150g Levo and cannot lose weight - do i need ot... - Thyroid UK

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150g Levo and cannot lose weight - do i need other meds?

joayres
joayres

Hi

Typical hypo person, have many symptoms which i can manage but the weight issue is my biggest. Im vegan, work out 6 days a week and cannot lose weight or build muscle. Ive been doing this for 2 years now.

Meds:

150 g Levothyroxine daily and I supplement with •Vit C, B12, D, Iodine & Selenium, Omega 3 (vegan)

My blood tests results are:

TSH - 0.39 | T4 - 16 | fT3 - 5.5

FSH - 5.1 (he thinks it's menopause - Im 45 years old)

I have my doc appointment later today - any advice would be greatly appreciated. Im doing all the right things I think and seeing no results at all.

Do you think T3 meds would help?

Thanks in advance.

19 Replies
oldestnewest

Hi your bloods look good. Look at sex hormones - low estrogen will cause weight gain along with low testosterone. T levels should be at least half way. Progesterone (natural) is also importnat in equation and its usually when this declines in perimenopause that thyroid plays up. Progesterone increases our basal body temp mid cycle because of its positive effects on thyroid. T decreases TBG causing less binding of thyroid hormones.

Testsing should be on day 21 if you have a 28 day cycle do all tests on same day to get an accurate snapshot. Tests should include

Shbg

Fsh

LH

E2

P4

Testosterone

Tbg

Rt3

I assume you have had bsl and cortisol as these can cause weight issues also.

Good luck

Kittysmum
Kittysmum in reply to Kittysmum

Sorry typo. Testosterone drops our thyroid binding globulin and estrigen increases this. If hrt is recommended best to go transdermal if tou have a thyroid issue this way your Shbg will not be pushed up by oral estrogen.

joayres
joayres in reply to Kittysmum

Had to beg just for the basic tests - so will ask for these ones as well. Thank you for your advice.

Kitten1978
Kitten1978 in reply to Kittysmum

"low estrogen will cause weight gain"

Wrong: high estrogen, in relation to progesterone, causes weight gain. So called estrogen-domiance syndrome - see Dr Lee books. Farm animals are given estogens so that they put on weight quicker...

In fact there are several studies showing that low estrogen levels in menopausal women were the likely cause of weight gain; and as I understand it, oestrogen dominance is about not having enough progesterone to counterbalance the oestrogen, whatever their respective levels ie not that oestrogen is high per se, it could even presumably, be low but higher than the progesterone.

However it isn't as straight forward as arguing simplistically if high or low levels of oestrogen do X or Y, weight-wise. For instance, Insulin and cortisol have far greater impacts on fat metabolism compared to estrogen and progesterone, hence why increasing levels with hormone replacement therapy does not suddenly result in weight loss, because the stronger effects of insulin and cortisol can counteract the positive effects of estrogen. In terms of the bigger picture, one meta analysis - Estrogen Deficiency and the Origin of Obesity during Menopause - looks at the very complex detail of oestrogen functioning and its' inter-connectivity with many other factors including at genetic and epigenetic level and in terms of critical brain sites.

It's the balance that's important.

We don't know whether Joayres is post-menopausal. Her gp thinks she might be - we all know how incompetent gp's are in the area of female hormones... She is only 45 - it's a bit early to be post-menopausal. Peri-menopause is more likely or, as Dr lee called it, pre-menopause. It can start years before menopause. In pre-menopause estrogen and progesterone levels fall BUT progesterone falls more quickly than estogen.....(or estrogens to be more precise). In addition, hypothyridism can lead to estrogen dominance (one can also wonder whether the reverse situation could also be true: estrogen dominance leading to hypothyroidism). If we add the impact of estrogen-like substances in our environment (hormones in meat and diary products, chemicals ect.) we are all more likely to experience excess estrogen in relation to progesterone, rather than low estrogen.

Which studies are you referring to? Even if they indicated the correlation between low estrogen and excess weight that would not mean that the low estrogen was the cause of participants' weight gain. Correlation does not imply causal relationship. I wouldn't imagine anybody would ever receive an acceptance of ethics committee for carrying out experimetal studies on menopausal women (I hope!). The one reference you provided focuses sorely on estogens. Post-menopausal women would have very low progesterone and it's the balance between estrogens, especially estradiol, and progesterone that is crucial.

I don't mean to be mean but the summary of the article talks about "nervous systemn", instead of "nervous system". If the authors couldn't have been bothered to get the spelling right one wonders what else they got wrong. The fact that something was published doesn't mean that it has any value.

I had a chat with my endo about thyroid hormones and female sex hormones. He admitted that probably there was a relationship (over 90% of hypothyroid patients are women) but they (=medics) didn't know what the nature of this relationship was. Endos specialise either in thyroid & adrenal issues OR sex hormones OR diabetes. It's scary how little they know about anything that lies outside their speciality.

Neither do we know that the OP isn't menopausal; but whether she is or isn't was not in debate. My post was written solely in response to your assertion that Kittysmum was wrong, in order to offer a different perspective. I didn't provide detail about the studies to which I made reference, as you likewise didn't, when alluding to "Dr Lee books" - which Dr Lee, and which books - so I intentionally matched generality with generality. Whether you judge the quality of someone's work by a single spelling mistake, when the abstract could presumably have been re-typed and spell checked by an independent third party working for PubMed, is entirely your choice. However, in your first post you wrote "Estrogen domiance" and "Farm animals are given estogen"; and in your recent post, "focuses sorely on estogens", demonstrating how easily these errors can arise; but by your own yardstick, might give a reader cause to wonder perhaps, 'if you couldn't have been bothered to get the spelling right, what else have you got wrong'. Regarding your comment that "The one reference you provided focuses sorely on estogens (sic)", well yes, intentionally so, given that I was commenting on the low estrogen / high estrogen makes you fat debate. However, the meta analysis demonstrated that there is more/other aspects to the involvement of estrogens in obesity, than a simple quantitative relationship with progesterone.

SlowDragon
SlowDragonAdministrator

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

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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)

Is this how you do your tests?

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

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

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.

If you have Hashimoto's then iodine is NOT recommended

drknews.com/iodine-and-hash...

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

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

All four vitamins need to be OPTIMAL before even considering T3

Essential to know if cause is autoimmune thyroid disease, if it is often we need to be strictly gluten free as well

TSH around one, FT4 in top third of range and FT3 at least half way in range

Come back with new post once you get new results and ranges

joayres
joayres in reply to SlowDragon

WOW! 🤩 This is amazing info - I am Hashimoto, soy and gluten free.

Im going to look into all these links - thank you so so much!

SlowDragon
SlowDragonAdministrator in reply to joayres

Good to hear you're aware of diet issues

Did you find gluten free has helped?

Soya lecithin is hidden in loads of things, best avoided if possible

joayres
joayres in reply to SlowDragon

Gluten free definitely helps.

SeasideSusie
SeasideSusieAdministrator

joayres

Do you think T3 meds would help?

Without you giving us the reference ranges for FT4 and FT3, as well as the results, no-one can tell you that. We need to see where your results lie within their ranges so that we can see how well, or not, you convert T4 to T3. That will tell us if you would benefit from the addition of T3.

work out 6 days a week

That wont be helping. Hard exercise depletes the body of T3. You need to know that you have a good FT3 level and convert well enough otherwise this type of exercise will make things worse. Gentle exercise for now, until you know how well you convert and if you have a good level of FT3.

joayres
joayres in reply to SeasideSusie

How do you know if you are converting well?

Thanks for your advice will def take onboard.

SeasideSusie
SeasideSusieAdministrator in reply to joayres

How do you know if you are converting well?

You look at your FT4 and FT3 results, tested at the same time. If FT4 is high in range and FT3 low in range, you don't convert well. If they are reasonably well balanced within their ranges (eg both about the same percentage through their ranges) then you convert well.

SlowDragon
SlowDragonAdministrator in reply to joayres

Do you have the ranges on your FT3 and FT4 results?

SlowDragon
SlowDragonAdministrator

You need vitamins tested. Ask GP or endocrinologist to test

joayres,

I know it's going to sound really boooooring as it gets mentioned on this forum so often: have you considered some sort of iron issue? Being vegan would make you more prone to having problems with low iron or low ferritin. I've been reading about the relationship between suboptimal iron, suboptimal ferritin, low hemoglobin (not necessarily all at the same time) weight gain, and hypothyroidism. I actually logged in today to post the following articles:

restartmed.com/low-ferritin/

wellnessresources.com/news/...

joayres
joayres in reply to Kitten1978

Really interesting read, mine was 23 ug/L - so apparently OK but this was a couple of years ago I should probably get it re-checked again.

Thanks for this information - so valuable. :)

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