I have been on Levothyroxine since 2006 after having been with diagnosed autoimmune Hypothyroidism, I tend to fluctuate between 125 -150 micro gms depending on blood results and stick to the dose daily, taken around 30-40mins before breakfast, the dose recommended by my GP, my weight is around 85kg.
For years I have had disturbed sleep, never have a problem getting to sleep but rarely sleep all the way through the night, I usually wake up between 2-4 hours after going to sleep and this can happen twice. I have tried going to bed earlier around 10-10:30 and going later after midnight but seems to have no effect as I still wake up, the usual time is around 3am. My bedroom is cool and I have not had any alcohol or caffeine since the end of January 2020, nearly 10 months and do not smoke.
Does anyone with Hypothyroidism have similar problems, I can just about cope with the sleep pattern but it is getting troublesome and cannot be very healthy longer term, Or any suggestions to overcome this would be appreciated.
P.S I take 20mg of Propranolol in the morning 30-40 mins after my Levothyroxine and take an occasional Omeprazole when required, around 2 hours later than Levothyroxine if needed in the morning.
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thyreoidea
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Drugs that may decrease PTH include cimetidine and propranolol.
If you must take propranolol ….it should be as far away from levothyroxine as possible…..minimum 4 hours
You could move levothyroxine to bedtime
If you’re ever going to consider stopping propranolol it has to be done incredibly slowly…..and over many many months
Lansoprazole is a PPI to treat high stomach acid
Vast majority of hypothyroid patients have LOW stomach acid …virtually identical symptoms, very different treatment
The fact you get acid reflux suggests your under medicated or poor conversion of Ft4 to ft3
Suggest you consider changing taking levothyroxine to bedtime and test thyroid and vitamin levels in 6-8 weeks time
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine or any significant change in how when you take levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
Low vitamin levels common as we get older too
What vitamin supplements are you currently taking?
Propranolol possibly lowers magnesium
Vitamin D needs magnesium
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 and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
I have been taking Omeprazole for about 13 years taking 20mgs daily at the same time as my levo and propranolol as I knew no difference and have at times weened myself off it, I only take it now if necessary.
I have never had my vitamin D, folate, ferritin and B12 tested as far as I know as I have looked at my blood results online. I started taking Vitamin D last winter but stopped after a bad spell of missing heartbeats which lasted quite a few months earlier this year unsure if it had caused it and could not get an answer from my GP. I have been trying to get outside as much as possible to get as much natural Vitamin D as possible and are cautious about taking any unless given the green light from my GP or a cardiac consultant as I have been waiting 8months for an echocardiogram and a 24hr monitor. I will contact my GP to see if I can get a blood test done.
I feel your pain, I had bad sleep for over 15 years. I have fibromyalgia and bad sleep is an extremely common symptom. Like you I rarely have trouble falling asleep but always wake up several times in the night and struggle to fall, asleep again. I also have a habit of awaking annoyingly early and that's it for me.
Over the years I've tried every cure known to humanity, sleeping tablets, antidepressants, even though I'm not depressed, some have sedating effects, I've tried antihistamines like Phenergan, natural remedies like lavender oil, chamomile tea, milky drinks, melatonin supplements.
I've even been on a sleep course where they tried to teach us sleep hygiene habits, like regular bedtimes, no caffeine or booze before bed, cool bedrooms. No phones or tablets before bed as there's evidence the blue light they emit disrupts sleep, no TV in the bedroom.
I'm sorry to say nothing has worked. My sleep problems come and go, I sometimes have periods of better sleep but it's gotten worse since I've been menopausal and now hypo.
Strangely though it doesn't seem to affect me during the day. I dont find I'm tired or sleepy so I've concluded I'm getting enough sleep, not as much as I'd like maybe but enough for my body.
We need less sleep as we get older anyway and its a fallacy that we need at least 8 hours a night. It's highly individual. My hubby can get by on 4 or 5. He's been like that ever since we've been together,30 years. Some need more, some need less. I've tried to stop worrying about it as anxiety isn't conducive to good sleep.
It's about how you feel, if you're tired, especially during the day and sleepy then it might be worth seeing a GP. If you're OK and can get through the day without excessive fatigue then you might be getting enough sleep.
You could try some magnesium glycinate tablets before bed. There's some clinical evidence they can improve sleep quality and many of us are deficient in magnesium anyway. And sour or tart cherry juice has similarly been found to help some people. You can get it as a drink or supplement. Its worth trying non drug remedies first.
I don't know to whom you were replying there, but on this forum you have to reply by clicking on the blue 'Reply' button if you want the person concerned notified.
I would suggest that what you have there is more likely to be an adrenal problem than a thyroid problem - although the two are closely linked. Have you ever had your cortisol tested?
It would only be listed as cortisol, I think. Might be a good idea to ask your doctor to do this - he would only do an 8 am blood test, but better than nothing. It would at least give you a clue what your adrenals are doing. But, you could do a 24 hour saliva cortisol test privately if you wished.
Propranolol reduces the active hormone T3. I find I need liothyronine (L-T3) to get good sleep, without it my brain is unable work properly and enable me to have deep sleep with vivid dreams. You need to have TSH, fT3, fT4 measured. Why are you on propranolol?
I had a palpitation problem some years ago as well as anxiety and have cut the dose down slowly to only 20mgms a day. The GP has never mentioned the effects it could have on my thyroid function or the other things affected by it. I do actually dream a lot so must be getting into deep sleep but I must be waking up in between the different phases of sleep.
Your GP would probably not know about propranolol and its affects on deiodinase (T4 to T3 conversion) as it's specialist stuff. If you still need a beta blocker they can consider one that does not affect the thyroid. As a starting point I would get TSH, fT3 and fT4 tested and post the results here. I use the Monitor My Health test as it's cheap and done by an NHS lab. Your GP will probably not be able to request an fT3 assay so hence you will need a private test.
I don't see any merit in paying extra to measure antibodies as you were diagnosed in 2006. They have probably declined since then and if they haven't they are unlikely to do so now.
This probably means your fT3 and fT4 are normal but it is worth checking fT3 and fT4 to see what is going on. Sometimes the pituitary produces too little TSH and so it looks normal but T3 and T4 levels can be low.
For that reason, I cannot compare with taking in the morning.
Before diagnosis, my sleep was badly disturbed. Typically, I would fall asleep fairly easily. Then wake up after something like half an hour to two hours. Once woken I'd be unable to get back to sleep - often till dawn, or at all.
Once I started on levothyroxine, my sleep slowly improved. By the time I was taking an adequate dose, bad nights were unusual - just an occasional night where I might wake up for a while. Now, after years, I sleep very easily and deeply and rarely wake at all. If I do, I get back to sleep quickly.
I had very bad insomnia for years, I never slept more than 2-3 broken hours per night, prior to my Hashi's diagnosis. My pattern was exactly as helvella stated in the previous post. I was undermedicated for two years after beginning treatment; my Free T3 was kept at about 2.9 (2.3-4.2 range). During that time, my sleep improved slightly but it was not good, usually I could get 4 hours. When I finally got my Free T3 high in range (80%+), I finally can get a full nights sleep most of the time. I want to point out that I have never had a Free T4 reading above 20% of the range, so I feel this was something that was resolved when my FT3 went up.
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