Increase of Levothyroxine from 25mcgs to 50mcgs…I can’t get no sleep… 😴

[MsWhistledown]

Good afternoon lovely people.

I changed to a new GP surgery and saw a GP that immediately spotted I was on too low a starting dose of levothyroxine. He increased from 25mcgs to 50mcgs. I had been on 25mcgs for 3 weeks and have now been on 50mcgs for a week and half. Which is great.

I understand it is going to take some time to feel better and each increase can you make you feel unwell for a while until hitting the right dosage. I have started getting headaches almost everyday since the increase and I am still suffering with insomnia. It could be the insomnia that is causing the headaches as well.

Have any of you who have suffered with insomnia as a symptom of Hashimoto’s found that once they are on the right dosage of medication the insomnia gets better as well? Or is this something you continue to struggle with and have to work on?

Thanks as always for your invaluable advice and sharing your experiences. 😊

[SlowDragon Administrator]

Which brand was 25mcg

Which brand is 50mcg

Try splitting levothyroxine as 2 smaller doses

taking 25mcg levothyroxine waking on empty stomach

Then take 25mcg levothyroxine at bedtime on empty stomach

If that’s no improvement……drop to 25mcg and 50mcg alternate days

Improving low ferritin levels should help too

[MsWhistledown in reply to SlowDragon]

25mcg was TEVA and 50mcg is ACCORD.

I will give that a go - thank you.

Working on my ferritin levels. Was vegetarian and have switched back to eating meat. Now gluten free as well.

[SlowDragon Administrator in reply to MsWhistledown]

have you got enough Teva to try at least a week on 50mcg as 2 x 25mcg Teva

[MsWhistledown in reply to SlowDragon]

Yes I do. I will definitely give that a try from tomorrow and trial for a week.

Is insomnia also a side effect of levothyroxine as well as a symptom of Hashimoto’s?

[tattybogle in reply to MsWhistledown]

Is insomnia also a side effect of levothyroxine as well as a symptom of Hashimoto’s?

Sort of ...

hypothyroidism can cause it and it will often improve / go away once dose is correct.

But in my experience, changing dose (in either direction) can also cause a temporary upset in sleep patterns, until the body has acclimatised to the new levels of thyroid hormone .

edit : even changing the time of day you take it, or starting to split dose if you normally take it all at once, or taking it all at once if you normally split it ..any of these can also cause a temporary upset in sleep pattern .

so , when you change anything ,, always give it several weeks to settle in before deciding how it feels.

[MsWhistledown in reply to tattybogle]

Thank you tattybogle, that is something for me to consider. I could persevere for a few more weeks and see if it improves.

[humanbean]

You could try changing the time of day that you take your Levo.

I can't take thyroid hormones at night because they make me restless, although I don't notice this effect when I take them as soon as I wake up. I'm not alone in preferring morning only.

Other people find they sleep like logs if they dose themselves at night.

Another option - some people find it helps to split dose e.g. they cut their tablets in half and take each half at different times of day. This obviously doesn't work if your prescription is in capsule form.

[MsWhistledown in reply to humanbean]

Thanks humanbean, I currently take them in the morning an hour before breakfast. I might try splitting the dose as you and SlowDragon have suggested to begin with.

[Regenallotment Ambassador]

I found increasing difficult too, I would go 25/50/25/50 for a few days then 25/50/50 then 25/50/50. I also used to split 25 at night and 25 in the morning l. I’ve stopped that recently but it worked well for me.🌱

[MsWhistledown in reply to Regenallotment]

I will give that a try if splitting the dose doesn’t help. Thanks so much 😊

[Rapunzel]

Hope that was a reference to Faithless. Rest in perfect peace, Maxi❤️‍🔥 xx no more insomnia for you

youtube.com/watch?v=P8JEm4d...(Not working as expected?)

Glowsticks arms in the air, babes

I found inulin very helpful, also sour cherry juice in a glass of hot water. I do both at the same time just how I roll xx

[MsWhistledown in reply to Rapunzel]

Well spotted Rapunzel 😀 It certainly is.

That’s interesting thank you. Something I will look into.

[Singwell]

Have you considered buying a pill cutter and increasing slowly to the 50mg? I specifically asked my GP to prescribe 58 × 25mg so I could do that. If I increase too fast my heart kicks off. Amazon sell pill cutters.

[MsWhistledown in reply to Singwell]

Thank you. Something I will look into as well.

[jusmee103dd]

Yes struggled with insomnia. Was on a higher dose than needed. Lots of anxiety and headaches

[MsWhistledown in reply to jusmee103dd]

Oh really? Sorry to hear that. I’m hoping this is just my body getting used to the medication and will settle down soon. The insomnia seems to be the worst symptom. If I could sleep I think I’d feel a lot better.

[HealthStarDust]

For me insomnia (and other symptoms) resolved by reducing dose. It was clear at the time that that full replacement dose as a starting dose was too much for my body handle. After many weeks of full replacement dose (6 weeks in total) hoping it would resolve, it didn’t. So, I stopped the medication for 3 days, felt immediately better and resumed on a lower dose with the view of titrating my dose up slowly as indicated by symptoms and blood tests combined. I informed my GP of the new plan who was supportive of it since insomnia was a huge risk to my health.

Hope that’s helpful.

[MsWhistledown in reply to HealthStarDust]

That is very helpful and something I have been wondering could be the case as well. How slowly did you increase your dosage. Was it less than 25mcg at a time? Thank you 😊

[HealthStarDust in reply to MsWhistledown]

I dropped by a whole half a dose. I was still quite fatigued on the the half dose, but a different kind of fatigue not the type one gets from not sleeping, but I was sleeping. Interestingly, while on the full replacement dose, I also had constipation when I normally suffer from loose stools which is the opposite one would expect in this scenrio.

It is suggested to come off medications for a few days to resolve any side affects, I think by the BNF. If I find the link I’ll repost. To resume on a lower dose was my idea as I didn’t want to risk not sleeping. I have since increased dose again by 25mg (less than a week mind) but so far slewing OK and feeling less fatigued. I think for many of us slow is the way to go, not just for those people with cardiovascular disease.

You may just have to go up more slowly.

Edit: here it is cks.nice.org.uk/topics/hypo...

See the section on Adverse Reactions

I believe it is often mentioned in articles and on here, that when in has been hypothyroid without treatment or adequate treatment then treatment should be titrated slowly.

To be honest, as with all things, it’s trial and error since we are all so different.

Good luck and I hope it goes well whatever you decide.

[MsWhistledown]

That’s really interesting. I have found the constipation I was suffering before medication is now starting to get better. I had insomnia before the medication but not as bad as it is now. Thank you for your invaluable advice and sharing your experience, it’s been really helpful.

[HealthStarDust in reply to MsWhistledown]

I think most suffer with constipation before medication, but it can be opposite. I think generally we hypothyroids have some sort of gut problem, and it’s not definitive which way it will go ie loose bowel movements or constipation. No idea why.

I also had insomnia before medication, but the insomnia with over medication was different for me. More jittery ish I guess is the best way I can put it. My eyes also became incredibly dry and painful (although I understand from this website this could be a symptom hypothyroidism too) but this resolved when stopping medication and resuming in a low dose they stayed resolved.

Glad you found it helpful. Best.

[Bearo]

I had insomnia before starting Levo , probably menopause related . When I started on 50mcg my sleep got worse - down to about 3-4 hours a night, generally waking at 3-4am and unable to get back to sleep. I then had two dose increases over time, and each time I averaged almost exactly an extra hour of sleep. Now that I have settled on a dose my sleep has continued to improve a little. I still sometimes wake in the night - either I need a pee or my partner needs a pee - or I get too hot - but I’m more likely to drop off again, although I still wake fairly early (5 or 6am).

Hopefully, more people have improved,than worse, sleep on titrating Levo but I have come to realise that we all respond differently.

[MsWhistledown]

Thanks Bearo. That’s good to know. I’m hoping same will happen for me and as I get used to the medication and settle on the right dose my sleep will improve.

I didn’t take any Levo yesterday and felt more sleepy. Still took a long time to get off to sleep but I did get some sleep which is interesting. Today I am trying split dose to see if that helps a bit.