Does anyone have any advice on weight loss when you suffer from underactive thyroid??
I'm on the lowest dose of thyroxine (50mcg) and my bloods have stabilised. The doctor however asked how my weightloss and tiredness is and to be honest I've done diets before and lost weight but this time seems alot harder. She's mentioned that she'll up my thyroxine dose but I know this won't just fix the problem and speed up my weight loss.
Has anyone had this trouble and found solutions that have worked?
Bloods have stabilised to what level ? 50 mcg is highly unlikely to be enough.
When on enough Levo , weight should hopefully decrease naturally over time with increased activity, but i confess weight gain is not a problem i had personally.
However be careful with dieting, (apart from the obvious 'cutting out empty calories')...Dieting by restricting calories severely will be counter productive to thyroid hormone levels .. you need enough calories to efficiently convert the T4 in Levo to T3. and it's the T3 that works in your cells not the T4.
I need to ask for a print out, all I know is they were in normal range
I've cut my calories back to 1200 a day, and avoiding the "not eating enough" problem. And making sure the calories I'm eating are from healthier options
Ok so 'normal range' is not what you want for optimal treatment . for example...Normal range for TSH is roughly 0.4 to 4 .5 ish ,, so a GP might say 4.0 was normal .. but it's really not very usual to have TSH 4.0 even for healthy people. most have it near 1 and once talking Levo the relationship between fT4 /TSH changes a bit, so those on Levo often need it slightly under 1 before they feel better .
See this graph of healthy peoples TSH levels .. you 'll see only a very few are anywhere near the top end of the reference range. healthunlocked.com/thyroidu...
50mcg levothyroxine is only a starter dose
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
Which brand of levothyroxine are you currently taking
Do you always get same brand
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
Please add your most recent results and ranges
GP is correct you will need next 25mcg dose increase in levothyroxine
The dose levothyroxine is increased slowly upwards in 25mcg steps over several months ….retesting 6-8 weeks after each dose increase
Important to also test vitamin D, folate, ferritin and B12
These frequently are low and need supplementing to improve
Have you had vitamins tested
Also important to test TPO and TG thyroid antibodies to see if your hypothyroidism is autoimmune thyroid disease also called Hashimoto’s
About 90% of primary hypothyroidism is autoimmune thyroid disease
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
bestpractice.bmj.com/topics...
Guidelines are just that ....guidelines.
Some people need more …..some less
Hello Bwrd :
Your metabolism is very much controlled by your level of T3 :
You are taking T4 which is a storage hormone and your body needs to convert this into T3 which is the active hormone that the body runs on.
As you slowly increase your T4 in 25 mcg increments every 6-8 weeks this will increase your level of T4 up towards or into the top quadrant of its range and this should in turn be converting in your body to a higher level of T3 and hopefully the relief your symptoms.
No thyroid hormone works well until ferritin, folate, B12 and vitamin D are maintained at optimal levels, and not just somewhere in the NHS ranges, and you may well need to supplement these yourself.
Maybe ask your doctor if they can run these vitamin and minerals for you :
What have you been diagnosed with to be being prescribed T4 - is it an autoimmune thyroid disease ?
I’ve used Slimming World and lost 3 and a half stone. It’s worked for me, and it’s a way of eating that doesn’t leave you feeling hungry. Plus you get group support. It was on Zoom during all the lockdowns and restrictions, but we’re back in Group Meetings now. Sometimes if we really restrict our calorie intake, our body goes into starvation mode. This means it hangs on desperately to everything we eat. Eating more of the right things makes it easier to lose weight. Good luck with finding something that works for you! I agree 50mcg is considered a starting dose!
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Need Advice Please 
