Salt & water retention

[Jenny25wilson]

someone has told me that weight gain when you are hypothyroid is due to salt and water retention, my last test 4 weeks ago showed Serum TSH level of 9.7. I stopped taking Levothyroxine altogether and this weeks blood test result showed TSH level of 4.5 can anybody explain please

[LivingWithHT]

Weight gain with hypothyroidism can be greatly due to water retention, yes, even if you don’t consume a lot of sodium. Having hypothyroidism can make it much easier to retain water than the average individual with an optimally functioning thyroid, but there can also be other underlying causes adding to that and making the water retention even worse.

Excessive water retention can also be due to many other factors, like consuming too many carbs or gluten-rich foods when you are insulin resistant, pre-diabetic type 2 or have celiac disease. Certain medications, even levothyroxine, can contribute to water retention. Many people report not doing well at all on T4 medication alone, myself included.

It’s possible you are a poor converter of T4 to T3 and, thus, taking levothyroxine alone was making things worse - not better. When you are a poor converter, T4 can sometimes convert into RT3 (Reverse T3) which is an inactive form of T3. It’s almost like you were adding fuel to the fire rather than dousing it with water. That may be why your TSH went up and not down.

When you stopped medicating altogether, you may have given your body the time it needed to rid itself of the RT3, which is why your TSH went back down. But you still need to be medicated, however. When you start medication again, consider taking selenium, zinc, magnesium, vitamin B12 and D3, folate and iron supplements to make sure all your vitamin levels are optimal so that you improve T4 to T3 conversion. It’s best you get your vitamin levels tested before doing so, of course.

Usually, Reverse T3 treatment consists of reducing and eventually stopping T4 altogether and only taking T3 and slowly increasing until you find your optimal dosage. If you are lucky enough to get a prescription of liothyronine from your doctor, that would be a great start.

[greygoose]

Were both tests done at the same time of day? TSH is highest early morning and reduces throughout the day.

Do you have Hashi's? That can cause levels to fluctuate.

Water retention has nothing to do with rT3. In fact, rT3 has nothing to do with anything. It is a safety valve stopping your FT3 levels becoming too high. It is inert and only stays in the body for a couple of hours before being converted into T2. It is a total red herring.

Don't start taking supplements without getting tested first. Taking vitamins and minerals will only help you if you need them. More is not better, and can be dangerous. Ask your doctor to test vit D, vit B12, folate and ferritin and work out a supplement routine according to the results - we can help you with that.

[Jenny25wilson in reply to greygoose]

Thank you for your reply I will get the tests done

[greygoose in reply to Jenny25wilson]

You're welcome.

[Jenny25wilson in reply to greygoose]

I had the radio iodine capsule 7 years ago. I have not been ok since then. I have put 2.5 stones on and my GP isn't at all helpful. I am very active and I have weighed 8st - 8.5st all my adult life. He says there is nothing wrong with my results and that I simply eat too much food. I have cut my food down dramatically I walk 1.5 miles everyday and I have put 2 lbs on in the last 2 weeks. Something is wrong

Jan 2020 results

Serum B12 386ng/L

Serum Ferritin 3.5 ug/L

Serum Folate 7.3 ug/L

TSH 9.2 MIU/L

I was given 125 mg Levothyroxine for 1 month which I didn't take.

Feb 2020 results

Serum TSH 4.6 miu/L

Serum free T4 16.0 pmol/L

[Hidden in reply to Jenny25wilson]

We need the reference ranges to be able to advise about results. They are usually in brackets after the result, or sometimes with a small "R" next to them.

But your TSH is still too high, ideally (for most hypothyroid people) it needs to be under 1.

Unless your thyroid is still recovering, as it's lower than the previous test?

[LivingWithHT in reply to Jenny25wilson]

Your ferritin and folate levels are quite low in your first blood test’s results, which can make it hard for thyroid medication to do its job optimally and reduce TSH. Have you started taking any supplements for them since then? If so, that may have helped bring your TSH down.

[Jenny25wilson in reply to LivingWithHT]

Can you please suggest which supplements I should take ,I am now taking 125 mg Levo everyday

[LivingWithHT in reply to Jenny25wilson]

Folate supplements can help but it is highly recommended to make sure they are in the form of methyl-folate and not folic acid because folate is the readily absorbed and active form that the body needs. Alternatively, you could try the new folic acid oral spray that BetterYou has come out with, liquid vitamins tend to be far better absorbed than capsules or pills. Softgels can be good if they don’t have a lot of fillers or inactive ingredients. As for increasing ferritin, the best way to do that is really from eating foods high in iron, like red meat. A lot of people on the forum recommend liver but I couldn’t stomach it. Iron supplements help, but only if your body is able to utilize and absorb them properly. Some people suffer from a gene mutation that negatively affects absorption and reduces the transferrin saturation. You could try looking for an actual Ferritin supplement, the readily active form your body needs.

[greygoose in reply to Jenny25wilson]

All GPs think like that, for two reasons: a) they know very little about hypothyroidism and its symptoms b) they know absolutely nothing about nutrition! It's all down to their poor education. Which is why thyroid patients have to educate themselves.

Low-calorie diets really aren't recommended for hypos. Too few calories can make you more hypo because it reduces conversion. You may find that if you increase your calorie intake you actually lose weight. But, you do need to take your levo.

Are you seriously saying that your doctor considers a TSH of 9.2 to be good? If so, you need a new doctor. There's no hope for this one. Some of them are willing to learn from their patients' experiences, but this one has his head so far up his backside that he will never make you well. Can you see someone else?

Why didn't you take the levo prescribed for you?

[Jenny25wilson in reply to greygoose]

I just thought to hell with it all, I won't take any at all for 1 month and see what happens. The level has halved and I wondered why. Before my thyroid went haywire my level was 1.5 but my go says it was irrelevant and that 4.00 is fine so I am on 125 Levi for the next 8 week what supplements do you suggest please

[greygoose in reply to Jenny25wilson]

As I said, your doctor is very ignorant. I presume we're talking about the TSH here - although TSH is NOT your thyroid. TSH is a pituitary hormone. And, 4 is not fine at all, it's much too high and it's hypo - it's hypo when it's at 3.

[Jenny25wilson in reply to Jenny25wilson]

Serum B12 level 386 ng/L (211.0 - 911.0)

serum ferritin level 35 ug/ L (10.0 - 322.0)

Serum folate level 7.3 ug/L (5.4 - 25.0)

[Hidden]

Why did you stop the thyroxine and how much were you taking? Even a TSH of 4.2 is too high. Most people with hypothyroidism need a TSH of under 1.

Unless your hypothyroidism is a temporary condition due perhaps to an infection or having a baby, it is for life and you need replacement hormone.

It seems that stopping Levo often gives a kind of high and you feel good for a while. But then the crash comes.

Another puzzle is why did you have tests only 4 weeks apart? It needs 6- 8 weeks for your body to stabilise after changing the amount of Levo.

[Jenny25wilson in reply to Hidden]

I had the radio iodine capsule 7 years ago. I have not been ok since then. I have put 2.5 stones on and my GP isn't at all helpful. I am very active and I have weighed 8st - 8.5st all my adult life. He says there is nothing wrong with my results and that I simply eat too much food. I have cut my food down dramatically I walk 1.5 miles everyday and I have piu 2 lbs on in the last 2 weeks. Something is wrong

Jan 2020 results

Serum B12 386ng/L

Serum Ferritin 3.5 ug/L

Serum Folate 7.3 ug/L

TSH 9.2 MIU/L

I was given 125 mg Levothyroxine for 1 month which I didn't take.

Feb 2020 results

Serum TSH 4.6 miu/L

Serum free T4 16.0 pmol/L

[Hidden in reply to Jenny25wilson]

" Something is wrong"

Obviously. The symptoms you describe are typical of hypothyroidism, which sadly often happens when you get hyperthyroid treatment such as radioiodine.

It seems likely that too much of your thyroid was destroyed so you need thyroid hormone supplements, usually Thyroxine (T4).

T4 doesn't suit everyone - some on here need T3 as well or even only. But if you won't take replacement hormone your symptoms will continue and perhaps get worse.

[Jenny25wilson in reply to Hidden]

I just thought to hell with it all and stopped for 1 month, the level halved I've on 1.25 mg Levo for 8 week then another test but I've been here many times everytimevitvdrops the gp lowers it to 100 and it goes up again, I'm at my wits end I feel so unwell but he says it is my mood not my thyroid

[helvella Administrator Thyroid UK]

Hypothyroidism causes certain proteins to increase within much of our tissue. These proteins - together with water - form a sort of clear jelly - called mucin.

Yes, the liquid will contain salt but it seems to be the excess of protein but it seems to be the proteins that cause the swelling.

Names like glycosaminoglycans, hyaluronic acid, chondroitin sulfate and mucopolysaccharides are sometimes used to identify the actual proteins.

This mucin causes swelling which is non-pitting. That is, pressing with a finger tip tends not to make a dent - the swollen tissue resists pressure.

[LivingWithHT]

Dear Jenny, it doesn’t hurt to do a lot of your own research and compare your symptoms to the possible causes of your situation.

Reverse T3 can occur due to a lot of stress and/or adrenal fatigue, you can test your cortisol levels to see about that. There can be so many reasons to a poorly functioning thyroid gland, and you may not be suffering from high cortisol or adrenal fatigue but the only way to figure it out is thorough blood tests and monitoring your symptoms.

It would also help if you post your FT4, FT3 and any other of your blood test results, too, so people here can give you better advice. You might have high thyroid antibodies. You cannot go by TSH alone.

[humanbean]

Serum Ferritin 3.5 ug/L

Depending on the lab the reference range for ferritin (iron stores) usually starts somewhere around 10 - 20. Your level of 3.5 is lower than the lowest number in any reference range for ferritin I've ever seen. Your doctor should have commented on it and started you on iron supplements.

I would suggest that you desperately need some iron supplements because your ferritin is so low. It would be better to see results for serum iron and transferrin saturation % as well. It is possible, but unlikely, that your serum iron and transferrin saturation % are high, despite your very low ferritin, in which case supplementing with iron would have to be done very carefully and cautiously.

If your serum iron and transferrin saturation % are low (which would be likely with such low ferritin) then you are definitely suffering from iron deficiency and may be anaemic too. To find out if you are anaemic you would need to know your haemoglobin level. But you don't have to be anaemic to need treatment for iron deficiency.

Note that if you live in the UK then it is possible to get iron supplements of the type the NHS prescribes from pharmacies without a prescription. You can also get finger-prick testing done by post without requiring the services of a doctor. See this link :

medichecks.com/iron-tests/i...

And you can get 10% off the price with the discount code given on this link :

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

[Jenny25wilson]

Sorry

Serum ferritin was 35ug/L not 3.5