Trouble sleeping with levo

[L154C0]

Finally had diagnosis of Hashimotos thyroidits (you had all figured this out months ago!) so been given 50mcg Levo (Accord). I’m taking it at 6:00am with only water and not having any brekkie til at least 8:00am. It’s only been a few days so I’m not expecting miracles. However, I’m struggling to get to sleep and am waking every couple of hours.

Is this normal acclimatisation or should I change timing?

[helvella Administrator]

A couple of my blogs discuss sleep and levothyroxine. It is something that appears individual - though it is unclear why we vary like this.

Not intended to push you in any direction - just to provide some information and background with a personal aspect included.

helvella - Personal Insomnia Experience

How hypothyroidism and levothyroxine treatment affected my sleep.

Last updated 10/02/2025

Link to blog:

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

AND

helvella - Bed-time dosing of levothyroxine

Discussion about taking levothyroxine at bed-time. Several linked references to relevant papers.

Last updated 12/02/2025

Link to blog:

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

[SlowDragon Ambassador]

Yes it’s common, when hypo adrenals have to increase cortisol levels to compensate for low thyroid levels. It takes a few weeks for cortisol levels to slowly drop

Which brand of levothyroxine have you started on

If it doesn’t improve

You could try cutting tablet in half with pill cutter or sharp scalpel

Take half in morning and half early evening or bedtime

See if that helps

Have you had vitamin D, folate, B12 and ferritin levels tested

Please add results and ranges

What vitamin supplements are you taking

Have you had coeliac blood test done yet

[L154C0 in reply to SlowDragon]

I’m taking Accord 50mcg starting dose.

I have my blood tests to check levels in 8 weeks time so I will ask GP to include the D, B12, folate and ferritin to the test.

I currently take 4000iu VitD+K2 from Cytoplan. I’m going to start their B12 sublingual too.

[tattybogle]

give it a couple of weeks at least . you can expect a few weeks of all sorts of odd changes as body adjusts itself to any change in thyroid hormone levels .

[pennyannie]

Hey there -

I just wonder if you might feel more relaxed taking the T4 before going to bed - as I would imagine it will be a good few hours after eating or drinking anything -

otherwise if you wake up in the night, like I do on a regular basis for the toilet, just take it then as your stomach is as empty as it will ever be and then you can wake up naturally and have that cup or tea/coffee and breakfast, as you please.

T4 needs to convert in you body into T3 which is the active hormone that runs the body - so just ensure ou also keep on top of your ferritin, folate, B12 and vitamin D ;

Stomach and gut issues are common issues , celiac and pernicious anemia common bed fellows, and food intolerance tests while eating foods of your choice can help identify if you need to look at what you eat - and even without any issues many feel so much better simply stopping stopping gluten.

I think you have this already - thyroidpharmacist.com - Dr Izabella Wentz 's take on living with Hashimoto's AI thyroid disease :