Hi does anyone have any advice on loosing weight with an underactive thyroid … I’ve put on so much weight :(

[Charr7]

I have put so much weight on and I can’t seem to loose any of it … it’s really getting to me

[SlowDragon Administrator]

Welcome to the forum

How long have you been on levothyroxine

How much levothyroxine are you currently taking

Have you had thyroid antibodies tested, or vitamin D, folate, ferritin and B12

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 at least annually

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 and thyroid antibodies if not been tested yet

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

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

Please add most recent results and ranges

[Lalatoot]

Remember that you need calories to convert T4 to the T3 that all our cells use. So extreme dieting and calorie counting will make matters worse.It is soul destroying when the weight piles on. You need to check what your thyroid blood results are to see if you are on an adequate dose of levo. Also check your vitamin levels to see if they can be improved.

This is the start of your journey to the new you

[Charr7 in reply to Lalatoot]

I’m due to have my thyroid levels re checked in august as it will have been a year since my levels were classed as normal … they checked my vitamins D over a year ago and was fine I will ask for that checking again too … I’m on 75 of levo … I don’t have an auto immune disorder they tested me for that. The weigh gain is ridiculous and I don’t know what to do for the best

[SlowDragon Administrator in reply to Charr7]

75mcg is only one step up from starter dose

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

Make an appointment and get FULL thyroid and vitamins tested NOW

Bloods should be retested more frequently than annually until thyroid results are stable after 2 or 3 tests

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 …lsome less

healthunlocked.com/thyroidu...

[Lalatoot in reply to Charr7]

We are on here because we have had to rely on each others experiences rather than the doctors. Doctors who know about thyroid are few and far between. We all need to learn for ourselves, monitor our blood results and be pushy for the correct treatment when necessary.

[SlowDragon Administrator in reply to Charr7]

Very much doubt NHS have tested both antibodies. If TPO antibodies are negative NHS doesn’t test TG antibodies

Significant number of Hashimoto’s patients only have high TG antibodies and struggle to get diagnosed unless tested both privately

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Have you had thyroid ultrasound scan

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

[Nanaedake]

You say you don't have an autoimmune disorder but what did they actually check? NHS usually only tests for TPO antibodies but you need TgAb checking too. Have you got an enlarged thyroid or have you had a thyroid ultrasound?

You say, they checked my vitamins D over a year ago and was fine. You need to know the actual blood test result as 'fine' might not be optimal. Also, 'normal' is anything in NHS range and might be low/high or just not right for you. Stick on this forum and you'll begin to unravel the problems.

[JAmanda]

For me, the only option is to get T3 and t4 high in range then do very low carbs and lots of walking. The hard part is sticking to any diet so I don't make it so restrictive you cut out entire food groups but I just really watch fruit, alcohol and anything sweet. No miracles here though!

[SmallBlueThing]

I'm at the mild end of pre-diabetic (worsened by COVID-19), and have found reducing carbohydrates and "eating to the meter" (testing with a blood glucose meter, before and two hours after a meal) to be a real help. If your GP is testing your HbA1c and the result is high in range, you may wish to consider this option. Carbs are addictive, so being rigorous with reducing them is probably best to begin with.

[Angeliki_]

Hi ! Try to make logical changes that you can stick on . Restricted diets will result in fat loss but also muscle mass . Also restrictions are not for long time periods . They don’t create habits . You should aim in changing habits .Try exercising every day ( not for kcal restrictions but for your hormonal balance and to avoid cravings). Drink lots of water . Can you aim at 3lt per day. Cut off any unnecessary sugars ( coffee, soft drinks etc.) eat foods that make you feel full ( high fibers food , salads , eggs , lentils , yoghurt Greek, add some bell peppers in your diet and lean meat e.g fish ) . Reduce salt !!! It actually increases your hunger . Eat up to 2-3 fruits per day . Watch out for low G.I. Foods ( prefer quinoa instead of pasta ,and consume whole grain ONLY) . If you want something sweetie try some honey, cacao , or carob powder !!Keep a food dairy so that you make sure you don’t eat more than you think . And finally be careful on your portion sizes .

[waveylines]

I really wouldn't start any restrictive diet until you are on an optimal dose for your underactive thyroid. Please dont rely on your GP telling you tests results are 'fine' ask for a copy. I usually ask reception who will print out for me. The NHS generally only test the TSH, sometimes Ft4 and rarely ft3. You need your ft4 & ft3 to be in the top third or near the top of the range. And importantly to have your b12, vit D folate and ferritin near top of ranges too as they are often low and we need good levels for uptake of thyroid hormones and well being. Its unlikely your GP will know this as they have minimal training on hypothyroidism. So get a copy of your results and post on here. Lots of really experienced and knowledgeable people on here that can help as they have also had to learn to self manage their condition. A good book to read is Your Thyoid and how to keep it Healthy by Barry Durrant-Peatfield

[Charr7 in reply to waveylines]

Thank you I will ask them when they test me again next month x

[Gerri030306]

Hi. I understand how your feeling, I put 2 stone on in 6 months. I was under active and with the help from this group I got my T3 and T4 tested and increased in Levo.I joined weight watchers 6 months ago and have now lost 13lb. It was very slow but it has stopped me putting more weight on while my body adjusts .

I have learnt from this group in order for your Levo to be absorbed and optimised your ferritin needs to be at the right level and vitamins. I have been taking supplements: vit D, zinc, selenium, iron, I was deficient in all.

If you read the advice here about all this you will start to feel better.

Don’t give up you can do this. Take control of your blood test results and follow the advice here.

[fuchsia-pink]

I for one can't lose weight unless both free T4 and free T3 are nice and high. It's really important to test free T3 - this is the active thyroid hormone every cell in your body needs, so if the GP can't/ won't test it, do please have a private test.

Beyond that:

* avoid soy. This means no diet shakes

* eat real food - ideally not processed, good range of green veg and protein

* restrict the rubbish as much as you can - fizzy drinks, booze, crisps, cake etc - you know the drill [allow yourself something occasionally or you'll go mad and/or off the rails!]

Some people do well on the 5:2 - I lost a stone quite easily then it stopped. Others lose a lot on IF - intermittent fasting - where you eat all your calories within a restricted time window - in my case that's between midday and 7pm, with just hot water in the mornings and evenings. It's very easy to adapt to and become a way of life - 3 years + for me. I don't lose weight on it myself, but it keeps the weight stable, which is half the battle. I have lost a bit on OMAD (one meal a day) - but can only do that in hot weather (or I get too hungry) and not for long, as it takes my blood pressure very low.

Good luck x

[Culnacille]

Hi Charr I had the sane problem but then started to take my levo at night before bed and at least two hours after I had eaten. It helped me.. maybe worth a try?

[Charr7 in reply to Culnacille]

I will try this aswell thank you xx

[Saz88]

Aw Charr7 wow as if you read my mind….. hugely appreciated keeping an eye on this topic as don’t understand and find frustrating my weight gain and inability to lose it also x

[meki]

I did two things became vegan and walked 10000 steps a day. Did not realise how much weight I had lost until Gp commented and asked what I had been doing

[Charr7]

Thank you to everyone for your help … I’m taking it all on board and will let you know how I get on xx

[Skylane2]

PALEO DIET Like you I-had gained so much weight when I was diagnosed with Hashimoto’s . A very underactive thyroid. Paleo involves a lot of coconut. Coconut oil, coconut sugar, coconut flour and meat! Lots of meat and fish and poultry! And vegetables. And some fruit no dairy.. But try to get fresh or frozen Vegetables. I lost 30 pounds within a year. I took Armour thyroid because I’m allergic to the synthetic kind. I live in the states but you can get most everything for the diet at Amazon; if you are unable to get it where you live. Google has the diet and there are lots of cookbooks available. It’s discouraging at first but preserver, You won’t be sorry. You should get your energy back!

[Venicefan]

I found this article very helpful for understanding weight issues when hypo:

restartmed.com/calories-hyp...

[Sammie46]

I have my ft3 , tsh and ft4 tested every 4 - 6 months. Ive had the same endocrinologist for 22 yrs so there are some doctors who know what they are doing. Research is helpful