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  • Writer's pictureMartha Lewis

Your Thyroid and sleep: what you need to know (Hashimoto’s and Grave’s disease)

I have Hashimoto’s. Autoimmune hypothyroid.

This is the first time I’ve told people.

I just got my thyroid results back and I have antibodies against my thyroid. Which means that my body is attacking my thyroid gland. It means autoimmunity.

I’m not shocked. I’ve had hypothyroid symptoms for years now, ever since I spent 6 months in Nepal and India (and got a parasite).

I’m cold when everyone else isn't. (I wear a sweater in the house while my husband wears a t-shirt.) I can’t lose weight even if I eliminate foods and restrict calories (which I don’t believe in!). I have dry skin. And thin eyebrows.

Many of my female clients also have Hashimoto’s. It’s the most common autoimmune disease in the US.

How does the thyroid work?

The thyroid is a gland in our throat that is controlled by the pituitary gland. The pituitary gland releases thyroid stimulating hormone, TSH, when thyroid hormones get too low. Then the thyroid produces T4 and T3. It generally produces 90% T4 and 10% T3. Then your body has to convert T4 into T3 in the liver and gut to use it throughout the body. There are thyroid receptors in every single organ and every single part of our body.

The thyroid works like a thermostat in our house. When the thyroid makes the right amount of thyroid hormones it keeps the temperature just right.

But if the thyroid is overactive, which is called hyperthyroidism, it’s making too much T4 and T3. It's like having a thermostat that is set too high, causing the house to overheat. This is definitely going to cause insomnia because you are too energized with too much of this hormone.

Now if your thermostat isn't active enough and it’s set too low then the house is going to get cold. That's called hypothyroidism which can also cause insomnia. One sign of hypothyroidism is poor quality sleep and feeling sluggish and tired all the time.

So many people get their thyroid tested by their doctor and they're told they’re fine, even though they don't feel fine. If you have many of the symptoms of hypothyroidism, such as inability to lose weight even with diet and exercise, feeling cold all the time, or hair thinning, most likely your thyroid isn’t working optimally. It’s really frustrating to have those symptoms and be told that everything is normal.

The problems with standard thyroid tests

Why are your results “normal” yet you don’t feel normal?

Each lab has different “normal ranges” that are based on the averages of people taking the test. The problem is that the standard ranges are actually based on sick people.

Not many healthy people without symptoms walk into a doctor’s office and say “I want my thyroid tested.” Therefore, the lab ranges are based on the extremes of sick people.

There is a huge difference between normal and optimal. Optimal ranges are based on healthy people without any symptoms. You want to be optimal which is why I interpret thyroid markers using functional ranges.

Another issue is that your doctor may not test for enough thyroid markers. Many doctors only test for TSH and maybe T4. You can be heading toward thyroid issues and have symptoms long before your TSH levels are out of “normal” range.

My doctor refused to test for more than TSH and T4. So I had to order a thyroid test on my own with the markers below that showed that I had antibodies against my thyroid.

Besides TSH, you also want to test for:

  • Free T4

  • Free T3

  • Reverse T3

  • Thyroglobulin

  • Thyroid binding globulin

  • TPO antibodies

  • TgAb or TGB antibodies

  • TSI antibodies

Many times the body isn’t properly converting T4 into T3 because of gut and liver issues.

It’s like trying to ride your bike and your bike will not pedal. If you only look at the pedal, you're not going to figure it out. You have to look at the entire system - the chain, the cassette, the cable, etc. You need to look at everything that could affect the pedal and not just a pedal itself.

You also need many different nutrients to make TSH: iron, iodine, tyrosine, selenium, zinc, vitamins E, C and A and B vitamins. Taking a drug to boost TSH is a band-aid. It isn’t solving the problem of why your body isn't making enough.


The most common causes of thyroid dysfunction are:

  • Autoimmunity: Hashimoto’s Thyroiditis and Grave’s Disease are the most common causes of hypothyroidism and hyperthyroidism, respectively.

  • Chronic Stress: Chronic stress and elevated cortisol levels can interfere with the hormonal signaling necessary for proper thyroid function

  • Liver Detox Issues: Excess toxins and/or impaired detoxification puts extreme stress on the liver. Since the liver plays a vital role in the conversion of thyroid hormones, a sluggish liver can be the root cause of a thyroid disorder.

  • Gut Dysfunction: Healthy gut flora is also necessary for adequate conversion of thyroid hormones. Parasites, pathogenic bacteria, yeast/fungus overgrowths, and increased gut permeability and inflammation can lead to lower levels of thyroid hormone.

  • Gluten: Gluten is a common trigger for thyroid autoimmunity, regardless of whether you are sensitive to gluten. Gluten sensitivity, however, is more common than you might realize and often goes undetected unless specific gluten sensitivity tests are performed.

If you find out that you have thyroid issues and you start treating your thyroid but you still have an underlying gut or liver issue, for example, then it's not going to improve over time. It's like being in a leaking boat and continually bailing out the water, but water just keeps pouring in. You have to fix the leak to permanently repair the boat. If you don't address the issues that are contributing to the thyroid problems, then you're not going to get better.

If you have thyroid and sleep issues, there are things going on in your body that are causing this.

I know so many people, women especially, who get their thyroid tested and are told everything is normal. If that's you, please get in touch with me and we can talk about more comprehensive testing to figure out why you aren’t sleeping and what’s truly going on with your thyroid.

If you're not sleeping your body is telling you that something is wrong and it could be many different things. That's why I look at all these factors: thyroid, hormones, gut health and more to get to the root cause of why you aren’t sleeping.

If you’re ready to find out what’s keeping you awake at night, book a call with me. You’ll discover why you can't sleep even though you’ve tried all the things and how to fix it so you can get the sleep you need.

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