Can you see any problem when taking these sleep meds?

In elderly patients with a slightly high TSH, the next step is to check free T4 and Free T3. If these support hypothyroidism then a low dose of levothyroxine is supported.

Thank you for your reply. That's exactly what I have - a TSH result from back in April '25 of 4.13 with a reference range of 0.45 - 4.5) So that's on the high side. And on the very same test sample my Free T3 was 3.1 (2.0 - 4.4); and my Free T4 was 1.14 (0.82 - 1.77). Seems like I need an increase in levothyroxine dosage to bring my TSH down lower to at least mid-range.

Have the doctor look into it.

Laura1970 and laughlin1947 - I'd encourage you to consider endocrine consult, if TSH is "slightly high" and dose increase is considered or before starting levothyroxine in someone over 60 years old. My understanding is in older adults to be cautious of adjusting levothyroxine doses based on laboratory tests. In particular, it may be incorrect to increase levothyroxine dose if TSH is slightly elevated, the laboratory ranges may not apply and patient comorbidities will be factored in by the endocrinologist and your primary doctor.
https://www.thyroid.org/patient-thyroid-information/ct-for-patients/feb
This link might not work for you. Another way to get at the information about elderly and over prescription of levothyroxine would be a search of terms levothyroxine + elderly + Mayo Clinic research, and you should get a good review of the cautionary aspects of Thyroid laboratory tests and older patients. Apparently this is an example where it is best to have a well informed clinician treat the patient and not rely on the laboratory tests alone! 🙂

Levothyroxine can cause insomnia and anxiety, among many potential adverse effects.

To circle back, I think we earlier agreed a good review might be helpful if a complicated list of medicines is being used.
Perhaps the team clinical pharmacist to start, maybe a sleep specialist and/or endocrinologist?

Best wishes

Your TSH isn’t slightly high. It’s on the high side of normal, which is normal. You levothyroxine dose is on the high side. I wouldn’t rush to increase it. You really need to know your TSH before you started taking levothyroxine to know with accuracy if you had a slightly high TSH (5-10) or a definitely high (>10). A definitely high TSH ((>10) requires treatment, especially in the elderly, where cardiovascular disease is rampant. Hypothyroidism increases rates of high cholesterol and atherosclerosis. One test that could potentially put the issue to rest if your pre-treatment TSH was in the 5-10 range is TPO antibodies, signaling an autoimmune reaction.

Also make sure you are taking levothyroxine first thing in the morning 30 minutes before food intake

Thanks for your comments, I've read them several times over by now. But I'm confused over your comment about increasing my dose of levothyroxine. I was heading along the path of thinking to reduce it or stop taking it due to my age being 77 years old. I believe the side effect of having hypothyroidism is a negative cardiac effect which I must be careful with.
My records of TSH/thyroid results before I went on any Synthroid were in 1999 thru 2001, with TSH results each of those years being 4.19, 3.21, and 4.56 (range being (0.3 - 5.7). I felt normal but my PCP said I was hypothyroid and to take the medication, When asked why I didn't feel and negative health results so far, he said I soon would. So he gradually increased my dose up from starting at 50 mcg in 2003 to by year 2021 getting to 150 mcg where I am now. Many years of data. I'll try to drop it in the lap of my endocrinologist and see if she wants to try anything.

No definitely don’t not think you should increase your dose of levothyroxine. If your highest ever TSH was 4.56 I agree with your seeking the counsel of an endocrinologist. Just make sure the endocrinologist has access to all of your previous lab work, ideally going back to before you were taking thyroid supplementation

From HealthCentral.com: "Levothyroxine is the second-most-prescribed drug in the US, with more than 102 million prescriptions in 2019. Historically, people were advised to take their pill first thing in the morning, on an empty stomach, and wait at least an hour before having breakfast. This is because a number of foods and beverages can interfere with its absorption, including milk, soy, coffee, papaya, and grapefruit.

More recently, the American Thyroid Association has endorsed two options for levothyroxine timing: either first thing in the morning, at least an hour before eating, or at bedtime, several hours after eating dinner.
Many studies have looked at whether one of these options is better than the other in terms of ensuring maximum absorption of oral levothyroxine, which is a synthetic form of the thyroid hormone T4 and most often prescribed to treat hypothyroidism (underactive thyroid). Newer research, including a meta-analysis published in 2020 in Clinical Endocrinology, suggests that taking levothyroxine at night may actually hold a slight edge over taking it in the a.m. But experts we spoke with voted for whichever time is more convenient for you, and more importantly, when you are most likely to remember the medication.

Taking at Night - Is Bedtime Better?
In the systematic review and meta-analysis published in 2020, researchers from North Sichuan Medical College in China analyzed data from 10 prospective or randomized controlled trials conducted in seven countries comparing levothyroxine schedules at morning to bedtime. Studies were conducted between 2001 and 2018, with duration ranging between two and six months. All formulations of levothyroxine were in oral tablet form.

Findings showed that across studies, taking levothyroxine before breakfast compared with before bedtime had no significant difference on the level of thyroid-stimulating hormone (TSH), an indicator of whether a person has adequate thyroid hormone in their system. However, in an additional analysis performed on nine studies, researchers found that levothyroxine administered at bedtime was associated with a higher free thyroxine (T4) level when compared with breakfast administration.

Although the finding did not reach statistical significance, these results appeared to “favor” a bedtime dose, the researchers wrote. One possible explanation they offered was that about 60% to 82% of levothyroxine is absorbed over three hours, so the one-hour interval before eating breakfast may not be sufficient. They also noted that a high-fat, large American-style breakfast may impact absorption of the drug.

Preference - A Matter of Choice: Experts we interviewed framed the choice of a morning or bedtime dose as mainly a matter of patient convenience.

“In general, it really doesn’t matter what time a patient takes their levothyroxine,” says David S. Cooper, M.D., MACP, director of the Thyroid Clinic and professor of medicine in the Division of Endocrinology, Diabetes, and Metabolism at Johns Hopkins University School of Medicine, in an email.

Why not take more idodine we dont have enough of it in our diets.