new problem sleeping: For over a week now I have... - Thyroid UK

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new problem sleeping

Quinc profile image
9 Replies

For over a week now I have been having problems going to sleep, not something that usually bothers me.

as I begin to fall asleep I suddenly jerk awake feeling as though I have suffered some mini attack and gasp for breath. Last night it kept occurring- 6/7 times - and I was awake until after three when I found myself dreaming and asleep.

i am on 25g Levo each morning and evening - so 50 per day. Stopped taking the 50 as a single morning shot as it gave me palpitations.

Is this a thyroid thing I wonder?

Might anyone throw any light on this rather disconcerting and strange new problem please?

Many thanks 🙏🏽

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Quinc profile image
Quinc
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9 Replies
RedApple profile image
RedAppleAdministrator

Quinc, Sounds as if you might need an increase in your levothyroxine dose. Have you had a thyroid blood test done recently? If yes, do post the result for others to comment. If not, I strongly suggest putting in a test request with your GP.

Quinc profile image
Quinc in reply toRedApple

thanks … I’ll call for a new blood test

SlowDragon profile image
SlowDragonAdministrator

50mcg is only the standard STARTER dose levothyroxine

How long have you been on just 50mcg

Heart palpitations can be caused by UNDER medication

ALWAYS test TSH, Ft4 and Ft3

See from previous posts you have Hashimoto’s

ESSENTIAL to test Vitamin D, folate, ferritin and B12 at least annually

What vitamins are you taking

Please add most recent results

ALWAYS test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Levothyroxine doesn’t “top up” failing thyroid…..it replaces it

guidelines on dose levothyroxine by weight

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

Quinc profile image
Quinc in reply toSlowDragon

Thanks, I will ask for a new set of blood tests. I would like to move from local doctor’s clinic to a hospital endocrinologist who perhaps understands the problem a bit better … advisable?

SlowDragon profile image
SlowDragonAdministrator in reply toQuinc

Get FULL thyroid and vitamin testing first making sure you test correctly

Are you currently taking any vitamin supplements

Likely to need several increases in levothyroxine over coming 6-24 months

If GP unhelpful …..then you may need to see endocrinologist

Vast majority of endocrinologists are diabetes specialists and useless for thyroid

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

Many Hashimoto’s patients need to be on high enough dose levothyroxine to shut their own thyroid output off to stop wildly fluctuating levels …..typically TSH well below one ….often below range

Most important results are ALWAYS Ft3 followed by Ft4 and OPTIMAL vitamins

Gluten intolerance and dairy intolerance common development with Hashimoto’s too

Quinc profile image
Quinc in reply toSlowDragon

Brilliant .. thanks so much for the advice

Quinc profile image
Quinc in reply toSlowDragon

I take vitamin supplements but somewhat unsure how how frequently I should be using them. I have Liposomal B-12 complex, magnesium (500mg), nutravita multivitamin and occasional NuU bio- cultures complex for gut health.

SlowDragon profile image
SlowDragonAdministrator in reply toQuinc

Test vitamin levels at least annually

Vitamin D twice year

Suggest you test now

Multivitamins never recommended on here …..most contain iodine not recommended for anyone on levothyroxine , especially with Hashimoto’s

Levothyroxine contains all the iodine you need

Remember

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

SlowDragon profile image
SlowDragonAdministrator

The sleep issue is likely excess adrenaline

Being on inadequate dose replacement thyroid hormones, adrenals try to compensate by running on adrenaline and cortisol instead.

Initially results in high cortisol

Eventually can result in adrenal fatigue

Blue Horizon test includes snap shot Cortisol test

More in-depth cortisol and dhea test if required

regeneruslabs.com/products/...

portal-app.inspira-regeneru...

As a bloke you also need testosterone test

thyroidpharmacist.com/artic...

Cholesterol test useful too

High cholesterol excellent indicator that you are under medicated for thyroid

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