Reduction in medication after weight loss?

[Febrero28]

I have lost over 15per cent of my body weight after a mixture of dieting and exercise. I have been on the same dose of Levothyroxine for over ten years and I was wondering if my dose needs to be decreased as I am feeling a bit jittery/anxious for no particular reason, difficulty getting to sleep, waking up hot at night. I am post menopause now. Does significant weight loss affect the dose needed?

[SlowDragon Administrator]

Welcome to the forum

Quite possibly yes

Do you always get same brand of levothyroxine at each prescription

Suggest you get full thyroid and vitamin tested done if not been tested recently

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

 

For full Thyroid evaluation you need TSH, FT4 and FT3 tested 

Also both TPO and TG thyroid antibodies tested at least once 

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Lower vitamin levels more common as we get older

Also …..Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

If in U.K.

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Just Thyroid includes BOTH TPO and TG antibodies -£49

randoxhealth.com/at-home/Th...

Monitor My Health (private NHS test service ) now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

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

Only do private testing early Monday or Tuesday morning. 

[Febrero28 in reply to SlowDragon]

Thanks. That's very helpful.

[PurpleNails Administrator]

Well done on your weight loss. 

Yes it likely would. 

While being more active would like require more hormones as the hormones are depleted quicker when you are lower in weight you’ll likely need less. 

A estimation is 1.6mcg of Levo per 1kg of body weight.  But this is only a guide.  

Your symptoms are typical of over replacement but symptoms can be very misleading & it is always best to check thyroid levels before adjusting a dose you’ve been stable on for so long.    

Tracking your thyroid results for comparison helps with know what level is good for you.  You need your TSH, FT4 & FT3 tested (often only TSH is tested.)

Nutrients (folate, ferritin, B12 & vitamin D) can also lower during weight loss and this can cause symptoms and also affect the way TSH reflects levels & T4:T3 conversion.  

There are private options if GP can’t test everything.  

[Febrero28]

Thanks. Yes, it's been the same brand for a while now. I also think I am a bit more irritatable, but don't want to ask my partner.