36 y/o male, diagnosed with symptomatic subclinical hypothyroidism in May, and have been taking levothyroxine and more recently liothryronine - current daily dosage is 50mcg levo and 15mcg lio.
My most recent blood test came back as follows, and it's certainly by far the best my FT3 has been since I started testing / treatment.
TSH - 1.76 mU/L [0.27 - 4.2]
Free T3 - 5.96 pmol/L [3.1 - 6.8]
Free Thyroxine - 17.1 pmol/L [12 - 22]
Given my FT4 was sub-4.0 at the outset, this seems like quite an improvement. I also feel somewhat better in myself; by no means perfect but if at my lowest ebb I felt 10% of my former self, I'm probably closer to 70% - 80% now.
One thing I've struggled with for some time that hasn't changed as yet is weight management. Back in the early part of 2019, I had a <10% body fat and was in really good shape. But even then, maintaining weight was hard work, and in the time since I've steadily crept up, now weighing in around 3 stone heaver than I did back then.
In normal weeks I can just about keep it stable, but every time there's a social event etc. that means eating / drinking more than I would on a typical day, I end up adding a pound or two which never disappears. You can literally see the difference the next day, it's that profound. And once it's there, I simply cannot lose it.
Given that I'm feeling generally better, happier, warmer etc. and with a much improved sense of energy and mental clarity, I can only assume that my metabolism in general has picked-up to facilitate that. On that basis, would I expect challenges with weight management to improve in tandem, or is that likely to take longer to kick-in? Is there a worst case scenario that it never improves, and I find myself stuck like this (which, not withstanding all of the other improvements I'm experiencing, is still pretty grim)?
Sorry for any basic questions, I'm still learning about all this.
Thanks!
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JonnyA
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Looking at previous posts…..you only increased dose a week or so ago?
It takes weeks/months for metabolism to slowly pick up after any dose increase
Bloods should be retested minimum 6-8 weeks after being on constant unchanging dose levothyroxine and T3
all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
On day before blood test, split T3 into 3 smaller doses, at roughly equal 8 hour intervals, taking last 1/3rd of daily dose approx 8-12 hours before test
Likely to need further increase in levothyroxine after next test
I can only lose weight when both frees are nice and high. Beyond this, I do the restricted eating thing - all my calories in a 7-hour window - in my case mid-day - 7pm [I only have hot water until noon] - and it keeps my weight stable, even if I have social event "big eating" days which stretch the window that day. Other have lost loads of weight on this, so maybe give it a try. You pick the hours that suit you personally
Thyroid hormone levels are looking much improved but even when finally optimised there will be much catching up to do of another systems.
Cortisol imbalances are notorious in hypothyroidism as adrenals will support inadequate thyroid hormone levels, and cortisol not only influences stress tolerance but how glucose is metabolised and muscles burn energy. Think of hypoglycemia (too little sugar in the blood caused by various reasons but in hypo/hashi peeps mainly insufficient cortisol to raise blood sugar into the normal range) and insulin resistance (too much sugar in the blood).
Consistently high cortisol levels result in the classic fat-around-the-middle scenario which can be terribly hard to shift and indicative of insulin resistance which reduces the ability to burn fat further. The excess sugar (glucose) in the blood is turned into fat by the liver (lipogenesis), and to some degree the fat cells if you carry a lot of fat, in an effort to balance blood sugar levels & once made into fat it can not be converted back into blood sugar.
Equally look into leptin resistance as this is the energy store (fat) controlling hormone telling us when we are hungry/full and influencing resting metabolism rates and lipolysis (fat breakdown). Leptin resistance also changes the behaviours of the deiodinase enzymes that dictates how our body uses our thyroid meds (same as happens on a calorie deficient diet or anorexia).
However, you are still optimising thyroid hormone levels and once you are there you may find any negativities just start reversing themselves at some point. Avoid calorie restriction as thyroid hormones needs steady levels of carbs/glucose to work.
My adrenals were shot when I started medicating thyroid hormone replacement & it was only keeping blood sugar levels stable throughout the day & night that allowed good utilisation of meds and weight to reduce, ie small regular meals all of which contained protein & enough carbs, and never allowing myself to become really hungry. Eating a peanut butter g/f cracker just before bed eliminated that 3-4am wakeup. Also using adrenal supports, ie glandulars or adaptogens.
Giving meds best chances of working by optimising iron & nutrients will help adrenals and consequently faster weight loss. However, depending on how long you have been thyroid hormone deficient & life style will also influence when your body starts regulating weight loss, ie optimising thyroid hormones alone may not make it happen.
HI Radd, that's a really interesting post. Please would you tell me (PM perhaps to avoid interrupting this post) where I can find more about both cortisol and weight, and, leptin resistance. In the last few years I have put on a lot of weight around the middle and had just put it down to age, it would be great to get rid of it and be able to wear clothes I like again.
There are many other reasons for weight refusing to shift such as bodily inflammation (adipose tissue-mediated chronic systemic/raised thyroid AB’s), menopause (lack of oestrogen, etc ), calorie deficit or even inadequate nutrients/iron preventing meds from working effectively.
Remember all other hormones, proteins, neurotransmitters, heath conditions, etc and will impact energy levels & weight management. I just focused on the hypo associated cortisol issues because o/p has been so thyroid hormone deficient and cortisol/blood sugar issues can go unrecognised until we balance glucose levels and suddenly feel so much better.
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Losing weight with Hashi. If you ignore the plugs for her own products the rest is informative information.
‘Fat Around The Middle’ by Marilyn Glenville. It’s quite an old book now but an easy read & the reasons for cortisol accumulated fat have never changed 😊
Going gluten-free might help reduce your weight. Do a trial for about 6 weeks. Excerpt below from the following link:-
A gluten-free diet: There's a link between gluten sensitivity and celiac disease and the development of autoimmune conditions, including Hashimoto's thyroiditis. Some patients have reported significant weight loss when they shifted to a gluten-free diet.
Have you had your testosterone levels tested? Low T can be a cause of weight gain. Sex hormones and thyroid hormones are often out of balance. Just a thought. I’m not male but in my experience, when my sex hormones are out of whack, I start to gain weight (I notice it immediately in my midsection). For me, this includes estradiol, progesterone and testosterone. I’m not sure if it’s the same for males.
I am HypoT and take Levo and Liothyronine and I’m also on HRT.
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