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Originally published on 27th May 2016 Last updated on 19th December 2018
A common symptom that people with hypothyroidism (also called an underactive thyroid) have is waking up not feeling refreshed, and, commonly, actually waking up feeling more tired than when they went to bed the night before.
I experienced this and it baffled me. I thought “How does that make sense?! I got ten hours of sleep last night and still woke up feeling more tired than when I went to bed!”
What are the possible causes for this?
The adrenal glands, two little glands that sit on top of each kidney, produce hormones and cortisol for many bodily functions, and these could be behind the problem.
Cortisol helps you respond to stress and has many other important functions, including regulation of blood sugar, metabolism of fat, protein and carbohydrates and immune responses. However, with ‘adrenal fatigue’ (though it is more accurately referred to as hypothalamic-pituitary axis dysfunction), your adrenal glands produce too much or not enough cortisol, and this can cause issues such as disturbed sleeping or struggling to really feel energetic in the mornings.
In Thyroid Pharmacist Izabella Wentz’s experience, adrenal fatigue is present in 90% of us with autoimmune hypothyroidism. 
Cortisol should be at its highest when you wake, slowly falling as the day goes on. The low levels at night time ensure you’re ready to sleep, and the low levels throughout the night ensure you get a good nights’ sleep, before it rises again around the time you wake.
However, if the adrenals’ output of cortisol for example becomes dysfunctional (producing too much or too little), this can affect energy levels and quality of sleep.
They generally start to dysfunction from responding to chronic emotional, mental or biological stress for a prolonged period of time. The ‘first stage’ is said to involve high cortisol, however, the body can only keep up with high levels of cortisol for so long before they start to fall, leading to low cortisol. Also adrenal fatigue.
When thyroid patients wake up still feeling tired, or even more tired than when they went to bed, they should really check their adrenal health, as they symptoms can be caused by cortisol levels being too high or too low. This was the case for me.
See also, The book ‘Adrenal Fatigue’ by James Wilson for more reading.
My Experience of Adrenal Fatigue
I had my adrenal output tested and discovered that I had high cortisol all day, causing my on-going fatigue, struggles to fall sleep in the evenings and then stay asleep; waking multiple times, sleep talking, tossing and turning and even sometimes sleep walking.
The best way to test them is usually said to be by completing a 24-hour four point saliva test, to see how your levels rise and drop in a day, so you can compare them to the ideal rhythm of being top of the range in the morning and fall throughout the day so they’re bottom of the range by nighttime. If your doctor won’t do this, you can very simply order it yourself and complete it at home. You can find testing options here and here.
I have blogged about correcting my adrenal fatigue since the beginning and I am pleased to say that it has been addressed now after unearthing the root causes behind it. In my case, a sex hormone imbalance, leaky gut, candida and gluten sensitivity were all driving it.
I now wake up not going ‘Urrrggghhhh, why do I feel more tired than when I came bed at 9pm last night?!’ anymore and instead feel much more rested.
I honestly made peace with the fact that I would never wake up feeling refreshed or at least not horrendously tired, ever again, and that for the rest of my life, getting out of bed would be the worst part of every day.
What Can You Do About it?
If you discover that adrenal fatigue is the reason behind your struggles to feel refreshed in the morning, then unearthing what is driving this is crucial.
Possibilities include food sensitivities/allergies, non-optimal thyroid levels, high antibodies, poor gut health and candida, sex hormone imbalances, chronic stress and improperly managing your stress levels, anxiety disorder, other medications or anything that can place mental or physical stress on the body or mind.
Many people have successfully unearthed these and addressed them by themselves as many mainstream doctors do not yet fully recognise adrenal fatigue in this form, but I was one thyroid patient who, after a year and half of trying to address it myself, finally sought help from a functional medicine practitioner who helped me massively. A test for Candida can be found here.
You should also be cautious about making any changes to your healthcare routine without consulting a medical professional first.
Have you ever experienced this frustrating symptom?
The book Be Your Own Thyroid Advocate: When You’re Sick and Tired of Being Sick and Tired, which builds on this article in detail and covers how Rachel overcome thyroid, adrenal and other issues.
There is also a comprehensive, six-week online thyroid course which you can complete from your own home and computer. Freedom From Thyroid Fatigue helps you tackle low energy with a personalised approach. Get your life back.
You can click on the hyperlinks in the above post to learn more and see references to information given.
Rachel Hill is the highly ranked and multi-award winning thyroid patient advocate, writer, blogger, speaker and author behind The Invisible Hypothyroidism. She has two books: ‘Be Your Own Thyroid Advocate‘ and ‘You, Me and Hypothyroidism‘. Her thyroid advocacy work includes authoring books, writing articles, blogging and speaking on podcasts, as well as being a board member for The American College of Thyroidology. Rachel has worked with The National Academy of Hypothyroidism, BBC, The Mighty, Yahoo, MSN, ThyroidChange and more. She is well-recognised as a useful contributor to the thyroid community and has received multiple awards and recognitions for her work and dedication. Rachel is British, but advocates for thyroid patients on a global scale.