A 68 year old female was having difficulty with some anxiety throughout the day but more problematic to the patient was that she could not sleep at night. Multiple different non-drug interventions were tried, but none seemed to make any difference. Trazodone was finally prescribed and insomnia did improve, but only minimally. This particular patient was also on Synthroid (levothyroxine) 75 mcg daily for treatment of hypothyroidism. Due to the anxiety and insomnia continuing even following the trazodone order, a TSH was finally ordered. The TSH was significantly suppressed at 0.05 indicating an over supplementation of Synthroid. The dosing was subsequently reduced. When the patient’s TSH was finally within the normal range, symptoms of anxiety and insomnia had greatly improved and the trazodone was eventually discontinued.