I’m new to this site. My thyroid has been borderline under active for some time but my GP only prescribed Levothyroxine in January this year. As I haven’t been offered a blood test since I’ve remained on the starting dose of 50mg.
Other health conditions include vestibular something (often feeling dizzy and sick), low vit D which I’m self medicating, poor sleep, hip bursitis, watery eye, psoriasis on hands, deafness, a skin tag, high cholesterol and triglycerides and about a stone overweight with a bit too much fat around the waist.
I’ve been wondering if inflammation is at the root of it all and if an anti-inflammatory diet could correct the problems. Before considering that I was thinking about the 5:2 diet but those with thyroid problems seem to be excluded according to Michael Moseley. I’ve seen specific foods advice for thyroid but much of it is contradictory.
Last blood test: Jan 2020
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Bearo
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I agree there’s a lot of conflicting information on diets, have you felt better since taking the meds? Have you had a test since and have things improved. Some try AIP or keto diets. Some say gluten free or dairy free or low carbs. GP told me I needed to walk at a pace to get my heart going. Think exercise and following a decent diet that’s right for you, improving lifestyle and reducing stress. It seems that under active our baseline calories are a lot lower for me it’s under 1200 cals but only lose weight once bloods are back in balance. Low vitamin D is common in these diseases as is B12.
Thanks for your reply. I don’t really feel unwell, despite my list of associated ailments. I haven’t had a blood test since January. I was going to push for one, but thought I’d investigate other options before having meds increased.
A 1200 calorie a day diet willpower T3 levels by up to 40%, it's the terrible catch 22 of thyroid disease that in order to lose weight, you have to drop calories as low as that, but that in turn it will lower your T3 to a point that will ultimately make it harder to lose weight.
Thanks for your reply, but now I’m confused.....I’d been reading those with thyroid problems shouldn’t practice calorie restriction, hence Michael Mosely saying 5:2 diet not suitable.
Sorry, just noticed my squint fingers wrote that out wrong. "Will lower". A1200 calorie a day diet lowers T3 levels by up to 40%, and lower T3 levels are obviously not desirable for thyroid sufferers. Go lower, and T3 will also drop even more, so that's why 5:2 isn't recommended.
First you need to optimise medication and optimise vitamin/mineral levels. For me, a paleo-ish diet then worked best - lower carb but not quite to the extremes of keto. We're all individual though, so you need to look at what works sustainably for you too.
Without treatment it’s near impossible for a hypothyroid person to lose weight. Most hypothyroid patients are about 20lbs overweight. It’s a metabolism disorder, so the usual calories in calories out doesn’t matter as the calories at that point are already low, and exercise is not an option due to lack of energy. If using the calories in calories out method, it will still work, but on a much much slower scale and speed than for a normal and healthy person.
I've alway's 'pushed' the process along to get a repeat thyroid blood test if i know they should be doing one, (and NHS guidelines for thyroid treatment say they can do one after 3 mths to asses the effect of the starter dose and any subsequent changes,)
I fear that if you leave it up to your GP to tell you to have a repeat test ,you will have a very long wait.
I don't know if this would work for anyone else but when i'm due for one after a dose change i go to reception and casually say " i need to book a blood test please"..... ignore the down their nose look from the receptionist and just carry on." thyroid function "........
"can you find me one before 10am please, i don't mind if i have to wait a few weeks "..... at this point the receptionist will usually give you a condescending schoolteacher look and start to say something like "did a Dr ask for it? you can't just......."
ignore that too and say "Dr-----(whoever prescribed the dose you are on) needs it, from--- ( whenever it was prescribed)"
Usually they look back at your history on the screen and will see that this was your last appt with said doctor and thyroxine was prescribed and they book the blood test.
When you've had it book an appt with GP to "Discuss your results"
It always works for me ... i don't know if it because i say it like i'm supposed to be there. or some ether reason.
But i think you need another blood test, however you go about it
That's great advice and so true. It made me laugh because I've been at it for so long and this is exactly how you have to handle Drs, appointments, and blood tests.
That’s a really good reply, thank you, but actually I have requested a follow up blood test and was told the surgery would call me when it was due. They said that in February, then I suppose COVID took over.
My method still works despite the pandemic, i got one booked like this(but with a mask on!) only last week The way things are going it could be years before they get round to ringing you up.
You'd be surprised at all the symptoms you can have from an underactive thyroid! Dizzy, sick, and poor sleep at the same time is really tough. I have to focus on one thing at a time or it's all too much. My nurse said to focus on getting the thyroid levels right and then move onto the next.
Trying to treat your thyroid with diet depends on the reason for your hypothyroidism. Sometimes your body can't provide you with enough hormone and you have to supplement. It can't hurt to follow a nutritious diet. I don't follow diets but like to focus on getting enough good carbs from rolled oats, beans, and vegetables, good protein, and nutritious food. I increase calories to feed my body but keep the meals smaller and spread them out to avoid reflux. All these diets and health blogs are so overwhelming.
My tsh was also 5 and 88mcg was the dose that made me feel better. Your dose can need adjusting over the years too.
Yes, I’ve been working on general diet improvement for the past year, basically because the GP made a point of telling me I was pre diabetic. They encouraged me to focus on the cholesterol but ignored the thyroid. Now I’ve decided to focus on the thyroid.
@Bearo I have decided to try an anti inflammatory diet (Auto Immune Protocol/AIP) due to my two autoimmune conditions, one being thyroid (Hashimotos). I’m not looking forward to it but can’t keep waiting for things to get better (it will take over a year to end up on the correct T4 meds and I haven’t gone down the T3 route because it doesn’t seem realistically treatable here. Been very sick for 4 months. Have 2 young kids and I’m in my 40’s. As a backup I’ve also booked an appointment (they only have space in Feb 2021!) at an allergy clinic who seem to specialise in chronic fatigue (and other things) who I am sure will test for inflammation and help me correct it via diet if I have not succeeded on my own by then. My diet is currently considered healthy but things like oats, nuts, lentils, etc have to get cut out in an AIP diet.
You need to get antibodies tested to see if you have got autoimmune thyroiditis which is also known as Hashimotos.
If you have this it means that your autoimmune system is attacking and damaging the thyroid thinking that it is a foreign body. If this has happened and your thyroid has been damaged then it may be unable to produce enough hormones for your body to function properly.
If this has been the case the only way to solve the problem is to take hormone replacement to make up for what the damaged thyroid cannot produce. No diet can replace hormones.
It is recommended that all vitamins are well over half way through their ranges. So testing vitamin levels is advised and diet altered accordingly if necessary to increase folate and iron.
It is recommended that we do not eat soya as soya blocks the function of thyroid hormones.
I’ve always eaten an anti inflammatory diet and really do best on keto or carnivore. But for thyroid treatment that would not be enough. You can’t heal your thyroid function on your own, although potentially if you were to reduce the everyday stress and be in sunshine all day and eat seafood on the Meditarranean, maybe you could. Actually come to think of it, things are always better with sunshine for me.
agree on the sunshine. I always feel better on holiday! There’s actually a book where the author suggests upping your thyroxine dose slightly during winter months as there’s a greater need. Will find the details and post it up.
Bloods should be retested 6-8 weeks after each dose increase
The aim of levothyroxine is to increase the dose upwards as fast as tolerated to bring Levels back to correct levels. Most important results is Ft3, should be at least 50-60% through range
guidelines on dose levothyroxine by weight
Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
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.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.
RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
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
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Thank you for the link to the cheapest private test . Is Monitor my Health a finger prick or a blood draw? Looking at their site online i couldn’t see that information. Will I be able to do it myself?
Or if I order the test and pay for it, do you think GP surgery might do it at the same time as the vitamin / antibody testing (If they agree to test those for free) Worth asking?
DIY finger prick is pretty easy ....Just allow plenty of time when doing first one
Only test as early as possible in morning on Monday or Tuesday. Post back via 24 hour tracked postal service
All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
No supplements that contain biotin a week before ANY BLOOD TESTS
when my free t4 was 10 and my tsh was 5 i felt like absolute death, having later found i had autoimmune thyroid disease which was causing my thyroid to slowly destruct. i feel i had this from a teenager and only discovered it 6-7 years ago after pushing for testing of my antibodies and t3, due to reading this forum and talking through my symptoms. It’s all very complex and sadly what works for me might not work for you, however the most important thing i’ve learnt is that we need to keep copies of blood tests, read and research to understand the condition & treat our bodies with kindness. In my family we have one person who responds well to thyroxine ( she’s not autoimmune just sluggish thyroid), and 4 of us who are autoimmune - those of us with autoimmune have or had all the supposedly unrelated issues of IBS type stuff, eczema, brain fog, goiter etc. the good news is each generation is less sick as we’ve learnt and helped ourselves.
I can’t profess to have all the answers about diet as i am less than perfect but certainly can’t see any harm in trying an anti inflammatory diet.
you might also want to consider a finger prick test to look at antibodies free t3, b12, folate and ferritin, that type of thing: I do a yearly one with thriva and it really helps me keep on top of things. I started addressing inflammation with some supplements and lifestyle changes, and removed gluten, whilst it’s not made a life changing difference i noticed a lot of my vitamin levels have actually gone too high and inflammation marker gone down. so despite having a very stressful year things seem to be improving.
I tried the the 5/2 some years ago and couldn’t understand why I wasn’t losing anything. It may’ve stopped me increasing but certainly didn’t work into lose & it was tough! I never thought I’d lose my hashi weight. However, when I changed to a vegan diet (not for health but ethical reasons), I was amazed, as I lost weight, which I really wasn’t expecting.
With regard to helping with the symptoms/inflammation etc. there is a Facebook group: Hashimoto’s Thyroid Alternative Approach UK group, which may be helpful. The lady that started it has controlled her symptoms through diet alone.
Thanks, Xanthi , I’m glad you found a diet that works for you. I’m going to get tested to see if I have Hashimoto’s and if I do the Facebook group you mention could be very useful, so thanks.
As others have said, until your bloods are at optimum levels, loosing weight would be a struggle. I tried 5/2 when my husband wanted to give it a go. I actually put on 6kg in the same time he lost 8kg - thats when I realised something was wrong and got my hypothyroid diagnosis.
If you can afford it a private blood test is a good idea. Through this I found I was quite deficient in Vitamin D. On getting all levels well balanced, I managed to loose just over a stone in 6 weeks following a Keto diet and then gradually added in carbs again - 3 months later, weight still good.
Everyone single person is different but dropping the carbs defo worked for me especially around the middle and it helped blood sugar and cholesterol too. Good luck in finding what will work for you, it is trial and error.
Thanks 964, I will def get my levels improved before concentrating on diet. My initial blood test showed vit D ‘through the floor’ to quote the GP so I’ve been supplementing, but thyroid was just borderline at 4.9 so GP wasn’t too concerned and was encouraging me to lose weight to lower the cholesterol. I now see the focus was wrong.
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