Hi all,
I am currently on 50mcg of levothyroxine (soon to be on 75mcg) and am finding my sleep really broken / almost non existent. I have read that this is a common side effect and wondering if anyone had any advice or tips on how to get better sleep whilst taking this medication?
So has GP agreed to increase dose to 75mcg
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
So request 25mcg tablets added to your prescription
(Rather than a single 75mcg tablet - which is only made by Teva)
Has GP agreed to test vitamin D, folate, ferritin and B12
If not make another appointment or email them and request testing
Both low vitamin D and low B vitamins linked to insomnia.
Low vitamin levels are extremely common with Hashimoto’s
Are you currently taking your levothyroxine waking in morning, or last thing at night?
Many people find it more convenient to take levothyroxine at bedtime…..might possibly improve sleep
Yes they have agreed to up my dose to 75, I will still be on the same brand so will have both 50 and 25 mcg.
Would you recommend taking further 25mcg every day or every other day? I’m worried that it might be a bit of a shock to my system otherwise.
They have agreed to test my b vitamins, folate and feratin but not D for some reason - will post on here once I’ve got results.
I will try taking the pills in the evening then and see if that makes a difference, with my general feeling of malaise compounded with lack of sleep I feel absolutely dreadful! Thank you again for all your helpful advice!
Suggest you test vitamin D yourself then GP’s hate testing vitamin D ….they consider it an expensive test and that it’s a waste of money……pity they haven’t actually read the research on vitamin D deficiency being widespread when hypothyroid
NHS easy postal kit vitamin D test £29 via
Come back with new post once you get vitamin D result
If vitamin D is below 25nmol GP should prescribe high dose vitamin D known as a LOADING dose
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
GP will often only prescribe to bring vitamin D levels to 50nmol. Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Research links on Vitamin D deficiency and hypothyroidism
pubmed.ncbi.nlm.nih.gov/286...
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
pubmed.ncbi.nlm.nih.gov/273...
Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.
pubmed.ncbi.nlm.nih.gov/300...
The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
ncbi.nlm.nih.gov/pmc/articl...
Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.
Same applies to low B12 - extremely common in hypothyroid patients
All patients who are hypothyroid should have B12 tested
ncbi.nlm.nih.gov/pubmed/186...
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,
ncbi.nlm.nih.gov/pubmed/169...
Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.
Folate supplements can help lower homocysteine
ncbi.nlm.nih.gov/pmc/articl...
Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.
Low ferritin frequent in hypothyroidism
endocrineweb.com/profession...
Magnesium is a good idea…but must be at least 4 hours away from levothyroxine
Perhaps initially just try magnesium at bedtime
If you want to take levothyroxine at bedtime….take magnesium early evening, at least 4 hours before
Increasing levothyroxine
Perhaps cut 25mcg tablet in half to add just 12.5mcg initially to 50mcg ……see how that goes
After 2-6 weeks assuming ok, increase to 75mcg
Retest thyroid levels 6-8 weeks after any dose change or brand change in levothyroxine
Thank you 🙂
Yes I definitely feel just from the little research that I have done, that doctors really seem to be a bit behind on the research when it comes to thyroid function / ailments. My doctor said he had never heard of pins and needles and headaches being a symptom but I have since found a few examples were people talk of very similar symptoms.
I’ve ordered the D test, have been taking vitamin D and B12 supplements this week, do you advise stopping taking them before being tested?
Also, I have just picked up my prescription and each box is by a different company! 50mcg by wockhardt and Mercury Pharma, and 25mcg by North Star and Accord…is it okay to mix so many brands? I guess it’s all the same drug…but feels a bit strange to mix them.
Thank you again for all your helpful advice, I would be totally lost I hadn’t found this forum!
Northstar 25mcg is Teva brand and Teva upsets many many people
Have you had Teva brand previously?
If it upsets you …Return it to the pharmacy and request new prescription for 25mcg Mercury Pharma brand
Levothyroxine only costs £1 per pack ….so it’s not a big deal money wise to return it
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva contains mannitol as a filler, which seems to be possible cause of problems.
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
But for some people (usually if lactose intolerant, Teva is by far the best option)
Teva, Glenmark or Aristo (100mcg only) are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Accord only make 50mcg and 100mcg tablets
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets
beware 25mcg Northstar is Teva
List of different brands available in U.K.
thyroiduk.org/if-you-are-hy...
Posts that mention Teva
healthunlocked.com/search/p...
Teva poll
healthunlocked.com/thyroidu...
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.
New guidelines for GP if you find it difficult/impossible to change brands
gov.uk/drug-safety-update/l...
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
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
REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex
How much vitamin D are you currently taking and is it mouth spray or a tablet/gel you swallow?
Just don’t take vitamin D the morning you do vitamin D test
GP testing folate and B12?
EXACTLY What B12 supplement have you started ?
Stop any supplements that contain biotin a week before ALL Blood tests …..that’s almost always includes any vitamin B complex
I’m taking a 4000 IU vitamin D supplement (in capsules) and a Holland and Barret B12 - though I have just ordered another B complex as it looked to be better than the one I’m currently taking.
I had my blood tests today for vitamin deficiencies so will post back once I’ve had them. They are testing B12 and folate but not D, will have to go privately for that. Also started on 75mcg on Saturday, and so far not adverse affects - still feel horribly exhausted though, but I expect it will take a few weeks for the higher dose to take affect.
Vitamin D capsules must be four hours away from levothyroxine
Test twice yearly via NHS private testing service when supplementing
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7.
One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
Another member recommended this one recently
Vitamin D with k2
amazon.co.uk/Strength-Subli...
It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average
Vitamin D and thyroid disease
Yes I definitely feel just from the little research that I have done, that doctors really seem to be a bit behind on the research when it comes to thyroid function / ailments. My doctor said he had never heard of pins and needles and headaches being a symptom
Extraordinary isn’t it
Levothyroxine is 2nd most prescribed medication in U.K. and almost 2 million people prescribed….yet medics are frequently clueless .
It’s not as if thyroid is a rare issue…..amongst women
9 out of 10 thyroid patients are female…..thyroid and autoimmune disease didn’t even get mentioned in recent announcements that there should be more equal medical care for women
I find taking a magnesium supplement early evening helps me sleep better. I like magnesium glycinate as I find it gentle on the stomach, but other types are available. Having your thyroid medication & key vitamins optimal will also support more restful sleep. Best wishes to you.
When my levothyroxine got upped to 75mcg from 50mcg I was the same. Had the jitters and felt a nervous wreck for a couple of months. I found taking magnesium supplements helped me sleep until I got used to it. Stick with it. It does get better, it's not permanent. I sleep better than I ever have done now I'm used to the dose. I don't take magnesium now either.
Thank you 🙂 Yeah it really has given me the jitters! Hopefully it’ll settle soon, I’m going back to work soon after a year of maternity leave and the thought of working on very little sleep is not helping my anxiety.
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