Help me figure this out, once and for all - Long Moan

[Batty1]

Thanks in advance!

Thyroid Med schedule:

Im thyroid-less and I split my 100mcg Synthyroid and 10mcg Cytomel between these times in parentheses (4:15am and 11:15am) and then once a week I add in another 50mcg Synthyroid (this 50 is recent addition) Ive been splitting my medications this way for the past 4 years.

Additional health issues:

Psoriatic Arthritis and possibly Allodynia Fibromyalgia (Not diagnosed) I have horrible pain just being touched (sad) and debating if this is even worth pursuing.

Medications/ Vitamins: (addition to thyroid) I take all the below starting around 4 pm.

Vit D3, K2 and Mag Citrate

Super B- complex (igennus)

Iron ( low ferritin) Take every other day

Prilosec , Estridol

Problem:

Im fine during the day (alert but tired) my pulse is steady and its not UNTIL bed time for some reason (I cannot figure out why) but I have terrible anxiety attacks during my sleep that wakes me up I feel wired but when I look at my fitness watch my pulse is in the low to mid 50s and then the panic attack shoots my pulse to 70 and I experience tongue numbness and restlessness.

What really irks me is as soon as I take my first dose of thyroid meds at 4:15am WITHIN 30 minutes Im sound asleep for 3-4 hours no issues .... rinse and repeat every night almost the same issues (I stop eating and drinking coffee by 6 pm and GO to bed at 11 pm) I do have constant pain between the joint pains and this touching pain that causes my skin to feel like it has a bad sunburn (it does cause agitation) the pressure of lying down and moving creates some agitation from this burning skin sensation and obviously joints.

I don’t know what to do (Should I) take my last set of thyroid meds at say 9pm and go to bed .... my only issue is my stomach pill that I take at 4 pm everyday.

Thanks again and hopefully someone has a solution... I don’t want to bother my endo because you all know he will say your over medicated (par for the course) never under always over and I don’t want to fight about meds. I’m due for blood test in the next 6 weeks anyway and I hardly think Im over medicated.

[Lalatoot]

The night is when I experienced a lot of y symptoms. I would wake up feeling so ill. Usually around midnight to 2 am and then sometimes 4am.

Our bodies work a lot when we are 'asleep'. The gut is working and the brain is processing. These are 2 big users of thyroid hormones.

In the normal rhythm of things TSH peaks around 2am and T3 peaks in the body at 4am.

It could be that your body is looking for these peaks or needing hormones to do gut and brain work and the hormones aren't there.

[Batty1 in reply to Lalatoot]

Do you think if I took my Last 5mcg Cytomel at 11am and then took the 50mcg at 9pm and go to bed this might help?

[SlowDragon Administrator in reply to Batty1]

That’s likely too long at 18 hours between last T3 at 11am and 4am

At least split the T3 so it’s two doses 12 hours apart

But personally, I find 3 doses split at 8 hour gaps gives best results ...for me that’s 20mcg split into approx 10mcg at 7am, 5mcg 3pm and 5mcg at 11pm

5mcg before bed gives wonderful sleep for many patients

[Batty1 in reply to SlowDragon]

Thanks SD

Would you keep the T4 at 11 am ? I only take 10mcg T3 (so split one 5mcg) and take that before bed? What about my stomach pill (this worries me)

Im desperate I will try just about anything.

[SlowDragon Administrator in reply to Batty1]

You can split. Levothyroxine, or take it all at once...it shouldn’t make a difference

Personally I changed to taking levothyroxine at bedtime about 15 years ago. I find it much more convenient and effective

Can you split 5mcg into 2 x 2.5mcg ....or is that a speck of dust?

What’s the pill for your stomach?

[Batty1 in reply to SlowDragon]

I take stomach pill for Gerd thats why I struggle so much to take meds constantly have to think about things not being absorbed and not getting the much needed thyroid meds.

I will keep T4 the same and just split out the last T3.

[wadhamk in reply to Batty1]

have you tried cutting carbs out they cause me terrible acid probs

[Batty1 in reply to wadhamk]

Actually I sat down and wrote out the carb/fiber/calories of everything I eat everyday and its just crazy everything has carbs and i’m torn on what to cut ...... So with those tears out of the way I have cut out ALL Junk food about 3 weeks ago and I never have been the pasta, potato or bread person (my family can’t understand how I survive without bread) lol so cutting those out really can’t they don’t really exist in my menu and if so very rare. I also cut back on my portion amounts and stopped drinking ice tea except with dinner.

Im beginning to think my slowwww digestion is to be blamed for my Gerd and its a family affliction since every person in my family has it (no kidding).

[SlowDragon Administrator in reply to Batty1]

Is this omeprazole, lansoprazole or some other PPI?

Most hypothyroid patients have LOW stomach acid

GERD is frequently linked to low stomach acid

PPI are to treat high stomach acid

Thousands upon thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

healthunlocked.com/search/p...

Links about LOW stomach acid

nutritionjersey.com/high-or...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

Protect your teeth if using ACV with mother

healthunlocked.com/thyroidu...

Ppi tend to lower vitamin levels

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

[Batty1 in reply to SlowDragon]

Omeprazole (prilosec)

[Batty1 in reply to SlowDragon]

Do you think my low stomach acid could be behind my recent sleep disturbance? If so why do I sleep for hours after my thyroid meds? i take my PPI at 4pm about hour before dinner and the dreaded time required from thyroid meds.

[SlowDragon Administrator in reply to Batty1]

Suggest you read the many posts about low stomach acid that I gave you link too

Omeprazole is to treat HIGH stomach acid

Many many people find addicting T3 calming and relaxing. Common to feel sleepy immediately after taking T3

[SlowDragon Administrator in reply to Batty1]

Strictly gluten free diet often essential...or certainly lower Beige carbs

[Lalatoot in reply to Batty1]

Give it a whirl. I take 75mcg levo and 5mcg lio 6amish and 50mcg levo and 5mcg lio at bedtime.

[Batty1 in reply to Lalatoot]

Just split out my afternoon dose for tonight!

[Lalatoot in reply to Batty1]

Fingers crossed!

[humanbean]

I have terrible anxiety attacks during my sleep that wakes me up I feel wired but when I look at my fitness watch my pulse is in the low to mid 50s and then the panic attack shoots my pulse to 70 and I experience tongue numbness and restlessness.

Have you ever done a saliva cortisol test? You might be producing more cortisol at the end of the day than you should be.

What time do you wake up and get up for the day?

[Batty1 in reply to humanbean]

YES, about 2 years ago and it was supposedly fine. I take my first thyroid dose at 4:15am and fall back to sleep until 7am or 8am at this point Im up for the day.

Im usually restless starting shortly after going to bed and I fall alseep around 2am Im up and anxious and restless worse then when I went to bed.

Maybe this is important: I have to force myself to eat Im never hungry and certain food repulse me.

[humanbean in reply to Batty1]

A suggested timetable :

4.15am - Take some or all of your T4 and half of your T3.

8am - Take your Vitamin D3, K2 and your B Complex

2pm - Take the remainder of your T4 and T3.

Prilosec - Take it just before your evening meal.

Mag Cit - Take it about an hour or two before bed.

Iron - Take it at about bedtime.

I was told some years ago that it is best to take vitamins in the morning and minerals in the evening. The reasoning behind this is allegedly that vitamins are "stimulating" and minerals aren't. I don't know if there is any proof behind this.

There are some exceptions to the above rule.

People should take iron and vitamin C together, but apart from everything else ; and should also be taken four hours away from thyroid hormones. I would suggest evening or bedtime.

The only thing I haven't mentioned so far is your Estridol. I think it should be taken at least four hours away from your thyroid meds.

If you don't like the above timetable, then tell me what you object to and I'll try and change it - but I make no promises!

[Batty1 in reply to humanbean]

I take the estradiol same time as the stomach pill.

Another thing: Im on a different brand of T4 and T3 (not by choice) Doctor ordered wrong one and then ordered the correct T4 but the pharmacy won’t release the (Synthyroid) which is what Ive always been on until my next refill in late October.

Im going to definitely follow your schedule as this is do able.

[humanbean in reply to Batty1]

It just occurred to me to ask. Prilosec is a PPI which will reduce your absorption of everything - food, drugs, hormones and supplements. I wondered why it was prescribed?

[Batty1 in reply to humanbean]

For me if I didn’t take it I would be in severe pain.

I did as you recommended and I think I will split my 2nd dose of thyroid and take it before bed..... I slept good and took my 4:15am dose as normal fell right back to sleep again.

Do you think the different thyroid meds could be the issue behind my anxiety attacks during sleep?

[humanbean in reply to Batty1]

For me if I didn’t take it I would be in severe pain.

There are good reasons for taking PPIs when people take certain drugs that irritate the stomach e.g. NSAIDs like ibuprofen or naproxen, but if the only reason you take it is because your stomach acid is low and you get severe indigestion and/or acid reflux then taking extra acid rather than shutting off what you do produce may actually help.

For more info than I could possibly give, you should download this free e-book from Chris Kresser - you only have to provide an email address :

chriskresser.com/heartburn/

It explains why so many of us have problems with stomach acid, heartburn, acid reflux and indigestion, and how to deal with it. I thought it was well worth the effort of reading it.

And it is also worth searching the forum for references to vinegar and betaine.

Do you think the different thyroid meds could be the issue behind my anxiety attacks during sleep?

I can think of a couple of reasons.

1) If the anxiety started suddenly then yes, obviously the change of brand may have caused a problem.

2) It may be cortisol related, and you are producing too much or too little. And/or the pattern of your cortisol output is "deranged" and is not being produced at the times it ought to be.