Latest results and belly fat /weight gain past year with a higher tsh

[sparklefairy]

Hey guys can anyone help me with these results please..

Inflammation CRP HS 0.82 (<5)

Free T4 14.8 (12-22)

Free T3 3.9 (3.1-6.8)

TSH 1.58 (0.27-4.2)

Ferritin (Iron) 59.8 (13-150)

Folate 5.1 (>3.89)

Vitamin D 46.9 (50-175)

B12 150 (>37.5)

Thyroid Antibodies

Thyroid peroxidase 14.3 (<34)

Thyroid thyroglobulin 16.6 (<115)

I have been on T4 and diagnosed with hashimotos since 2010. Since 2012 my dose hasn't increase from 150mcg thyroxine. I eat mainly veg and meat and avoid dairy and gluten. I weight train 2-3x a week, dance x3 a week and I walk 10,000 steps a day. I sleep 7-8hours. My calorie intake sits around 1400 and I know my iron is low because I have been having vegan chocolate this month quite a bit.. But the weight gain has been going on for about 2 years now.

Normally I am about 10llbs lighter and I notice my belly is flat and I am mostly toned.

I am desperately trying to work out if it's my T4 that needs upped.

I have just introduce 12mcg of cynomel T3 but I now think I need to adjust my t4 because my TSH was always coming out around 0.2 and now it's way up at 1.58!

The doctor just suggested I get a vitamin d supplement for 10 weeks up to 2000 a day and add slow iron.

But it's the weight gain that I want to tackle as I don't really get many symptoms except brain fog and some demotivation on tired days..

[SlowDragon Administrator]

Folate and vitamin D are too low

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Do you always get same brand of levothyroxine

Which brand

Your results suggest you are under medicated and need dose increase in levothyroxine

Low Ft4 shows under medicated

Ft4 is only 28% through range

Recommend trying increasing levothyroxine BEFORE considering adding T3

Just levothyroxine is much easier to manage

Most people on just levothyroxine need Ft4 at least over 18.....sometimes higher

Vitamin D needs improving to at least around 80nmol and around 100nmol maybe better

What vitamin supplements are you currently taking

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B is another option that contain folate, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[sparklefairy in reply to SlowDragon]

Thankyou Slowdragon. Yes I have followed all the guidelines, do you reckon upping T4 by 25mcg is enough slowly increasing after 3 months or is 50mcg increase okay?

[SlowDragon Administrator in reply to sparklefairy]

Only ever increase levothyroxine by 25mcg at any one time

Retest in 6-8 weeks

[sparklefairy in reply to SlowDragon]

Okay thankyou

[Hidden]

I would also like to add that I think 1400 is far too low given the amount of activity you do - assuming you track accurately and are not guessing? I have found that a low calorie diet doesn’t help thyroid issues. A smaller deficit would probably be more beneficial to your overall well being.

I don’t know your height and weight but I would suggest 1800-1900 at the very least. I imagine you’re requiring in the region of 2200-2500 per day with all that activity. A 100-200 cal deficit is usually recommended. Don’t use the online calcs to work out your calories especially the ones that have a ‘hypothyroid’ option. There are a variety of formula written out to work out your RMR, BMR and then activity.

[sparklefairy in reply to Hidden]

Thankyou. Yes I worked with a PT last year who had me up to a min of 1650 and I reduced my cardio. I lost about 2lbs in the full 3 months. I am terrified of upping my calories without getting my medication optimal because I'm a dancer and graduating in 3 months, but I am aware I may be making things worse.

I'm 35

150lbs

165cm

.

When my tsh was at 0.8 I managed to sustain 140lbs at the same calorie intake but I wasn't weight training back then.

[Hidden in reply to sparklefairy]

Difficult position but I would say eat more. 1800-1900; higher percentage of protein. T3 should help too. I’m v similar to you. Slightly taller but have got down to 132lbs from 150+ walking 10k plus a day on 1900; no other exercise. Added T3 and can do a lot more - I sit around 135. Weights (especially if doing heavy, compound) burn more than you think and you need the calories for recovery and muscle composition.

[Hidden in reply to sparklefairy]

Mifflin St Jeor resting metabolic rate equation has you burning 1375 calories day to day without any extra activity. Clearly there are assumptions around equations (I.e lean body mass will play a part) but it’s a good starter for 10.

[sparklefairy in reply to Hidden]

Thankyou so much for your help!I will up my protein and veg calories and trust T4 to do the work.

I will schedule a retest in 3 months