Antibiotic therapy. Now I have severe insomnia

[kiefer]

On February 25th, 2024 I must have injured my gum and I got a tooth/gum infection which was treated first unsuccessfully with amoxicillin, then successfully with cephalexin for 7 days (Mar 3rd - Mar 10th, 2024).

The night that I finished the cephalexin I had difficulty sleeping (5 hr 51min). Each night it seemed to get worse. Evening of March 14th my total sleep was 2hr 50min. I use an EEG device called Muse S which gives me accurate data on deep, rem and light sleep, so I'm not guessing on the amount of time slept.

Has anybody experienced this kind of issue and what did you do to fix it? I began taking probiotics a couple of days ago, as I read that insomnia can occur when the gut flora are destroyed. The other possibilities are (a) brain tumor (b) brain damage (c) Thyroid dose too high (T3) (d) sFI (sporadic fatal insomnia - very rare). One of the symptoms I recall having just prior to the start of this insomnia was muscle twitching, which is a symptom of sFI. It seemed to stop after I began taking magnesium again, though.

My current dose of thyroid medication is:

1) Levothyroxine 100mcg daily in the morning

2) Liothyronine 12.5mcg in the morning and afternoon

I'm skipping the afternoon T3 dose for a couple of days to see if that will correct the problem.

As I type this message, I'm unable to sleep. It's like I'm in a field and there's a fence that represents sleep 10 feet away but I can't reach it, or like the switch in my head to go to sleep is taped in the off position.

[Buddy195 Administrator]

Sleep issues can occur (or worsen) when thyroid bloods are not optimal kiefer, so it’s useful to share your blood test results (with ranges in brackets) for:

TSH

FT3

FT4

Plus any antibody and key vitamin tests (ferritin, folate, vitamins D and B12).

[kiefer in reply to Buddy195]

The reason that I didn't provide blood test results is that I've been on a new dose of Levo/Lio. Previously, I was on 100mcg/17.5mcg T4/T3. I don't have and won't have test results for the current dose (100mcg/25mcg T4/T3) for another 5 months. I wasn't having any problems with the current dose until after taking the antibiotics.

Thyroid bood test results on 100mcg/17.5mcg daily, done on Feb 1st, 2024:

TSH: 0.01 (0.4 - 4.5 mU/L)

FT4: 1.1 (0.8 - 1.8 ng/dL)

FT3: 3.8 (2.3 - 4.2 pg/dL)

It's possible that the current thyroid dose, combined with the stress of an infection and taking antibiotics, has caused the insomnia. I've never experienced the classic symptoms of overstimulation on any dose. BP 122/68 HR 63. I've consistently had elevated cortisol over the years, which was responsible for the severe insomnia I experienced starting in Nov 2013. Despite having been able to lower cortisol levels over the past few months, I would say that my gut health still isn't that great because of it (cortisol).

I was able to sleep last night, after an initial attempt to sleep failed. I stayed up for several hours, then gave it another try. This worked..I was able to sleep the rest of the night (5hr 51min).

However, I can't rule out that I was able to sleep last night due to a sleep debt I had accrued over the past 5 days. Tonight will be the test. Starting yesterday, I reduced my T3 dose for this experiment, only taking the Levo 100mcg and Lio 12.5mcg in the morning. If I'm able to sleep normally tonight, I'll begin adding T3 5mcg back in the evening, beginning tomorrow.

[Smartypants1]

Hi Keifer, I know you said you have started on a probiotic, but please make sure it’s a really high quality one. I can pinpoint when all my health issues started when I took a strong antibiotic for 10 days when I had mastitis. I didn’t realise the importance of gut health then and I’m now paying the price. Incidentally, one of those issues was insomnia, but I didn’t really realise it at the time. Hope you get on top of it because it’s torture not sleeping. I’m sure you’ll get some really helpful suggestions on here.

[kiefer in reply to Smartypants1]

The probiotic that I chose is called "Physician's Choice 60 billion Probiotic". I think you're right...gut health is where I'm going to do more research. In 2023 I had severely limited sugar intake and that made a crucial difference in my sleep. It was consistent for the first time in 9 years. The amount of bloating has been reduced quite a bit, but I'm sure I can reduce it even more.

[Bertwills]

I’ve had insomnia for years. Melatonin can be effective and is available from your GP. It helps with stomach flora too. If you can’t get to see a GP I’ve had success with a slow release form bought from Biovea. Their service was good.

The quickest thing is to try Nytol an antihistamine from a chemist Always works for me. If you can buy the “one a night” & break in two if it feels too strong. Valerian tablets work too but always make me depressed.

Although it might not feel like it many people only ever sleep for five to six hours, it won’t do you any long term harm.

There are sleeping tabs available from the GP but it’s a battle to get them.

I would restore your T3 dose. It’s more than likely helpful.

The other idea is one you’ve tried & it worked. Staying up much later than usual & then slowly returning to your normal bedtime. Personally I would not use your sleep tracker until you’re back to normal. I think it’s probably causing you more anxiety.

For blood sugar control & a positive effect on the stomach Berberine is very useful. Don’t take for more than 3 months without a break though. Stomach flora is increased by eating legumes so try adding in lentils & beans including green string or French beans.

[kiefer in reply to Bertwills]

"Melatonin can be effective and is available from your GP"

When I first experienced severe insomnia in Nov 2013 I tried melatonin, diphenhydramine, trazodone, hydroxyzine, ambien... none of them had much effect except for ambien, but it didn't last. The only thing that worked was sleep restriction and I refused to do that until May 2015, as I couldn't bear the thought of depriving myself of even 1 minute of sleep. Now I know better. Based on my experience, I would never take another prescribed sleep aid. I was wired-tired, never sleepy. I saw the same effect just this past week, but it was slightly different, and that's why I chose to reduce my T3 dose.

"Although it might not feel like it many people only ever sleep for five to six hours, it won’t do you any long term harm"

My severe insomnia in 2013 lasted close to two years; I was averaging around 3 hours per night, verified by sleep study. Prior to this occurring, I had calculated that I needed 7 hrs per night. I ended up with a damaged retina, cataracts, parotid cancer, severe bloating when eating. It's the elevated cortisol I had that does the damage long term. It took me 9 years to get back to the amount of sleep I needed. Once I cut out sugar in 2023, my sleep was consistently around 7 hr.

"I would restore your T3 dose. It’s more than likely helpful."

I cycled this dose (levo 100mcg/lio 25mcg) a few times and while I never experienced the classic symptoms of overstimulation, I had a suspicion that it might be affecting my ability to sleep. So I dropped 12.5mcg for several days. I do intend to raise the T3 dose. At this point I'll stay at levo 100mcg/lio 17.5mcg for a few weeks.

"Personally I would not use your sleep tracker until you’re back to normal. I think it’s probably causing you more anxiety."

Actually, just the opposite. I feel more at ease knowing how much I'm sleeping. I also check the clock throughout the night. I use a digital recorder to document each awakening by announcing the time and my activity, if any, which usually consists of trigger point therapy for Restless Leg issues or to eat something for hunger.

The EEG data often shows me information that exceeded my perception. When I thought I got no sleep, I actually got 2hr 50min. When I see that I get less than what I perceived (not very often), I brace for impact. I know I'm going to have to rest during the day. Initially (2013) I had severe anxiety regarding the insomnia. This past week was a bit worrisome but not to the degree I experienced in 2013.

If our gut health has an impact on thyroid function, then it also has an impact on thyroid dosing. So my intention now is to learn everything I can about restoring my gut health and if you know of any books or articles you might have seen on that subject that you consider useful, I would appreciate knowing about them.

[Bertwills]

It sounds as if you’re an expert insomniac. I think you’ve tried everything. I’ve been reading recently about the “dawn effect” which is not fully understood, it may be caused by blood sugar or even liver detoxification. It may be contributing to your difficulties.

I’m no expert on pre or probiotics unfortunately. It such a rapidly evolving field that it’s difficult to keep up. Resistant starch seems to be receiving much attention. Testing your gut biome may be the answer. I hope you’re successful at pinpointing a solution.