Difficulty losing weight. On 50mcg Levothyroxine. Had private tests done since GP insists dosage is correct. Help interpreting results?

[TMarti]

I was diagnosed with UAT about 2 years ago - I had started feeling lethargic, cold, and had alopecia - and was initially put on a 25mcg Levothyroxine dosage by endocrinologist. The endocrinologist then decided he was going to take me off medication since he became convinced my symptoms were due to stress and depression, but I insisted my problems were physical so he relented but later discharged me since he claimed there was nothing more he could do. About a year after this, GP retested my levels and increased my dosage to 50mcg.

Though I still feel excessively tired once in a while and my mind tends to go blank, I do feel overall better than I used to. However, I have been unable to lose the weight despite exercising regularly and eating very healthily and limiting my calorie intake. I also cut lactose since that seemed to upset my stomach. I therefore asked GP to recheck my levels but she claimed they were correct. I then had further private tests done and the results are below. I was hoping somebody could help me interpret these and tell me whether there is anything else I should be doing in order to lose the excess weight? I recently had psoriasis start showing on my feet and am not sure whether this is related to the UAT?

Thank you all for your help!

THYROID STIMULATING HORMONE 3.66 mIU/L 0.27 - 4.2

FREE THYROXINE 15.1 pmol/l 12.0 - 22.0

TOTAL THYROXINE(T4) 117 nmol/L 59 - 154

FREE T3 4.0 pmol/L 3.1 - 6.8

Thyroglobulin Antibody 55.0 IU/mL 0-115

Thyroid Peroxidase Antibodies * 128.2 IU/mL 0 - 34

[lc1973]

Hi

To a degree your GP is correct that your results are in range, BUT.... they are far from optimal. Others will be along to give you more info but ideally you may feel better if your TSH is 1 or below. If it were me i would contact my GP and ask for an increase to see if you feel any better. This is probably why you arent losing any weight...no amount of exercise or dieting will help you do this unless your medication is optimal...trust me...i've tried extreme dieting and exercising and all i achieved was making myself feel worse! You could also get your nutrients tested to see if they are also optimal like ferritin, folate, B12 and D3 but i thin initally you need to get your dose increased to 75mcg and then retest 6 - 8 weeks later to see if you results have improved and more importantly how you feel.

[greygoose]

You can't lose weight be cause your FT3 is still too low, and it's low T3 that causes symptoms like weight-gain, and not being able to lose it. Your TSH is too high because your FT3 is too low. But, your conversion looks ok, so you just need an increase in levo.

Did you know you have Hashi's? The high antibodies say so. With Hashi's, you need your TSH suppressed. But, doctors don't know that - in fact I doubt your doctor knows very much about thyroid at all.

There is no cure for Hashi's, but you could try lowering antibodies by going 100% gluten-free - that might also help you lose weight - and taking selenium, which also helps with conversion.

[shaws]

You will have to educate your doctor. They make this mistake very often in assuming that once the TSH is somewhere in the range, they're job is done. Not so.

Once diagnosed, our TSH has to be 1 or lower and some need it to be suppressed.

We cannot get well if we don't have sufficient T4 to convert to T3 and it is T3 alone which is the Active thyroid hormone - not T4 - levothyroxine.

I am doubtful if they know the basics whatsoever so it's up to the patient to be knowledgeable so they can rid themselves of clinical symptoms.

Your antibodies are high and they attack your thyroid gland until you are hypothyroid (antibodies mean you have an Autoimmune Thyroid Disease called Hashimoto's) and they wax and wane until you are hypothyroid. Going gluten-free can be helpful in reducing antibodies.

You can tell your GP you need an increase in dose to bring your TSH to 1 or lower as you've had advice from the NHS Choices for information/advice on dysfunctions of the thyroid gland.

[shaws]

P.S. all blood tests for thyroid hormones have to be at the earliest possible, fasting (you can drink water) and allow a gap of 24 hours between your last dose of levo and the test and take it afterwards. This helps keep the TSH at its highest and may stop the doctor adjusting your dose unnecessarily.

[SlowDragon Administrator]

Read as much as possible about Hashimoto's

Doctors think it irrelevant, or they don't understand it

We usually need to find root cause to get improvement - often Hashimotos affects the gut with low stomach acid & poor nutrient absorption leading to low vitamins

Get vitamin D, folate. Ferritin and B12 tested too. Make sure to get figures and ranges

Many/most with Hashimoto's find gluten free diet helps significantly

See The Thyroid Pharmacist website plus her video series the Thyroid Secret

Amy Myers, Chris Kresser, scdlifestyle.com

All advocate trying gluten free

[TMarti]

Wow! Some really great advice. Thank you so much for your help. I really appreciate all of the advice. I have now started reading into Hashimotos (you guys were the first to ever it give it a name!) and will definitely try going gluten free.

To be fair, my GP is probably the best GP I have ever had and actually does take the time to listen. So I'm hoping she'll take this new information into account... the endocrinologist on the other hand was useless and quite rude.

Hopefully these changes will finally aid me in losing weight! Thank you again!