Hello I was diagnosed with an underactive thyroid in October 2018. I also have insulin resistance. I'm overweight and trying to lose weight. One of my biggest issues (which lead to being told I have insulin resistance) is constant hunger. I take metformin which has helped to reduce my blood sugar and very occasionally my hunger.
My blood sugars are getting near normal so I'd hoped that would deal with the hunger but it hasn't. So I'm now thinking about how my thyroid might be having an impact. This hunger isn't just I would like some good it's a knawing feed me now hunger.
My last TSH was 4.25 and my levothyroxine was upped to 100mg. This was just on Friday. Does anyone else have experience of being really hungry with an underactive thyroid? If so is there a way to deal with it? It's just so depressing.
Thanks
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"Thyroid hormones are known to effect metabolic rate. Thyroid dysfunction can have clinically significant consequences on appetite and body weight. Hypothyroidism classically causes reduced basal energy expenditure [2] with weight gain [3, 4]. "
Don't try to diet yet - until your TSH is 1 or lower and FT4 and FT3 in the upper part of the ranges.
Many people, before being diagnosed, gain weight and don't realise it's due to being hypothyroid. Once they are diagnosed and given levothyroxine (T4) doses are gradually increased until the TSH is 1 or lower and Free T4 and Free T3 should be in the upper part of the ranges. The latter two are rarely tested but, if you wish, you can get these privately through one of the recommended labs who do home 'pin-prick' finger tests. If you decide, make sure you are well-hydrated a couple of days before blood draw.
Levothyroxine is also known for causing weight gain if the dose isn't high enough. Many doctors, when TSH is somewhere in the 'range' stop increasing dose. The aim should be TSH of 1 or lower and FT4 and FT3 in the upper part of the ranges.
If you're hungry, eat. Hunger is a way of telling you you need more food/calories. And you need more calories in order to use your thyroid hormones correctly. You need calories to convert T4 to T3. Have you had your FT4 and FT3 tested?
Bloods should be retested 6-8 weeks after your dose increase in Levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
Have you had antibodies and vitamins tested? If not, request GP does so
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).
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.
Is there a reason you don't just eat when you're hungry? Are you saying that no matter how much you eat the hunger is still there?
I have definitely had different patterns of hunger since I've been hypothyroid. For some of the time the problem was not feeling hungry and I struggled to eat. At other times I didn't feel the sensation I used to think of as hunger, and the only way I'd tell I needed to eat is the other feelings that come later like nausea, sore tummy, feeling confused and tired, etc. A strange thing I noticed was that even though I didn't feel motivated to eat very much, if a big meal was put in front of me I could eat and eat and didn't seem to feel full up when others did.
As I've got onto a better thyroid dose, I do sometimes feel much more hungry. But it's very variable, and more that I will suddenly be starving for no reason I can see. Definitely not every day, only a couple of times a month. Because I currently take my thyroid hormone in 3 doses per day, a lot of the time I'm not able to eat, and I have my meals at specific times. Since I've been doing this I've been surprised that I'm much less troubled by hungriness at strange times.
I've just seen that your TSH has recently been 4.25. This is very high and indicates you are quite undermedicated. I expect you'll need at least one more dose increase after this one. Make sure you get retested in 6 weeks or so and have another adjustment.
Being as undermedicated as this means you would expect to be quite symptomatic and it could be all kinds of strange things. I'd say the first thing to try to deal with the hunger is to get your thyroid dose optimal, which will take a few months. Thyroid hormone is not one size fits all, we need to be on the exact right dose for each individual person, which can take several increases and adjustments.
TSH is not a very good way to monitor your thyroid status. It's only useful at all at this point because it's obviously too high, but once you start closing in on your optimal dose you'll need to see freeT4 and freeT3 as well. If your doctor won't do these you can order finger prick mail order tests, the ThyroidUK website gives more information. Unless you're on a tight budget get vitamins as well, because being hypo trashes these: ferritin, folate, vit D, vit B12.
If you're worried about gaining weight by eating, ironically when we're hypothyroid restricting food can cause weight gain, because sufficient calories and food are needed to make full use of thyroid hormone. You might find if you eat a bit more it will keep your weight down. Weight gain is a very typical hypothyroid symptom, and if you are lucky it will reduce once your dose is optimal.
I get suddenly very hungry - like low blood sugar, wobbly, “hangry”.... i try and eat sensibly, and carry healthy snacks in case.
I try and ignore it, late evening, and tyat’s ok. (I take my thyroid tablet at night, so need empty stomach.)
I’ve been advised by a nutritionist to eat a breakfast early, and then a good early lunch as well. Plus decent snack at 3/4pm to see me through to dinner. (One prob i have is i hate cooking, and deciding on and cooking dinner is tricky when i’m hungry/hangry!! But have an 8yr old so have to push through! (Often by snacking at 6, as i psyche self up to cooking!)
Good luck. Sorry its slow going and frustrating. Have come on today for that very reason!! Sick & tired of feeling sick & tired!
Well done on tackling your blood sugars. So ‘insulin resistance’ is that another way of saying pre diabetes?
If you are keeping to an extremely low carb diet then for now I would just stuff myself with fats and proteins. A low carb diet is the best for getting control of blood sugars. You are very under medicated with a high TSH so I’m glad youve got an increase in Levo. I’ve just got low carb again after a few months of splurging. It’s killing me!! 😬 I’m not one for eating the usual carb foods (pasta, breads ect) but I do love my wine! And I’ve been enjoying rice and some gluten free breads at least once/twice a week. But I had been really ill for a long time and had no appetite for food. I could go all day til 6 and then eat, I’d feel so stuffed it was uncomfortable and yet I put on 2stone 😬 So when I did get adequately medicated it was just so lush to enjoy food again. Now however I’ve still a stone to loose and so now I have to behave myself. ITS.JUST.NO.GODDAMN.FUN 😩
So there you have it, eating, not eating, it just doesn’t seem to matter when one is under medicated.
And with regards to cooking. Can you get yourself a meal planner? I sit down for a good hour on Mondays,,work out my meals for the week and then order my home delivery for Tuesdays. Going to the shops became such an effort and even now that I’m well I could t go back to doing the big shop myself. Although I do go get some of the fruits and veg myself because the pickers and I seem to have different ideas on size and quality of some the fresh produce 😩
When you’re unwell you can’t think straight enough to cook, there’s no inspiration. Give me a shout if you want any ideas for low carb meals. I’ve got it nailed after 5/6yrs
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