So for the past 11 weeks I have been doing an intermittent fasting diet to lose weight for my sons wedding. I knew within a couple of weeks that this was the diet for me, in that I had a lot more energy and for the first time in years started going swimming and felt so much better in myself.
Today I had a routine nurse check up appointment where she did a thyroid blood test and I had a GP on the phone earlier in a panic as I've gone hyper now.
Results today:
TSH - 0.03 (0.27 - 4.2)
FT4 - 25.8 (11.1 - 22)
The GP suggested I drop my current dose of 150mcgs to 100 mcgs which I thought was too bigger drop. So we agreed I'd drop it to 125mcgs and retest in 6 weeks.
This does explain the swollen legs and feet I've had recently although my heart rate has been fine, in fact if anything lower than previously bizarrely. I wasn't right by a long way before I started the diet and it looks like it will be a lifetime thing for me and my metabolism!
My question is, do you think I should have dropped the whole 50mcgs to 100mcgs or should I stick with my original plan of dropping 25mcgs to 125mcgs?
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Jaydee1507
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I had a GP on the phone earlier in a panic as I've gone hyper now.
No, you haven't gone hyper, that's a physical impossibility. You have hypOthyroidism so your thyroid cannot regenerate and produce excess thyroid hormone. What can happen is that you could be overmedicated which your results suggest might be a problem but you wont know unless FT3 is tested, that's the test that tells us if we're overmedicated.
Also, you have Hashi's and that could also explain your current results, maybe it's a temporary hyper swing.
Do you actually have any symptoms of over medication or hyper type symptoms?
This does explain the swollen legs and feet I've had recently although my heart rate has been fine
I wouldn't be surprised if a good percentage of the population has swollen feet at the moment with the temperatures we've been having, I certainly have.
I should have dropped the whole 50mcgs to 100mcgs
Dose changes should be no more than 25mcg, and in some cases smaller dose changes are in order.
You could reduce by 25mcg or maybe try 12.5mcg. Presumably you keep a record of your results, where have you felt optimally medicated before and what dose gave you those levels?
OK so I may be overmedicated. Splitting hairs really. Symptom changes are: drier hair, swollen legs/ankles with cramps, peeing more often, also at night and thirst, feeling more tired. The swollen feet didn't happen in the worst of the heat, only past few days when it was a lot cooler.
TBH I've never felt actually well with no fatigue since being Hypo/Hashi's (25+yrs). Almost since diagnosis my 'best' dose has been 150mcgs which is what I took today before this result. I've tried many diets (also NDT) etc and this fasting one has made the most difference in the shortest space of time.
I know there's no T3 result but I've never felt well when below the TSH range, it just doesn't suit me well at all.
So you agree with the 25mcgs drop. I thought 50mcgs was a big leap. Also my son's wedding is in 5 weeks and I'd rather not be either hypo or hyper. Yikes!
All your symptoms are same as mine when overdosed, really feeling those swollen legs with cramps, dehydration and hair brittle. I would personally drop by 12.5.
Intermittent fasting improves intestine motoric complex, I think it's called MMC, you could be absorbing your meds better thanks to it. I just had an appointment with my clinical dietician about it yesterday.
Just seen your remark below, did you have your meds before the test the same morning? That would cause a high ft4 result
Thanks for your input. Pretty sure I am slightly overmedicated. It's weird how some people have barely any symptoms when over and others like me can't stand it at all. I'll also start on selenium and zinc as a double backstop.
based on my own experience of being overmedicated ,and reducing by too much , i'd suggest trying a reduction of just 12.5mcg first for a couple of months ,..... even 25mcg can be too much, and could knock you for 6 if you're feeling relatively well at the moment . i was on 125mcg ( fT4 went loads over range, but i felt ok) ... tried 112.5mcg and it did feel a bit undermedicated for the first 4/5 weeks (slightly constipated etc) , but then things improved and i'd started to feel ok again.
However GP insisted i reduce further to 100mcg (fT4 was still very over range) , which i eventually agreed to .... it felt much more undermedicated than the 112.5mcg dose had ,and this time it didn't improve once it settled in , it got worse ... the whole process messed me up severely for many months , which was annoying as i was actually feeling pretty good (for me) on the 125mcg ,
Argued to have dose put back up to 112.5mcg and things improved significantly within g a few weeks , and after a few months i decided to keep it here as my sleep was better than it was on 125mcg.
Thanks for sharing your experience. Turns out I was on 140mcgs (I'm on liquid) so I'm going to cut it to 125mcgs, a 15mcg drop and see where that takes me. For sure I have a lot less go than I should have at the moment! GP was being ridiculous wanting me to cut it to 100mcgs. lol
You don't mention where your TSH was at while your FT4 was over range. Funnily enough when I first started treatment my FT4 was always over range and had to be to get my TSH under 1. I'm glad you stuck to your guns for what was best for you.
on this occasion my TSH was 0.04 which is usual for me so TSH wasn't much help . It was just the over range fT4 that we were going off .. but it was unusually high 20.5 (7.9-14] 206% confusingly when i decreased dose it went higher , to 22.7 (242% ~(GP wondered if i'd done the opposite and increased dose , i hadn't)
And these tests were done carefully for accurate comparison, so it wasn't due to taking levo closer to test .
Some yrs prior to this i had become overmedicated on the 150mcg that i'd been OK on for many years , and on that occasion the TSH was a useful clue .. my 'usual' is about 0.04/0.05ish ... but when i was overmedicated , it was 0.018
My fT4 had occasionally been over range before on 150mcg levo .... up to approx 130% , but i hadn't been over medicated on those occasions and my TSH was still 0.04 ish ...
So for me over range fT4 doesn't always mean overmedication .. my results don't always make logical sense , but i've learned to recognise it by symptoms.
Fasting could have reduced your conversion of Ft4 to Ft3
You’re only over medicated if Ft3 is over range
Lower heart rate possibly suggests lower Ft3
With your son’s wedding imminent, the last thing you would want is to reduce levothyroxine dose by such a large amount
Personally I would get FULL thyroid and vitamin testing done privately via Medichecks or Blue horizon
Only do private testing early Monday or Tuesday morning, always do ALL thyroid tests early morning, ideally before 9am and last dose levothyroxine 24 hours before test
Do you always get same brand levothyroxine at each prescription
Fasting could have reduced your conversion of Ft4 to Ft3
Wouldn't that have made my TSH numbers go higher i.e. more hypo?
..the last thing you would want is to reduce levothyroxine dose by such a large amount.
Exactly, but at the same time I don't want to be a jittery nervous mess by then!
I invariably take the same brand of levo as I'm on liquid. It doesn't tend to change at all brand wise.
Interestingly just rechecked recent bloods and realised that in February my TSH was 3!Not sure how I didn't notice that back then. In April it was 0.92 so probably some kind of blip with no change in medication.
Supplement wise I'm taking CoQ10 and Quercetin. Folate was 10.2 in spring, Ferritin good at 125, B12 552. Lab didn't give the ranges but I think* they seemed OK from memory.
I'll look into a private blood test but need a supplier that offers blood draw as I can't do the silly finger prick tests due to poor blood flow.
Very good point. I wasn't actually expecting a thyroid blood test and the appointment was at 10.40 which is later than I would usually test. Yes I had taken my meds and wouldn't have done that usually.
Also though I haven't had a T3 test for a very long time, so I will get that checked out and see where I'm at without taking meds before it.
Well at least you know that your t4 result is a false high because of taking your meds. I wouldn’t reduce the dose at all if I were you. I’d wait and test again without taking meds first.
Your symptoms could well be due to low t3 because of the fasting. 🤗
I do the 16/8 type of fasting. This doesn’t seem to affect the t3 level like other types of fasting.(Keeping all eating within an 8 hour window). I eat between 12pm and 8pm and just water or other no-cal drinks for the other 16 hours.
So previously you were doing longer fasts? I was fasting every other day(500 calories on fast day), but as the hyper symptoms caught up with me I naturally went to 18:6.
I'm stumped as to what to do now. Probably could use a tiny addition of T3 but don't want to be messing around with that atm. Have added in Selenium and Zinc and dropped dose by 15mcgs which may well help for the mean time.
So are you saying that doing 16:8 fixed your numbers?
I’ve done every diet going including the different types of fasting, and totally messed up my metabolism. My basal metabolic rate is now 1350 ( measured at the gym) instead of 2000.
The 16/8 is the only way I’ve been able to get balance and lose some weight. I’m taking t3 (NDT), so my level is good. My conversion on levothyroxine was non-existent because I’ve inherited the DIO2 genetic fault from both parents.
Before I realised I had the FT3 result I ordered the thyroid + vits + selenium test but can save that for next test.
For the genetic conversion is that the Blue Horizon DNA Blue Thyroid Genetics? They have an offer on atm with £100 off so I might give that one a go.
What I've heard of the 16:8 is its really just a maintenance type diet and doesn;t really allow for weight loss. Is that right? I have about 20 kilos to lose!
Did you self treat with NDT? I have tried it a long time ago but was really too much T3 for me.
Hi Jaydee…I am a 63 year old male. Haven’t had a thyroid for well over 12 years.
On that note, intermittent fasting has worked for me as well in losing my Covid belly. As far as testing goes, don’t rely on TSH as a good indicator. Get your blood tests done early, without taking any meds prior. FT3 and FT4 are the important ones assuming your other vitamins and cortisol check out.
On a side note, not having an active thyroid has always presented daily issues even when meds were covered. Ya got your good days, and not as good days. Hope this helps.
Thanks for the tips Aardvark00. I'm now 58 and not had a thyroid for 25+years. I always hope this nuisance condition will go away and finally I've sorted my numbers out but it never happens!
Really pleased that IF is working for you too. I've only been doing it for about 7 weeks but already dropping the pounds really well and it's not too hard to keep doing it. I'm changing my eating window at times to suit commitments but generally doing 18:6.
It hasn't changd my high cholesterol yet but lets see where my T3 is at!
Indeed, they did cholesterol at the same time which didn't look so awful to me but GP again offered statins which I refused.
I've been down a rabbit hole with DIO2 and DIO1, realised I had an Ancestry DNA result which eventually I worked out shows I have one copy for both DIO2 and DIO1. That plus 25+ years Hashi thyroid erosion is starting to add up with the low T3! I've rejoined Thyroid UK, will get the doctors list and get myself some T3 added after the wedding end of August.
I also read some of Paul Robinsons website and wonder if I just need to cut out T4 altogether, but T3 only therapy scares me.
You are not over medicated. How can you be when your T4 is near the top of the range? Your GP has fallen into the trap on thinking TSH is all that matters. I use intermittent fasting as well and follow a one meal a day diet, I’ve found it’s the best way to keep my weight down and like you it gives me more energy. My recent blood tests found suppressed TSH for the first time - so I suspect it’s a symptom of long term fasting.
It’s absolutely nothing to worry about having a suppressed TSH. If you feel great you’re probably healthier than you were before.
If I were you it would refuse the reduction in dose- write a letter to your GP ask why they are dosing only by TSH when not is not best practice. Ask how the Dr can deduce you are over medicated when your actual thyroid hormone T4 is in range and when they haven’t even tested the active hormone T3. Also if you have hashimotos it’s impossible to become hyper over time - how can you become hyper when you have less functioning thyroid cells than you had when you were diagnosed due to autoimmune attack?
Your doctor will make you Ill from ignorance if your condition if you let them. Put your foot down.
Newmummy82 ...."You are not over medicated. How can you be when your T4 is near the top of the range?
Perhaps you misread the results ?Jaydee1507 's fT4 is over range . FT4 - 25.8 (11.1 - 22)
It would have been a bit lower if there was a 24hr gap from last dose , but it's still likely to be fairly high in range , and if symptoms fit, and she already knows from experience that she doesn't feel well with low TSH then overmedication IS the likely cause .
from my experience increased frequency of urination was a sign of slight overmedication.
So all things considered i think a very small decrease is a perfectly reasonable thing to try, just not as drastic as reducing from 140 to 100 as GP suggested .
Yay another positive vote for intermittent fasting. It's so amazing the difference on this diet I can't tell you. I've done OMAD a few times but don't feel great atm so mainly 18/6 with longer fasts odd days. Will try longer once I get this thyroid blip sorted.
The only research I've seen about thyroid and fasting was done around Ramadan and says it makes no difference to thyroid levels. It could do with having a large general trial of hypo folk.
Thing is I probably do need to drop the dose, but only a bit. Fear not, I'll be sticking to my guns, have had some practice.
I love fasting. It makes such a difference to how I feel. But I am worried about next time GP demands a blood test as I know they’ll question the suppressed TSH!
I know. The suppressed TSH is awful with GPs. I've very curious to see my conversion rate when I get my private tests. Wondering if adding in selenium and zinc will improve that and therefore my TSH.
I just found this article that talks about reduced T4 to T3 conversion and TSH changes. I haven;t looked into it yet but there's another diet - Protein sparing Modified fast that doesn;t affect thyroid function like IF does. I need to look into that if fasting is going to mess with my numbers!
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