Trying to get my tsh ft4 etc all in range after a levo increase, levels now worse on levo than pre treatment 4 years back. My GP insists on a 3 month gap between raises though and I think I probably need another couple of rises of 25mg on top of this one to get back in range, not even optimally.
My question is, my weight has always been pretty stable but gone up by a stone this year. In peoples experience what does your tsh/ft4/ft3 need to get to, to start losing weight without too much trouble? I’m on weight watchers but not losing weight, sigh!
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Sarah5-5
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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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
Do you have Hashimoto's?
Are you on strictly gluten free diet?
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood 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)
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
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Watching the post every day for my medicheck full thyroid plus tests to come through. I wasn’t comfortable waiting 3 months 🙄. I’ll post as soon as I have them. Thanks for your reply again!! Do you know if other people have started losing weight naturally once their thyroid results were better, and do these have to be in the optimal part of the ranges, almost hyper before weight loss occurs? I’ve always managed to lose weight dieting and walking before now it seems impossible! Really depressing! TSH is over my labs range at 4.51 and ft4 is under at 10.8, on 100mg levo x
Thanks again you are an oracle on thyroids!!! Weight gain sucks and diets coming up to Christmas do too!! Had my antibodies tested in 2015 and they were fine then. So does that mean secondary hypothyroidism and there’s something going on with pituitary glands if it’s not Hashimotos? Confusing! Early menapause not helping too though ironically I thought my thyroid was under control and bc all of these symptoms was the big M! 🙄
So does that mean secondary hypothyroidism and there’s something going on with pituitary glands if it’s not Hashimotos?
No, it doesn't. There are many reasons for having primary hypo apart from Hashi's. It could be caused by injury to the gland, or by endocrine disruptors, or low iodine (although that's rare in this part of the world), or various other things.
Do you remember what your TSH was when you were diagnosed?
HI Greygoose I am getting severe headaches daily and was wondering is it connected to the illness, My Thyroid has now stopped functioning., so my Endo has told me from the ultrasound that I have had.
Also what should our ranges be, I keep being told so many different things especialy from my Consultant.
Thank you for all the support, I would be truly lost without you guys.
Headaches can be a symptom of hypo, yes. But, if they're really severe, you ought to get it checked out, because they can be caused by so many things. But, if your thyroid has stopped working (not sure he can be certain about that just from an ultrasound) then your thyroid hormone replacement should be taking up the slack.
Do you mean what should your results be, where in the range? They should be where they make you well. We're all different so some people might be fit and healthy with mid-range results, but others might need them at the top of the range - or even slightly over. I'm talking about FT4/3, of course. The TSH is more or less irrelevant, and doctors that insist it should be at any given level are the doctors that keep their patients sick. You need what you need, whatever that might be.
Intermittent fasting seems to be quite popular and there are plenty of success stories on Dr bergs Facebook group. Some have thyroid problems too and are doing very well on his keto diet. It may be worth a look.
Have you ever had a thyroid function test done in the past before you became hypothyroid? Might be worth checking your medical records yourself, please do not rely on GP admin to be thorough enough. If you have, then those results would give you a fair indication of what levels are good for you. I advise not to do any radical dieting until your levels are right and all your symptoms disappear. Keto does work but I think it's taxing for the body until you are Euthyroid. Also it is vitimin deficient and you want to make sure you have that sorted. I used to have migraines but they stopped after correct thyroid replacement. Birth control pills can cause headaches in lots of women. Just eat clean, only healthy carbs and walking and keep an eye on calories. To be honest weight watchers is going to be disheartening for you at the moment. A stone us not a lot to loose once your levels are stable. Just weigh yourself once a week. If you are gaining then you need to increase your meds sooner.
Ferritin far too low. Has GP done full iron panel testing for Anaemia?
Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption
Folate is best over ten
B12 over 500 as minimum
Obviously these are old test results.....wait to see new results on Medichecks before starting any supplements
No vitamin D test
20% of Hashimoto's patients never have raised antibodies. Be interesting to see if they are still both negative. Getting ultrasound scan of thyroid may be helpful
Thank you so much! That’s really interesting what you say about nutrient levels. Ferritin is always low with me but at the moment it hasn’t affected my haemoglobin etc and I’ve started a multi vitamin with iron since getting my last ferritin result in October. I’ve just received my medicheck pack this morning so I’ll be doing the rest tomorrow morning and hopefully have fresh results for you next week. Thanks so much for the input. Xxxxx
Only do test on Monday, Tuesday or Wednesday otherwise kit may arrive at lab on weekends
2nd
Only test after 6-8 weeks minimum on any new dose of Levothyroxine (or new brand of Levothyroxine)
3rd
Multivitamins are not usually recommended on here here. Too little of what we do need, cheap ingredients and and most is not absorbed. Nearly all multivitamins contain iodine, not recommended for anyone with Hashimoto's.
4th
Stop any supplements that contain biotin a week before any blood test as biotin can falsely affect test results
5th
Don't supplement iron, unless full iron panel shows you need it. If wanting to retest iron levels if supplementing then you need to stop supplements a week before
Make sure to do blood tests as early as possible in morning before eating or drinking anything other than water and last dose Levothyroxine 24 hours prior to blood test
Sarah5-5, These results all look very undermedicated. Most people will feel well with freeT4 high in range and even slightly over. Which will hopefully give good freeT3 levels. So far you look like quite a good converter, so hopefully you will be lucky and once you get that freeT4 up nice and high you'll feel well.
I think you're right that you'll need a few increases of 25mcg to get you there, and it looks like you've been badly treated for the past few years and not given the raises you very clearly need. As you say yourself, the important thing is to be optimally dosed, not just to be inside the range.
The question about whether you will lose weight at that point is unfortunately a roll of the dice. Some people are lucky and it drops off easily once their thyroid dose is good. Others are unlucky and the weight they gained sticks around. But if you're in the latter category you may be able to lose it with diet and exercise. At the moment, being as undermedicated as you are, weightwatchers is just doing you more harm than good. Restricting calories will just reduce your body's ability to use thyroid hormone properly.
If you're lucky, eating more will make you more likely to lose weight than restricting. Because restricting impairs your body's use of thyroid hormone, it's effectively like taking a dose decrease, which means your metabolism is lower and you're more likely to gain weight.
Unfortunately weight gain is a symptom of being hypothyroid for many of us The only real way to combat it is to get your dosage optimal, things like dieting just make it worse.
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Levothyroxine starting dose
Some evidence showed that a high starting dose of levothyroxine produced more rapid improvements in quality of life than a lower starting dose followed by titration. The committee agreed that this was also their experience and therefore recommended a high starting dose (1.6 micrograms per kilogram body weight per day) in adults unless contraindicated (adults over 65 or with a history of cardiovascular disease).
so weigh yourself in kilo x 1.6mcg
this is the approx dose you should have been started on ....and certainly need increase up to
Just a follow up to this, had my results back from medicheck and my t4 and t3 are in range now.
Tsh 2.06 (0.27-4.2)
Ft4 16.5 (12-22)
Ft3 4.33 (3.1-6.8)
Antibodies all way below range 😊
Folate 6.16 (>3.89)
Vitamin d 62.4 (50-175)
Active b12 70.6 (> 37.5)
Ferritin 19 (15-300)
I think my GP will be happy keeping me on the new 100mg levo then now that I am “in range”. Any advice on this and whether to push for 125/150 is appreciated.
Also any advice as to why all of my vitamins and minerals etc are all low would be appreciated!
I just know that my weight went up at an alarming speed when I stopped vaping and started on levothyroxine...I was borderline at first too.....2 yrs on haven't went back to vaping I'm careful what I put in my mouth and try to excessive but still feel tired a lot....😢
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The only real way to combat it is to get your dosage optimal, things like dieting just make it worse. 
How do I convince doctor to do something about my thyroid problem? What should I be asking her to do?
Levothyroxine / Liothyronine combination advice
Question on lowering levo while adding t3
