Has anyone here used Orlistat to help them loose weight? I had a blood test recently that showed my T3 a bit high, not massively over but high .. Dropped my dose by 25mcg’s on the advice of my doctor, so I now take 50mcg’s Levo + 25mcg’s T3 (Tiromel) ... Must admit feel worse for it. In conjunction with this I have had my anxiety medication put up from 50mcg’s to 100mcg’s and more recently (Around the same time as I got my NHS blood test results back) to 200mcg’s of Sertraline in the mornings whilst maintaining 30mcg’s of Mirtazapine at night .. It’s having effects now, the quite demoralising ‘men’s issue’ if you all know what I mean but also my weight is piling on even though I follow slimming world plans quite religiously!! I asked the Dr for help and because my BMI is only 27 at this point he won’t help me with Orlistat ... So I’ll have to wait until I get even heavier and more depressed before I’ll get any help ... Once again and I PROMISE YOU ALL I don’t over eat, eat rubbish etc at all!! I try to exercise but we all know how hard that can be ... took me over a year to loose 10lb at the best point at slimming world but that would fluctuate by +4-5lb from one week to the next .. Got down to 12st 2lb, do slimming world SP and loose nothing, go back the next week and would have put on 4lb, back up to 12st 6lb, SP week again and loose 0.5lb, week after that loose 3.5, week after that put 3.5 back on!! Driving me MAD!!!!!! I’m tempted to buy my own Orlistat to help me at least maintain the weight loss I have achieved, does anyone else do this?? .. It’s really REALLY getting me down
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Do you have any recent thyroid results you can add
How much levothyroxine were you on BEFORE you added T3?
How do you take your T3....as split dose?
What vitamin supplements are you currently taking?
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to regularly retest 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
You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
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)
when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
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
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
I used to be on 225mcg’s of Levo at 1 point and still felt rotten. I had a blue horizons Thyroid + 12 done a while back and it showed some weird results of high out of range TSH as well as high out of range T4 (Got accused of missing doses which I DID NOT!) Also showed me to have high RT3 (Which was responsible for the TSH levels) and high Hashimoto’s antibodies (My results are up on one of my posts) I’m planning to get another one done soon when I can afford it.
My GP practise is pretty useless if I’m honest, only ever made me worse!
Also showed me to have high RT3 (Which was responsible for the TSH levels)
That's not quite right. The high rT3 was not responsible for the high TSH. The TSH was high because you had low FT3, because you weren't converting properly. Your FT4 was high, you say, which is why the rT3 was high, to recycle some of the excess T4. But, if you weren't converting properly, your FT3 would have been low.
And, here, I think, we have the nub of the problem. It's low T3 that causes symptoms like weight-gain and inability to lose weight. Not TSH. Not T4. And, I bet your doctor never tests your FT3 - and probably wouldn't understand it if he did!
Also, you have Hashi's, if you had high antibodies. Which means that your levels are going to jump around anyway. And Hashi's people are very often poor converters. So, what you're going to need, if you can get it, is some T3 added to your levo.
SSRIs can affect the absorption of levothyroxine. So your higher dose may mean that you are not absorbing the levo so well and that you may need to up your levo dose - please be aware that this is only an opinion and that I'm not medically qualified. I have not read anything about SSRIs affecting T3 absorptio
I wouldn't do that, if I were you. And, I wouldn't follow Slimming World! Both are based on the principal of low fat and low calories. Which might work in the short term but not long term.
Eating fat doesn't make you fat. And, low-calorie diets are contre-indicated for hypos. The body needs fat, and hypos need a decent calorie intake in order not to put on weight. You can make yourself more hypo with low-calorie diets.
Besides, you are hypo, so is your extra weight even fat? Very often it's mucin/water-retention, and low-fat/low-calorie diets aren't going to do anything to help that! What you need to do is optimise your thyroid hormones and nutrients, as SlowDragon suggests.
I will say that I did loose weight with SW, keeping it off is near on impossible. I eat plenty of veggies and tonnes of fruit .. Don’t drink excessively etc but since this med change it’s shot up!!! Not changed my diet at all really.
I’m useless at keeping track of vitamins etc, brain fog is always terrible and I feel utterly drained by the time I get home after work ...
Of course you can't keep it off with SW, that's what I'm saying. That's how they make their money: returning customers.
And, of course your weight has shot up since your reduction in dose. It's made you more hypo. You're now very under-medicated.
It's not just about your diet, and eating tons of fruit and veg is not going to help nourish you if you don't get enough fat and protein. It's a balanced diet you need. Sounds as if your diet is a bit lop-sided. But, even that isn't going to help you if you're hypo. It's the hypo causing the weight-gain, not your diet.
Well, then, I would suggest that should be your next step. Even if your excess weight is fat - which I doubt - you won't be able to lose it if your nutrients aren't optimal. And, if your nutrients aren't optimal, your body won't be able to use thyroid hormone efficiently, so you won't lose water-weight, either.
Obviously it would be difficult on the NHS at the moment. But, in normal times, your GP might agree to do them. Or, you could have them done privately. Details about private tests here:
Ok. I’m due another thyroid + 12 so I’ll get them done too. Last time I had one done the endocrinologist totally ignored the results saying ‘Some assays are different’, ignored all the awkward questions I asked about them and so on, took near on 8 months to sort out a cortisol test ... That said my GP did take notice of the vitamin D deficiency but that was it ... Might as well have showed the results to the dustman! The only thing I regret about my endo appointment was not knocking the lying little coward on his NHS salary pulling incompetent bum!!
That's how I've felt about most of the endos I've seen! lol
Doesn't surprise me at all that they ignored your results because they seem to feel threatened by patients doing private tests. They take it as a personal insult. Besides, I don't suppose he understood anything apart from the TSH!
But, at least you will know, and optimising nutrients is something you can do for yourself. If doctors know little about thyroid, they know nothing about nutrients. So, you'd be on your own with that, anyway. Unless the results are really, really terrible. But anything in-range, even right at the bottom, they consider to be 'perfect'!
Not much I would recommend without getting tested first. You should get vit D, vit B12, folate and ferritin tested, to start with, and build up a supplement regime according to the results - we can help you with that.
Supplements you can take without testing first are vit C - which is even more important these days - and magnesium. But, don't start both at the same time. You should leave at least two weeks in between starting supplements, in case one of them doesn't agree with you.
Start with 1000 mcg vit C, and see how well you tolerate it. Vit C is a vitamin you can take with anything because it enhances absorption of other things. You can slowly increase vit C to bowel tolerance.
With magnesium, you need to chose the one that is likely to help the most:
Magnesium citrate: mild laxative, best for constipation.
Magnesium taurate: best for cardiovascular health.
Magnesium malate: best for fatigue – helps make ATP energy.
Magnesium glycinate: most bioavailable and absorbable form, non-laxative.
Magnesium chloride: for detoxing the cells and tissues, aids kidney function and can boost a sluggish metabolism.
Magnesium carbonate: good for people suffering with indigestion and acid reflux as it contains antacid properties.
Worst forms of magnesium: oxide, sulphate, glutamate and aspartate.
Don’t worry about scale. Actually, I would advise you to hide the scale for 3 months. The weight you lost and gained might be just water ( or water retention).
You need to target fat and change your body composition. You can have completely different bodies and the same weight.
Can you start running? Can you eat just veges and protein? There are lots of meals examples on YouTube. Do it for 1 month consistently and at the end of the month evaluate the result.
The SlimmingWorld ‘SP’ is basically that and I have done it before and it’s worked, soon as you stop back on it goes ... And it’s even more so now. Exercise is hard as we all know ... My legs etc feel like lead when I get home, get cramp in my feet and I have something going on with my left foot at the moment, quite painful in the arch of the sole of it ... Comes and goes but it’s becoming more often than not now, don’t want to bother the GP at this time of outbreak, my foot isn’t hanging off in agony but something is going on.
Is this guy hypothyroid? I am asking because before I developed hypoT running worked great to help me lose weight and keep it off. Now, it no longer has the same effect on me. Of course, back then, I was in my early 20s so it´s normal that I would no longer get the same results at 50, but still...I enjoy jogging, so still do it 3-4 times a week, but it does nothing for my weight anymore.
I´ve even read (but cannot remember where) that strenuous exercise may be counterproductive for hypos, and that walking may be better than running...not sure though if that applies to undiagnosed hypos or also those who take thyroid hormone replacement.
Sounds like hypo symptoms - too much exercise (for you) results in lower T3 and inability to recover from exercise like a healthy person - and foot problems like plantar fascitis. Perhaps stick to just walking until meds are optimal
Maybe that was what I was referring to above...reading about strenuous exercise not being good for hypos but not remembering where I read that. But it makes sense that high intensive training would deplete T3 levels and that the body cannot make enough of it afterwards. I certainly have noticed physical exercise having much less effect (if any) on my weight since going hypo...however, I feel better when I exercise regularly, which is why I keep doing it. But it seems that losing weight simply by jogging, which I did in my 20s, will never happen again.
What I am wondering is: if intensive exercise depletes T3 levels, is that a problem for people on T3/NDT as well, or only for people on T4 only drugs...?
Magnesium will help cramping in your leg and foot. I used to have really sore feet and leg cramps but started taking magnesium at bed time and it literally disappeared and never had a problem since.
You will need to change your food choice but anyways, from my experience good quality multivitamins, Omega-3, Q10, CLA, ALA would be beneficial.
You mentioned you experience IBS symptoms which is indication you eat something your body rejects and highly likely you have inflammation which contributes to weight problems. As soon as you calm down inflammation via nutrition (not via tablets) you problems with weight will disappear.
Sorry to hear things aren't good for you at the moment.
You said in reply to Greygoose
"I’m due another thyroid + 12"
So if you've had that done previously, did you post your results and were any of your nutrient levels in need of improving?
Can I suggest that you don't waste your money, and the extra time waiting for an rT3 result, just do the Thyroid PLUS ELEVEN (now called Premium Gold) or do the Medichecks Thyroid Check ULTRAVIT.
The rT3 is not important, your FT4/FT3 tells you if you are a poor converter, and rT3 can be caused by many other things besides a build up of unconverted T4.
Only fingerprick tests and self arranged blood draws are available at the moment, home phlebotomy and clinics don't seem to be an option just now. The Plus 12 test requires venous blood draw due to the rT3 test being included.
Also, a couple of important things:
1) Don't supplement until you have your nutrient levels tested, they will tell you what you need to supplement, if anything. Post results on here for guidance once you have the results.
2) Don't use multivitamins, they are not advised for many reasons, eg they tend to have too little of anything to help low levels or deficiencies; they tend to use the cheapest, least absorbable and wrong form of active ingredients; they often contain ingredients that we need to test for and only supplement if found to be deficienc i.e. iron, calcium, Vit D, iodine; if they contain iron then it affects the absorption of everything else, iron needs to be taken 2 hours away from any other supplements (and medication).
I wouldn't use Orlistat. As far as I remember from reading about it years ago it is one of those things that stops the body from absorbing fat. The worst side effect of this is usually severe and sometimes uncontrollable diarrhoea.
There are only three macronutrients in the human diet - protein, fat and carbohydrates. Protein and fat are essential for life. People can't survive without them. Carbohydrates are optional and as long as you eat protein and fat you can live without carbs.
Having said that, people with thyroid disease generally do need to include some carbs in their diets because it is needed to help the body to convert T4 to T3, which is a problem for many people with thyroid disease.
If you want to learn how to eat healthily (and can stick to it) then this website is worth browsing:
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.
Suggest you get FULL thyroid and vitamin testing ASAP
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)
If/when also on T3, make sure to take half or third of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
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
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
Yes many of us need addition of T3 alongside levothyroxine.....but it’s also ABSOLUTELY ESSENTIAL to get vitamin levels regularly retested. Frequently we need to supplement some, or all four to maintain OPTIMAL Vitamin levels
Frequently strictly gluten free diet helps or is essential to improve gut function
I haven’t gone from 225 to 50. I used to be in 225 before I started self medicating with T3 (Tiromel) .. was taking 75mcg a day and the 50mcg Levo, felt ok, lost some weight etc BUT my free T3 was high ... So took the docs advice and started taking 50mcg Levo and only 25mcg T3 ... And this has all happened, back feeling crap, put weight on etc. Gunna go back to what I was on before, go on a meat and veg only for a week or so and see how I go. Absolutely tired of all this! I don’t care if I’m over or not .. If I feel better that’s what counts ... What’s the point walking about, feeling like death, brain fog everywhere, putting on weight because heightened T3 ‘Puts stress on the heart’ .. Well feeling crap all the time and putting weight on puts stress on me, makes me feel utterly miserable ... And that’s on 200mcgs Sertraline and 30mcg’s Mirtazapine.
Yes, 75mcg’s to 25 ... But I’m going to step it up again ... rather feel better and have a heart attack at 80 that feel crap for the rest of my life and have one at 85.
Well said about the carbohydrates. I've lost more than a stone by cutting out all refined carbs, potatoes and bread. I eat more lentils, brown rice and vegetables. And yes full fat yoghurt and fat on my meat. Eating some fat will curb the need to eat sugar. I now weigh just two pounds more than when I got married 20 years ago. I'm 56.
I have tried a product in Australia called zenical years ago which is same as Orlistat, it did work but be prepared to not go far from home, it blocks fat absorbtion so yes you will literaly see this in the toilet bowl, dont know much else about it and side effects apart from the toilet or long term effects.
Hello, I agree with the others. SW is not a good diet for thyroid sufferers because the weight won’t stay off.
We shouldn’t be eating any grains with thyroid disease (worse one being gluten) . Eat lots of good protein and healthy fats with veggies and fruit. You will feel much better if you follow that.
There’s a diet called auto immune paleo and I’ve lost 1 stone in 2 months, I have energy and feel much better, I’m slowly adding in other foods now like more starchy veggies..
I used to be on anti depressants and they also made me gain a lot of weight and hold water. I’m still grateful I took them because they helped me cope but now I have psychodynamic therapy and breathing exercises (wim hof) and I can work through my anxiety.
Hope you feel better soon.
Btw I took that slimming drug when it first became available 20 years ago and it didn’t work for me, I didn’t even lose a pound. I even took Legal speed from a diet doctor for a few months. As soon as I stopped taking it, the weight went back on immediately.
High protein diet has definitely been the best one for me and easy to do.
This article should help, I do eat nuts and eggs now because I eliminated everything and now know my triggers. I started adding back in foods slowly over a few weeks so I can eat some white potatoes and quinoa but just not everyday, once a week.
I make a bread from Danielle Walkers against all grain.
It’s important while doing the diet to look at healing leaky gut - there are supplements which can help with that.
Currently whats important is getting your thyroid meds balanced so your symptoms are minimised or preferably gone -weight loss can be looked at after this. Your doctor was wrong to tell you to make drastic changes. I learnt the hard way years ago that one, to make one change at a time, two to make small changes, three to give each dose change 6 weeks to allow your body to adjust. This is a very frustrating process but it is the only way.
Secondly do check your vits and minerals as they can help with uptake of thyroid hormones and secondly commonly low in hypothyroidism. For example B12. My b12 was low but in range & now am optimal I actually need less thyroid hormones.
Lastly keep a daily record of all that you are doing, your signs symptoms, pulse/ temp first thing before rising, meds & vits taken and your blood test results. All this info should help you to identify patterns and trends which in turn should help with finding the best combination & dose of thyroid hormones for you.
Unfortunately there seems to be very few doctors or sadly endocrinologists who have the skills to help you with this process, the good ones are like gold dust....... However there are some really knowledgeable people on here.
Make sure on the day of your blood test you havent taken any thyroid hormones, have the test first thinh in the morning, fasting till after its done when you can take your meds.
Lastly you mentioned high TSH AND high Ft4 - that combination is unusual. Has anyone offered any explanation or done further tests? What did your doctors say about that.
Hi there is lots of good advice here, my only comment would be about the Orlistat, my sister was on it for a while and she felt for a long time after she had come off it that it messed up her bowel. She said never again.....
My friend took Orlistat and also said never again. She had an embarrassing incident at a friend's house involving white sofa and carpet and leaking fat. I was considering buying as my weight not quite high enough to be prescribed but she put me off with this story.
I also took it and any fat you consume goes through your system and often catches you out. Even a cup of tea with semi skimmed milk still triggered the runs. I ruined a mattress and several pairs of underwear with this yellow oily mess. Don't ever think you just have a bit of wind, it will not be and you could find yourself in unexpected trouble. I had to lose six pounds before I was allowed to be prescribed it which defeats the object a bit. I lost a further four pounds whilst on it but it really wasn't worth the worry of ending up in a state.
I am on a diet now and finding portion control to be the best option for me and it is certainly worth it as I have lost 10 kg in less than three months.
Have you considered the keto diet? Myself and my husband have been on it for a few months and it's been very successful, plus we have felt a lot better too (I have hypothyroidism, he's always been big and we have both struggled losing weight until now!
They say it doesn't work for everyone but I decided it was worth a try...and I'm very glad for it.
We feel so much better that we are making it a lifestyle change rather than a diet that you go on and off...
Looks like you've got plenty of responses anyway - just thought I'd throw my pennies worth in!! All the best
A colleague of mine used Orlistat a couple of years ago, and she says there is nothing she regrets more. It will prevent your body from absorbing fat, and the fat is then excreted in your stools. The idea is to keep your fat intake to a minimum if you don´t want to end up with horrible diarrhoea. As others have pointed out, hypos need enough good fats in their diet.
My colleague never lost any weight because she was constantly hungry on Orlistat (probably because she was not eating enough fat), so she was constantly snacking...saying "at least sugar won´t give you diarrhoea".
Did you lower your T3 dose from 50 to 25 mcg in one go? The usual advice is to lower it by 5/6.25 (so a quarter 20/25 mcg pill) at a time. You may have ended up under medicated as a result.
If you do not eat a high fat diet then Orlistat will be a waste of money and will probably make you feel worse, I self medicate as well, although the doctor has doubled my dose since I moved to Wales last year, and I feel good for it. I would go with what your body is telling you NOT a medic (this coming from a nurse). I did a no/low carb diet in the new year and I lost around 18lbs in less than 3 weeks so I would recommend a low carb diet as I was struggling to lose weight as well.
Morning 🌞.. I'm not going to give advice on doses etc as I'm useless at them myself ..and trying to balance mine at the moment as I'm now on NDT .. which worked for me fir a while ..I lost 14kg on it ..over about 8 months but then plateau...🙄.. I've adjusted my dose according to bloods ..which I had full panel with medichecks ...but still no good ..I used to be very thin till mid thirties when all this started ...and I kept on putting on weight without overeating... And like you .. you feel like you're lying when you tell doctors your weight is increasing but you're not stuffing your face with junk ...😞.. you can see they don't believe you !!! Very soul destroying...it's only when I joined the thyroid group and was confirmed with hashimoto that I realised I wasn't alone and making it all up in my head !! I'm going to try the levo / T3 combo as well for a bit ! If SW works for you then I see no harm following it ..it's just trying to maintain it ...but advice on other methods is also good as works for some ...and always worth a try ..something I'm going to do as well ! I took orlistat twice ..once In South Africa under the other name and once here in UK .. did nothing for me ...so I wouldn't advise it.
The pain in your foot sounds like planter fasciitus... It's very painful ..comes and goes for no reason ..and I see a few people with thyroid problems get it so maybe it is related ? Not much helps it unfortunately ..as in meds ...but one good thing is get a golf ball and roll your foot over it ...it's painful but relieves the pain afterwards ... 🥴🥴🥴
after having my thyroid removed I piled on the weight, I did SW and my doctor prescribed Orlistat. I lost all my weight but then the doctor wasn’t allowed to prescribe it again, I have piled on the weight and more, it’s just impossible to lose it. I was then given T3 which helped me lose some weight but this has been stopped then started then stopped again and now restarted. I now feel like a fat lump and wish I had never had to have my thyroid out. I don’t think I will ever get back to normal. I have considered buying Orlistat but would have to lie to get it as it says you can’t have it if you have thyroid problems. My vitamins are never tested so I wouldn’t know if I am missing anything.
Orlisrat works by holding the fat out of your diet. However fat contains many vitamins and minerals , your brain is 80% fat.
I tried Orlistat many years ago. I had initial weight loss but then developed further autoimmune conditions due to lack of vitamins and minerals. After seeing a Functional practitioner and her dietician I regained my health , and sensible weight with a no sugar diet. No sucrose , dextrose, maltose no baked goods, reduced fructose only berries allowed. A low sugar diet is much better for your health than low fat.
Hi I’m sorry to hear your dilemma but I know people who take Mirtazapine and they have piled the Weight on and can not shift this weight maybe this might be the problem you could discuss your medication and see if there is an alternative ?
Imho Slimming World was a waste of my money; when I went I spent half the time queueing to be weighed and then clapping others when that was done. The other half being sold products. I was hoping for good advice. Also its very low fat balance isn't good for you as the way they make up for this is often extra sugar. Not all classes are the same though. I have done much better on proper diets like the DASH diet and the Mediterranean diets. It's hard to lose weight. I wish the best for you.
my GP would not give me Orlistat due to my Graves Disease as it speeds up your metabolism in addition to the over activeness of GD - that was the reason he gave me anyway.
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maybe this might be the problem you could discuss your medication and see if there is an alternative ? 
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