSH, a lot of people don't get diagnosed in a timely manner.

Also in 12/10, your FT4 was very low in the range, if your range is typical of what we normally see.

High cholesterol is a symptom of hypothyroidism.

If you are in the U.S., your doctor is obligated, by law, to provide you with a copy of your blood work, upon request. You should always try to get a copy of labs every time you get them done and keep them for your records.

Do you think you can get your doctor to test FT3 and FT4?

[missdee172]

My last TSH on 5/29/13 was 1.71 (back on levo for 3 mos).  Had a test in February after I'd stopped the levo but the doc didn't give me the results.  My lab history (that I've had access to):

12/10 (prior to starting on levo).  I don't know what they all mean but were all in normal range.
TSH 5.15
T4 Free .99
Thyroxine (T4) 6.3
Thyroid Peroxidase AB 7
My cholesterol was total 232, HDL 66, LDL 161 and triglycerides 95 plus creatinine of 1.02 which my pharmacist indicated might be an indicator that I had a thyroid problem

6/11 (three months after starting levo):
TSH 1.69
T4 Free 1.1
Thyroid Peroxidase AB <10
AST 19
ALT 16
Cholesterol total 202, HDL 65, LDL 116, triglycerides 107.  

9/11
TSH 0.97
T4 Free 1.2

6/12
TSH 1.65
Triiodothyronine, Free, Serum 3.0

Thank you for taking the time to talk to me, I appreciate the advice of other people who have been through this.

[Barb135]

"I should mention that in 1984 I had radiation therapy on both sides of my neck for a non-Hodgkins lymphoma.  I have always worried that the treatment might result in long term issues with my thyroid."....  yeah that's kind of important, because there's a good chance that the radiation "killed" your thyroid...

Can you post actual thyroid hormone levels, so we can see where you're at? Fortunately, for a lot of our members, we don't put a lot of stock into "normal", because what's normal for me probably isn't normal for you... the lab ranges are totally off........

Unfortunately, TSH is all that a lot doctors test, because they believe it to be the be all, end all of thyroid treatment, when in fact, it's only pituitary hormone that's not always/very accurate.  My TSH runs at 0.01, so imagine the excitement when doctors see that...... it means nothing, because my actual thyroid hormones are pretty close to where I need them.

You might have to keep looking for different docs until you find one that will combine labs (FT3 and FT4), with symptoms and treat you clinically, not by the labs.

[missdee172]

Yes, it was the pro/est/DHEA that I was told to drop.  I dropped the Levo on my own and felt great being off everything but my TSH was low (that's all the gyne tested me for).  Went to my PCP shortly after and he didn't do bloodwork but I have a follow up in October.  I'm going to call for an earlier appointment.  I don't feel the levo is helping.  I've been on the same dosage for the entire 2+ years as my levels are in the normal range.  Yet I have low body temp, night sweats, hot flashes, brittle fingernails and intolerance to cold.  None of the docs listen to me when I give symptoms, they just go by the lab results.  The PCP I had prior to starting on the levo said "you don't want to start on thyroid meds, they will make you feel worse".  At that time I had some mixed cholesterol and triglyceride results that indicated a possible thyroid issue, but he just wanted to put me on cholesterol meds (without even asking about my diet).  I changed PCPs then.

I should mention that in 1984 I had radiation therapy on both sides of my neck for a non-Hodgkins lymphoma.  I have always worried that the treatment might result in long term issues with my thyroid.  I have had about a dozen skin cancers removed from my neck and chest since then.  Again, no docs give any attention to that fact.

[Barb135]

I'm a bit confused, so let's make sure we're all on the same page.  Was it the progesterone, estrogen and DHEA that your gyno told you to drop?

The night sweating can be a symptom of hypothyroidism.  I had it really bad, when I was most hypo. It could indicate that you need a an increase in your levo dosage.

What are your current thyroid hormone levels? You should be getting tested for Free T3, Free T4 and TSH on a regular basis.

There is no alternative treatment for hypothyroidism; your body has to have the hormones to stay alive and your thyroid can't produce them, you have to replace them, with medication.