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What causes weird feeling with Hashimoto's thyroiditis and insomnia?

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Practicing since : 2001
Answered : 1481 Questions
Hi - I have Hashimoto's thyroiditis. My labs are in range. I have insomnia almost every night. I work in a stressful hematology lab and get home around 10 pm. I often feel wired then. I am researching adrenal fatigue. If my cortisol levels are low in the pm (I have not done an adrenal saliva test) would that mean feeling wired could come from high adrenaline compensation? I don't know if ashwaghanda would help. Today I am trying DGL to keep what cortisol I have from breaking down. I am 5'5" 110 lbs. I take a Pure encapsulations multi vitamin daily with no iron and no iodine and Solaray B complex. I take Mega Food magnesium 500 mg. Today I started Solgar Ester-C calcium ascorbate 2000 mg. I eat eggs, chicken and fish, fresh steamed vegetables, fruit, organic lactose-free milk and yogurt, cranberry and tart cherry juice. Would you add anything else?
Posted Fri, 20 Dec 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Shehzad Topiwala 8 hours later
Brief Answer: Cytomel not recommended Detailed Answer: Thyroid guidelines by experts have always recommended levothyroxine alone for the long term treatment of hypothyroidism caused by Hashimoto's or any other reason. Unithroid is one brand name type of levothyroxine. People who take excessive amounts of levothyroxine or cytomel often feel wired due to medication induced 'hyperthyroidism'. Cytomel tends to cause insomnia I would like to see the results of your blood tests,in particular the following: TSH Free T4 Total T3 Total T3 T3 resin uptake CBC CMP TPO antibodies TG antibodies 8 am cortisol I do not suspect you have any adrenal excess. You seem to be eating a healthy diet and taking a number of supplements. These have no bearing on thyroid or adrenal function
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Follow-up: What causes weird feeling with Hashimoto's thyroiditis and insomnia? 14 hours later
Thank you for your answer. I have to have my annual employee health labs drawn 9/12/2013 and I will ask to have the labs that you suggest drawn at that time too. I will copy them to you. I have results from 6/19/2013 but not all of them: Vitamin D: 998 (200-1100PG/ML) Vitamin D, 25-OH, total: 38 (30-100NG/ML) Vitamin D, 25-OH, D3: 38 Vitamin D, 25-OH, D2: <4 CMP all chemistries are in range CBC all results are in range TSH 0.6 (0.40-4.50 MIU/L) Free T4 1.8 (0.8-1.8 NG/DL) 8/26/2013 after 3 weeks of lowering Unithroid dosing and Cytomel only 2x/week. I finally realized in August that the doses were probably a problem: TSH 2.13 (0.358-3.74) Free T4 1.34 (0.76-1.46) 1/1994 original diagnostic labs: TSH 97 T4 very low T3 below the lowest calibrator TPO antibodies >than the highest range TG antibodies >than the highest range Should I retest for both antibody panels at this time? Would a Reverse T3 test be helpful to know? I take my meds around 8 am on an empty stomach and wait 1 hour before eating. I think the Cytomel 5 is only active for a relatively short time. So how would it effect my sleeping? Is there a reverse T3 problem maybe? If so, how long does it take to clear the body of it? I have the same symptoms almost all day: tingling, pins and needles everywhere, like there is too much of something or an imbalance. I did not sleep well last night. This pattern has been going on for 5 months. Sometimes I think a different thyroid med would make a difference. I will not use Synthroid. Tyrosint is probably the same levothyroxin material. Desiccated thyroid sounds good but in 2000 I had a serious hyperthyroid reaction with the 1st refill. I occasionally use Liposomal Melatonin Drops by Biogenensis. In fact, I use 1 drop under my tongue and it is enough to help me fall asleep but I wake up often. I had a sleep study done 11/2011. Apnea was not significant in my study the doctor said, but restless legs syndrome was strong. My ferritin level is within range. Is it ok with you if I send my results to you when I get them back next week? Please advise about lab work: repeat antibodies? include reverse T3? additional iron studies? test saliva or test blood cortisol levels? Should I stop the Cytomel starting tomorrow at least for a week and test next week? Thank you I appreciate your help. XXXXXXX
Answered by Dr. Shehzad Topiwala 23 minutes later
Brief Answer: stop cytomel. do labs in 6 weeks Detailed Answer: No need to recheck antibodies. You definitely have Hashimoto's. Just stop cytomel and take only unithroid. Do TSH and free T4 and 8 am cortisol (all blood tests only) in 6 weeks and lets see where your thyroid stabilizes. No role of testing reverse T3.
Above answer was peer-reviewed by
Follow-up: What causes weird feeling with Hashimoto's thyroiditis and insomnia? 22 hours later
Thank you for your answer. I will stop Cytomel 5 and do TSH and free T4 and 8 am blood cortisol in 6 weeks. XXXXXXX
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