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Thyroid UK
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Gastreetomy Sleeve Surgery

I have UNDERACTIVE THYROID which I take 200mg per day of Thyroxine and I also have DIABETES which I take 2000 mg per day.

I weigh nearly 15 stone and my BMI over 45, I'm struggling losing weight and considering Gastric Sleeve Surgery , with these health issues can anyone advise if surgery is an option.

Thanks in advance.

11 Replies


If you are taking 200mcg Levo per day and still cannot lose weight, it would appear that for some reason your Levo isn't working. This could be an absorption problem, it could be a problem converting T4 to T3.

If you would like to post your test results, including reference ranges, members can help. For a full picture we need to see




Thyroid antibodies

and because optimal nutrient levels are essential for thyroid hormone to work properly you also need

Vit D




I have no experience of gastric surgery, but from what I have read I believe it brings problems of it's own and probably best avoided. Let's see if we can help with your thyroid first :)


Welcome to ou forum, and I am sorry you have hypothyroidism and also that you are considering having a gastric by-pass.

Your weight gain - very common in hypothyoid patients - and I believe it is due to the fact that patients are not prescribed a replacement dose which allows their metabolism to rise.

First thing you must do is to get a Full Thyroid Blood Test and it is as follows:- GP will not do all of these but the one he wont/or cannot do you can get privately as we have some recommended labs which will do them.

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 levothyroxine (I assume) and the test and take afterwards.

Weight gain is the commonest query on the forum and the most upsetting for many people. Especially when the medical professionals tell us that it is due to what we are eating that is the cause, when it is actually too low a dose of thyroid hormones and maybe levothyroxine (alone instead of a T4/T3 combination). T3 is difficult to get prescribed recently as the pharma company raised the price exorbitantly and it is now before the House of Lords as many had it withdrawn instantly, without any warning and difficulty in sourcing privately.

Levothyroxine when not on an optimum dose can cause weight gain as it doesn't raise our metabolism sufficiently. I doubt doctors are aware of this. Many do better when on a combination of T4/T3 (T3 impossible at present in the UK). There is also a 'natural dessicated thyroid hormone' which also used to be prescribed and also withdrawn, leaving levothyroxine the only replacement.

You need to have tested and if GP wont do all, there are several private labs which will do them and they are home pin-prick finger tests. Make sure you are well-hydrated a couple of days before blood draw and that arms/hands are warm:

You need TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. Also B12, Vit D, iron, ferritin and folate.

There should be no problems in getting all of the thyroid ones, except the FT4 and FT3 but the others should also be taken by the doctor.

You are looking for a TSH of 1 or lower and a FT4 and FT3 in the upper part of the ranges. If you have antibodies, going gluten-free can help reduce them as they attack the thyroid gland and wax and wane until you're hypo. It is called an Autoimmune Thyroid Dease or Hashimoto's. Treatment is the same.

Always get a print-out of your results with the ranges and put them on a new post for comments.


An optimum dose of thyroid hormones should enable your weight to reduce. Doctors usually keep the TSH 'somewhere' in the range - even the top when the aim is 1 or lower.


Getting vitamins tested and optimal is likely essential

Assuming you have autoimmune thyroid disease also called Hashimoto's diagnosed by high thyroid antibodies.

Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise

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.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes 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






Getting FULL Thyroid and vitamin testing is the first step or copies of any recent blood test results

You are legally entitled to printed copies of your blood test results and ranges.

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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


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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random


The first thing is consider is that your thyroid hormone may not be optimal. Altho sometimes people don't lose the weight, for a lot of people the weight just comes off automatically once they get to a decent dose.

Having additional surgery sounds excessively dangerous. I'm a couple of stone heavier than you, but I've had add really rough ride with my thyroid and am far from being well, I've come to accept it as just one more part of the stupid illness. I don't feel bad about it because I know it's not my fault.

When we're hypo we also get the problem that we need calories to make the thyroid hormone work and keep our metabolism up. So restricting can make things worse by making is more hypo again, and a hypo symptom is gaining weight. We don't have the freedom healthy people have to diet and lose weight in a simple way.


Yes its very frustrating, if you reduce calories it makes things worse and if you eat normal you gain, I am on thyroid S and still cant lose, I have started doing plates at home as cant see how thyroid can intetfere with slimming down that way x


You need FULL Thyroid and vitamin testing. Levels all need to be optimal

If you have Hashimoto's then often strictly gluten free diet helps

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Sorry meant pilates

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Hi yes agree all my results were good, stress caused my thyroid to go wrong, so possibly something as well thats not working right, I need to save up to get tests done that doctor wont do x


I hope you're not taking 200 mgs of thyroxine a day or you would be dead. I think you mean mcgs which is doable.


You are, of course, quite right. I hoped it was a simple typo!

In case the units are not clear, have a read of this:


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As the others have said, gluten free seems to be a good idea for hypothyroid. I don’t know a lot about diabetes but have you had to keep increasing insulin to keep your sugars in check (I’m assuming you’re on insulin?)? If so then you could try a low carb type diet (easier when gluten free anyway). You should watch ‘The Magic Pill’ on Netflix if you can. Some pretty amazing results from changing diet.


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