Thyroid UK
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Hashimotos with Weight Loss

Hi, I am just wondering if there is anyone who has similar blood tests to myself and also has a problem gaining weight. My recent blood test: TSH: 2.78 (range 0.35 to 5.50), FT4 9.5 (range: 10.3 to 22.7). Cortisol at 9.00 am was 370 - not sure if that is normal? I currently take Erfa 60 mcg.

I am concerned by my weight loss, I also experience pins and needles in my legs, but my Dr just says he has no idea what is causing it!


4 Replies


You are undermedicated to have TSH 2.78 on 60mg Erfa. Most people optimally dosed on Erfa will have FT3 in the upper third of range with TSH <1.0 perhaps even suppressed <0.1.

Your GP should do a tissue transglutaminase blood test to check for coeliac disease causing weight loss. If you have unexplained weight loss your GP should investigate further. If you are simply having difficulty gaining weight then try eating frequent small meals and I found protein shakes in between meals helpful in gaining some weight.

Ask your GP to check B12 and folate. Pins and needles in legs may be due to B12 deficiency.


As Clutter says ask for your B12 and folate to be tested as pins & needles are a classic symptom of a low levels. The only time I've lost any real weight in my thyroid journey is in the 6 months leading up to my diagnosis of pernicious anaemia which is an autoimmune condition preventing B12 absorption from food.


Your are under medicated to have TSH so high. Your FT4 is under range

How much Levo are you taking?

You antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges.

Post results when you have them, members can advise

Low B12 is extremely common

Symptoms include pins and needles

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

More people gain weight with Hashimoto's, but significant number struggle to keep weight on

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ask GP for coeliac blood test first

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:


Hi, Many thanks for all your replies. They were very helpful.


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