# Does Synthroid (or other synthetic T4) make anyone sleepy?



## HeidiBR

I'm just curious. It makes me sleepy.


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## Lovlkn

Why do you think it's the synthetic T4 making you sleepy? It does not have that effect on me.


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## HeidiBR

Because about an hour after I take it, it makes me drowsy. Less so now then when I first started taking it, but it still makes me sleepy. Which is why is worked so well taking it at night.


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## Lovlkn

I take mine in the middle of the night as I always wake up at least 1x during the night. The reason I take it then is to avoid the hour wait on food, plus I take alot of vitamins after my breakfast and don't want any interaction.


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## Andros

HeidiBR said:


> I'm just curious. It makes me sleepy.


I cannot find sleepy listed as a side effect of T4 but I am thinking that you are at a bad place in the titration process and therefore you are experiencing narcolepsy.
http://www.drkaslow.com/html/thyroid.html

What are your labs looking like?

And, I am wondering if you are taking any other meds, herbs or supplements that could cause this and/or an interaction?


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## hillaryedrn

I agree, Synthroid should not be making you sleepy! If anything, it should have the opposite effect! Hmm, that does make me wonder if Andros isn't right about you just being in a "bad" place in your titration.


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## HeidiBR

It makes me less sleepy and dopey than it did when I first began treatment. It made me so sleepy and dopey back in March that I had to take the pills at night. That way, it didn't matter if I fell asleep 

Today, I went for my blood work and had to take the pill after the draw - I took it at 9 AM and so far, no sleepiness. So, maybe the sleepiness was a result of starting treatment and now that my body has gotten used to it, maybe it is gone? This was the first time I took the pill during the day as I have been afraid I would fall asleep. Hopefully, that is gone.

I am still at 75 on the Synthroid. I see the endo in 2 weeks. I bet my dose gets upped again.


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## CANDON

Well, none of us claim to be experts at this, just experienced....my only sleepy or tired problem was when I was going up to the level I am at now..once I hit my present level (150) I feel good. This level is actually a bit low for a male my skeletal and musculature build, but they have to keep me slightly hypo to watch the kidneys...I should probably be at 175...

When I work out heavily I can be a bit tired and sleepy the next day, but that is from other problems ( like going at it too hard).

Now I did find doing a search on the internet one medical site that did list a overdosing of Synthroid as causing fatigue, but also with that you should get sweating etc, similar to hyperthyroid actions.

So, like everyone else has said, probably you are still a bit hypo and as they get you within normal range you should feel better...


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## HeidiBR

Thanks! Oh yeah, I think I am still hypo. For sure.


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## Andros

HeidiBR said:


> It makes me less sleepy and dopey than it did when I first began treatment. It made me so sleepy and dopey back in March that I had to take the pills at night. That way, it didn't matter if I fell asleep
> 
> Today, I went for my blood work and had to take the pill after the draw - I took it at 9 AM and so far, no sleepiness. So, maybe the sleepiness was a result of starting treatment and now that my body has gotten used to it, maybe it is gone? This was the first time I took the pill during the day as I have been afraid I would fall asleep. Hopefully, that is gone.
> 
> I am still at 75 on the Synthroid. I see the endo in 2 weeks. I bet my dose gets upped again.


Did your doctor tell you to not take your Synthroid before the draw, I am wondering?

Consistancy is extremely important. I take my thyroxine faithfully @ 5:20 AM every single morning and have done so for many many years.


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## HeidiBR

Yes, no meds before the blood draw.


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## CA-Lynn

Sleepy? Not me. In fact, in the years before I broke down and bought little plastic pill cases, and would sometimes forget to take my pills, my admin assistant could always tell when I hadn't taken Synthroid because I was very sluggish.


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## CA-Lynn

HeidiBR said:


> Yes, no meds before the blood draw.


Hmmm...... Seems to me it wouldn't make much of a difference if you've been taking Synthroid for a while because it's got a half life of 6-7 days. So you're bound to have plenty in your system even if you don't take meds before the blood draw.

Am I missing something here?


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## Lovlkn

HeidiBR said:


> Thanks! Oh yeah, I think I am still hypo. For sure.


OK- you think you are still hypo, you had blood drawn today and you do not go back to your endo for 2 more weeks.

Will your endo call you if he wants and increase in meds or will he wait the full 2 weeks until you are in his office?

How long has it been since your last blood draw? What were those results?

Hypo alone would cause fatigue.


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## Shiraz

CA-Lynn said:


> Hmmm...... Seems to me it wouldn't make much of a difference if you've been taking Synthroid for a while because it's got a half life of 6-7 days. So you're bound to have plenty in your system even if you don't take meds before the blood draw.
> 
> Am I missing something here?


I always wait to take my Synthroid until after labs. According to the NACB, a person should withhold medication when getting blood tests. See this link (on page 36)...

http://www.aacc.org/SiteCollectionDocuments/NACB/LMPG/thyroid/Thyroid-FullVersion.pdf#page=19

"The optimal time for TSH testing is not influenced by the time of day the L-T4 dose is ingested (133). However, the daily dose should be withheld when FT4 is used as the therapeutic endpoint, since serum FT4 is significantly increased (~13%) above baseline for 9 hours after ingesting the last dose (225)."


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## GD Women

But don't we want to know if the meds. are working. We already know our thyroid are not. Its the thyroid medication that is compensating for what the thyroid doesn't. Medication is what rasises or lower our levels. So if we don't take our meds. to me the test is not accurate and reflecting our real thyroid status via levels. I take mine before Labs but it might be several hours after before Labs are done.

I couldn't get into your site, I don't have adobe. Do you have a another site you can recommend. I have only read this about T3 meds. but still question that as well, and one other certain but rare type of thyroid disease. Nothing about T4 because it has a long shelf life so which probably means the day we have our test done reflect the day before meds. Therefore, it doesn't make a difference that we take our meds. the same day for it shows up in our blood the next day and not on the same day meds are taken.

It would be very interesting and educational to read a site stating otherwise.


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## Shiraz

GD Women said:


> But don't we want to know if the meds. are working. We already know our thyroid are not. Its the thyroid medication that is compensating for what the thyroid doesn't. Medication is what rasises or lower our levels. So if we don't take our meds. to me the test is not accurate and reflecting our real thyroid status via levels. I take mine before Labs but it might be several hours after before Labs are done.
> 
> I couldn't get into your site, I don't have adobe. Do you have a another site you can recommend. I have only read this about T3 meds. but still question that as well, and one other certain but rare type of thyroid disease. Nothing about T4 because it has a long shelf life so which probably means the day we have our test done reflect the day before meds. Therefore, it doesn't make a difference that we take our meds. the same day for it shows up in our blood the next day and not on the same day meds are taken.
> 
> It would be very interesting and educational to read a site stating otherwise.


That link is not "my" site. It is information published (only in PDF) by the NACB -- National Academy of Clinical Biochemistry. We cannot change the format. You will either have to download Adobe or, if you try the link below, perhaps you can save the document to your computer.

http://www.aacc.org/members/nacb/Archive/LMPG/ThyroidDisease/Pages/ThyroidDiseasePDF.aspx

Sorry, I don't know what else to suggest...


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## GD Women

Shiraz said:


> That link is not "my" site. It is information published (only in PDF) by the NACB -- National Academy of Clinical Biochemistry. We cannot change the format...


It was meant metaphorically Shiraz, metaphorically.

.


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## GD Women

Shiraz said:


> That link is not "my" site. http://www.aacc.org/members/nacb/Archive/LMPG/ThyroidDisease/Pages/ThyroidDiseasePDF.aspx...


RE: "take my Synthroid until after labs"

WOW! That was a long read.

Your site - the site your refer, states Central hypothyroid (secondary or tertiary) a disorder of the pituitary, hypothalamus, or hypothalamic-pituitary portal circulation where the hypothalamic-pituitary axis is damaged. The causes are the same as the causes of hypopituitarism.

The site did nott advocate this procedure for subclinical, primary or overt hypothyroidism.

So therefore, I can assume you have central hypothyroidism.

By the way it's a very good site, one in which I have taken notes from for years, and can recommend plenty of other sites that suggest the same i.e. central hypothyroidism.


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## Shiraz

GD Women said:


> RE: "take my Synthroid until after labs"
> 
> WOW! That was a long read.
> 
> Your site - the site your refer, states Central hypothyroid (secondary or tertiary) a disorder of the pituitary, hypothalamus, or hypothalamic-pituitary portal circulation where the hypothalamic-pituitary axis is damaged. The causes are the same as the causes of hypopituitarism.
> 
> The site did nott advocate this procedure for subclinical, primary or overt hypothyroidism.
> 
> So therefore, I can assume you have central hypothyroidism.
> 
> By the way it's a very good site, one in which I have taken notes from for years, and can recommend plenty of other sites that suggest the same i.e. central hypothyroidism.


That is not the way I read it -- that it is recommended only for people who have central hypothyroidism. That whole page deals with hypothyroidism in general and, if you are pulling that one sentence out of context, then you would have to say that you do not agree with anything else that is recommended on that page either -- i.e. that soy, vitamins, etc. have an effect on thyroid medication. So, that too, only applies to those with central hypothyroidism? I don't think so.

All of this aside, my doctor adjusts my medication based on both the Free T4 levels AND TSH so she prefers that I do not take my meds before labs are done. The original poster also stated that her doctor told her not to take meds prior to blood tests. Bottom line is that one should always be consistent and one should always follow the advice of their physician.


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## CA-Lynn

_"The optimal time for TSH testing is not influenced by the time of day the L-T4 dose is ingested (133). However, the daily dose should be withheld when FT4 is used as the therapeutic endpoint, since serum FT4 is significantly increased (~13%) above baseline for 9 hours after ingesting the last dose (225)."_

My sense of it is that the physician wants to see what the conditions are while under the influence of the medication. Therefore, I would take the medication when I normally take it, regardless. Of course, if the physician instructs otherwise, so be it. [Mine has never done so, so business as usual for me.]


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## Lovlkn

I think consistency is key whether deciding to take replacement meds before or after lab testing. Don't forget folks... dosing on how you "feel" along with labs is what the goal is.

I have always taken my replacements after my lab draw and so far so good it works when making decisions on whether to adjust doses. I also do it in hopes of eking out a smidge of TSH but still little to none shows up- got to give it to those antibodies - they are strong little buggers.


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## HeidiBR

Wow! Thank you all for your concern! I am not suffering from narcolepsy, nor is the sleepiness a result of my levels. Being sleepy from being hypo feels very different from the "Synthroid sleepy." I think the sleepiness may possibly be a result of sensitivity to one of the med's binders or fillers.

As for the fasting from meds for the blood draws, I am positive that is what I am supposed to do per doctor's orders. I will ask him when I see him what the rationale is behind this as I am curious. I will not second guess this - and won't even consider it - until I know why he orders what he orders. I figure he knows more about this than I.


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## HeidiBR

Shiraz said:


> All of this aside, my doctor adjusts my medication based on both the Free T4 levels AND TSH so she prefers that I do not take my meds before labs are done. The original poster also stated that her doctor told her not to take meds prior to blood tests. Bottom line is that one should always be consistent and one should always follow the advice of their physician.


This makes total sense to me re: the FT4 and the TSH. I'm curious to see if this is the rationale that my doctor follows.


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## happysunshine

it does the opposite for me, I have heaps of energy, but it's good energy, I can go to uni now without any issues and not have anxiety attacks like I did early this year and had to postpone my course.


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## HeidiBR

Yes, it gives me energy - just not the first hour that I take it


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