I am interested in knowing if there is anyone here who has used T3 to treat middle insomnia. It is known that the normal body raises T3 during the sleep cycle, and that this increase in T3 is necessary for deep, restorative sleep. I am looking for a couple things:
1) If you have used T3 to support sleep, what dose(s) have you used, and at what time(s)? Have you discovered a dose size, and time of administration, that seems to be optimal? I use 25mcg Cytomel tablets. So far, I have experimented with a 6.25mcg dose at bedtime, followed by a 6.25 or 12.5 dose when I wake up (usually sometime between midnight and 3am). These experiments have had positive results, but I don't think the results are optimal.
2) Since T3 labs can’t be taken at night, is successful treatment of insomnia via T3 administration, diagnostic of T4->T3 circadian conversion deficiency? I have a friend who cannot afford lab work, and whose doctor is uncooperative anyway. I’m considering whether I should instruct him to try a small T3 dose at wakeup to see if it improves his sleep.
Eddie83, An interesting idea. I don't have anything to contribute, but it's important to mention whether or not your friend is already on thyroid hormone therapy and if so, what and how much.
He is not on thyroid hormone. He goes to one of those maddening docs who only takes a TSH test, and doesn't give results to his patients - he just told my friend that "you're normal". Argh!
I’ve never heard of middle insomnia, however my sleep improved once I started taking NDT, along with ending the afternoon energy crashes once I reached an optimal dose of THs.
He uses magnesium. He isn't using 5HTP. What I've learned in my case is that no amount of tryptophan, 5-HTP, or other amino acids/derivatives is a substitute for proper hormone levels. Hormones have a much stronger effect, unless the patient is obviously in hypoproteinemia (indicated by albumin & total blood protein tests).
I’ve also never heard of ‘middle insomnia’ do you mean that people who can fall asleep and then wake up in the middle of the night, 3/4hrs later? And what do you mean ‘since T3 can’t be taken at night’ ? A lot of us spread out our dose and some T3 is taken last thing before sleep.
For me the side affect of spreading this dose out is beautiful, wonderful, deeply satisfying sleep.
I’m going o go back and watch your link later as I briefed it this morning and it talked about Alzheimer’s briefly and I’m interested in T3 in that way for my Dad 🤗
Hi Paula, Eddie83 wrote T3 labs can’t be taken at night, I assume meaning testing unless it is a typo. “... beautiful, wonderful, deeply satisfying sleep “, sounds fantastic, oh how I wish for that 🙂
Doh! 😂 My Reading ability as really gone down hill! Although I have just woken up from my ‘beautiful,wonderful, deeply satisfying sleep’! Lol maybe it’s a side effect 😂
My ears pricked up at the mention of Alzheimer's , as I worked for the Alzheimer's Society, supporting people in their homes, giving the family a break etc. I didn't know anything about T3 at the time, but if you want to chat or ask about other aspects and problems of dementia, especially to do with your dad please pm me. Has he had his thyroid levels checked?
Dementia is a horrible illness, often worse for the family than the person with the disease. Severe hypothyroidism can even mimic dementia. So can depression. And hypothyroidism can cause depression too, as you probably know.
Thank you Jnetti 🤗 I am just in the process of getting full thyriod function testing for him and my mum. They live at home in Ireland and I am here in England so the logistics can be difficult. They live with my sister who is very senior in NHS but she’s not very helpful and thinks it’s all quackery so she’s an obstacle to overcome 😬
I became more interested in my Hashi’s as I wasn’t responding as I should to Levo for the past 10yrs and it led me down a rabbit hole of genetics and and and..... 😂 you can imagine once you start. I’d always assumed that my Hashi’s came from my mother (hypothyroid) and m grandmother (hypothyroid) and my sister has Graves. My mum and Nan only ever told they had an underactive thyriod, no other testing other than TSH.
BUT my Dad was diagnosed with Alzheimer’s 11yrs ago. My mum and sister were hot on early diagnosis and he’s recieved treatment ever since. However in the last 11yrs his deterioration has no followed the usual path an a few years ago he had a brain scan that did not show liaison and yet his diagnosis remains. Only now am I picking up on this as I really haven’t had much influence in his care, my know it all sister controls it (that’s unfair, she’s very good and extremely knowledgable but NHS through and through 😬)
My Dad does repeat himself and gets confused but he self sufficient in the day and takes the dogs for a walk ect ect He does forget to eat and often says he’s not hungry (that was one of my main symtoms) BUT 11yrs later and that’s the height of it? Something doesn’t ring true!
So here I am looking into it for them. I don’t want to give my mum false hope (she’s only 66yrs, Dad is 76) but it’s worth a shot surely??
I would love to get advice as and when it arises and I thank you for your support 🤗
Re the dementia, loss of appetite can be a symptom, but it could also be low nutrients and/or thyroid problems, or other causes, as you say. It certainly doesn't help.
Do you think maybe your dad has another form of dementia, not Alzheimer's. Or possibly mixed dementia? There are lots of different kinds, though Alzheimer's is the most common.
Alzheimer's shows slow, steady deterioration, except if the person is ill (urine infections commonly cause a sudden increase of confusion) or even constipated. Other dementias show a different progress. Has he had any TIAs ("Mini strokes"), or heart or circulation problems for example? Has he shown any marked personality changes, does he have difficulty with coordination? Check out the Alzheimer's Society's website. Like Thyroid UK it has lots of helpful information.
It must be so difficult with your parents being so far away, and the bossy sister - who in general probably does know more than we do, but...
My sis thinks the T3 link is quackery. I can’t understand her myself. We are complete opposites, in every sense, her thyroid disease was Graves and mine Hashi’s. She has seen me struggle over the years but wont really engage in conversation about our conditions (me being the stupid non academic sister 😬) When I’ve tried to talk to her about our parents and our family history of Thyriod she says well ‘I think my thyriods dead now so I should really get tested again ‘ She was signed if from Endo a couple of years ago. She took Carbimazole but refused the radiation treatment or removal (large goitre) So she is a rebel like me but likes to think it’s because she more educated 😩
Anyway i told my mum she’s definitely hypothyroid now and I don’t know how she’s functioning, probably on adrenaline and she’s do her heart damage if she keeps it up (history of heart disease in family). She looks awful, her fave is swollen and she’s go from a size 8 (normal even before Graves) to a size 18 😬 But she won’t be told, not by her little sister anyway.
With regards my Dad, yes I think he has some form of dementia but I really don’t think it’s Alzheimer’s. But I’m being more pro active now and so I think my mum will get more reassurance that everything possible was/is being done.
Quackery? Is your sister even willing to admit that T4 is not an active hormone, and T3 is active, so T3 is the only thyroid hormone which exerts substantial influence on normalizing biochemistry?
There is such a thing as "hypothyroid dementia". Unfortunately the average doctor doesn't test thyroid in Alzheimer's patients. Those few who do, probably only use the TSH. If I had a parent with Alzheimer's, I'd be screaming at the doc for a full thyroid panel, and esp. FT3.
Thanks Eddie83. Yes it’s taken me a while to catch up with my fathers health but I suppose it’s only since I started looking at reasons why i wasn’t ‘normal’ on Levo for 10yrs. Drs blaming me for not getting better. I’m now on T3/T4 and feel ‘normal’.
My FT3 has always been low 3.5 (3.5-6.5) but my daughters is below range and now I AM thinking there’s something genetic in my family.
Mum said they’d got the sample and sent it off Monday so 😱 could have results today. I guess what I mean by ‘quackery’ is she doesn’t think that untrained people should be interfering, if we as ‘lay people’ have concerns then we should go through the proper channels because too many are self diagnosing and at risk of harm. She firmly believes in the people she’s surrounded by she believes her colleagues are the best. They may well be but it’s disrespectful to me that she doesn’t believe that I’ve had poor treatment.
They will never acknowledge that a previous doctor provided poor treatment. It's just part of the authoritarian & legal games which MDs play. Having had my daughter's future destroyed by a careless MD, I am one of those people who Questions Authority!
What I meant was "T3 can't be tested at night". Yes, middle insomnia means that you go to sleep ok, but wake up and can't go back to sleep. I think it is sometimes called "short sleep".
I used to be awake from 3-5am every morning, which is some people's normal to have two distinct episodes of sleep. However, I couldn't stay awake at 4pm which was very bad if I was at work.
There are some who insist that the "natural" pattern of sleep, is to sleep in 2 parts. Robert Moss, the writer on dreams, insists on this. However I am skeptical. (1) Industrial society insists on a long continuous session of work, so sleeping in 2 parts is incompatible with most jobs. (2) Healthy teenagers always sleep in one long session. So what is it that changes that pattern as we age? Haven't seen anyone answer that question.
Eddie83, being on an optimal thyroid replacement dose improves insomnia in itself.
I believe Paul Robinson talks about using T3 dose timings to kick start circadian rhythms, but I think he's talking about the later part of the night preparing to wake up, rather than the earlier part trying to get to sleep. I think the book is called Recovering with T3.
Waking up around 4am is thought to be caused by adrenal problems. I used to have this, and be stiff as a board for the rest of the night. But its slowly cleared up, in a combination of improving my dose, meditation, and melatonin.
I wake up between 2am-4am. I take .75 Synthroid for hypothyroid with Hashi, and have a lot anxiety. Never feel fatigued even after only 4 hours sleep...almost feel speedy, no weight gain, some loss of hair (probably just alopecia). My Free T3 is on the low end a 2.5 (range is 2.3-4.21), my Free T4 is 1.3 (range .8-1.8) and my TSH is 2.29 (range .40- 4.50). I am asking my Endo Dr. if she can give me 5 mcg of Cytonel (T3) to try and help me with my insomnia. (I've tried everything else...my circadian rhythm has been screwed up from PTSD for past 2 years of caregiving dying husband). She seems to think because I am so hyper, anxious and nervous, that adding T3 may make my insomnia worse. Yet I read about those who find it helps their insomnia. I also developed a hoarse voice as well. May I ask what dosage you used, when you took your T3 (do you take on empty stomach like Synthroid?) and if you titrated up? Thank you!
Medicine is an experimental science; the doc doesn't know it will make insomnia worse. Only way to find that out, is for her to give you T3 and for you to try it! How I've used it is: I no longer take any T3 during the day. At bedtime, I take a dose of either 6.25 or 12.5 micrograms. When I wake up, 3-4 hours later, I take another dose of either 6.25 or 12.5 micrograms. I used to be very hyper and nervous; one of the reasons I was on T3-only for a while, is that T3 is much "smoother" than T4 for me. T3 would actually make me less hyper and nervous. So I don't know what the correct/optimal dosage pattern is; was hoping to find someone here who had ideas about that.
Thank you. I guess I'm confused. I don't understand taking T3 in the middle of the day. I am never fatigued, don't have weight gain, nor dry skin, constipation, slow heart rate. It is my circadian rhythm that is out of whack and I know the thyroid glands effect that. Does taking T3 have a sedating effect? My temperature in the AM is 95.9. I am concerned about getting a fast heart beat with Cytomel (T3). My blood pressure dips to 85/58 at night with a pulse over 100 (I'm talking at 2 a.m. when I wake up) My b/p could be dropping more at night since I do use medicinal cannabis for my glaucoma and that can cause that. However, my hands and feet can get a bit cold, but I believe that is a circulation problem, more than hormones. My Endo mentioned,instead, to up my dosage of Synthroid from 75 mcg to 100 mcg instead of giving me T3, but if my TSH is 2.29 (range .40-4.50) and my Free T4 seems to be smack in the middle of the range 1.3 (range .8-1.8), it seems that my T4 isn't converting into T3 properly, so I don't know why I that would be suggested.
I'm not advocating taking T3 mid-day; I'm advocating taking it between bedtime and 6am. For some people, whose thyroid circadian rhythm is out of whack, taking T3 during the sleep cycle can be sedating; I am one of them. It doesn't matter what my FT4 is, my body just won't convert T4 to T3 in sufficient amount, and esp. won't do it during the sleep cycle. What's more, if my FT4 goes above about 20% up in the range, it causes anxiety, so I don't have the option of pushing FT4 up to range top. It is known that T3, in the "normal"/healthy body, increases during the sleep cycle. Since your endo apparently refuses to take FT3, she can't possibly know if you are converting a reasonable amount, and she can't possibly know the status of your T3 circadian rhythm (which isn't easily testable). She is obviously following the "party line" of the various establishment thyroid associations for MDs, whose position is always that T4 is the only treatment to be used. That policy flies in the face of common sense, "common sense" being that sure, there are some people who cannot convert well, and given no understanding of the biochemistry of why they don't convert, the only realistic thing to do is to give them supplemental T3.
With those thyoid panels, you have plenty of room for an increase, and I would think you will need several increases to get your freeT3 to the top of the range, which is where most people feel well.
I don't know how any doctor can think you're optimally medicated. Your TSH is still raised - even conservative suggestions are that it be close to 1. Personally I think it will usually need to be at the bottom of the range or below for people to feel well. And freeT3, which is the number that best predicts symptoms out of the three, is scraping the bottom of the range.
My personal view is that it's important to get close to your optimal dose before thinking about trying any additional techniques. Often people will be kept ill for years by doctors not tuning up their dose, and its tempting to want to branch out and try new things. But most people will feel much better by just getting their blood tests to a point where they look good.
Its possible to feel very wired when undermedicated. I had a lot of problems with stiff muscles when I was undermedicated, I looked into it and found actually muscles use energy to relax, its not just a matter of collapsing. A lot of symptoms are quite hard to determine whether they are hyper or hypo, as there's a lot of crossover. Some people even lose weight when hypo, even though it seems very characteristic to gain weight.
Thank you. No, I do not have weight gain, nor dry skin, nor sluggishness, nor muscle aches/stiffness, nor slow heart beat. My temperature in the AM is 95.9. I am concerned about getting a fast heart beat with Cytomel (T3). My blood pressure dips to 85/58 at night with a pulse over 100 (I'm talking at 2 a.m. when I wake up) My b/p could be dropping more at night since I do use medicinal cannabis for my glaucoma and that can cause that. However, my hands and feet can get a bit cold, but I believe that is a circulation problem, more than hormones. My Endo mentioned,instead, to up my dosage of Synthroid from 75 mcg to 100 mcg instead of giving me T3, but if my TSH is 2.29 (range .40-4.50) and my Free T4 seems to be smack in the middle of the range 1.3 (range .8-1.8), it seems that my T4 isn't converting into T3 properly, so I don't know why I that would be suggested.
When thinking about a conversion problem, we can't really draw conclusions until freeT4 is right at the top of the range and freeT3 still isn't good. When both TSH and freeT4 are still in bad shape, then of course freeT3 will be.
If you have free access to T3 in your country (I assume you're not in the UK?), then its true that most people prefer a little T3 in with their T4, but of course it is still important to adjust and get optimally medicated. T3 also needs to be dosed correctly.
Having low blood pressure can be a hypo symptom, I've always had low blood pressure, but its starting to get better as my dose is close to optimal. Unfortunately these things can be a bit confusing, as being hypo can cause both low and high pulse. My story was, I had a low-ish pulse when hormones were super low, as I slowly increased my dose the pulse rose to about 92-ish resting pulse, and as I continued to increase my dose, my pulse is now dropping again, currently about 82 resting, and I hope it goes a bit lower
In your position, clearly undermedicated, I would advise continuing to raise your T4, the goal is to push freeT4 right to the top of the range. See how you feel then, and at that point it's about juggling different things to see if you can get a bit more improvement. Best practice is to stick on a dose for 6 weeks, have a blood test and a dose adjustment, stick for 6 weeks again, retest, and so on. Adjust by 25mcg, if you're like me you'll need a few increases to get up to the top, but everyone's different.
I think when numbers are low like this it can be confusing to work out where you are, especially if you're getting confusing symptoms. Just realised we're highjacking someone else's thread! You're welcome to make your own thread if you want to get advice from more people.
Thank you. I don't see how you think my Free T4 is not in range. It is 1.3 (range .8-1.8) while my Free T3 is clearly low. I keep reading that the Free T3 level is as important, if not more so, than total TSH. Would taking a bit of T3 also lower my TSH? Wouldn't just taking more T4 (Synthroid), just raise my TSH without fixing my Free T3 levels?
I saw this post from an Endo Dr regarding using Cytomel to help insomnia: ". Cytomel (liothyronine) is not appropriate as a thyroid replacement medication. It has a short action, can be harmful, can't be measured in routine blood tests. Use only brand name T4 replacement at the correct level to keep thyroid lab normal.
Unfortunately there is a lot out there by doctors discrediting T3, including within the NHS, where the official line is often that T3 doesn't add anything. Patient groups such as ThyroidUK, and the doctors we are very influenced by such as Dr Lowe, Dr Skinner, Dr Peatfield, would disagree with that.
I also heard that if one has Hashimotos, that it is better to gauge ones' symptoms rather than just relying on thyroid blood levels. Am also reading tons that Cylomed (T3) can CAUSE insomnia/anxiety, which is probably why my Endo is not keen on offering it to me.
Yes, T3 can cause insomnia/anxiety; and T3 can also relieve insomnia/anxiety. But don't listen to the authoritarian poppycock that so many MDs spout. If you have an FT3 test and it shows you are anywhere below mid-range, then the only way to find out what T3 does for you, is to try adding in a small dose. An appropriate time for a small dose is during the sleep cycle. Then if you see no effect, titrate the dose up in small increments to see if you can get an effect - good or bad.
I am scared about trying Cytomel because of fast heart rate. Should I try upping 100 mcg of Synthroid/Levo from 75 mcg FIRST, to lower my TSH from 2.29 (my Free T4 is 1.3) rather than adding T3 to raise my Free T3 from 2.5 to a better level? I heard that the Free T3 level can be more important than total TSH, especially with Hashimotos...sorry for all these posts...I am going bonkers trying to figure this out.
In my case, I have found that there are 3 factors that affect muscle function: (1) minerals, esp. magnesium. (2) blood protein level (I have hypoproteinemia). (3) thyroid T3. If I stop taking T3, I begin to notice problems with cramping in my legs. I have pronounced hypothyroidism (long-term Hashi's destroyed my thyroid), and in addition, my body won't increase conversion during the sleep cycle, to the level sufficient for good sleep.
I read Robinson's book. My recollection is that his style of T3 dosing, actually requires the patient to set an alarm clock and wakeup at a specific time, to take T3. After reading his book, I decided it wasn't really applicable to my situation.
There is very little info on the T3 circadian thing! I've been looking, without much result. If I come across something useful, I'll post it here, or PM it to you.
Some take a small dose of T3/NDT before sleep for a deep refreshed sleep . To much T3/NDT before sleep can wake one up from sleep and have a hard time to fall back to sleep .
I watched the TED talk, and it doesn't mention T3. Admittedly I would been a bit surprised if it did, because that would have been cutting edge research, and the TED talks tend to be a bit more conventional.
Overall the argument of the talk is that sleep is good for us, and there are health implications of getting poor sleep. I don't think anyone would disagree with that!
There were a few tiny bits I tend to disagree with that you hear everywhere. One is that we should aim for 8 hours of sleep a night. To me this seems insanely low, and even before I got sick I would have struggled on sleep that low. Although of course everyone is different.
A more specific thing that bothers me is the idea, if you can't sleep, that you should get out of bed until you feel sleepy. This may work for healthy people, but I think if you have insomnia because of being hypothyroid you will probably never feel sleepy. In my case I was at my most awake and alert at 4am. At one point when I was too ill to prepare food all day, I would sometimes get up and cook a meal in the middle of the night! I'm a lot better now, but I still don't naturally feel sleepy. It will take me several hours of lying down with my eyes closed to get relaxed, and this is reflected in my pulse.
I agree when he says that the bed can become associated with feeling unable to sleep, but personally I think it's much better just to feel relaxed and comfortable with not sleeping. I got to a point where I knew that after my first few hours of sleep, once I'd woken up it would take me 8 hours to get to sleep, so my job was to make that 8 hours as comfortable as I could. I strongly recommend podcasts and audio books, although music could be just as good. I found 'reading' a book in a night gave me a sense that I was accomplishing something just as worthwhile as what I'd have done if I was up and about ( I searched for audiobooks that were the longest number of hours - the Complete Sherlock Holmes is something like 50 hrs, and a great book to encourage sleep. And I relistened to books several times because I was not very alert and would lose the flow).
I too am an avid Audible book worm 🤗 I found it about 7/8yrs ago and I too look for the longest books! Lol I love Sci-fi fantasy trilogy’s. Audible has been my absolute life saver with insomnia. As a child I would lay awake for hours. Even at 8 or 10 I’d still be awake at 2am even though I’d probably been put to bed at 7pm.
Also fabulous to take the monotony out of housework 🤗
Me too! I am totally addicted to books on CD. Funnily enough It was needing to drive 400 miles round trip to pick up my thyroid meds that got me into it. I would go crazy now if I had to do that trip in silence. Now it is an absolute joy, it is the same as sitting there all day and just reading a book and how often can we do that, I actually look forward to my drive.
There is a lot of boilerplate stuff offered by those who write articles about sleep. Unfortunately those articles seem to re-hash and re-hash a set of suggestions which do nothing for me. I would agree that getting out of bed seems like it could be a Stupid Idea. I have never seen an article in the popular press that even mentions T3 circadian rhythm.
A google search with fewer terms ("thyroid T3 circadian rhythm") turned up a few interesting things, although nothing on dose size/timing. Like this: academic.oup.com/jcem/artic...
That study indicated that FT3 peaks about 0400. I.e. about 6 hours after bedtime. I awaken for my second (larger) dose about 0300 or shortly therafter, so I'm going to continue that to see how it works. NOT going to set an alarm clock as suggested by Paul Robinson!
What a fantastic talk by Matt Walker. Thanks for posting that.
As far as "middle insomnia" is concerned though I only get that when I drink too much wine with my dinner - and I am only talking 2 glasses of wine instead of one. Or if I have even a small glass of Bailey's round at my friend's house. Yes, it makes you fall asleep fast but you will wake up in the middle of the night.
Now T3 is interesting as far as sleep goes. I take my NDT (contains T3) first thing in the morning but I have found that if I don't get up after half an hour after taking my pill then I will fall asleep again, very deeply for at least an hour. I find that quite fascinating because it is the T3 that keeps me lively. Now, when you first take T3 there is a very big "rush" because of it's potency profile and maybe it is that which has the narcotic effect and knocks you out unless you fight it via normal morning activity.
I do know that with some people they can get to sleep if they take their T3 at bedtime but whether they stay asleep, I do not know.
That's an interesting point. I've experienced this effect, too. For me it's been being awake for ages, feeling that definitely awake in relaxed feeling, and knowing that after I take my tablets I will be able to feel relaxed again.
I have also had this with eating in the night, which I think is the adrenal connection. The adrenals are responsible for keeping our blood sugar up during the night once all the food eaten in the day has been used up or put into storage, and when they're not up to doing the job we wake up hungry. This explanation chimed with my own experience of waking up hungry, or even if I didn't feel hungry, eating a few oat cakes would help.
In terms of dosing schedules, when I split my NDT dose for the first time and having an afternoon dose around 4pm, even just that improved my sleep and I felt better on waking up.
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