Still can't lose weight

[Foggy73]

I have recently had all my tests done again following about 8 weeks on Levothyroxine 125, which was increased from 100. I am feeling less tired, but still not as good as I feel that I should, and I still can't lose any weight despite more exercise. I am not suffering from any overactive symptoms either despite my TSH result. My results are:

Vit D = 80 (50 - 120 nmol/L)

Serum ferritin = 53 (13 - 150 ug/L

Serum C reactive protein level = <0.3 (0.00 - 5.00 mg/L)

Serum free T4 = 19.7 (12 - 22 pmol/L)

Serum free T3 = 5.5 (3.10 - 6.80 pmol/L)

Serum TSH = 0.16 (0.30 - 4.20 mu/L)

Serum calcium = 2.21 (2.15 - 2.55 mmol/L)

Serum adjusted calcium conc = 2.11 (2.15 - 2.55 mmol/L)

Serum Vitamin B12 = 643 (197 - 866 pg/mL)

Serum folate = 15.9 (4.60 - 18.70 ng/mL)

I am definitely feeling a lot better than 2 months ago, as my concentration and brain fog has improved, but I am still more tired that I would like to be and also my weight has not dropped off.

Is there anything else I can do? I am thinking of trying Forever Aloe Vera Gel drink, but I don't know if this is OK with Levothyroxine. Does anyone know if there is any interaction between Forever Aloe Vera Gel and Levothyroxine?

[greygoose]

Your TSH result does not say that you are over-replaced. Actually, it doesn't say anything, because at this stage of the game, it's a useless test. But doctors insist on doing it...

Far more important is your FT3 level, which says that there's room for improvement. You probably Don't have enough T3 to make you lose weight. You certainly Don't have enough T3 to exercise. When you are hypo, exercise is in no way going to make you lose weight. Quite the contrary, if you exercise you are using up what little T3 you have and thereby making yourself more hypo. Just gentle walking is the best.

But, you do have room for an increase in dose, there. Did the doctor give you an increase?

[Foggy73 in reply to greygoose]

Hi Greygoose

Can you tell me what T3, T4 and TSH do and how they interlink.

I haven't had my Levothyroxine increased. How will Levothyroxine increase help increase my T3? I know what my GP will say......increasing my Levothyroxine will push me hyperthyroid!!

[greygoose in reply to Foggy73]

TSH is a pituitary hormone (not even a thyroid hormone!) - Thyroid Stimulating Hormone - which rises when concentrations of T4 and/or T3 are low in the blood. It stimulates the thyroid gland to produce more hormone because your body needs it. And that, more or less, is all it does. It has no effect on your heart, Or you bones. It just stimulates the thyroid.

The thyroid mainly produces T4 - which is basically a storage hormone (Levo is T4). It only produces a tiny amount of T3 which is the active hormone needed by every single one of the thousands of cells in your body. When T3 is low, and there's not enough to go round, that's when you get symptoms. The symptoms can affect any and every cell in your body, making you cold, your hair fall out, weight-gain, aches in joints and muscles, etc.

So, as the gland only makes a tiny amount of T3, T4 has to be converted into T3 in the cells, mainly in the liver. However, not everybody is very good at converting, so although the TSH is low (because you have 'enough' T4), and the FT4 looks good, you can still be very hypo because you are not converting that T4 to T3, it's just building up in your blood unused.

The way to tell if you aren't converting very well is to compare an FT4 test result with an FT3 test result, done at the same time. If the FT4 is high in its range, and the FT3 is low in its range, then you aren't converting well.

So, if you have an increase in Levo, and it converts to T3, you should feel better. If you Don't feel better, you probably aren't converting very well.

Doctors have this false idea that if you have a suppressed TSH it leads to heart problems and osteoporosis, but that's because they weren't taught very well in med school. They are confusing a suppressed TSH - and it has to be suppressed, 0.01, not just Under-range - caused by oral thyroid hormone replacement, and suppressed TSH caused by hyperthyroidism in diseases like Graves.

With Graves, not only is the TSH suppressed, but the FT3 is very high, and it is the high FT3 that can possibly - but it's not a certainty - cause heart problems and osteoporosis. But it is the high FT3 NOT the low TSH that is the problem.

[Foggy73 in reply to greygoose]

So with a Serum free T3 = 5.5 (3.10 - 6.80 pmol/L) I could push to have a T3 medication and say that my T4 is not converting to enough T3 for my body then?

[greygoose in reply to Foggy73]

Sorry, I got a bit confused there below. Actually, your results Don't say you're not converting. You appear to be converting well. Above I was just explaining how it all works.

As your doctor is so afraid of your TSH getting too low, I very much doubt that he will give you T3 because that will suppress the TSH. Even taking more Levo is going to lower it, so what you've got to do is convince him that that isn't going to make you 'hyperthyroid' (actually, that's physically impossible, because you're hypo, your gland isn't working properly. What he should say is 'over-medicated' or 'over-dosed.)

You are only over-dosed if your FT3 is over-range. Not a suppressed TSH, not a high FT4, but and over-range FT3. As long as that's still in range, you are not over-medicated. He just doesn't know much about thyroid, does he.

[Foggy73 in reply to greygoose]

Thank you very much greygoose. I understand now. My GP is worried that I will become over-medicated and get the symptoms that hyper patients get such as heart problems. I think I need to be right at the very top of the range of FT4 and FT3 to feel well. I will keep pushing to get the increase and will take the information that you have given me to her, as this worked before when I printed off information and she read through it, she then increased my Levo from 100mcgs to 125mcgs a couple of months ago. I will push to try 150mcgs.

If I do become over-medicated, in terms of my symptoms, I assume all I need to do is tell my GP and then be put back down to the lower dose? I presume its not a permanent issue once the meds are reduced?

[greygoose in reply to Foggy73]

You're absolutely right. All you have to do is go back to the dose you were on before - you can even do that yourself, without having to go and see your doctor first. It's not a permanent issue. But I very much doubt that an increase of 25 mcg is going to make you go over range because you aren't that close to the top yet.

Another thing you could try, it 25 turns out to be too big an increase, is take 125 one day, and 150 the next, alternate doses. That works for a lot of people.

[Foggy73 in reply to greygoose]

Thank you very much Greygoose. I have more ammunition to go back wit now. I really appreciate your help.

[greygoose in reply to Foggy73]

You're welcome.

[Fruitandnutcase]

I'm hyper so I can't advise on hypo blood levels and I don't know about how Aloe Vera reacts wth thyroxine but I do know that I shared a kitchen in a community centre some time ago wth an the organisers of an Aloe Vera conference and it is a pyramid selling arrangement. It was like a religious revival meeting with all the new hopeful sellers at the bottom of the heap aspiring to be like Mr Big who arrived in his Porsche - it was amazing - they all rushed out to see how well he was doing.

Even the most casual conversations with them while waiting for the kettle to boil left you feeling you were being eyed up as either a potential agent or a potential customer.

I would tend to avoid becoming trapped in the Aloe Vera hard sell world, but then I've never tried it and there are people who take it.

I would try and get your medicines optimised and as GG says, stick with gentle walking for exercise and eat a good balanced diet, don't be tempted to starve yourself

[Foggy73 in reply to Fruitandnutcase]

Thanks Fruitandnutcase.

There is no chance that I would starve myself as I like my food!! I have never had a weight problem until 5 years ago after my 2nd child was born and I was diagnosed with hypothyroidism. I was always full of energy and my metabolism was always fast. It's so frustrating.

[greygoose in reply to Foggy73]

It is frustrating! Tell me about it! But the only way to over-come it is to optimise your FT3. And you're not going to be able to do that with a doctor who is scared of a suppressed TSH, I'm afraid.

[Foggy73 in reply to greygoose]

So do I need leave the Levothyroxine as it is and ask for T3 too?

[greygoose in reply to Foggy73]

Well, you can try, but they Don't like prescribing it. Or, you could get your FT3 tested privately and see if you are converting or not.

[Foggy73 in reply to greygoose]

My free T3 and free T4 results are below:

Serum free T4 = 19.7 (12 - 22 pmol/L)

Serum free T3 = 5.5 (3.10 - 6.80 pmol/L)

Do these show that I am not converting and need some T3?

[greygoose in reply to Foggy73]

As I just replied above, no they Don't. You are converting, you just need an increase in Levo. Sorry about the confusion, I muddled you up with someone else.

[Foggy73 in reply to greygoose]

My GP is reluctant to increase my Levothyroxine as she says according to my weight I'm on the maximum dose of Levothyroxine. She has agreed to do my bloods again in 6 weeks because she says I need to allow up to 4 months for the Levothyroxine to be optimum. As my Calcium is low....(see result below) she said that this could be causing my tiredness and weight problem as I cannot lose weight despite exercise. How does low Calcium affect weight?

Serum adjusted calcium conc = 2.11 (2.15 - 2.55 mmol/L)

[greygoose in reply to Foggy73]

It doesn't. Well, only slightly. Your doctor isn't very clued up on these things, is she.

Your dose of thyroid hormone replacement has nothing to do with your weight. The weight guide is just for people who have had a thyroidectomy to give them an idea of how much they need to start on. It is then adjusted after that with six weekly tests, same as any other form of hypo.

It takes more like two months for the Levo to become optimal. If you Don't feel any better after that, you need an increase.

Low calcium may cause tiredness. But It's more likely to be your low iron and/or low T3. And you're probably low in magnesium, too.

Exercising is NOT going to help you lose weight, or anything else. It is just going to use up your T3 and make you put on more weight. So, if you can't lose weight, you need more T3.

Is she doing anything for your lowish vit D? If that comes up a bit, the calcium might also. Is she giving you calcium suppléments? If so, is you also giving you vit K2? That's another mistake they all make : not giving vit K2. You need that because it gets the calciium into the bones, and not the tissues. But they Don't seem to know that!

[Foggy73 in reply to greygoose]

I have been told to go back on my Adcal to improve both my Vit D and Calcium. No Mention of Vit K2. Can I get this myself? I am soooo frustrated that she won't put my Levothyroxine up again at the moment, but I am going to make a double appointment when I get my results from the next tests and stand my ground. I think she is already fed up with me because I wont give up!!!

[greygoose in reply to Foggy73]

And neither should you give up!

How much adcal did she tell you to take? I really Don't like these combined things, because to get enough of one thing, you have to take too much of the other.

Taking calcium suppléments is hazardous - especially as your doctor doesn't seem to know what she's doing. If I were you, I would research it for yourself. There's quite a bit about these things on this site. And it's possible that if you take enough vit D and magnesium, the calcium will come up by itself, anyway. And you Don't want too much.

But, either way, you should take the K2, or the calcium could get into your kidneys and your heart tissue rather than the bones. You can buy it on Amazon, and other places .

[Foggy73 in reply to greygoose]

I have judt started bsvk on Adcal-D3 1500mg calcium / 400iu D3 two tabs a day. When I stopped taking Adcal and just took 1000iu a day of Vitamin D my Vit D3 went up from 48 to 80 but my Calcium dropped to below normal.

[greygoose in reply to Foggy73]

OK, but that's an awful lot of calcium, and not much D3 - not enough to treat a deficiency. Don't forget the vit K2, though, will you. That is essential for getting the calcium to the right place. You also might be better off adding a little magnesium and zinc to the mix, because they all work together.

[Foggy73 in reply to greygoose]

I am nervous about buying vitamins online, i would prefer a reputable pharmacist or healthfood shop. I have already started taking magnesium and zinc.

[greygoose in reply to Foggy73]

Well, most of us do buy them on line - usually from Amazon. I'm afraid I can't help you with reputable pharmacists or healthfood shops because I Don't live in England.

That's good that you're taking magnesium and zinc with your vit D and calcium, because they all work together. But do get the vit D and calcium rechecked soon, because you Don't want to take too much calcium. You might find you need to move to a higher dose of vit D on its own.