Could someone please look at my blood test results and tell me if there’s any issue? I am desperate.
Long story short, I am a 29 year old female, I have Hypothyroidism and Hashimoto’s. I can’t lose weight, in spite strict diet and regular exercise (dance cardio or walking on a treadmill + weightlifting 5 times a week).
In 2014, I had a TSH blood test done. My TSH was 3,25 UI/mL (lab reference 0,27 - 4,20). I wasn’t diagnosed with Hypothyroidism then. However, I was already pretty fat and tired all the time.
In May 2017, I stopped taking my birth control pills. A blood test I had taken after quitting my birth control pills showed my TSH was 4,29 uUI/mL (lab reference: 0,27 - 4,20) so I asked my doctor to run a full thyroid panel.
In July 2017, my TSH raised to 5,37. You can see my blood test results down below.
Free T4: 1,06 ng/dl (1,00-1,60) OR 14 pmol/L (13-21)
TSH: 5,37 (0,27 - 4,20)
TSH Receptor Antibody: 0,4 UI/L (<1,75)
I then saw an endocrinologist who said I had subclinical hyperthyroidism and put me on 50 mg of Levothyroxine. By the time I got diagnosed, I weighted 116,4 kgs. My doctor told me to follow a diet, to lose the weight.
3 months later, I was able to lose 1,5 kg. I only did the diet and no exercise. I had another blood test done. My TSH went down to 3,12 but my doctor wasn’t satisfied. He said it wasn’t well balanced, so he prescribed 62,5 mg of Levothyroxine. I had and still have to split a 125 mg pill of Levothyroxine in half. That seemed to do the trick. In March 2018, my TSH went down to 2,89. However, thyroglobulin antibodies went up: 336,70 UI/mL (lab references: <115). You can see the full blood test below.
Free T4: 1,17 ng/dl (1,00-1,60) OR 15 pmol/L (13-21)
TSH: 2,89 (0,27 - 4,20)
My weight loss stopped and I started gaining weight again. By May 2018, I had gained 7,1 kgs. As a result, I weighted 122 kgs.
I quit eating gluten then and started taking curcuma with black pepper, in hopes of reducing my antibodies.
In June 2018, my anti-thyroglobulin antibodies went down to 302,00. My TSH went down to 1,65. You can see the rest of the blood test results down below.
Free T4: 1,35 ng/dl (1,00-1,60) OR 17 pmol/L (13-21)
TSH: 1,65 (0,27 - 4,20)
I changed the doctor as I wasn’t satisfied with my old one, and the new doctor prescribed me a stricter diet. In her opinion, I wasn’t eating enough protein. By doing vigorous exercise and following her diet, I was able to lose 6 kgs in 6-7 months, just to gain almost 2 kgs back during the holiday season just now (I allowed myself to eat fancy food on Christmas and New Year’s Eve).
I haven’t done another blood test since June 2018 but I will soon. My doctor is refusing to test anything except TSH though. Well, both of my doctors refused to do those blood tests. Every time I had a full thyroid panel ran, it was either my family doctor or gynecologist who prescribed it.
Problem is, it takes me like 2 months to lose 1 kg but I am extremely obese so I have to lose about 45 kgs. I weigh 117,3 kgs at the moment. If I stop eating according to what my nutritionist prescribed me, I gain weight immediately. This has been a problem all of my life. If I exercise regularly, my extreme fatigue seems to get better. However, I’m still losing hair. Strangely, the hair on my face (upper lip, for example) seems to be growing excessively since I have started taking Levothyroxine. I do experience fatigue, and even brain fog or difficulty concentrating occasionally.
I live in France, and I have no idea if some other thyroid medicine is available here.
It would mean the world to me if someone could have a look at everything and tell me if there’s any problem with my thyroid that might be interfering with my weight loss.
Thank you. I’m so desperate.
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First of all, thyroid-wise, I don't think your levels are optimal. I have Hashimoto's myself and need a really low (suppressed) TSH to feel well and lose weight (along with a blood sugar and insulin balancing diet). When on T4 only, I required 200 mcg of Euthyrox daily to achieve that. Now, I'm on NDT and my TSH has dropped very low (<0.01). In my own experience (which may differ from others'), FT4 levels need to be close to the upper normal range when on T4 drugs only (and around midrange when on NDT), and FT3 levels in the upper third of range. That may be easier said than done on T4 only, though. It all depends on how well you convert T4 to T3, really.
Don't let any doctor tell you that, as long as your labs are "anywhere in range", there is nothing wrong with your thyroid hormone replacement.
A doctor I saw years ago told me that, with Hashimoto's, you need a TSH below 0 to calm antibody activity down.
There is a complex relationship between hormones, autoimmunity and inflammation. I am still trying to figure it all out, but it seems inflammation can cause an imbalance in your blood sugar and insulin levels, causing insulin resistance or even diabetes 2. Both of these conditions cause weight gain as insulin is a fat-storing hormone. It's common not only to be severely overweight, but also to store fat around your waistline.
Have you had your blood sugar and insulin levels checked?
Anna
• in reply to
PS. I'd like to add that I've been severely overweight myself (102 kgs, 173 cm) and was unable to lose weight even on thyroid hormone replacement. I was diagnosed with insulin resistance (or pre-diabetes) and managed to lower and stabilise my blood sugar and insulin levels with supplements (which I preferred to the Metformin my doctor wanted to prescribe) and some dietary changes. That way, I managed to lose 29 kgs rather effortlessly and I've also kept them off since. Hence my question about your blood sugar and insulin levels as my own experience is that weight loss is extremely difficult or even impossible when you are pre-diabetic.
Berberine (500 mg three times a day with each main mail, so 1500 mg in total) during all the time I lost weight (I still take it as it has been so good for me), I have also recently added beans and lentils to my daily diet. They seem to have been the missing piece of the puzzle in that they contain resistant starch which keeps you full longer and keeps your post-meal blood sugar and insulin levels stable for hours. After adding beans, lentils and chickpeas to my daily diet (after reading about how legumes can reverse diabetes 2), I no longer need to snack between meals, but have energy and feel pleasantly full (not stuffed, and no cravings either) all day long.
My earlier dietary changes consisted of removing fast carbs from my diet, but also reducing the total amount of carbs, even so called healthy or slow carbs such as rye bread or brown rice. I simply replaced starchy food with more vegetables and also added more fat to my diet, both satured fat and olive oil. But, I think the biggest difference was finding the courage to eat virgin coconut oil. I grew up believing that coconut oil was the worst thing you could eat, but it turns out it has fat-burning qualities and is excellent for your health. I use it in smoothies and for cooking, and am convinced it also contributed to my weight loss. In any case, eating less carbs and more fat was a blessing for me. I think I could probably eat even more fat than I currently do, but it takes time to realise that something you grew up avoiding at all cost can actually be very good for you...but I'm working on it and slowly but surely getting there! I never imagined myself eating legumes ever again, but I have read enough about their anti-diabetic, fat burning qualities to have reconsidered.
Thanks for the comprehensive response and I do love to read a success story! So inspirational when we mostly come to this forum to get advice about the shortfalls in our health.
Amazing that things previously tagged as unhealthy now seem to be the key to health! Like you with coconut oil, I grew up on the mantra of avoiding avocadoes due to their high "unhealthy" fat content, yet now it is thought of as a superfood.
Yet I grew up in the 80s when low fat was the thing, so my brain is still wired to try to avoid it, must work harder on that!
So did I (born in the 1970s) and recently read that was when the low fat-high carb mantra was first introduced. That is also when today's "obesity epidemic" in the Western world started and then exploded in the 80s. When you think about it, it makes sense that eating a lot of high carb, low fat foods raises your blood sugar and insulin levels, causing insulin resistance and ultimately diabetes 2. You are then prescribed anti-diabetic drugs and told to lower fat ever more and increase your carb intake. A vicious circle that is very difficult to break...
Your diet and experiences sound just like mine. Low carb, high fat or for me low-ish carbs, high-ish fats. Well done. I’m off to look into berberine now
Nice to hear that it seems to work for you as well! "Eating a little of everything, and mostly carbs and very little fat" never worked for me. The last time I tried Weight Watchers (when already insulin resistant), I lost about 2 kilograms in six months...while not cheating, but eating low fat margarine, a lot of potatoes and pasta (especially after WW introduced their new programme making those foods "points free" meaning you did not have to weigh your portions) and not eating enough protein. I don't want to say that WW is bad for everyone, but in my experience it does not work well for someone with pre-diabetes as their programme allows you to eat limitless amounts of carbs and not enough fat to start burning fat (fat contains a lot of calories so "costs" a lot when on WW...when you see how many points there are in a single teaspoon of olive oil it's tempting to choose something fat free and high in carbs instead for fewer points...that is what happened to me anyway).
I never did well with WW and it was so depress8ng when I knew I hadn’t cheated. My son used to say he could never understand why I (and others) paid £5 a week for ritual humiliation!
After I became T2 because of the steroids I was given by my rheumatologist I bought a book called Reverse your T2 diabetes by Dr David Cavan and I did exactly what it said to do.
I bought my own blood sugar meter, tested before and 90 minutes after every meal, made a quick record of everything I ate and by doing that I was able to pinpoint exactly what raised my blood sugar and was being stored as fat.
Once I cut out the culprits weight came off very easily. My culprits were bread - even healthy whole meal bread, cakes biscuits, nice healthy jacket potatoes, parsnips - even a bowl of parsnip soup. Surprisingly enough I discovered I could have a slice of pavlova with cream and berries and it didn’t make any real impact on my blood sugar. Weird but lovely.
I discovered I had become T2 because I was on a pre diabetes study at a local hospital and a couple of months after I started the steroids - huge dose reducing over three months - I went back for my annual study check up and was thrown off the study because I was T2.
I was very lucky to discover it so quickly. I was warned several times about taking hydroxychloroquine (I started that when the steroids finished) and how it could affect my eyes but T2 as a side effect of steroids wasn’t even mentioned.
If you are prediabetic then you should have a look at the DietDoctor.com and Diabetes.co.uk websites, there is a huge amount of helpful information on them both. DietDoctor had a series of videos showing good LCHF choices that are well worth signing up for.
Dietdoctor.com, is that the Swedish site run by the doctor advocating lc for his diabetic patients? I have his book and love it! I have not compared various countries, but Sweden really seems to be well ahead of many other countries in this area. There are several lc sites where you can download delicious recipes free of charge and dozens of books. It was actually after reading Swedish a book about the health benefits of legumes that I decided to add them to my diet...with great results.
Interesting to read what you say about bread! Back in the "good old days", WW always advocated "healthy" bread (with grains) and always told me I must be cheating when I was constantly giving in to cravings...so depressing and humiliating.
Don’t know if it is Swedish. The guy who runs it is called Dr Andreas Eenfeldt - if you want to join his ‘club’ they seem to charge in $ so I thought he was American although Swedish makes sense. What is the Swedish book called? It sounds interesting.
No, he's Swedish. I've been a follower of his for years although I only joined his club just now. His book is called "Matrevolutionen" ("The food revolution"). Not sure if it's available in English.
• in reply to
It is available in English! (I hope it's OK to advertise it here):
I cannot recommend it enough. I remember when he first started advocating a high fat, low carb lifestyle. Since he's an MD, ge got into trouble with the Swedish Medical Association and was heavily criticised by many colleagues. But he remained true to his convictions and now has hundreds of thousands of followers, both in Sweden and abroad. Many more people have since discovered the health benefits of a high fat, low carb lifestyle, so he is no longer considered a renegade by his peers
ASanders69, It's fine to link to the book. But as this is a UK based forum run by the charity Thyroid UK, I've changed your link to the UK 'Amazon Smile' version. ( Purchasing via this link means people can choose to allow Amazon to make a small contribution to the charity )
Just ordered it! Thank you, I didn’t realise he had a book out. It’s interesting how some doctors / scientists considered to be renegades by the establishment (but not by their patients) for their views on controlling blood sugar are now being recognised as having a point. Yet so many endocrinologists are still dinosaurs when it comes to progress
I know if I had stuck with the advice from our surgery’s diabetes nurse I would still be T2.
The interesting thing is that as a thyroid patient I used to see what was happening to other thyroid patients and look at diabetic patients and think how lucky they were to be able to be responsible for controlling their own medicines when us thyroid patients had so much trouble with ours.
Since my T2 experience I have realised that things aren’t really all that different for some people with diabetes - especially T2 where I feel they would prefer to give patients metformin or insulin than work with them on their diets. That’s endocrinology for you.
Initially I was told to ‘watch my diet’ and was given a ‘healthy plate’ diet sheet - that is basically loads of ‘healthy’ carbs with every meal.
I was left wondering how on earth was I supposed to know what foods would spike my blood sugar without a blood sugar meter so I bought Dr Cavan’s book and realised that there was no way I could possibly know what was happening inside my body unless I had one. Paid for my own, took control of my body and didn’t look back.
I couldn't agree more Swedish society is very much based on conformity, I'm afraid...about a decade ago, a few MDs started to question the dietary advice patients had been given since the 1970s; for instance, for years, the slogan of the National Food Agency was "Eat 6-8 slices of bread a day". Those doctors were chastised by their peers and I think at one point risked having their licenses to practise medicine pulled. Now, there are simply too many success stories in order for the establishment to claim that fat is bad and carbs are good for us...!
Thank you for sharing your advice .I also struggle to lose weight with being underactive thyroid and type 2 diabetic seems to be a Life challenge.I have cut down my carbs trying to eat healthier but find the scales going up not down .I am also taking statin for high cholesterol so worried about eating too many fats. I am 12stone was 11.8. three weeks ago and even with eating healthier I put weight on ....grrrrrr ..so annoying.
Thank you sooo much for getting back to me, I really appreciate your input! I didn’t know all those things about FT3 and FT4 optimal ranges, as well Hashimoto’s requiring a higher dosage of medications. Looks like I’ll have to have a difficult conversation with my doctor... From what I understood, the only thyroid medication available in France is Levothyroxine. And doctors don’t prescribe T3. By the way, is there any way to know how well I convert T4 to T3? Congratulations on losing the weight, by the way! Diabetes is my worst fear, my mother has diabetes type 2... So anyways, my blood sugar is 5,6 mmol/l (lab ranges: 4.1-6.0). How exactly does one test for insuline resistance? I did ask my doctor about it after I went for a full hospital check up, and after having a look at my blood work, she said I had no insulin resistance. Whatever she meant by that. I’m just so desperate: I’m 167 cms tall, and I weigh 117 kgs. I think my obesity is literally destroying my knees.
Usually, when FT3 levels remain lowish despite high-normal FT4 levels, you don't convert T4 well enough, and could benefit from the addition of T3.
My own experience is that when your fasting blood glucose levels are at the very top of range, you are insulin resistant (ideally, they should be close to the lower normal limit and definitely not above midrange). Yours look dangerously close to pre diabetes.
I also had my fasting insulin and HB1ac levels tested at the same time, and they followed my fasting blood glucose levels, so very close to the upper normal limit.
Knowing what I know today, I regret trying all those weight loss diets based on eating enormous amounts of carbs, hardly any fat and moderate amounts of protein (for a long time, meat consumption was also something to limit because it was said to raise our cholesterol levels). I am convinced that is what caused my metabolic problems in the first place.
Yes, it seems French doctors only prescribe T4 drugs. There used to be a T3 drug called Cynomel and also a T3+T4 drug called Euthyral but they no longer seem available. NDT is available in neighbouring Belgium (as well as online, OTC) and T3 drugs in Germany (provided you can find a doctor prescribing it). In Germany, there is also a T3/T4 combination drug called Novothyral (also available in neighbouring Luxembourg). The problem is finding a doctor to work with you.
Thank you so much for explaining all that to me. I’ve recently had my HB1ac tested. It was 5.4% (lab ranges: 4-6). To be honest, my fasting blood sugar level has always been this high, 4.6 mmol/l. I do not believe I’ve had fasting insulin tested. So then, does this really mean prediabetes? Is there any treatment for this? I just remembered I’ve also had a glucose tolerance test performed back in 2016. It was a 3 hour blood test. My fasting blood sugar was 5,11 mmol/L. Then, if one is being tested for type 2 diabetes, two hours after drinking the glucose solution, A normal blood glucose level is lower than 7.8 mmol/L. Mine was 6,11 and then it dropped to 4,66. So they concluded I had no prediabetes. Ahh, this is stressing me out, haha. Nutrition wise, I actually have some pretty serious gut issues so I am on a FODMAP diet. I’m talking about my diet in detail in response to greygoose’s comment, if you’d like to have a look.
I don't know if there is a standard diagnosis for pre diabetes, to be honest. I think it is very much up to the individual doctor to decide whether his or her patient is in fact insulin resistant. To me, symptoms such as persistent weight gain, sugar cravings (and that includes all fast/high starch carbs, even the ones considered healthy), and inability to lose weight despite exercise , along with fasting glucose and insulin levels close to the upper normal limit, are all indicative of insulin resistance or pre diabetes.
You’re right, all those symptoms altogether do seem to point in the direction of either insulin resistance or ore diabetes. Also, if you don’t mind me digging deeper, you mentioned that you added beans, lentils and chickpeas in your diet, and that it seemed to help the situation. Now, I can’t digest beans (unless we’re talking about green beans) or lentils but I can have 50 grams of chickpeas per day. How did you incorporate it in your food regimen? Do you usually replace meat with chickpeas? Or do you eat them as a side dish? What does your typical lunch or dinner plate look like?
Do you have any other symptoms like insomnia, excess hair on your face but losing head hair, high blood pressure, muscle weakness? Is the weight mostly on your abdomen but you have thin legs & arms? If so then ask your Endo to look at Cushing's syndrome - it might not be, but it would be worth being tested for it.
Thank you so much for getting back to me! I have insomnia and trouble sleeping/staying asleep, I most definitely do have excess hair on my face but I am indeed losing hair on my head. I don’t have thin arms/legs, and I do have a pretty big belly. I’ve heard about Cushing’s syndrome before and I did bring it up with my doctor but they refused to test me for it. Well, other than testing my 24 h cortisol or urine and sending me to a sleep doctor to determine if I don’t have apnea or something. Both of those tests are a work in progress atm, I’ll get everything done by the end of January.
I would push for them to do more tests for you, they should do 2 or 3 24hr urines, the early morning blood cortisol, if these are high then they should do a Dexamethasone blood test.
I’ve had my early morning blood cortisol tested, it was 15,51 ug/dL OR 427,92 nmol/L (lab ranges: 6,02-18,40). Would you say it’s high? And thank you so much, again. I’ll talk to my doctor and push her to do more tests.
Hopefully, greygoose may see this post as I’m sure she lives in France, so maybe able to help with blood testing privately, and give her expert advice.
Anyway, you have Hashimoto’s which you say has been confirmed, this causes your TSH to fluctuate. You mention you are gluten free which should help with antibodies, some also find going dairy free can help as well.
Selenium can help with Hashimoto’s.
The problem you have is that you are not on enough Levothyroxine.
Our Thyroid controls everything, metabolism, mental well being everything, hence why you feel so unwell and also struggling with weight.
It doesn’t matter how much you cut back eating, in fact dieting can make things worse, it will not help, you could run a Marathon everyday and your weight wouldn’t shift. The GP that told you to diet is an idiot.
Any endo or GP that is just interested in TSH will never make you feel better. T3 is the one that makes us feel better, T4 is an inactive hormone.
Are you still taking Levothyroxine?.
The normal procedure for Levothyroxine is you start on 50mcg of Levothyroxine, I use to take mine in the morning an hour away from breakfast, you keep on 50mcg for 6 weeks, you then have a blood test, testing TSH, T3 & T4, as early in the morning as possible before 9am, don’t take your Levothyroxine or eat and only drink water.
Then you increase your Levothyroxine by 25mcg every 6 weeks and repeat the process.
You do this until your TSH reaches 1 or below and your T3 & T4 are in the upper figures of the lab ranges, and MOST importantly you feel well.
Some take Levothyroxine at night, but I always took my in the morning.
Vitamins play at very important rule in supporting the thyroid, vitamin D, B12, iron, Ferritin.
When people have Hashimoto’s there vitamins can be low, mine were.
If you can no longer obtain Levothyroxine then try NDT, but, you need to test your vitamins and perhaps look to see where your thyroid (blood test) is at the moment.
Hi Peanut31, I can’t thank you enough for your response. Nutrition wise, I actually have IBS so I have to follow a strict FODMAP diet: my body can’t tolerate most fruits and vegetables, and I absolutely can’t eat any gluten, dairy, sugar, etc. I’m not really dieting, I guess. I wouldn’t say I’m hungry. From what I was able to count just now, my diet is around 1200-1500 calories but I posted the details of my diet plan below, in a response to greygoose’s comment, if you’d like to have a look. My doctor is all about portion control, not that much about calorie counting. The standard procedure for Levothyroxine that you had described is exactly what happened: they started me on 50 mgs and then 3 months later, increased the dosage to 62,5 mgs. After that, my TSH dropped to 1,65 which my doctor seems to consider the optimal range for me. Yes, I’m still taking Levothyroxine. Usually, I take it on an empty stomach in the morning (5 am), and then I go to the gym. So my breakfast actually happens 2 or 3 hours later. NDT is apparently illegal in France. I’ve had my vitamin D and ferritin levels tested but not other vitamins/minerals. Which ones would you suggest to test?
Well it appears you have cut out a lot of foods they advise with thyroid issues.
It appears you haven’t been told the correct procedure on Levothyroxine (not your fault).
6 weeks on 50mcg then increase by a further 25mcg = 75mcg, then to 100mcg, then 125mcg and so on.
is it a typo as you said you went on 50mcg and now 62,5 of Levothyroxine and that was increased 3 months later, add 50 + 25 mcg = 75mcg, it shouldn’t be 62,5mcg.
Anyway you need to keep adding more Levothyroxine and don’t stay on that same dosage for more than 6 weeks.
Test your B12 levels.
I didn’t know NDT was illegal in France, I would try increasing your Levothyroxine and if no success I suppose the other option is adding some T3 to your T4.
Hi again, Peanut 31, and thank you for your reply. Ah, I see now. Well, I can’t increase my dosage on my own because in France, you need prescription for Levothyroxine. Only my doctor can give me that prescription, and this is not something she wants to do. So I’m stuck here. Of course, I’ll try talking to her again but I doubt I’ll have any luck in talking her into this. As for the dosage, no, it wasn’t a typo. They started me on 50 mcg, then increased the dosage juuust a little bit. I now have to split a 125 mcg Levothyroxine pill in half. It’s been a little over a year, actually, since I started taking those 62,5 mcg.
I don't think NDT Is illegal in France per se, just because it is not available in pharmacies there. It is certainly legal in Belgium where it is prescribed by several so called Hertoghe doctors, so French patients seeing a Belgian doctor should have no problems buying NDT in a Belgian pharmacy with a prescription.
I am French living in the UK. You should go and see a specialist in "médecine fonctionnelle". He/She would cover all your hormones as the imbalance with the thyroid create imbalance in the other hormones.
Your level of T3 and T4 are far too low. You definitely need to be on the upper end or even slightly above.
In the meantime, stop gluten, dairy and sugar. The 3 combine will allow you to loose weight.
Have a look at the Regenere website. It is mostly in French and it gives good ideas about food.
Thank you for your input, greatly appreciated! I don’t eat any gluten, dairy or sugar due to digestive issues. I have IBS so I have to follow a strict FODMAP diet, and I can’t tolerate most of the forementioned products, as well as most fruits and vegetables. I’ve been following this diet for over a year now, and haven’t had any significant changes in my weight. As for the medicine fonctionnelle, I’m currently looking into it. I’d love to find a good functional medicine doctor slash naturopath but haven’t had any luck so far. Hopefully I’ll be able to find someone soon!
So, what are you taking at the moment? Is it still 62.5 mcg levo? That's only really a starter dose. You probably need an increase in dose. But, doctors in France are as ignorant about hormones as they are everywhere else in the world, apparently.
Have you heard about the levo scandal in France? There is only one brand of levo available, and they changed the formula. And since then, lots of people have been complaining that they aren't doing so well on it anymore. That could have something to do with your problem.
As for 'other things', well, there's no much choice. You can get T3 prescribed in France - it's very cheap, here. But, you need to have the right doctor for that. So many of them - both GPs and endos alike - have no idea what T3 is! So, it can be difficult to get it prescribed for that reason. However, NDT is illegal in France, so don't even ask about that!
At one point, before NDT was made illegal, I found a doctor to prescribe it, and it made me worse (well, we're all different), and I put on so much weight! I went up to 130 kilos, and then just stopped weighing myself, it was too depressing. By experimenting with various things, in a long and tortuous process, I found that I was much better on T3 only, and I manage to lose a lot of weight - came down to about 75 kilos, but have since put a little back on…
So, why am I telling you that? For two reasons:
1) What I found was that my extra weight was not fat! It was water retention. I had to find that out for myself, because for a doctor any weight gain just has to be fat, and it has to be due to the patient being a lazy pig! They just cannot conceive of any other explanation. It's called 'Patient Blaming', and they do it to cover their own ignorance.
So, if the weight-gain is water, all that dieting and exercising is not going to get rid of it! In fact, it could even make the problem worse. Because you need calories to convert T4 to T3, and if you're not eating enough calories, and then using up all the calories you have eaten on exercising, then there's none left for conversion. Result: you get more hypo, and put on even more weight.
So, looking at your results, you don't seem to have a conversion problem, because your FT3 is quite a decent level - well, it would be for some people, but obviously not for you. Wouldn't be for me, either. Some people just need their FT3 higher than others. Although, I doubt you'd ever find a doctor to admit that! But, some people have what is called 'Thyroid Hormone Resistance', meaning that even though you have good levels of T3 in the blood, it just isn't getting into the cells, and you therefore remain hypo. Could be that that is your problem - plus you are under-medicated, so don't stand much chance, anyway.
2) Another thing I found is that it's not all about hormones! Nutrition also plays a huge part in it all. And, by that, I do not mean 'going on a low-calorie diet', for reasons I explained above. What I mean is that you need optimal nutrients for you body to be able to function correctly, and be able to use thyroid hormones efficiently.
So, have you had your vit D, vit B12, folate and ferritin tested? Now, I know that is difficult to obtain in France. For a country that is so obsessed with food, they are remarkably ignorant about it. (I could tell you some stories… But, I won't!)
So, it is essential that you get those four basic nutrients tested, to see if you're deficient. And, if you're on a low-calorie diet - how many calories, by the way? - then you probably are. Plus the fact that hypos often don't digest and absorb nutrients very well due to low stomach acid.
You probably won't know much about nutrients either, but just post results and ranges on here, when you get them, and people here will help.
And, then, there's the vexed question of fat! All the doctors and nutritionists/dieticians I've seen have insisted that to lose weight I need to cut out all fat. And they have no idea how dangerous that is! Plus they don't seem to understand the difference between fat and cholesterol, and tell people with raised cholesterol not to eat fat! Poor fat, so maligned. The body needs fat and low-fat diets are very dangerous for health. Plus, cutting out fat won't lower your cholesterol or your weight, so, don't do it, will you. Eat plenty of good fat - things like butter, olive oil, coconut oil, nut oils, etc. Just cut out the processed oils, like rapeseed and sunflower seed.
In conclusion, my advice to you would be to eat more and move less - quite the opposite to what any doctor or nutritionist would say, but what do they know? Unfortunately, not a lot!
First off, thank you so much for your detailed response. I greatly appreciate it. That’s great to hear you live in France, and thank you so much for explaining that NDT is illegal in France. Yes, I’ve heard of the Levothyroxine scandal. I have never had anything other that Levothyroxine prescribed to me but I guess that indeed, it might have something to do with my problem. By the way, how did you get T3 prescribed? I think my doctor will just tell me off if I bring it up.
Yes, I’m still taking those 65 mgs of Levothyroxine. Concerning being under medicated with Levothyroxine... if my dosage gets higher, doesn’t it mean my TSH will drop even lower? Isn’t it dangerous? My TSH is 1,65 as of now. As for all the other things you talked about, I actually went to a hospital for a full check up, and they performed a scan of my body to determine how much fat vs muscle I had. Turned out, it was 50/50. My doctor told me it was pretty crazy, considering I do weightlifting but can’t seem to gain muscle. That’s how we had to up my protein intake. So nutrition wise, my diet goes like this (no idea how many calories):
Breakfast: 1 portion of oatmeal + 1 fruit OR 1 portion of oatmeal + 1-2 coconut milk yoghurts.
Lunch and dinner are similar: A piece of meat, 100 grams (I mostly eat chicken fillets) + 4-6 spoons of rice/buckwheat/quinoa OR 2 potatoes + unlimited vegetables.
After lunch, I can also eat 6-8 nuts OR 1 portion of oatmeal + 1 yoghurt OR 1 portion of oatmeal + 2 squares of chocolate.
I have IBS so I have to do a FODMAP diet to help with my digestion problems. Can’t eat most fruits and vegetables, milk or dairy products, gluten, etc.
Supplements wise, I had my ferritin and Vitamin D tested. My ferritin is 53,0 ng/mL (lab reference 15-150) OR 119,1 pmol/L (33,7-337,1). My vitamin D is 16,4 ng/mL (lab reference 9,6) OR 41,00 nmol/L (24,00). My doctor said my ferritin was fine but she did prescribe me some liquid vitamin D to drink every 2-3 months for 1 year. Everything else wasn’t tested, all of my doctors simply refused to get my bloodwork done for folate, B12 and some other vitamins/minerals. I guess I’ll have to go and do them myself as in, pay out of my own pocket.
Well, I don't like the sound of your diet very much. There's not much fat in it. And I rather doubt there are enough calories.
As for the TSH, at the moment, it is too high. Once on thyroid hormone replacement, it should come down to 1 or under. No, it's not dangerous to have a low TSH. The TSH has two jobs: it stimulates the thyroid to make more hormone - which is somewhat redundant in your case - and it stimulates conversion. But, if you're taking T3, that doesn't matter. TSH has no connection with bones or hearts or anything else. And, if the TSH goes very low, it's because the pituitary senses that you don't need it anymore.
Producing muscle is not just a matter of exercise, you need optimal hormones. Human Growth Hormone, for example, and testosterone. Have you ever had either of those tested? I doubt it. But, as you're hypo, they are probably low.
How did I get T3 prescribed? First time round, I went to see an endo in The American Hospital, in Paris. I told the endo I wanted NDT. He was very scathing and made all the usual excuses not to prescribe it. But, he said I could have T3 if I wanted, and prescribed Euthyral (I forgot! that is also a possibility in France!) which is 100 T4 and 20 T3. I started to feel much better, and to lose weight.
But, fool that I was, I had set my heart on NDT - Armour, to be precise. And, I finally found a doctor in Paris that would prescribe it for me. This was before it became illegal. And, I think it was the worst thing I have ever done in my life, as far as my health is concerned!
So, long story short - and it is a long story! - the second time I wanted T3 prescribed, some 5 to 10 years later - can't remember exactly - I went to a new doctor and just said 'I'm hypo and I take T3 only'. He didn't know what T3 was, and the most 'hilarious' dialogue ensued! But, he finally agree - possibly just because he didn't know what it was! But, he's retired, now, and I cannot be bothered to break in another new doctor - even supposing I could find one! - so, I'm going it alone, now.
I don't understand the purpose of your scan. How does it help you knowing that you have equal amounts of fat and muscle? It doesn't give you any idea what each weigh, so how is that helpful? What about water? How much of that do you have? Because water is heavy! When I was pregnant for the second time, my legs swelled up something rotten! And the midwife reckoned that I had about half a stone of water on each leg! Can you imagine? Doctors didn't understand that, just told me I was putting on 'too much weight', concluding that it had to be fat, and I was a greedy, lazy pig. Doesn't your nutritionist have one of those scales that measure how much bone, how much fat, how much muscle and how much water in your body?
As for your IBS, that could very well be down to your under-treated hypo! IBS is a hypo symptom.
Forgot to say, your ferritin is too low! It should be at least mid-range, if not higher. So, is your vit D, but what your doctor is giving you will not help much. It's not enough.
Which fats would you suggest to add? My body can’t tolerate avocados or cheese, at all. I do add a bit of feta cheese to my rice or salad. In your opinion, what else could I add to my diet? I’m very open to suggestions. It’s just I can’t digest a lot of things though.
Thank you so, so much for explaining how TSH works. I’ll have it tested in about 2-3 weeks, I’m wondering if it’s still 1,65 or perhaps, it went down a tad.
I’ve had my testosterone tested by my gynecologist. It was 0,23 ng/mL (lab ranges: 0,084-0,481) OR 0,80 nmol/L. I have no idea what that means. They also had my sulfate de DHEA, prolactine, FSH Sérique, L.H., lestradiol and progesterone, along with some other hormones, tested. However, HGH was definitely NOT tested. I shall Google some articles on HGH and how it affects the muscle gain, I don’t think I completely understand this issue for now as I haven’t read anything about it before.
By the way, how are you getting T3 if you don’t have a prescription, then? Do you just buy it in your local pharmacy? I thought prescription was a must. As for that body scan, it was done with an iDXA machine. The machine emits a very low dose of X-ray that is picked up by the scanner and translated in to data about bone, body tissue and fat. I don’t know the details though. I had this body composition scan done in late September, and the hospital hasn’t sent me a detailed report yet. So yeah, no idea how much water I have... After hearing your story about water gain during pregnancy, I really am wondering... The nutritionist I saw was attached to the hospital so she had no scales of that sort, they prefer to perform a body composition scan.
Also, that’s really crazy your doctor had no idea what T3 was. Oh, the ignorance!
Good fats? Butter, olive oil, nut oils - hazelnut nut oil in a salade is to die for! Coconut oil (if you like it!), lard, dripping, any animal fat, really. Avoid processed seed oils, like rapeseed.
Getting T3 has become a sore point, recently. No, I can't just go into a pharmacy and buy it, it is prescription only. There used to be lots of sources, but they're drying up, one by one. It's a problem, and I don't know what the future holds. But, if I can't get hold of T3, I might just as well curl up and…
Yes, I do know what a body scan is like. Perhaps fuller details will be on the report, when you get it. Funny thing is, when I had mine, I got the results straight away, as far as I remember.
If you want to know if what you have is fat or water retention (mucin, to give it its correct name) try the pinch test:
Hazelnut oil sounds yummy indeed! Thank you, I’ll give it a try. I already add a little bit of olive oil to my salad, and I also use 1 teaspoon of olive oil per chicken fillet. Do you think that’s enough or should I add more oils to my diet? Also, I’m kind of like the lady in a video. I can’t reallt pinch my skin the way her husband can. I can still pinch the skin on my jiggly inner arm part though. I can’t seem to pinch the skin on my leg either... Also, I’m so sorry to hear about the T3 struggle... I hope my doctor will give me a prescription then.
So, if you can't pinch your skin up, it's not fat, it's mucin - a mucousy substance under the skin that attracts and holds water, and which is found in abundance in hypos. The only place on my body where I can pinch up the skin is on the backs of my hands!
I don't think a little more oil/fat would go amiss. It's fat that stops you getting hungry - and it's what gives food flavour, so Mother Nature obviously meant for us to consume it. Oh, and how about salt? They didn't tell you to cut out salt, did they? Adrenals need salt, and struggling adrenals need more salt.
Dear greygoose, thank you so much for your patience and your detailed explanations! I guess my weight is water weight indeed. I hope that balancing out my T4 and T3 will solve the problem, and I’ll make sure to add more oils to my diet. So surprised to hear that about the salt! I have actually been salt free for at least 5 years now but I did that entirely on my own. Now that you’ve told me adrenals need salt, I’ll slowly introduce it back to my food.
Cutting out salt is a sure-fire way to retain water. The body needs salt, so it hangs on to what little it can find. Therefore it has to retain water, because when the water goes, the salt goes with it.
I’m so glad I decided to post on this forum! Honestly, I had no idea I’d get so many valuable pieces of advice and information. Really, I can’t thank you enough.
P.S. Greygoose, could you please recommend me some supplements for thyroid health sold in France? Or do you order yours from somewhere? I’m thinking about placing an order from the iherb website but decided to wait, in case you have advice here. Of course, we do have Solgar in France but are there any French supplements brands that you fancy?
I had my ferritin and Vitamin D tested. My ferritin is 53,0 ng/mL (lab reference 15-150) OR 119,1 pmol/L (33,7-337,1). My vitamin D is 16,4 ng/mL OR 41,00 nmol/L. My doctor said my ferritin was fine but she did prescribe me some liquid vitamin D (an ampule of 100 000 UI), to drink every 3 months for 1 year. Everything else wasn’t tested, all of my doctors simply refused to get my bloodwork done for folate, B12 and some other vitamins/minerals.
Ferritin is slightly low. Eating liver or liver pate once a week should help improve. Or other iron rich foods plus vitamin C or orange juice to improve iron absorption
As you can't get B12 or folate tested.....two options
Private testing - greygoose may know of French options
Or simply supplement. B vitamins are water soluble so we just pee out excess
Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial. B vitamins best taken in the morning after breakfast
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
Greygoose doesn't know any options for private testing in France. I've never found any. I just know that some labs will do tests your doctor won't do, if you offer to pay for them. But, they won't do many at a time. And some labs refuse out-right.
I can’t thank you enough for sharing the articles/links! Thank you, thank you, thank you. Those New NHS England Liothyronine guidelines are spot on. My doctor speaks perfect English so I’ll make sure to print it and show it to her. Have you got any articles where a medical professional talks about the facts that FT4 must be in top third of range and FT3 at least half way in range? I could print those for my doctor as well. Now, on to my vitamin deficiency...
Vitamin D: I was prescribed liquid vitamin D of 100 000 UI, to take every 15 days during 6 weeks, and after that, every 3 months for 1 year. I started taking it in August 2018, had my levels retested in late September in a hospital but I still don’t have my results back. I believe they tested vitamin K as well.
Strangely enough, my calcium levels seem to be quite high, in spite Vitamin D deficiency: 97,5 mg/L (lab references: 86-100) OR 2,44 mmol/L (2,15-2,50).
Overall, I regularly supplement with a multivitamin, coenzyme Q10, vitamin D, magnesium. I have recently stopped taking my multivitamin and started taking Solgar’s Advanced Antioxidant Formula. I haven’t supplemented Vitamin B12 but I’ll get my levels tested. I’m willing to pay out of my own pocket. Hopefully, the lab will agree.
multivitamins are not usually recommended on here. Too little of what we do need plus stuff we don't want. Eg iodine is best avoided unless tested as deficient. With Hashimoto's most experts recommend avoiding all iodine
Calcium levels rise as vitamin D increases. Hence why many functional medics recommend vitamin K2 Mk7
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
I see. Are antioxidants best avoided as well then? Or are they okay to take from time to time? As for calcium, my levels remain pretty high in spite severe vitamin D deficiency. Again, thank you SO much. I’ll email Dionne later today!
Thank you for your response! I haven’t heard of Izabella Wentz but if her protocol is just like any other autoimmune paleo protocol posted on the Internet, then my diet is very similar. I don’t eat any gluten, dairy or sugar due to digestive issues. I have IBS so I have to follow a strict FODMAP diet, and I can’t tolerate most of the forementioned products, as well as most fruits and vegetables. I’ve been following this diet for over a year now, and haven’t had any significant changes in my weight.
Yes, it is AIP. However, if you're on FODMAP, that suggests you have gut issues too?
The most important thing is that you need to heal your gut. You won't lose weight unless you address any nutritional deficiencies, and get your meds right as well. I think vitamin D deficiency can prevent you from losing weight, so that's one to look at.
Yes, I have irritable bowel syndrome (IBS). Strangest thing is, every time I take vitamin D, I seem to feel better. But that doesn’t last long, Le sigh. I was prescribed a liquid vitamin D ampule of 100 000 UI, to take every 3 months for a year. I haven’t tested my other vitamin deficiencies as my doctor simply refused to test them but I’ll do it ASAP. Thank you again!
There are different types of probiotic, so make sure to try different ones there's lactobacillus, acidophilus and sacromyces boulardi. I think sacromyces boulardi is meant to be very good at firming things up!
Another thing you can do is to eat resistant starch, which is really good for improving the good bacteria you already have. You can do this by cooling things like pasta and potatoes, and reheating them.
You might benefit from seeing a nutritionist if it's something you're open to?
Thank you for your reply. Yep, I’ve tried all of those probiotics, all of them seem to make things worse for me. I’ve seen a nutritionist already, that’s how I had FODMAP prescribed to me. It seems to work quite well, except for when I’m stressed or anxious. Which happens quite often, to be honest, In that case, no matter what I eat, nothin seems to firm things up, haha.
Sorry to hear that our guts are really confusing sometimes! I guess if probiotics are a no go, then stick to resistant starch - if you have Netflix, there was a really good show on gut bacteria/resistant starch - it's "Ask the doctor" episode 9.
With IBS and Candida no probiotics it makes it worse you are right. I take Euthyral and separate T3. I got it prescribed by a doctor in Belgium and buy it in France. I chose this doctor after long research and he has given me back my health. I am still overweight for my seize but nothing in comparison with what you describe. If you are interested to know I can give you his reference privately. He is becoming very famous due to huge success.
Is it the same doctor who wrote a book on reversing the signs of physical ageing and charges obscene amount of money for his consultations? If not, please do give me the reference privately, I’d greatly appreciate it.
I don't know who you are talking about. The one I see I pay privately as the NHS is not about to pay abroad for something it doesn't want to pay for here. But life is a choice.
I have gut candida, and had IBS, and have been working on them for the last year with probiotics... Where did you hear not to treat them with probiotics?
Because the flora in the guts has gone crazy and probotiocs develop the flora even further while we are trying to get rid of most of it to go back to the right balance. Hence probotiocs is not recommended.
I am also working on the same and was advised to take probiotics by my functional medical practitioner, so would also like to understand this, please would you mind passing on any info you find out, I would really appreciate
I am! My IBS has improved a little bit when I went gluten free (well, the FODMAP diet) but it's not completely gone. I feel like it's stress related...
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