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Hypothyroidism and Insomnia
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Hypothyroidism and Insomnia

I would like some help with Hypothyroidism and Insomnia, as that was the main reason that I finally after 2 weeks got in to see my DR and did the blood work.  On July 10 I was diagnosed HYPOthyroid and put on Synthroid 50mcg.  Most of what I read says that it is a HYPERthyroid symptom, but I have both fatigue and sleeplessness.  My symptoms started the month before when my wife noticed puffyness under my eyes.  I also felt a bit depressed for no reason and lacked energy.  The week after Father's Day the symptoms really kicked in.  I started waking at night, and would be up for 2-3 hours and then fall asleep again, this would happen 2-3 nights a week.  I also felt fatigued and had a bad case of 'brain fog' that only abated temporarily if I took a strong B-50 Complex.

As the following weeks went on the sleeplessness got worse, I would wake up and be up all night.  The following night I would sleep probably from exhaustion, but then the next night I'd be up all night.  This cycle continued.  The other Hypothyroid symptoms persisted as well.  When I got the blood work back I was advised that in March my TSH was 4.5 and now it is 16.5.  I have been on Synthroid for a week, and the brain fog is gone, the fatigue is much less but still present, my head is clear but the sleep cycle disturbance continues.

For the first 6 nights after starting synthroid, I went back to the way I was a month ago where I would sleep, be up for 2 hours, then sleep till sun-up or the alarm.  However on the 7th night I was up all night, the next night was like the previous 6, and the following night I slept all night for almost 9 hours uninterupted! I felt groggy but a good work out cleared my head.

Do you have any advice for me?  Is this something that the Synthroid therapy needs more time to get my sleep rythem cycle back on track?  I don't understand how I slept all night on Saturday but then last night I was up all night.

Thank you in advance.
PeterB
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22 Comments Post a Comment
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393685_tn?1325870933
Being Dx with hypothyroid is only- sorry to say - for most only the beginning.

Until your levels begin to balanced out and you feel better - THEN you body will start the healing process - THEN your symptoms will start to go away.

I do know what you are going through - as many here also. I still have bouts of sleeplessness (like yesterday).
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499534_tn?1328707778
Me too.....last night i couldn't sleep for nothing!! This happens to me a few nights a week and I never seem to sleep deeply anymore!
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314892_tn?1264627503
I had awful insomnia as well.

I read that the sleep pattern getting back to normal indicates sucessfully treated hypo.

Your dose is still probably too low to bring the TSH down to below the recommended level of 1-2. It may take a while as stated above.

You should be due for repeat labs and a med adjustment in August, is that right?

You may consider asking the doctor for a short term sleep aid. I needed Trazadone and Ativan to sleep for a few months.

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565646_tn?1216818148
i haven't slept deeply in who know how long. i wanted to see if anyone else is having to use the bathroom alot at night i think last night i got up like 6times.
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Avatar_m_tn
Yes I have a feeling the initial dose is too low at 50.  I was given a 1 month supply sample and a prescribed another 50 but told to come in for follow up blood work.  I guess that should be before I fill the prescription? Which would make it around the first week in August.

I guess also I should not settle for 5.0 TSH but should really be below 3.0 TSH is that correct?
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314892_tn?1264627503
I'll give you a link on the proper TSH:

http://www.thyroid.org/patients/brochures/Hypothyroidism%20_web_booklet.pdf

page 18 states this:

"The American Thyroid Association recommends that your doctor try to keep your TSH within a narrow range of 0.5 to 2.0 mU/L. Within this range, your body gets the best possible amount of thyroxine and you're likely to feel the best."

The above paragraph should be screamed into the ear of every doctor, no matter what specialty.

So, really not even below 3 is good enough. Below 2, closer to 1. My endo will me go to the bottom of the range to see if we can find where I feel best. (If only my TSH hadn't jumped up to 5.1 from 1.2.)  :((

Print out the above brochure and bring it with you.
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458072_tn?1291418786
i have insomnia with my hypothyroidism. The thing is, I had it for so long before a diagnosis. 2.5 years of waking up EVERY 1.5-2 hours all night long. Read some of my whining, I mean posts to see what I cried, I mean "Shared" with the others.

It is HORRIBLE. My med levels are not optimum yet, and I am so looking forward to that time.  

I have not had any relief with with any sleep med. Sorry, I could not give you better news. It has gotten to the point, I am traumatized to go to bed. Really.

I am trying to just reprogram my thinking so that I can tolerate it. I feel your pain.
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Avatar_n_tn
I honestly can't remember ever sleeping through the night. I always wake up every 1-2 hours when I can actually sleep. I get excited when I get 3 hours of sleep straight. It is so frustrating...I am 20 and I tell my mom that I can't get any sleep and she just blows it off.
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Avatar_m_tn
Well...last Thursday I was on the 50mcg Synthroid for 2 weeks.  Since posting this on the 21st I had a very good week.  I slept like I used to (still woke up..either myself or one of the kids crying....but went right back to sleep) for 6 nights and felt very good the next day like I hadn't felt in a while.  But Sunday was the last good night, Monday and last night the insomnia is back and I feel lousy today.  I still don't get how I can vary like this?  Are my levels fluctuating again?

I'm scheduled to see the DR on Monday and I plan on getting retested and asking for an increase in dose. Next week is 4 weeks and I hope that is not to early to be retested but I really think I need more.
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458072_tn?1291418786
when a setback like that usually occurs it has something to do with your levels. either they need raising or are too high.

If you are in tune with your body and have experienced a time of hyper, you will be able to know which you are. I know I did. I react one way when hypo and then another when i get to much hormone and become hyper.

4 weeks should be okay to be tested, unless you are like me and your med bounces all over the place.
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Avatar_m_tn
I know the feeling as in addition to the insomnia I have been diagnosed sleep apnea as well, (further making sleep of any  kind problematic at best!).  I hate to say this, but I now take some measure of solace in knowing I am not alone in my plight.
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Avatar_m_tn
I have been losing my mind as well. TSH levels range between .1 and 5.1, but I get these terrible bouts of insomnia....can't sleep more than 2 hours and I'm up, sometimes for the rest of the night. Makes me very depressed, mostly in the morning. I am so stressed, but I admit I have a lot on my plate; 3 jobs, a PhD dissertation, rental apartments, etc. I don't if the stress, insomnia or depression is from the workload or the thyroid, but I know this *****...it gets to where you don't know what is a cause and what is an effect.Sure would like to talk to anyone sharing my plight, or who might have suggestions!
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Avatar_m_tn
TSH is a pituitary hormone that is affected by so many things that it is totally inadequate as the sole diagnostic for thyroid issues.  At best TSH is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, Free T3 and Free T4.  If you have been tested for Free T3 or Free T4, please post those results, along with reference ranges shown on the lab report.  

Have you been previously diagnosed as having a thyroid problem?  If so, are you taking any thyroid med?  If so, what type and dosage?
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Avatar_m_tn
When my TSH count was at 5.09, my free thyroxine, which I guess is T4, was at .96, and the range is supposed to be between .59 and 1.17. I am going to an endocrinologist now, thinking he would know more than my PCP, but he also said that tsh is the gold standard for determining thyroid function. He said that free thyroxine is meaningless, because its just measuring the synthroid replacement I'm taking. I have been Hypo for about 10 years, initially taking 175 mcg, over time its down to 112 now...my main concern was figuring out where the insomnia was coming from! I can get to sleep ok, BUT WAKE UP EVERY COUPLE OF HOURS...BTW, thanks for responding...
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Avatar_m_tn
I totally don't understand why doctors continue to believe TSH is the gold standard for thyroid function.  There is no evidence that TSH correlates well with either of the biologically active thyroid hormones, Free T3 or Free T4, much less with symptoms, which are the main concern of the patient.  In contrast there is scientific evidence that hypo symptoms correlated best with levels of Free T3, and did not correlate at all with either Free T4 or TSH.  This is only logical since Free T3 largely regulates metabolism and many other body functions.  

So the first thing I suggest is that you dump your Endo and find a good thyroid doctor.  By that I mean a doctor that will treat you clinically for symptoms by testing and adjusting Free T3 and Free T4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results.  You can get some good insight into clinical treatment from this paper written by a good thyroid doctor.

http://www.hormonerestoration.com/Thyroid.html

Further, I suggest that you should make sure that you are tested for Free T3 and Free T4 each time you go in for tests.  If any doctor resists, just insist on it and don't take no for an answer.  Also, since hypo patients are frequently too low in the range for Vitamin D B12 and ferritin, I suggest those tests as well.  Since good thyroid doctors are hard to find, if you will tell us your location, perhaps a member can recommend a doctor for you.  
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Avatar_m_tn
Yeah, I thought that that was what I was doing; getting a good thyroid doc by looking up an endocrinologist. The only thing he really said different was to stick with brand name synthroid...too much variation in generics. I get that. What I don't get is if I'm looking in the wrong place; maybe it's not my thyroid at all creating or adding to my insomnia, stress, and ultimately depression... Adrenal fatigue, or is that nonsense? All I know is that I have a lot going on in my life, and once I start back in an insomnia cycle, everything comes crashing down. BTW...you asked my location...'m in the Scranton, northeast Pennsylvania area. Thanks for your time-
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Avatar_m_tn
Yes, adrenal issues can also be a factor, but when you started as hypothyroid and your doctor has had you on T4 med only at varying amounts and you are being medicated based on TSH, then the first and most likely place to evaluate is definitely thyroid hormone levels.  I expect that you will find that your Free T3 level is too low in the range.  Once you correct that, and also correct any Vitamin D, B12 and ferritin issues, you can have a better idea if there are other issues.  But i would first tackle the obvious and most likely before worrying about others.  If you do want to test for adrenal function in the future, be aware that the best test is the 4 sample, 24 hour saliva test.  

Sending a PM with doctor info.  Just click on your name and that takes you to personal page.  Then click on messages.  
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Avatar_m_tn
I live in Northern Minnesota and I need a Thyroid Specialist.  I'm willing to travel anywhere in Minnesota.
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Avatar_m_tn
If you will give us your location a little more precisely, perhaps we can do a better job of finding a doctor that won't require a long journey for you.
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Avatar_m_tn
Finally... someone who is making sense! I've had two TSH tests, all within normal ranges, but I just know that something else is going on. Symptoms include hair loss, insomnia, non-pigmented growths appearing on my nose that seem to be hormone related plus two growths on my thyroid that they are "watching" via ultrasound. I live in the Lakes Region of New Hampshire and would appreciate any suggestions for an endocrinologist who would take a careful look at my symptoms.
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Avatar_m_tn
I am traveling right now and don't have my info on doctors.  As soon as I get back on the 5th I will see if I have a member recommended doctor in your area.
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Avatar_f_tn
Hi. I was diagnosed with hypothyroidism 2yrs ago and was prescribed 50 mc g synthroid. I have symptoms of insomnia, fatigue, hair loss, mood swings, depression to name a few with no change in medication by the doc. If you know of a good endocrinologist in the dallas suburbs (I live in frisco) that would greatly help. Thanks!
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