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Hyperthyroidism and Sleepless Nights

I have been diagonalized with Hyperthyroidism since the 24th of May.  I am a 51 year old female.  I have been on Methimazole for three weeks (5MG for first week, 10MG, the second week, and 15MG for another week).  My blood work result is as followed:  TSH <0.005, T4 2.15, Glucose 137, Bilirubin 1.9, and Thyroid Stim Immunoglobulin 3.42.

I suspected that this started in late 2020 when I start losing weight.  I lost a total of 25lb, and I am currently weighing at 125lb and I am 5’5.  Things got bad when my 19 years relationship ended in  March.  Before the diagnosed, I thought I was just going to breakup with weight lost, sleepless, anxiety, nights, and rapid heartbeat.

Once I was diagnosed, I was relief, but my anxiety and sleeplessness didn’t go away.  I was on 10MG Propranolol as needed basis.  However, to make the anxiety go away, I must take it three times a day.  About 18 days into the Methimazole, I started to take only one or two 10MG Propranolol.  I think I may not need to take it today or even just one.  I have heard that Propranolol, beta blocker, can also create insomnia.

However, I still can’t sleep.  I am rotating between Benadryl, motion sickness med with Meclizine, and Zzzquil to avoid tolerance for high dosage of the meds.  I was able to sleep like 2-5 hours when I took them separately.  I took Ambien once, but I will reserve that for special occasion like my 20th anniversary last week.  5MG Ambien is wacky since when I took it, I was telling myself, hmmm, it’s not working, but I woke up the next day after having 5 hours of uninterrupted sleep.

I guess I want to know if this has happened to you with the sleepless nights and when Methimazole will start kick in and I can sleep again.  I used to be able to sleep like a baby and I never have any issue sleeping.  Please HELP.
Best Answer
Avatar universal
Hi, sorry to read of sleep difficulty.  A few years ago, I was experiencing hyper symptoms, sleep seemed impossible, 3-5 hrs nightly.  I tried Melatonin, and other sleep aids, that put me to sleep, but didn't keep me asleep.    

I was prescribed Hydroxyzine 10mg, for sleep.  Hydroxyzine put me to sleep and kept me asleep up to 10 hrs solid.  Only con was, waking up a little tired, but tiredness wears off after an hour or two, was active rest of day.        

Hydroxyzine is also used to treat anxiety, but at higher doses.

Wish you well.....        
3 Comments
Would you able to sleep when the hyperthyroid was treated?  I have not been able to sleep for so long that I am so anxious about never able to get a good sleep.

Thanks!
Sleep returned to normal, after med were adjusted.  Give Hydroxyzine a try, till your hormones balance.  
I was taking 10MG doxepin for a month and is not working any more.  I asked my PCP to provide Hydroxyzine 25MG.  I will be pick it up today and try it tonight.  Hopefully, I can have some restful sleep.  The doxepin works sometime but my sleep had always been interruptive as much as 10 times a night.  Thanks AJWS6!
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Avatar universal
The half life of Methimazole is only 3-5 hours, which means that your serum levels should reflect your dose in the same day.   However, T4 has a half life of about a week.  This means that if all T4 production by your thyroid gland was stopped, It would take 4-5 weeks to be fully reflected in serum levels.  Because of that, this is info I found.  "The decreasing rate of free T4 level per one tablet of methimazole during 1 month, was 4.33 pmol/L, which means that, if a patient takes one tablet of methimazole (5 mg), during 1 month, his free T4 level will decrease by 4.33 pmol/L  (.3364 ng/dl). " Since you need to get your FT4 down from 2.15 to about 1.30 (mid-range), It seems that you have the right dose, but unfortunately it may be up to several weeks  yet before the symptoms go away.   Wish I had better news.  Hang in there and please let us now how it goes.  
Helpful - 2
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Per this calculation, I should already fall within range 1.63 in three weeks.  First week, I had 5 MG: .3364 divided by 4 and multiply by 3 equals to 0.25.  Second week, I had 10MG: .3364 divided by 4 and multiply by 3 equals to o.17.  Third week, 15MG: .3364 divided by 4 equals to 0.09.  The sum of them would be 0.52.  My blood work says I have 2.15, and 2.15 - .52 = 1.63 which is less than 1.77.

Thank!
649848 tn?1534633700
COMMUNITY LEADER
Your glucose level was also too high - if it was fasting glucose, it was in the diabetic category.  Has that been addressed?   Diabetes/glucose issues can also cause weight loss, anxiety and insomnia.

That said - even if your FT4 is down to 1.63 (per your calculations), it would be higher than necessary and could still cause symptoms.  FT4 should be approximately mid range.  You need a Free T3 test, also, to determine exactly what's happening since FT3 is the hormone actually used by individual cells.
Helpful - 0
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Thanks for your response.  It not fasting glucose.  My next test is this Thursday and it will ask for Free T3 test.  I notice my symptoms still didn't go away as I will need to take Propranolol to control my symptoms.  I have been taking Methimazole for 2 solid months and I wonder how long it will get adjusted.
Avatar universal
Was that T4 test for Total T4, or Free T4?  Also what reference range was on the lab report?
Helpful - 0
1 Comments
The T4 is Free and Direct.  The reference range is .81-1.77.

Thanks!

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