Diet

[Lunatic16]

Hi I have had my thyroid removed 4years ago I am putting on weight I take 175 levothyroxine I am also a diabetic for 34 years anybodyoutwith advice for diets

[SeasideSusie Remembering]

Lunatic16

Maybe you're not on enough thyroid replacement. Weight loss wont happen unless optimally medicated with a good level of FT3.

What are your latest test results (including reference ranges)?

[Lunatic16 in reply to SeasideSusie]

What are FT3

[SeasideSusie Remembering in reply to Lunatic16]

Lunatic16

FT3 = Free T3 = one of the most important tests in the thyroid panel.

[shaws Administrator]

Thyroid hormones are T4 i.e. levothyroxine also known as levo and T3 -also known liothyronine. We usually just refer to T4 (an inactive thyroid hormone which has to convert to T3). T3 is the only active thyroid hormone needed in our millions of T3 receptor cells. We have to have sufficient T4 (levo) to do so and need an optimum dose, i.e. a TSH of 1 or lower with Free T3 and Free T4 in the upper part of the range.

All blood tests for thyroid hormones have to be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take afterwards. This helps keep the TSH at its highest and may prevent doctor adjusting dose according to the TSH (which they should not do).

I shall give you an explanation of results:

thyroiduk.org.uk/tuk/testin...

You will see from the above that Free T4 and Free T3 are the best tests but rarely tested. We can get private tests if we wish and have two private labs that do home pin-prick tests.

Also get GP to test B12, Vit D, iron, ferritin and folate as deficiencies in these also cause symptoms.

Levo should be taken, usually first thing with one full glass of water and wait an hour before eating. Food interferes with the uptake of the hormones.

[shaws Administrator]

These are two links which may be helpful:-

hormonerestoration.com/

hormonerestoration.com/Thyr...

[Lunatic16]

My TSH 7.4 is that bad or good

[SlowDragon Administrator in reply to Lunatic16]

Terrible. See GP urgently for 25mcg dose increase of Levothyroxine

Do you have type one diabetes? Or type 2

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting.

When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If 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. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's very important to get TPO and TG thyroid antibodies tested at least once .

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

Many take early morning on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

[Lunatic16 in reply to SlowDragon]

Hi all I've been to doctors they said my thyroid is fine but I have put on 2 half stones my stomach is so bloated and uncomfortable I only eat wholemeal bread no potatoes or pasta my sugar levels high I cannot exercise for complication with my feet from a road accident what can I do

[SlowDragon Administrator in reply to Lunatic16]

See a different GP

On Levothyroxine TSH should be under 2 and most patients need it under one

Ask for 25mcg dose increase in Levothyroxine and bloods will need retesting in 6-8 weeks

Suspect you have autoimmune thyroid disease diagnosed by high thyroid antibodies. Also called Hashimoto's. Majority of hypothyroidism is due to autoimmune thyroid disease

Do you have type one diabetes? This is autoimmune.

You need vitamin levels testing. Vitamin D, folate, ferritin and B12

Private testing as listed above if GP is unhelpful.

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels. Low vitamin levels affect Thyroid hormone working

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

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)

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

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

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

[Bumley]

I have an underactive Thyroid and currently take 75 mg of Levothyroxine daily. Mostly my thyroid tests come up OK. I had an incredible fight with my doctor (not now though) to get treatment at first and with the advice from this site got a full private thyroid test which showed not only was my TSH high at 7 but I had thyroid antibodies of 1000! Went back and shoved the test results under his nose and he reluctantly started my Levo

Like you I am also diabetic (LADA - Late onset Diabetes). I am on short and long term Insulin and have been for 28 years. Insulin is well known for making people put on weight indeed I put on nearly three stone until I was given a new drug called Byetta which reduced my insulin requirement and in the process reduced my weight back to normal. I should stress that I was not given the drug to reduce weight but to control and reduce the high level of insulin I was taking.

I am fortunate for the last 5 years I am being seen by an Endocrinologist who treats me for both maladies.

[SlowDragon Administrator]

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 at

[e-mail]

P

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3

rcpe.ac.uk/sites/default/fi...

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

[SlowDragon Administrator]

Reread all these replies

Getting FULL thyroid and vitamin testing essential