Just wondering if anyone has found taking levothyroxine at night hasn’t helped?
For years and years I’ve done morning and avoided eating though did probably have a tea with milk about 30 mins after taking.
I thought I’d try evenings and since this I’ve definitely felt more tired, and have somehow gained 6lb in 4 weeks. 100% am not over consuming calories as I log my fitness pal and around jan I was doing around 1000 cal per day and then sat sun allow more, then more recently I would say around 1200-1400 per day. My bmr is estimated at 1500 so I cant see how this is possible.
I’m thinking the biggest change is doing levo at bedtime
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Bellsonit
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There are 2 changes there. It could be that nighttime doesn't suit - it is very much an individual thing.
It could also be that you are not eating enough - we need calories to convert T4 to T3 - if a person is on a calorie-restricted diet they can affect conversion leading to more hypo symptoms including weight gain as ft3 decreases.
Thank and wow i didn't know that. Honestly sometimes i just dont know what to do diet wise my weight just keeps going up and up and its affecting my mood / self esteem dramatically.
I've just had panel results through today and i think again the doctor will just say i'm fine and dont need any further support. I really want a referrral to an endo (i do have bupa so maybe they'll say yes)
Todays results from NHS are
TSH - less than 0.2 (range 0.27 - 4.20)
Free T4 - 21.3 (range 12-22) -
Free T3 - 4.8 (range 3.1-6.8)
Ferritin - 63 (range 15-350)
Folate - 6.2 (range 3-18)
My TSH, Free T3 consistently stay around those ranges since at least 2018 and I've been on 150mg
When i was on 175mg Free T3 was 6.7
I'm pretty certain i have hashis as when first diagnosed i had a goitre and vaguely recall endo saying it was hashis. Also 1 year ago did Thriva test and TPA was 29 and TGAP was 1391
I definitely felt better but the GP always focusses on my TSH levels - rather than the T3. I'm guessing that the conversion of T4 to T3 isn't great based on the levels which is why i hoped an endo might be able to help?
Just my personal opinion (feel free to dismiss), but if you've had a very significant increase in your free T3 on 175mcg and felt better, I'd be inclined to save my money with private route. 6.7 is near the top of the range for T3. Even a private endo (unless they are truly steller) is likely to keep you in that range for T3 and pronounce you as approaching over-medicated regardless of how you feel.
I would get the vitamins optimal first. Endo is also going to focus on that anyway and likely try and sell you their own recommended brands
If I knew I could get my t3 up on levo alone I'd start fine tuning once I reached the top of the range adding tiny increments of levo till truly feeling great.
I'm assuming there aren't other issues like fatigue that are indicative of adrenal issues, in which case defo go private as you'll get zero help on the NHS with that.
Results show you are a poor converter of Ft4 to Ft3
First step is to test B12 and vitamin D
Make sure all vitamins are optimal
Folate and ferritin at least half way through range
Vitamin D at least over 80nmol and around 100nmol maybe better
Serum B12 at least over 500
Or active B12 over 70
Ferritin a bit low
Looking at increasing iron rich foods in your diet
Folate and B12 likely to need daily vitamin B complex to maintain at good levels
Remember to stop taking any supplements that contain biotin a week before all blood tests- eg all vitamin B complex, as biotin can falsely affect test results
Assuming you have Hashimoto’s
Have you had coeliac blood test done
Or are you already on strictly gluten free diet
If not, test for coeliac BEFORE considering 3-6 months trial on strictly gluten free diet
Retest thyroid levels 2-3 months after getting all four vitamins optimal and gluten free and always same brand levothyroxine
If FT3 remains low looking at needing small dose T3 prescribed alongside slightly reduced dose levothyroxine
Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3
tukadmin@thyroiduk.org
I really want a referrral to an endo (i do have bupa so maybe they'll say yes)
Vast majority of endocrinologists are diabetes specialists and useless for thyroid patients
Hi Thanks for the response. No they didn't do Vit D or B12. I am going to do blue horizon as i want the antibodies but was thinking of doing silver as that gives TPA, TGA, Cortisol + Magnesium.
My last 2 vitamin D were from a healthcreening which was 69 in June 21 and Thriva which was 46 in Nov 20. (range 50-200)
And B12 was June 21 - 77 and Thriva - 80.3 (range 25-165)
I had TTG done according to the form the nurse had but they didn't have the results but my health screening in June 21 said 0.4 so it looked unlikely i was coelic.
I'm having many symptoms of hypo. Tiredness, Weight gain, Feeling the cold, Depression, Brain Fog and Confusion, my resting heart rate is about 46-52 during the day. My weight is really erratic, i managed to drop 4lb in 7 weeks through calorie deficit (800 ish) but in 3 weeks have put that back on and that through having around 1200-1400 calories daily. I've been feeling so low about that too that its lead to self harm which I've been really having to give myself a kick to stop doing.
I had given taking vits a rest as wanted to make sure that there was nothing lingering when i tested. But was taking Iggneus Super B complex and Better you Vitamin D Daily Oral Spray - 4,000 IU. Also I was taking some Selenium for a while but stopped that.
And i had my blood test at 8.49 and hadn't taken my levo for over 24 hours. It was about 30 hours gap as have been taking at night time.
The brand is nortstar accord. And this seems to be one i've had for a long time.
I had TTG done according to the form the nurse had but they didn't have the results but my health screening in June 21 said 0.4 so it looked unlikely i was coelic.
I'm having many symptoms of hypo. Tiredness, Weight gain, Feeling the cold, Depression, Brain Fog and Confusion,”
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but a further 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
As your coeliac result is negative you can now consider trialing strictly gluten free diet for 3-6 months.
Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
And i had my blood test at 8.49 and hadn't taken my levo for over 24 hours. It was about 30 hours gap as have been taking at night time.
The brand is nortstar accord. And this seems to be one i've had for a long time.
Last dose levothyroxine should be 24 hours before test (not less & not more)
So your Ft4 result would have been higher if you had only left 24 hours
At next test
As you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Remember to stop taking any supplements that contain biotin a week before all blood tests
Brand levothyroxine
Northstar is Accord brand, boxed as Almus via Boots or Northstar via Lloyds
Accord only make 50mcg and 100mcg tablets.
Beware Northstar 25mcg is Teva brand and Teva upsets many people
So if reducing to 125mcg or increasing to 175mcg …..will need to cut 50mcg tablets in half to get 25mcg
Many of us take thyroid meds with food. It's better for the stomach and simplifies the daily routine. Weight gain can be due to insufficient thyroid meds and not due to diet. So stop counting calories and see if you can get your thyroid bloods to optimum. Many docs don't understand the difference between 'in range' and optimum blood results.
I don't know about that. Personally I don't take coffee or tea with meals. I have a decaf when I get up, then breakfast is an hour or so later. My next coffee is mid morning.
Here's a link to a previous post about taking levo including my reply and various links about taking with food.
I'm probably wrong for doing it but when i was taking it in the morning it was highly unlikely i would eat for a few hours, only drink tea with milk.
Its rare for me to have breakfast - particulary as i've been trying to minimise my calorie intake in desperation of losing weight and feeling less disgusted with myself following my weight gain.
She quotes from Dr Kenneth Blanchard's book "The functional approach to treating hypothyroidism". This book is well worth reading. He switched many patients to taking meds with food and says nothing about insisting that it is always the same food. He says that a few patients needed more T4 because of the reduced absorption of T4, but "this effect is surprisingly uncommon".
There are other benefits to taking meds with food, such as simplifying the daily schedule.
Taking at night doesn't work for everybody, no we're all different and some of us have hidden adrenal.issues etc. Taking levo at night keeps me awake, unless it's a very small dose.
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