Recent convert to NDT, now gaining weight

[TeaEarlGreyHot]

I recently moved from 150mcg of Levo to 2.25 grains of Thiroyd.

I got my bloods done after a couple of weeks on my target dose which suggested that I might need a little boost as FT4 was low and TSH wasn't completely suppressed, so I am now on 2.5 grains.

Results I had done when I was on 2.25 are attached.

My move from Levo to NDT has been positive in all cases except one. I am gaining weight. In 4 months I have put on 8 pounds and now weight 15st 4lb, this is the heaviest I have ever been (I am a 5ft 11in, 46 year old male). I have made no changes to my activity levels nor have I changed my dietary habits. My calorie intake is the same has it has been for years. I have been around 14st 6lbs - 14st 12lbs for about 8 years.

I take my NDT in 3 goes - 1 grain at 06:30, 1 grain at 16:00 and 0.5 grain at midnight. I avoid food and coffee for a couple of hours before and for at least 45 mins after.

My FT3 is towards the high end of the range (especially as I have increased dose by .25 grains since the results), so I really have no idea what is going on.

I will admit that am a snacker, my weakness is carbs and I know that I really do need to lose weight, BMI is 29.7. I was hoping that moving from T4 to NDT would be a catalyst to assist with this, but I am going in the wrong direction!!!

I feel that I need to have a complete break from carbs to allow my snacking mindset to alter, so I am going to do a Keto diet for a few weeks just to break the carb dependency cycle - I know that diets are no good in the long term unless you adjust your lifestyle too, that is my ultimate aim. At least with Keto, I know that if I give in to carb cravings I will come out of Ketosis which defeats the object, so knowing this will boost my willpower.

Exercise is also a bit of a bugbear for me as I have EIA (exercise induced asthma), which limits my cardio somewhat as I get breathless so quickly.

Anyhow, if you guys have any thoughts on why a well medicated T3 reading and no change to lifestyle habits or calorie intake has equated to a net weight gain I'd be pleased to hear! Maybe NDT just isn't for me, which would be a shame.

Many thanks, Paul

[Pamanda]

Hi Paul,

I'm not a medic but it appears that you may still have room to increase your dose as your TSH is still not under 1, and your T3 could be a little higher.

Good on you for tackling the snacking, it's not easy I know. If it's too hard to go cold turkey on the snacks, maybe better snack choices like vegetables or nuts if you can tolerate them would help.

All the best

[TeaEarlGreyHot in reply to Pamanda]

Thanks Pamanda

Those results were taken on 2.25 grains, I'm on 2.5 now. Might increase to 2.75. If there's no palpitations from the additional T3, I could stay on that and see how it goes.

Cold turkey works best for me - I tend to do better when things are black and white, rather than having "grey" areas, which I will always then try to exploit! I smoked for 20 years, but one day just decided "that was my last cigarette" and that was it, never smoked after that, so I can apply myself if the choice is binary.

[greygoose]

How are your nutrient levels - vit D, vit B12, folate, ferritin? It's not just about hormones.

If it's any consolation, I put on a ton of weight on NDT - tried several different ones - and could only lose anything on T3 only.

[TeaEarlGreyHot in reply to greygoose]

Honestly, I don't know.

I will get those included in the next blood test.

Glad I'm not alone. Logic suggested to me that by getting better T3 levels by moving onto NDT, I would lose weight not gain it!

I am wondering if I might be better off on a hybrid solution - maybe go back onto Levo and supplement with either a small does of NDT or even T3.

[greygoose in reply to TeaEarlGreyHot]

Well, as you've reacted badly to NDT, I wouldn't go adding it to your levo, if I were you! But, I don't think you should do anything until you've had your nutrients tested. They all need to be optimal for your body to be able to use thyroid hormone of any kind.

[TeaEarlGreyHot in reply to greygoose]

The weight gain is the only negative that I've experienced. Since moving to NDT I feel a lot more positive, more energy, less brain fog and dry skin completely cleared up.

I agree thought that without knowing the full picture re nutrients, it's hard to know what the right course of action would be.

[fibrolinda]

Give the NDT time as you have so many positives but make sure you've been on the dose for 6weeks before testing as it takes that for the t4 in NDT to convert to t3. Test early as you can and 10 - 12 hours after last dose of NDT. If you take anything with biotin in it, multivitamins or multi b vitamins, then don't take them for a couple of days before test as they can give false results. You really do need to get the tests done gg suggested, you need all your ducks in a row. It took me 22 months to finally get everything right and find my sweet spot.... hopefully... been 14 weeks with ft3 of 6.08top of range is 6.80 and I have lost 13 lbs.... soooooo slowly but losing it and eating well. Before that starve and gain.

Its hard to be patient but hang on in there and good luck

[TeaEarlGreyHot in reply to fibrolinda]

Yes, there's no need to rush things, I'm a lot happier than where I was before NDT, so other than the weight gain, things are moving in the right direction.

It was a comment from my Mum at the weekend... "you're getting a bit of a belly on you from this angle" and the fact that my belt *has* felt a bit tighter these last couple of weeks that prompted me to get on the scales this morning. Whilst I wasn't surprised as I could feel I'd gained weight, it wasn't something I had planned for when moving over to NDT, in fact quite the opposite!

I'll give it longer to settle down, and then get the bloods done again but with vitamins/nutrients too.

I know I'll be losing some weight soon when I start the Keto diet as it is less calories than I consume now with very low carbs (which will hopefully force me to deal with my mental sugar addiction). All fresh home cooked food too, no processed stuff. Couple that with some more walking, and asthma permitting, a few blasts on the exercise bike I'll soon be moving towards a lighter, fitter me

[fibrolinda in reply to TeaEarlGreyHot]

You need carbs to convert to t3 and many do do the high fat low carb diet I know but hmmmmmm When I first began uncontrollably gaining weight In desperation I tried the Atkins diet, similar thing, but in a month I gained 7lbs whilst hubby lost a stone also turned veggie. Same deal with jumping on the exercise bike you'll just use up t3. Until you get your body working correctly metabolically you will just waste you time and precious energy. I'm on the Harcombe diet but only when my t3 was finally in the right place... its working but would it before??? Its helping me back to proper healthy eating, three meals a day and ditched the sugar :) miracle for me. No calorie counting and important to eat enough so don't get hungry, hard for me at first as starved for years now eating more than have done for many many years.

greygoose gave me lots of advice on not dieting and exercising till properly medicated including how we need healthy fats

[TeaEarlGreyHot in reply to fibrolinda]

That's very interesting, thanks for the information. I'd not considered the role of carbs in T3 conversion. I think that I need to so some more research before making any significant dietary changes.

This Harcombe diet that you mention sounds ideal. I am very interested in making long term lifestyle changes, I think I am at "that age" where you start to take these things more seriously.

Do you take any thyroid benefit supplements to aid your T3 conversion?

[Simba1992 in reply to TeaEarlGreyHot]

Ray Peat stresses the importance of carbs for thyroid function.The key is to normalize your metabolic rate, then your weight will normalize.

raypeat.com

[TeaEarlGreyHot in reply to Simba1992]

Thanks for that resource, I will take a look.

One thing about carbs and thyroid function... Is this the same for people with Hashi's on NDT, rather than people for whom their healthy thyroid requires "assistance"?

My limited non medical knowledge on this subject suggests that the pills we take for Hash's contain the necessary T4 (storage and later conversion to T3, for which carbs are required) and also "ready to use" T3. I was on 150mcg of Levo (T4 only) prior to moving to NDT, which I understand is a higher than average dose, suggesting little natural residual thyroid function. Which such reduced thyroid function due to auto-immune issues, is the role of carbs so important?

Thanks for your input all, learning here!

[Simba1992 in reply to TeaEarlGreyHot]

I believe this is what Ray Peat stresses. He is really an expert on thyroid function. Do have a look at his articles. Very scienced based and helps you to understand what is essential in thyroid function. Getting up your metabolic rate is essential both for thyroids and normal weight. People with Hashi's have shown to benefit from his diet together with thyroid supplement. Do read read his articles, very informative!

[TeaEarlGreyHot in reply to Simba1992]

That's great, thanks Simba. I see there is a Ray Peat forum too that I think it will be worth having a look on.

[mb008 in reply to TeaEarlGreyHot]

Hi I've been on naturethroid for the last 2 months and am putting in weight despite exercise. How are you getting on? Have you managed to figure it out? I'm exactly the same as you in that i feel better on ndt but weight gain is very disappointing ?

[TeaEarlGreyHot in reply to mb008]

I have resolved my weight gain issues through diet. I thought that a more holistic approach may be required, rather than just looking at this from a thyroid only perspective.

I mentioned earlier in this thread that I was looking into starting a keto diet, and I took on board the advice I was given here regarding carbs and T3 conversion and then did a lot more research, including talking with people who have hashi's and have followed a keto WOE (way of eating) for a number of years. I decided that I would give it a try. I have now been eating Keto for 4 weeks, I have lost just over a stone (18 pounds).

I am following a diet of around 1900 calories per day, with around 30g of net carbs (carbs minus fibre), with absolutely no sugar. This level of carbs puts the body into a mild ketosis. I feel absolutely great! The first week was fine, I didn't suffer with "keto flu" which some people experience as the body gets used to using fat rather than glucose for energy - the bone broth I made which contains lots of minerals and electrolytes helps with this. For me, the diet is easy to follow as I am not hungry and I am eating food that I like, plus I enjoy time in the kitchen actually cooking rather than just reheating food in the microwave. I don't find it restrictive,, however you really do need to plan your meals, and it can be a bit of a pain eating differently to the rest of the family. As long as you follow your macros (ratio of carbs/protein/fat) you will lose weight.

In much the same way as this community and the STTM website opened my eyes to the benefits of NDT and made me more informed about my Hashi's, much more than my GPs ever did, talking to people who follow a Keto or Paleo diet has also convinced me that there are ways of eating that may be better for me. The group I joined are quite strict and see it as a way of life rather than just a diet, so there's essentially very little, if any, processed food, no sugar or even artificial sweeteners, meals prepared from scratch, real cooking!

At the moment, I am the lightest I have been in about 10 years, I feel energised and above all I feel happy. I couldn't ask for more. My target is to get into the 12 stone range, I am 1 pound off of the 13 range which for me is amazing. For once the belt is going in a notch rather than out!!! For me the combination of NDT and a Keto WOE has been a positive experience, and one that I hope continues. I have discovered that my carb heavy diet was bringing me down both physically and mentally, and lower carbs definitely suits me. Search on Facebook for the group "ketodiet blog support group", they have a lot of interesting information, free 14 day meal plan, free recipes and lot of enthusiastic members and admins.

[mb008 in reply to TeaEarlGreyHot]

Wow! I was not expecting to receive such a positive, uplifting response seeing as your issue was raised only a month ago! Fantastic. It's very motivating. I think it's going to be difficult - but worth it if I get such positive results.

I've only been on NDT for a relatively short while so I haven't reached my optimum dose yet. If I can get used to this mindset of total holistic living (which i'm not opposed to) it can only be good.

Good for you - I'm going to research Keto diet right now.

Best wishes and thanks for such a detailed reply!

[mb008 in reply to mb008]

One last question. Are you exercising as well? I have started swimming again and doing well but I am conscious that I am depleting T3 which may actually be contributing to weight gain?

[TeaEarlGreyHot in reply to mb008]

You're most welcome I not good at being succinct hence my long posts!

I am not a keto evangelist or anything, and I am very new to it myself. It's just something that I have found that works for me, but as always research before committing! The group I mentioned are great, but they are strict... don't expect to be "allowed" to drink diet coke anymore for example!

My other half says that since I have started eating keto, I've "become an arse", always looking at food labels and commenting on the amount of bad things that are in the food they all eat!

Personally I feel like I am at a crossroads, and aged 46, I think it is time to take certain things a little more seriously. I can't continue to eat pizza, sausage rolls and pasta like a 20 something any more, I need to increase my activity levels and I need to embrace other people experiences and learn from them.

Lower carbs and substantially less refined and artificially sweetened food has had a positive impact on me.

I will be getting my blood tests done in a few weeks, so will see what the effect has been on my levels, but from a patient outcome perspective, the last few weeks have been all good

[mb008 in reply to TeaEarlGreyHot]

Once you have your results, I think you should post your comments as a new thread to share with others here. It's great to hear a positive story.

Same here by the way, 48 years old and recognise that I need to make some lifestyle changes.

Good luck and let us know how you are once your blood tests come back.

[TeaEarlGreyHot in reply to mb008]

I will.

Re exercise, yes, but not a lot. I am on the exercise bike for 2 or 3 45 minute sessions per week, keeping heart rate around the 115-120 bpm mark for the duration.

I have also started taking a multivitamin, and I supplement magnesium via a skin spray as eating keto means magnesium may need topping up, although I do eat an avocado most days too.