Weight gain since taking levothyroxine

[Essexlil]

When I was diagnosed with Hashimotos two years ago I hadn't gained any weight. I was started on 25mcg Teva Levothyroxine, gradually increased to 50 the 75 mcg. My GP says I'm slightly overmedicated, but not enough to alter dose. My problem is that, although I feel a lot better, I have gained 10 lbs in weight since being on medication and I find it very difficult to even loose 1lb. I thought being slightly overmedicated would help me loose weight, but just the same. I've thrown away so many of my clothes which no longer fit - it's very depressing, can anyone advise me why this has happened please

[SlowDragon Administrator]

First thing is, do you have any actual blood test results? if not will need to get hold of copies. You are legally entitled to printed copies of your blood test results and ranges.

Likely GP is only testing TsH and FT4 Which is completely inadequate

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 tested. Also extremely important to test vitamin D, folate, ferritin and B12

As you have Hashimoto's Low vitamin levels are extremely common

What vitamin supplements do you currently take?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

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

Link about thyroid blood tests

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

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

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

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet




(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

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

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

restartmed.com/hashimotos-g...

healthcentral.com/article/t...

Other gut issues due to being hypothyroid

healthunlocked.com/thyroidu...

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

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...

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

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

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

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

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 or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.

[Essexlil in reply to SlowDragon]

Hi, thank you very much for our reply. I hope you'll be able to look at my blood results for me, taken June, 2019:

vit D3 level 63.1 nmol/L (adequate range)

Serum TSH 0.08 miu/L

Serum free T4 level 19.8 pmol/L

Serum ferritin - stable no changes required 272 ng/mL

Serum vitamin B12 267 pg/mL

I can't find a result for folate - does it have another name sometimes? FT3 wasn't tested

I'm 63 and have annual blood tests in connection with Sjogrens Syndrome which I also suffer from. Mt GP is very good an it was her in 2016 who tested for thyroid and diagnosed me. I don't think I'd been well with Hashimotos for many years but my previous GP wasn't as thorough with blood tests and I put my symptoms down to Sjogrens Syndrome, which I've had for over 20 years.

I've got to have another thyroid test in 3 months as lab states, 'slightly over replaced but continue with current dose and re-check in 3 months'

On the day of the blood test I took my levothyroxine at 6am and eat breakfast as I always do, 30 mins later.

I was given many different brands of levothyroxine early on and for some reason I felt better on Teva and asked for it on a regular basis. I'm not lactose intolerant. Now I'm a bit worried as it doesn't seem to be recommended.

Thank you once again for your help, I hope you can throw some light on the tests for me.

[SlowDragon Administrator in reply to Essexlil]

Teva is a marmite brand as many can’t stand it, but many love it, especially if lactose intolerant

Vitamin B12 - assuming this is standard serum test by NHS

(Not a private active B12 test)

Range on serum B12 is typically 210-780

A result under 500 can be enough to cause low B12 symptoms

You may benefit from a good quality daily vitamin B complex- eg Igennus super B

If taking any supplements that contain biotin (most Vitamin B complex) remember to stop any b come supplements a week before any blood test as biotin can falsely affect test results

Vitamin D is too low. But not low enough for GP to prescribe

Self supplementing with vitamin D mouth spray by Better you to bring levels up to around 80nmol or around 100nmol May be better

Always get all thyroid blood tests as early as possible in morning and fasting and last dose levothyroxine should be 24 hours prior to test

As recommended by NHS guidelines

Strongly suspect you would have low FT3 if tested

Would recommend getting private testing 6-8 weeks after starting vitamin supplements

[Essexlil in reply to SlowDragon]

Hi, thank you very much - I'm going to get both supplements you've suggested and will get FT3 tested 6-8 weeks after. My mum suffered Hashimotos and was never well, tried Armour too. I wonder if we may both have conversion problems. If FT3 is low do you think I should have the genetic conversion problem test?

Your help is really appreciated

[SlowDragon Administrator in reply to Essexlil]

Only start one supplement at a time and wait at least ten days to assess before adding another

Suggest you get FULL Thyroid and vitamin testing 6-8 weeks after adding vitamin D and a good vitamin B complex

Vitamin D

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Vitamin D mouth spray by Better You is good as avoids poor gut function.




It's trial and error what dose each person needs. Frequently with Hashimoto's we need higher dose than average

B Complex

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Come back with new post once you get results and ranges

If FT3 remains low once TSH is low and Ft4 near top of range, and all vitamins optimal.....then it may be time to consider DIO2 gene test

Many of us who eventually got prescribed T3, turn out to have this relatively common gene variation

DIO2 gene test is only available on NHS in Kent. Everyone else has to get tested privately

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

[Essexlil in reply to SlowDragon]

Hi, thanks for all of your help and I'll follow all your advice