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May 11, 2023 8 min read

Sleep is vital to our well-being, yet many people struggle with it. For some, the source of their sleeplessness could be connected with the consumption of synthetic thyroid medication like levothyroxine. This medication is a crucial component in the management of hypothyroidism. However, insomnia and other sleep disturbances are common side effects of this medication, leaving you frustrated and tired during the day. But what's the connection between the two? And how can you overcome it? Keep reading to find the answer so you can improve your sleep quality and have your health back on track!

What is Hypothyroidism?

Before we jump into the intricacies of levothyroxine and sleep, let's quickly recap what hypothyroidism is. Hypothyroidism, or underactive thyroid, is a thyroid disease that occurs when your thyroid gland cannot produce enough of the essential thyroid hormones, chiefly thyroxine (T4) and triiodothyronine (T3). These hormones are crucial for maintaining your body's metabolic processes and overall energy levels. Some of the common symptoms associated with this thyroid dysfunction can include fatigue, weight gain, joint or muscle pain, depression, and feeling cold, among many others.

What is levothyroxine, and how does it work?

Levothyroxine, a synthetic form of thyroxine (T4), is the most commonly prescribed medication for individuals with hypothyroidism. The primary function of levothyroxine is to compensate for the lack of thyroid hormones in your body by mimicking the action of naturally occurring T4. Once ingested, levothyroxine is converted into the more active form of thyroid hormone, T3. This conversion process helps enhance your body's metabolic functions and restores your energy levels.

Can levothyroxine affect sleep?

Yes, levothyroxine has been linked to sleep problems. Like all kinds of medication, levothyroxine has its own set of side effects or risks. While many people taking levothyroxine do not experience any adverse side effects, some have reported having difficulty falling asleep, restless sleep, or even insomnia and sleep apnea. These side effects of levothyroxine often occur when the dose consumed is too low or too high.

How does levothyroxine cause trouble sleeping?

Here are some possible ways levothyroxine might be affecting your sleep:

1. Too high of a dose

The primary goal of levothyroxine therapy is to balance your thyroid hormone levels. However, sometimes, finding the correct dose for an individual can be challenging. Taking too much levothyroxine may end up causing an overactive thyroid state, also known as hyperthyroidism or overactive thyroid. This condition may result in increased heart rate, anxiety, night sweats, and restlessness, all of which can contribute to disrupted sleep.

2. Too low of a dose

Sleep disorders are mostly associated with an overactive thyroid. However, there may be a link between hypothyroidism and sleep problems. A 2019 study found that people with subclinical hypothyroidism (a condition where your thyroid stimulating hormone (TSH) level is high but your T4 level is normal) have shorter sleep duration, lower satisfaction with sleep quality, and longer sleep latency.

When you're taking the correct dose of levothyroxine, these sleep problems should be eased. However, if your dose is too low, you won't experience any improvement in symptoms. Thus, you'll still experience symptoms of hypothyroidism, like sleep disorders.

3. Fluctuation of thyroid hormone levels

Levothyroxine can cause fluctuations in thyroid hormone levels throughout the day. Changes in thyroid hormone levels can affect the internal body clock responsible for your sleep-wake cycle.

4. Timing of medication

Levothyroxine is usually taken once a day, preferably in the morning on an empty stomach. If taken too close to bedtime, it may cause stimulation and interfere with your sleep. This might be especially true for individuals who are sensitive to the medication's effects.

5. Levothyroxine absorption interactions

Certain medications, supplements, and even food can affect the absorption of levothyroxine, which may cause fluctuations in thyroid hormone levels. For example, calcium and iron supplements, as well as high-fiber diets, can reduce the absorption of levothyroxine. This fluctuation in hormone levels might cause sleep issues in some people.

6. Levothyroxine is not for you

It's essential to understand that every person is unique, and the way a medication affects someone can differ from person to person. While one person taking levothyroxine may not experience any sleep issues, another person may find it challenging to get a good night's rest. This can arise due to varying responses to levothyroxine.

One reason is that levothyroxine only contains the inactive hormone T4, which must be converted into the active hormone T3. However, not everyone can efficiently convert T4 to T3, rendering an increased dosage of T4 ineffective for some individuals.

In such cases, considering a medication containing T3, like natural desiccated thyroid (NDT), might be beneficial. Derived from dried pig thyroid glands, NDT contains not only T4 and T3 but also T2, T1, and calcitonin. This alternative is particularly appealing to those seeking a more natural approach to hypothyroidism treatment. Furthermore, a study has indicated that individuals with hypothyroidism tend to prefer NDT over levothyroxine. For those interested in exploring this option, you can buy desiccated thyroid online in the form of a supplement, such as VitaliThy.

How to manage sleep disturbances due to levothyroxine?

An elderly woman taking natural desiccated thyroid (NDT) or thyroid hormone replacement therapy.

1. Dosage adjustment

Determining the appropriate dosage of thyroid medications, like levothyroxine, can be a complex process due to factors such as inter-patient variation, absorption, and the effects of other medical conditions or medications.

If you've been having trouble falling asleep ever since you take levothyroxine, talk to your doctor about it. They'll likely take blood tests to see if you have too low or too much thyroid hormone. If your TSH and T4 levels are not optimal, your doctor will adjust your dosage.

2. Change the timing of your medication

Changing the timing of your medication may minimize the impact on your sleep. For example, don't take it as soon as you finish eating or right before you go to bed.

3. Try other types of thyroid replacement medication

At times, neither the timing nor the dosage is the issue; rather, levothyroxine might simply not be the right fit for you. Thankfully, natural desiccated thyroid (NDT) serves as a viable alternative treatment that may be more effective for those experiencing side effects from levothyroxine.

Unlike levothyroxine, which only contains T4, NDT provides a more balanced ratio of T4 and T3 hormones. Thus, it can boost your thyroid function more effectively. This can be especially beneficial for those who have difficulty converting T4 to T3 in their bodies, a common problem among hypothyroid patients.

If you want to try this natural approach, one great option is VitaliThy, a natural desiccated thyroid you can buy online. It's free from gluten, lactose, eggs, fish, and shellfish, as well as artificial coloring and flavoring. Thus, it's safe for anyone, even those with food sensitivities.

4. Test for other conditions that may be causing insomnia

Sometimes, it might not be thyroid hormone deficiency or its treatment that's causing your sleep troubles like insomnia. That's why it might be a good idea to evaluate your life and test for other conditions that may be causing insomnia. Here are some causes of insomnia besides thyroid dysfunction:

  • Genetics: Sleep traits and conditions, including insomnia, tend to be hereditary.

  • Brain activity differences: Brain activity differences and imbalances in the brain can affect a person's ability to sleep.

  • Medical conditions: Physical health conditions, such as temporary illnesses like minor infections or injuries or chronic conditions like acid reflux or Parkinson's disease, can also impact your sleep. Disruptions to your body's natural sleep/wake clock, also known as the circadian rhythm, can also be a factor.

  • Mental health conditions: Mental health conditions are another factor that can contribute to insomnia. Approximately half of the people with chronic insomnia also have at least one other mental health condition, such as anxiety or depression.

  • Life circumstances: Life circumstances and changes can also affect your ability to sleep. Stressful situations, such as complicated life circumstances, can contribute to insomnia. Temporary changes, such as jet lag, sleeping in an unfamiliar place, or adjusting to a new work schedule, can also disrupt sleep.

  • Life changes: Changes in our environment and routine can significantly affect our sleep patterns. Brief or temporary changes, such as traveling across time zones, sleeping in an unfamiliar place, or adjusting to a new work schedule (especially shift work), can all contribute to disrupted sleep. Long-term changes, like moving to a new home, can impact your sleep.

  • Your habits and routine: Your habits and daily routine can affect your sleep quality. Factors such as napping, caffeine consumption, and bedtime habits can all impact your ability to fall and stay asleep.

Is there any other way you can get better sleep?

People with difficulty sleeping can try the following to help them sleep better:

1. Exercise

Regular exercise is one of the best ways to improve sleep and overall health. Getting regular exercise during the day can enhance all aspects of sleep and has been shown to reduce insomnia symptoms.

2. Manage stress or practice relaxation techniques

Have you ever tried a pre-sleep routine that makes you relax? If not, you should try relaxation techniques before going to bed as it is proven to improve the quality of your sleep, which is one of the solutions for dealing with insomnia.

You can try relaxation activities such as listening to relaxing music, reading books, meditation, deep breathing, or other methods that suit you and make you more relaxed.

3. Quit Smoking

Quitting smoking or vaping is one of the best ways to improve the quality of your sleep. This is because nicotine is a stimulant, and stimulants make it difficult for you to fall asleep or sleep for the optimal duration. The effects of smoking on your sleep quality can be worse if your smoking habit is accompanied by consuming coffee and alcohol.

4. Wake up and go to bed at the same time every day

Setting a consistent sleep schedule can be a powerful tool for improving the quality of your sleep. Your body's natural sleep-wake cycle is regulated by a set loop that aligns with the natural patterns of sunrise and sunset. Maintaining regular sleep and wake times can help your body stay in sync with this natural cycle, promoting better overall sleep quality.

Research has shown that individuals with irregular sleep patterns, those who go to bed late on weekends, are more likely to experience poor quality of sleep over time. By waking up and going to bed at similar times each day, you can help establish a more consistent and effective sleep routine, allowing for more restful and wholesome sleep.

5. Create a comfortable temperature in your bedroom

The temperature of the place where you sleep can also affect the quality of your sleep. Where the temperature is too high or too low can disturb the comfort of your sleep. As you might experience in summer in a hot area, you may find it very difficult to sleep comfortably when the room temperature is too warm.

A comfortable bedroom temperature for most people is 70°F (20°C). This number can be adjusted again according to the preferences and habits of each person. Just make sure the temperature is comfortable for you to sleep and rest.

6. Avoid caffeine in the evening or at night

About 90% of the US population consumes caffeine. However, drinking caffeine too late in the day can stimulate your nervous system and interfere with your ability to relax and fall asleep at night.

Studies have shown that consuming caffeine up to 6 hours before bedtime can significantly reduce sleep quality. Caffeine can stay elevated in your bloodstream for 6-8 hours, so it's best to avoid drinking large amounts of coffee after 3-4 p.m., especially if you're sensitive to caffeine or have trouble sleeping.

If you crave coffee in the late afternoon or evening, it's better to opt for decaffeinated coffee instead. This way, you can still enjoy the taste without negatively impacting your sleep.

Conclusion: Trouble sleeping is a side effect of levothyroxine

The connection between levothyroxine and trouble sleeping is multifaceted and depends on various factors like dosage, timing, absorption interactions, and individual differences. Proper communication with your healthcare provider, along with developing good sleep hygiene, can contribute to a more restful night's sleep while taking levothyroxine.

It's also important to remember that levothyroxine is not for everyone. If you've been taking the medication for a while and you've adjusted your dosage several times, but you haven't felt any better, then it might be time to try natural desiccated thyroid (NDT). VitaliThy, a natural desiccated thyroid you can buy online, is a great option if you want to explore this natural approach to hypothyroidism treatment.

Wojciech Majda
Wojciech Majda


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