Insomnia after thyroxine increase

[Molly161018]

I have recently had a raise in my thyroxine from 100mcg to 125mcg, as I went to my doctor with increasing hypo symptoms.

I do feel a bit better generally following the increase (although still not great...) but I am struggling with sleeping. Could it be that I'm now overmedicated? I certainly don't have any other signs, but it seems like it's only started since the increase in thyroxine.

From previous advice received on here, I clearly have T3 conversion issues, but could this mean that having extra T4 is causing insomnia as a hyper symptom, although I still have a lot of hypo symptoms because I don't convert to T3 properly?

I'm loathed to go back to my GP about this in case they reduce the thyroxine again - I don't want to go back to feeling rough like I was a few weeks ago!

Any advice would be appreciated!

[SlowDragon Administrator]

Do you always get same brand of Levothyroxine?

How long since dose was increased?

Bloods should be retested 6-8 weeks after any dose change

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Do you have Hashimoto's (high thyroid antibodies)?

Low vitamin D or low FT3 can cause poor sleep

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

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 primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.

So it's important to get TPO and TG thyroid antibodies tested at least once .

[Molly161018 in reply to SlowDragon]

Hello slowdragon, thanks for your reply.

I now have two different brands of thyroxine - Northstar in 100 mcg and Teva in 25mcg - is it possible that the Teva addition could have caused a reaction?

I have been on the new dose for Four weeks now - due for a retest in two weeks time.

Yes I have hashimotos. I take a liquid vitamin D supplement - 3000 iu, plus 1000mg vitamin C and selenium and zinc.

I haven't had a full thyroid profile for a while (I can't afford it right now) but my latest GP results (August) are as follows. These were taken after fasting and 24 hours from my last thyroxine dose, and along with my symptoms are what promted the GP to increase my dose:

TSH 1.71 miu/L (Normal range 0.55 - 4.78)

FT4 11.5 pmol/L (Normal range 10 - 20)

FT3 4.1 pmol/L (Normal range 3.5 - 6.5)

My previous private blood tests have always shown up low T3 and raised antibodies, but vitamins and minerals seem to be fine (I posted these previously and had advice on this forum that I definitely have T3 conversion issues)

[HLAB35]

You don't mention B12 levels. Supplementing with a quality b complex could make a difference to both conversion and insomnia. I find that B6 as P5P ( only found in good methylated B vitamins) and B3 are vital for good sleep. They work much better (as does vitamin d) if you include a good deal of Magnesium as well. Magnesium helps with conversion and insomnia and turns vitamin D into its active form. Glycinate, Malate and Citrate are recommended forms ( not Oxide which is rubbish and gives the runs). Alternatively, use Mag oil spray, lotion or gel which bypasses the gut.

[Molly161018 in reply to HLAB35]

Thank you for your reply - very kind! I will have to get some b complex - I used to take it but ran out and haven't got round to ordering more.

I've got some magnesium already but haven't been taking it recently so I took this again yesterday and slept fine...so will see what happens for the next few days!!

Thanks again for your advice!

[jgelliss]

I'm so sorry that your having symptoms . Hypo symptoms can be from low FT3 and not being a good converter may be causing you to have a highish FT4 . Having labs done with FT3 FT4 TSH can be very helpful . When my FT4 is on the highish side one of my symptoms is insomnia, sweating ,aches/pain, weight issues, high BP,anxiety .

Nutrients are very important here too . Vitamin "D" K2 , B-Complex , B-12/folate , Iron if your Iron/ferritin levels are low , Vitamin "C" , magnesium , fish oil .

Selenium helps with converting T4 to T3 . Some don't do well with Selenium. If you decide to try Selenium not more than 200mcg or you can try to eat two Brazilian nuts that has enough Selenium in it.

I hope you feel well very soon .

[Molly161018]

Many thanks for your reply.

I will be interested how my next results come out so I can see what my actual levels are...should be having another blood test next week...

I will have to get some more supplements - I have taken various ones in the past... but it's hard to know what helps most, and they do become expensive don't they?!

I've taken selenium for about two years now...so perhaps it's not working for me as my conversion hasn't improved in this time...! I've carried on taking it religiously, as I know it's supposed to help support the thyroid...although I've let other supplements drop off!!

I have always taken vitamin C regularly otherwise I get ill all the time...and I also take vit D in liquid form as I was deficient.

Perhaps I need another comprehensive thyroid blood test to test for vitamin and mineral levels too, to guide me what to try next...

Thanks again for your advice and well wishes! xx

[Simplyred57 in reply to Molly161018]

Both myself and my sister were very unwell after taking Teva , might be worth trying a different brand , I get mercury pharma in 25 mcg pills or cut your 100mcg into 1/4 to see if it makes a difference.

[Molly161018]

Thanks for that advice - I'll give it a try and see if it makes any difference!