Thyroid UK
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2am Wake Up?

I’ve been on nature throid since early January. A few weeks ago my doctor upped the dose to 97.5mcg or whatever it is. I am also on cortisol management at night. I take the thyroid pill in the morning, along with ortho thyroid twice daily. And then an hour before bedtime I take the cortisol manager. Now all of a sudden out of nowhere I’m waking up at 2am and I am unable to go back to sleep.

I’ve literally just been diagnosed hypothyroid this year so I’m still learning so much. Any tips?


20 Replies

Hi ktikal, welcome to the forum.

Why are you taking ortho thyroid? It's another one of those stupid so-called 'thyroid support' things which is likely to do more harm than good. By the time you've been diagnosed hypo, it's too late to 'support' your thyroid, and with this formula you are actually stimulating it, not supporting, which will make it burn out quicker.

It contains a high dose of iodine, and unless you have had your iodine tested and found deficient, a high dose of extra iodine is the last thing you need. It is actually anti-thyroid. You're already getting iodine from your NatureThroid, plus what you get from your food. You do not need all this extra iodine, more is not better. And, as your thyroid is failing, what you probably need is less iodine. And it's doubtful you need copper.

What you should do is get your vit D, vit B12, folate and ferritin tested, and just supplement what you need, according to the results.

Do you know your cortisol levels? I don't know what you mean by 'cortisol management' but it seems rather strange to be taking something if you don't know your levels. Does it contain a bunch of adaptogens, like ashwagandha? If so, they are more likely to decrease your cortisol levels than raise them. Is that what you want? You're already getting ashwagandha in the thyroid support, so it doesn't seem like a good idea to be taking a double dose. Could have something to do with your early waking. These multi supplements are never really a good idea.


Thank you for your response!! All valid questions. I don’t know my cortisol numbers off hand but when I had it tested it always spiked right before bedtime. The Cortisol manager I take does have ashwaghanda! And yes! Because of the spike in the evenings I was taking it as a means to lower. I’ve also always taken melatonin but I am seriously thinking that is not helping my cause either

The ortho thyroid was given to me by my naturopath as well as a D vitamin. I live in Montana so we’re all deficient where that is concerned. I’ve never had my B tested but I’ll bring that up at my next appointment.


Well, that just goes to show how much naturopaths know about anything! That ortho thyroid is really, really not a good idea, it is giving you far too much iodine.

There are other ways of lowering cortisol, but the most important question is : what is your level first thing in the morning - not what is it at night. If your cortisol is low in the morning, and you raise it, then the night time level will sort itself out. By taking something to lower it at night, you are probably lowering it in the morning, too.


I’m going to stop with the ortho.. I was really bad about taking it before and have gotten diligent these last few weeks and now my sleep is garbage.

My cortisol is normal all day and then seemed to spike at bedtime. I’ll find my results from that test when I get home to confirm that.

I am not hashimotos or anything but I’m certain I’ve been hypothyroid for most of my life. Never ever been able to lose any amount of significant weight with hard work and I gain weight with little effort. And it’s been like this since I was 16. So if you have any other tips. I’ll find my thyroid numbers when I get home as well. I want to say my tsh wasn’t horrible but it was the others that tell the whole story.


Yes, posting all your results is a very good idea. Then we'll really know what we're talking about. :)


I’m so new ☺️ Forgive me! I know my TSH was about a 3.9... but it’s the other numbers I can never remember.


No problem. Just post them when you find them. :)

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So here’s what I do know so far. Of course more tests have been ordered after I adjust to this new dose

Other than my TSH being at a 3.91

My t4 is .8

My t3 is 2.6

I know there’s all kinds of a reverse and free and all that but I’m still just really learning. I’m not even sure what questions to even ask. It’s like baptism by fire.


Sorry, but we need ranges for those results - although I can see your TSH is high. But, when were these tests done? Were you taking anything at the time? New tests should be done six weeks after starting thyroid hormone.

The important tests are Free T4 and Free T3. Never mind reverse T3, it doesn't give you any useful information. You say you don't have Hashi's, but have your antibodies actually been tested? You also need your nutrients tested - vit D, vit B12, folate and ferritin.


My t4 is at the lowest part of that range but I don’t have the exact range on hand.

And the range for t3 is 3.5-6.5

Yes she checked my antibodies.

These were my results after being on 68 mcg of naturethroid for 6 weeks. Nothing had even shifted between my first untreated tests and these results.

So now that she’s upped it, I’ll know more in a few weeks when I test again. My D was also low. But I live in Montana and we are all pretty low considering the sunshine is limited in the winter here. And any other time. I’m currently on a D supplement. I haven’t had the others checked but I will bring it up at my next appointment.


So, your FT3 is actually below range! Do you know what the antibody results were?


I think it’s also with the rest of the results. I’ll be home in about 45 minutes and will check.

That’s what makes me so angry. I’ve had my tsh checked by my normal doctor a thousand times since I was 16 but no one ever took the time to order the others. So I always looked “normal ish” but I’ve always been overweight and my hair has always been awful. I can already tell a Not I only difference in the texture of my hair.. that’s the one thing that has changed abruptly.


Recognition, diagnosis and treatment of thyroid problems is universally awful. I'm pretty sure I've been hypo since I was about 8, judging by symptoms. But I never so much as had a TSH test until I was 55!


How frustrating! A girlfriend of mine had an elevated TSH last year. This year she was diagnosed Hashimotos! They just ignored all of her symptoms and said “meh probably isn’t” when in reality she’s been suffering from it for a very long time.

So the TPO range is 0-10 and mine was 1.5 at last check.

And the official number for my evening cortisol is 3.1 and they want it less than 1.5. I also have low progesterone (142.5 out of a 200-400 range)


Yes, it is frustrating. They are ruining people's lives with this attitude!

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I didn’t take the ortho thyroid yesterday or any melatonin and I slept clear through until 4. My alarm is set for 5 so I feel like this is a win so far.

Thanks for the advice!


You're more than welcome. :) Be careful of that naturopath! Double check anything he tells you to take!!!


I’ve recently started taking Ashwagandha for high cortisol and am also now waking up at 2.30am and can’t get back to sleep 😡

I’m also on Nature-throid but haven’t had a problem until now.

I’m gonna to do some research and I’ll let you know what I find out

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The only thing I can find which makes any sense is:

As well as lowering cortisol Ashwagandha can also lower blood sugar. Normally the body would release cortisol to regulate low blood sugar. Low blood sugar will cause you to wake up.


For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT4 and FT3 plus vitamins

Private tests are available

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, and T3 or NDT 12 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

If you have Hashimoto's the last thing you need is extra iodine


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