Is being overweight normal with under active th... - Thyroid UK

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Is being overweight normal with under active thyroid?

CharlyMae profile image
21 Replies

Hey!

Regarding my other post about being tired, I had a really bad week and cried lots due to the tiredness but I am calling the doctors in the morning to discuss increasing my dose etc. Thanks for all your advice!

My next question is about food/weight.

Over the last 4 years my weight has crept up from 13 stone to 15.8 stone. I really struggle to shift it.

I want to see if I’m eating well/right?

My usual diet:

Breakfast:

Banana + coffee with oat milk

Lunch:

Mixed spinach salad with 2 boiled eggs + 1tbp of olive oil

Snacks:

Apple

Quinoa crisps (1 small packet)

Coffee + oat milk

Water:

2 litres

Dinner:

Chicken or Turkey

Sweet potato

Salad or green veggies

Sauces:

Mayo

Ketchup

I have decaf coffee after 3pm.

Am I doing anything wrong? I eat around 1500 calories a day and walk for one hour.

Should I add in a workout?

Do my levels need to be optimal to lose weight?

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CharlyMae
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21 Replies
SlowDragon profile image
SlowDragonAdministrator

Results from Previous post

My TSH was 45 which was when I got diagnosed and is now 3.4 and I’m on 50mg.

Request 25mcg dose increase in levothyroxine

Bloods should be retested 6-8 weeks after each dose increase

Likely to need several further increases in levothyroxine over coming months

jimh111 profile image
jimh111

Coffee can substantially reduce the absorption of levothyroxine so make sure you take your levothyroxine at least one hour away from coffee. You can take your levothyroxine at bedtime if you find this easier. If you are having levothyroxine and coffee around the same time wait and see how you get on with the new timing before adjusting your dose.

CharlyMae profile image
CharlyMae in reply tojimh111

I have been having my coffee 1 hour after taking my levo! :)

userotc profile image
userotc

Since your question is about diet/weight control, have you considered seeing a naturopathic nutritionist?. He/she should consider not just weight control/loss but optimum nutrient intake which is important with thyroid dysfunction and many other health conditions.

Meanwhile you'll receive good thyroid support on this forum.

SlowDragon profile image
SlowDragonAdministrator

guidelines on dose levothyroxine by weight

Even if we frequently 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 eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

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.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Guidelines are just that ....guidelines.

Some people need more .......some less

healthunlocked.com/thyroidu...

As you are already on strictly gluten and dairy free diet you likely need several further increases in levothyroxine and may need addition of T3 once levothyroxine dose is up high enough

Which brand of levothyroxine are you currently taking

As you are dairy free, are you on lactose free levothyroxine?

If GP won’t increase levothyroxine dose Email Thyroid UK for list of recommend thyroid specialist endocrinologists...

NHS and Private

tukadmin@thyroiduk.org

The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is ALWAYS under 2

When adequately treated, TSH will often be well below one.

Most important results are ALWAYS Ft3 followed by Ft4. When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)

Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works

Localhero profile image
Localhero

CharlyMae

First of all, I really feel for you. I’ve been struggling with weight recently. Actually, more so on medication than before. I’m still working on getting my levels right, so it’s all a work in progress.

However, some thoughts:

Breakfast:

Banana + coffee with oat milk

I would say that you need to review this. Banana, lovely as it is, is high in carbs, and combined with coffee is not necessarily the best way to set your nutrition up for the day. Thyroid hormones need well balanced blood sugar to work well. And the best way to ensure good blood sugar is to eat proteins with slower carbs and a little fat at each meal.

You might consider having old fashioned porridge oats, with some protein powder mixed in (I use a lovely vegan one from Form), and a sliced apple or some berries with a little nut butter on top. Or switch your eggs from lunch and have them on gluten free seeded toast (Waitrose one is very good).

I eat around 1500 calories a day and walk for one hour

Is 1500 calories enough for you? I think we have to be careful not to undereat when we’re hypothyroid as our bodies do need calories for thyroid hormones to do their job. Also, if you’re tired, making yourself walk for an hour a day may be counterproductive.

SlowDragon profile image
SlowDragonAdministrator

15 stone 8lbs is 98 kilo

98 x 1.6 = 156

So Guidelines suggest you might need somewhere around 156mcg levothyroxine per day

We have to only increase dose slowly upwards in 25mcg steps, retesting levels 6-8 weeks after each 25mcg dose increase

fuchsia-pink profile image
fuchsia-pink

It's normal - but not inevitable ...

I for one cannot lose weight unless both free T4 and free T3 are nice and high in range. As others have said, I suspect you are still quite severely under-medicated - 50 mcg is only a starter dose really and you have little chance of losing the hypo weight on such a low dose.

Can you try and get both a dose increase - 25 mcg to start and another blood test after 6- 8 weeks (always an early morning fasting test when TSH is highest) - and see if the GP will do full testing - ie TSH, free T4, free T3 and key nutrients - ferritin, foate, vit D and B12? I've had some success with mine by saying that these are the tests recommended by Thyroid UK - but if s/he refuses, can you treat yourself to private testing? You need the free T4/free T3 tests to what your actual thyroid hormones are doing and see how well you convert and the nutrients are important because so many of us hypos are low and need to supplement - and you need them to be decent to get the best from your levo.

Even after you get onto the right dose, weight loss is difficult- but at the moment you are trying to climb a mountain with your legs tied together. Good luck x

FancyPants54 profile image
FancyPants54

Your diet is very dull and lacking in variety. The eggs are great (good source of protein, fat and vitamins) but you need more variety and more of it too probably. You won't loose weight if your body thinks these a shortage of food.

Eat some red meat too. Fat doesn't make you fat, you need it. You need red meat and blood products for good iron levels. Good iron levels are essential for thyroid medication to work properly. And I agree with the others, you are most certainly under medicated at this stage. You need to know what your Free T3 and Free T4 are, not just your TSH. You will probably have to do a private test for that.

Sleepyachy profile image
Sleepyachy

Hi ya , I also get tired , weight gain etc . I ask to test my ferrtin as advised. Was low . Now on ferrous sulfate, iron tab , 3 times a day. Have defo noticed a difference in the tiredness and defo more alert. Weight loss takes a while , easy to put on hard to take off. I've defo put weight on since started with this knackered thyroid. Try not stress , u look fab in ya pic . Dont be so hard on ya sen. Worse things than weighing abit more . Just enjoy ya sen x

WomanInPink profile image
WomanInPink

I feel for you. I gained a lot of weight whilst trying to persuade my doctor to test me for hypothyroidism. I managed to lose 4 stone after eating keto (clean version) for 8 months. I am now stable and have added a few more carbs mainly from root vegetables into my diet. I swear by it.

shaws profile image
shawsAdministrator

This is a link of photos from an American site and it might surprise you but I hope it is helpful:-

stopthethyroidmadness.com/h...

BelfastGirl83 profile image
BelfastGirl83

I am fairly new to the under active thyroid/hashimotos world so I’m still on my learning journey. I have always been active and try to eat well though so I echo what others have said and I think you need to consider adding more calories and protein to your diet. If you base your meals and snacks around some form of protein, adding in veg/carbs in the mix, then you will feel more satisfied overall. I would suggest a larger protein rich breakfast to kick start your body after fasting overnight-I used to skip breakfast regularly but once I started eating a good breakfast, it made a big difference to my energy levels throughout the day. As others have said you likely need more levo and optimise your vitamin levels so all systems are working together optimally. Your body is reluctant to let go of weight because you probably are not feeding it enough-it’s a very easy mistake to make and I think we are all guilty of it from time to time! You look fab by the way!

tattybogle profile image
tattybogle

Trust your body to know what it's doing.. (of course you can help it along at the moment by avoiding the empty calories in cream cakes and lager and biscuits, which you seem to be doing a good job of already)... but remember that thyroid hormones change you body slowly whilst you are becoming hypothyroid.. and they change your body slower than you'd like once your thyroid hormones are optimally replaced AND stable. The metabolism takes it's time to decide if everything is 'OK now' ... this won't happen until it gets enough thyroid hormone and the level stays reliably the same... then eventually it will turn it's attention to the fact that it can safely burn calories faster, and this will go hand in hand with increased ability to be more active and burn more.

If you try and force the pace , you may not be helping. If your body thinks it's not getting enough nutrition it will slow everything down, counterproductive to what you are trying to achieve. And it won't allow you to make the best use of the thyroid hormones you do have.

Some protein at breakfast often helps everything work better.. i took to having 2 poached eggs and a green veg, or live yoghurt and fruit/nuts/seeds.

Don't be afraid of 'good' fats.

You're already doing the best thing by making sure your thyroid hormones get optimised as quickly as is possible.... give yourself a year off from thinking too much about 'weight'... eat well concentrating on the quality of nutrition in your ingredients,

When you eat at the moment don't think of it as calories that you don't want.. instead think of it as building a good base for the body's systems to work best from.

Trust your body .. it's smarter (and more beautiful!) than you think.

DACG profile image
DACG

I'm certainly not an expert but you appear to be on a permanent diet and yet you're stlll putting on weight which is very unfair. When I was first diagnosed with an underactive thyroid the GP gave me the comforting advice that taking the levothyroxine would help me with my weight. It did a little but I eat FAR too much - not like you! My thought would be that you are undermedicated as the levothyroxin is meant to balance you and replace the action of the thyroid - as I understand it! Again, I'm no expert... Hopefully an expert will answer you soon.

Legoparis profile image
Legoparis

I also think you look great in the photo I agree with previous replies but-

My eventual success followed a consultation with a functional doctor who advised me to focus on getting The Gut in good order -so eliminated various foods likely to cause sensitivity such as dairy coffee tea eggs beef pork seafood bad oils and only ever eat carb with protein never snack only three solid balanced meals a day -eat until you feel satisfied then ensure at least 12hours between dinner and breakfast once a week leave 18 hours (varies throughout month) eat at least 20 different fresh fruit and veg a week eat olive oil and avocado

Add in some quiet meditation daily a walk and try to stop focusing on the weight but optimise all the other parts of your life( not easy)

I’ve been doing for 6 months and feel the best I’ve been in years and lost over a stone and all bloating ended much easier to follow than I ever imagined

I know we all wish you luck with your dilemmas but be reassured there is some very good advice on this forum

CharlyMae profile image
CharlyMae

Thanks everyone! I got this book for some meal ideas - the writer has PCOS/Endometriosis and Hashimoto’s!

Recipe book
Venicefan profile image
Venicefan in reply toCharlyMae

I found this article very helpful:

restartmed.com/calories-hyp...

Pippi39 profile image
Pippi39

Hi I have underactive thyroid and Hashimotos recently diagnosed by scan.

I went to see a endocrinologist as I felt so tired and unwell. I was told to cut out gluten and dairy for 3 months. Then I will return to see him. Also no potatoes, pineapple or banana. He said no coffee but I couldn’t do it! I have cut down to one cup per day (an hour or so after levothyroxine).

I have lost weight (9 pounds so far) and so feel better. I also worked hard at improving my vitamins levels (advice on forum is excellent for this).

Like you, I was walking for at least an hour a day but not seeing benefit. Endocrinologist said to walk 15 mins from house and then turn back again. Do this x2 a day. He said you will see results. I have to admit I haven’t been doing this every day but it’s my next step now that I’m feeling better.

Hope this helps!

WAP21 profile image
WAP21

Hi Charly. I had exactly the same problem. Increased weight over time and really struggling to shift it. Last Christmas I had some bloods run and got concerned over the increased cholesterol. I decided to do something about it. At a cost, I engaged with a nutritionist who specialised in nutrition for those with an under active thyroid. With her guidance we run private bloods. As a result I’ve cut out Gluten, I studied my meds and as a result of advice from this site changed them for the better. I’ve promoted my gut health with foods and supplements and improved my vitamin intake. I’ve also undertaken more activities, running, swimming etc. I lost a stone, and I’m feeling much better. I’ve still a way to go, it’s ongoing and hope to remove more in time. I’ve learnt to balance what I eat to avoid having highs and lows with sugar intake. I’ve hopefully done enough to not be diagnosed with diabetes. Fingers crossed. There’s no quick fix but it can be done the nutritional help I got was invaluable, best money I’ve spent. Shouldn’t have too but my health really mattered to me. Hope this helps

Lulu2607 profile image
Lulu2607

Hi CharlyMae. It's a while since you posted and I was wondering how you are getting on as I fully identify and sympathise with your problem. Has anything changed? Hope you are doing well.

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