Hashimoto's and night eating syndrome / extreme... - Thyroid UK

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Hashimoto's and night eating syndrome / extreme night hunger?

thornhollow profile image
8 Replies

Hi all, I was diagnosed Hashimoto's in January and began medication late February. Before my diagnosis I would sometimes awaken in the middle of the night (between 1-3 am) with extreme hunger, but since getting medicated it happens almost nightly. I eat normally throughout the day and try never to go to bed hungry, and this happens even if I eat dinner before bed. Sometimes I can go back to bed if I drink a few glasses of water and take my Levothyroxine so that I know I can't eat for another hour, but most times the hunger is so painful that I'm often physically clutching my stomach in bed because of how uncomfortable the feeling is and I have to eat to be able to go back to bed. I know it's not in my head, either, because my hands are often shaking as if I have low blood sugar (though I can't measure this because I don't have a monitor at home). Since starting the meds I've also gained about 5 lbs, whereas before I was consistently a 110-113 lbs without any effort. I exercise (5+ miles walking each day and daily yoga) and eat very healthfully, mostly vegetarian. My doctor simply upped my prescription from 50 to 75 mg of Levothyroxine and told me to eat a spoonful of peanut butter or deli meat before bed, but it really hasn't done much.

I just want to be able to get a full night's sleep and not be woken up by this excruciating hunger. I am thinking of maybe taking melatonin to see if that does any help. Any tips or similar experiences around here?

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8 Replies
Cooper27 profile image
Cooper27

This sounds frustrating!

It could be worth signing up to Cronometer (food logging app) to check how your macros are and when you eat them. Possibly playing around with what you eat and when e.g. restricting carbs in the evening, to see if that's causing a blood sugar crash in the night.

Sometimes I wake up feeling extremely hungry in the night, but I realised it's actually dehydration. It's no fun. This could also be your problem. It's worth checking how much you drink.

I'd generally want a doctor to check there's nothing wrong, but it sounds like yours is writing it off.

thornhollow profile image
thornhollow in reply toCooper27

Thank you, I'll look into that app! Sometimes I log with MyFitnessPal but I suffered from anorexia for about 6 years so after a couple days of logging it makes me very hyperaware of all my eating in a bad way. Frustrating as I'm sure it would be helpful if I didn't have bad food relationships! I definitely drink loads of water throughout the day (I probably manage an entire gallon!). Maybe I'll try lowering my night carb intake and see how that goes.

Cooper27 profile image
Cooper27 in reply tothornhollow

That's fair enough. I'd certainly only suggest using the app for a few days to get an idea of macro ratio, as long as you don't think it would cause you to relapse or become obsessive. You can just play around with your fat/carbs anyway without logging first to see if it helps.

It's important that when you reduce carbs, you increase fat and protein to compensate the calories. It might not be the answer, but it's worth trying.

Do you get enough salt in your diet? That much water can flush the system of salt, which is actually quite important for keeping us hydrated and running bodily functions.

SlowDragon profile image
SlowDragonAdministrator

75mcg is only one step up from starter dose

Bloods should be retested 6-8 weeks after each dose increase

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

healthunlocked.com/thyroidu...

Low blood sugar is common hypo symptom while still under treated

Have you had vitamin D, folate, B12 and ferritin tested yet?

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

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

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

What vitamin supplements are you currently taking?

thornhollow profile image
thornhollow in reply toSlowDragon

I had vitamin D tested at time of diagnosis, but not since! I have always been deficient and just barely became yo to normal while taking a prescription of 5000% of my vitamin D once a week. l’ll see if my doctor can add those to the list of requested tests when I’m in for my next blood lab.

I currently take a women’s multi, vitamin D, and magnesium, though I always take it at least 4-8 hours after taking levothyroxine.

SlowDragon profile image
SlowDragonAdministrator in reply tothornhollow

Multivitamins not recommended on here, often cheap poorly absorbed ingredients

Frequently contain iodine not recommended for anyone with hashimoto's

Better to test and supplement vitamin B complex if B12 and/or folate are low

Folate better than cheaper folic acid

How much vitamin D per day are you taking?

thornhollow profile image
thornhollow in reply toSlowDragon

I take 200% of my daily vitamin d and I get out in the sun for 2 hours each day (I live in the States) and my vitamin D is still only at a level of 30! I think I need to go somewhere tropical at this state, haha. I did not know that about the multivitamin. Do you normally get prescribed your supplements then?

SlowDragon profile image
SlowDragonAdministrator in reply tothornhollow

No prescription unless deficient

We all self supplement to bring levels to optimal

Rare in USA to get folate (B9) tested

If multivitamin contains B12 it’s unlikely you will test as actually deficient

Vitamin D...common for Hashimoto’s patients to need around 2000iu or even 3000iu per day as maintenance dose.

Dr Gominak On vitamin D and B vitamins

drgominak.com/sleep/vitamin...

In YouTube video...vitamin D at 40ng/ml (USA units) is equal to 100nmol (UK units)

youtu.be/74F22bjBmqE

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