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Dr. P. Jyoti
Dr. P. Jyoti , Consultant MD
Category: Medical
Satisfied Customers: 9126
Experience:  17 yrs experience in treating OPD & Emergency patients.
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I am a 47 year old female athlete. I eat a healthy diet, weigh

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I am a 47 year old female athlete. I eat a healthy diet, weigh 112 lbs, and feel energetic. I take no meds except spironolactone for acne. My issue is that every night I awake repeatedly. I do not wake up sweating. The sweating starts predictably one to two minutes after awakening. Concurrently, my breathing becomes shallow. I do NOT feel anxious when this happens. I become so hot that I take my clothes off and sweat all over. It does not start in my face, and I do not appear flushed. It subsides in 5 minutes. I do not believe I am having nightsweats associated with perimenopause. I have multiple blood tests. My doctor put me on 90 mg of armour thyroid a few months ago, but this issue has been occurring for about 2 years and the armour thyroid has not improved my sleep and sweating problem. My recent bloodwork was normal except for low TSH (.045). My only other symptom is hairloss. My neurologist and endocrinologist have nothing else to offer.
It will help if you could provide some further information:
What is your temperature during these episodes?
Have you been able to perform any testing during one of these episodes?
For example, has a blood sugar been checked during an episode, either because you were being seen or by a fingerstick blood sugar at home?

Customer: replied 3 years ago.

I have done some testing during the episode. A finger prick blood sugar result was 98. My blood pressure goes up just a little (it's normally low: about 100/60, so even when it goes up during the episodes, it's still normal. However, I have not taken my temperature (seems basic, but I never thought of it). But I definitely do not feel "sick" or feverish when it happens. I guess taking my temperature would be the next logical step.

One more piece of information that may or may not matter is that much of the time I have loose stool with the no underlying cause. It's been going on for about as long as the sleep problems. I put up with it (take an occasional immodium) and am not seeking your help for that, but I thought you might want to know.

Customer: replied 3 years ago.

Will someone be answering the question? I didn't mean to block Dr Love.


I would like to help you since you have opted out of Dr Love.

It is interesting that you state that you do not believe that you are having perimenopause. I would like to know why you state this so definitely?

Customer: replied 3 years ago.

These night sweats are not like the night sweats associated with menopause. Instead of waking up in the midst of a sweat, or to wet sheets, I wake up and I feel fine (dry and comfortable) for a predictable one or two minutes. Then my breath becomes shallow. Sometimes this is accompanied by a slightly metallic taste in my mouth. Then the sweating starts. I do not feel flushed or appear red. I do not have this experience during the day time, and no one I know in menopause or perimenopause describes their night sweats that way.

Additionally, my estradiol level is 55.3. DHT, Free T4, Free T3, Free testosterone and total are all within normal limits.

Thyroid abnormalities and perimenopausal symptoms are the commonest cause for this.

In your case, Thyroid levels are all normal so that is ruled out. But perimenopausal still remains a possibility. Normal Estradiol levels of course makes it less likely, but normal estradiol does not rule out perimenopause completely. Night sweats are a very typical symptom of perimenopause. The exact nature of the sweating episode is not at all significant, there can be wide individual variations.

Besides these two causes, the other causes which you need to rule out are:

* Carcinoid syndrome : This is a possibility for you. Carcinoid tumours developing in the intestine may cause this. You have to do tests like HIAA.
* Medullary tumours of the thyroid: This is again a possibility. You have to do thyroid function tests and ultrasound of thyroid, etc.
* Mastocytoses: These are rarer causes. Mastocytes are benign cells of the connective tissue. Growths of these are to be rued out.
* Pheochromocytoma : This is usually accompanied by other symptoms, still must be ruled out.

Besides this,
* Drugs: Certain drugs can cause this. Check with your doctor if you are taking any drugs.
* Food: MSG, in Chinese food, is well known for this. You will also have to observe whether you have started any new foods which might be the cause.

Discuss all these causes with your doctor. They are rarer causes and not necessarily significant for you. Still you must discuss with your doctor so that you get an informed discussion.

Hope this shows you the way forward - wish you good health and a quick recovery.

I trust my answer has helped you gain more knowledge and confidence about your problem and in knowing what to discuss with your doctor.

I hope my answer has satisfied you. Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Bonus is always welcome - Thank you!

Dr.P.Jyoti, MD.

Dr. P. Jyoti, Consultant MD
Category: Medical
Satisfied Customers: 9126
Experience: 17 yrs experience in treating OPD & Emergency patients.
Dr. P. Jyoti and 4 other Medical Specialists are ready to help you
Hi Christine,

I'm just following up with you to see how everything is going. Did my answer help?

Is there any further information that you need? Please do write if you wanted to know something more.

Do write back to me if you have any follow up questions,

Thank you,
Dr. P. Jyoti
Customer: replied 3 years ago.

Thank you! I am going to follow up with my doctor regarding those other possibilities.


What do you think about my hair falling out and my low TSH levels, even while on 90 mg of Armour Thyroid. Any connection?

Yes, definitely, hair will fall out with both high or low TSH. It needs to be in the normal range for optional health of hair.

Low TSH means you are having sub clinical hyper thyroidism. So discuss this with your doctor.

Thanks for the accept.

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