Liothyronin T3 and sleep

[Wired123]

Hi all

I’ve been on 2x5mcg daily T3 for about 6 months.

I take 5mcg on waking with 150mcg T4 and another 5mcg T3 at 2.30pm (90 mins after lunch).

My levels are stable and Endo is happy. Recent results in previous post:

healthunlocked.com/thyroidu...

Today’s question is around sleep and lack of it.

Since starting T3 my sleep is much improved, I sleep much more deeply and wake up feeling refreshed. This is the first time in over 20 years I can wake up without a problem and be ready for the day ahead. No drowsiness or brain fog! I put this down to higher morning cortisol. I no longer need an alarm clock whereas on T4 only treatment I needed multiple alarm clocks yet still struggled to get out of bed for work even if I had got 8 hours of sleep.

So far so good, however there is a flip side. I can never have a lie in anymore.

I awake like clockwork at 7.30am and do not need an alarm clock. Normally this is brilliant. However even if I sleep late I’m am wide awake at 7.30am.

For example last night I slept at 3am (circumstances outside of my control) yet here I am wide awake at 7.30am. Yet my partner is fast asleep and will probably awake at 10-11am I would guess so would have got a decent amount of sleep.

Any ideas of why this phenomenon occurs and any solutions? My Endo had no advice other than “try taking a siesta” which is not ideal if you work UK office hours! Luckily today is a bank hol and I may be able to sneak in an afternoon nap but I am still probably sleep deprived by at least 3 hours and had today been a standard work day I would struggle.

My other concern is that over time I am not catching up on sleep as I always wake at 7.30am so the days I don’t get enough sleep and even 1 or 2 hours a day of reduced sleep adds up over the weeks.

I recently suffered a family bereavement and have had disrupted sleep for a few weeks so I know I’ve not averaged anywhere near the daily 7-8 hours sleep I normally get and need. I’m worried this will start adding up over time and lead to other health problems. I’ve probably averaged 5-6 hours over the last 3 weeks which is a significant and sustained reduction in sleep hours.

Any thoughts and advice welcome.

[waveylines]

Sorry to hear about this though pleased to hear the T3 is helping you. The interesting thing about sleep is that the body will adjust its level and amounts of deep restorative sleep. You maybe sleeping less be cause your body is programmed to wake up at a certain time despite what time you went to bed but the body will catch up on itself. Its not all about how many hours of sleep but the quality of sleep you get. One option is to try going to bed a little earlier the next night after you had a late night out but woke early.

Its amazing how our environment and life happenings affect us. For myself Ive always been an owl but lately Ive been having building work going on so have to be up early to let builders in........its been a few months of building work & getting up early so my body clock has changed so now Im awake much earlier but desperate to go to sleep by 10 or even earlier!! This happenes at weekend and bank hols......my body wakes up early. Annoying!

The other thing to consider is light polution. With the early dawns now you maybe waking because of this too......so a sleep shade might help.....or not!

[Wired123 in reply to waveylines]

Thanks for your reply.

I’ve always struggled with waking until I started T3. Perhaps it’s just working too well!

Blackout shades are being used so this is not an issue.

Tempted to take some night nurse tablets to try and get some extra sleep as I’m worried the weeks of reduced sleep may impact my health soon.

[waveylines in reply to Wired123]

Have you tried going to bed earlier? I know it sounds daft but honestly that is what I ended up doing and accepting that currently Ai am not a night owl anymore. Stress is a great interruptor of sleep too. The more you worry about how much sleep you are getting the more you will interupt your sleep......its viscous circle.

[Wired123 in reply to waveylines]

I have on occasion gone to bed a little earlier, but not by more than an hour.

The T3 gives me enough energy to last the whole day regardless. I no longer get that lethargic feeling around 6pm.

[SlowDragon Administrator]

Many of us on T3 find taking 5mcg at bedtime improves sleep

Perhaps try moving 2.30pm dose later in day ....initially to say 6pm or 8pm

[Wired123 in reply to SlowDragon]

Thanks SlowDragon. This isn’t about improving sleep, it’s more about the timing and volume of sleep as I seem to have a very fixed waking point regardless of what time I slept.

Case in point, last night I slept at 3am and was still up before 7.30am.

Normal bed time for me is 11pm which gives me a nice 8 hours-ish sleep a day.

Clearly 4.5 hours sleep is not enough and I struggle to catch up with lost sleep.

[SlowDragon Administrator in reply to Wired123]

My point is ....currently your last dose T3 at 2.30pm is too long a gap until next dose when you wake (at approx 17 hours) So you may be getting drop in T3 after 12-14 hours

Personally I find it important to dose 3 x day at roughly 8 hour intervals. And currently I am experimenting with 4 doses per day at approx 6 hour intervals

[Wired123 in reply to SlowDragon]

So do you feel if I move my second daily dose of T3 to 6pm or 8pm, I will sleep for longer?

Ultimately I am happy with my 7.30am waking as it allows me to start work on time. I don’t want to lose this.

It’s just the days when I don’t get enough sleep I want to be able to catch up on sleep and/or have some lie ins at weekends to catch up on any missed sleep.

[SlowDragon Administrator in reply to Wired123]

Yes...possibly help sleep longer, when required

It’s all trial and error what suits each person

[Wired123 in reply to SlowDragon]

Great thanks, will experiment and report back on this.

[Seasons7 in reply to Wired123]

I'm finding I'm experiencing the same thing except I have been waking up consistently at 4 or 5am! Did moving your dose later help with this?

[radd]

Dk123,

You have only been medicating T3 for about 6 months. I am still seeing new benefits of medicating T3 6 years later. Both T3 and adrenal issues heavily influence sleep, and it takes us years to get into the state we do so makes sense it can take a long time to get out of it.

Sorry to hear about your family bereavement. Your thyroid levels are now stable and I would cherish that lovely sleep you were getting and have confidence your sleep patterns will eventually resume now you have the benefits of T3 .

On a side note I completely stopped remembering dreams after medicating T3. Very weird.

[jamesal0]

Hi Wired, I wouldn't worry. If your body needs sleep you'll sleep, if it doesnt you wont. And we need less and less sleep as we age. I know people who are their most creative at 3am in the morning and have been for years and years and they seem fine. I think the suggested link between sleep and illness is abit over done to be honest.

J

[StitchFairy in reply to jamesal0]

Goodness, if only it were that simple! You obviously have no personal experience or understanding of the relationship between sleep and thyroid hormone levels.

[jamesal0 in reply to StitchFairy]

If I take too much NDT I can't sleep and if I dont take enough I cant sleep. If I get it right I sleep from 10pm to 3am. Take another 60mg NDT and go back to sleep until 6am. But if I'm having a rough night and cant get back to sleep at 3am. Don't stress, listen to the radio or read a book until 6am - go to work - feel like garbage, prop my eye lids open with caffeine. Hopefully the next night or the night after I will be fine.

[helvella]

I take only levothyroxine. But, for me, improved sleep was the first significant improvement I noticed. Exactly as you say, deeper and feeling more refreshed.

Recently I took a fairly low dose of Amitriptyline for a while - for pain. It helped a lot but as days went by, I realised that not only was it helping me get to sleep and sleep through the night, it was also making me oversleep and I lost at least some of the refreshed feeling in the mornings. Even when I had slept plenty of hours, I felt I could have done with longer!

Have now given it up and realise I am back to better, more refreshing, sleep. And waking up earlier. Earlier than before taking Amitriptyline!

I am fully endorsing the impact of thyroid hormone on sleep. Something I think is missing from most descriptions of hypothyroidism.

But also that other things can affect sleep. I have a feeling that my current sleep pattern is still reacting to dropping Amitriptyline. Initially over-doing it and waking too early. Am hopeful that it will return fully to how it was - and seems to be going in the right direction.