I'm new to this forum but keen to expand my knowledge but I did have a question regarding losing weight while on Levothyroxine.
Background is, March 2020 I had thyroid removed as diagnosed with Graves Disease and suffered from Hyperthyroidism. Fast forward to today, my weight pre-surgery was 66kg and now weigh in at 80kg. I'm a middle age male, 6ft and regularly exercise and control my diet. However nothing seems to make any difference to my weight.
I am on 100mg Levothyroxine which I have been since March 2020.
My last blood test results from December 2022 were as follows:-
TSH Level: 1.23 miu/L (0.35 - 4.94)
T4 Level: 13.5 pmol/L (9.0 - 19.1)
T3 Level: 4.6 pmol/L (2.4 - 6.0)
Is there anything you can suggest that I do which I have not mentioned in order to bring my weight down by approx 10%?
I spoke to my GP and they have no suggestions apart from having blood test to see if something else is happening!
Thanks in advance.
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craigdaddy
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Can you please add the reference ranges for your results (these are often in brackets at the side of the results,.eg
FT4: 15 (12-22)
Ranges vary from lab to lab so we need your lab's ranges to interpret your results .
It could be that you are undermedicated wbich would make weight loss difficult. The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well .
Also, in order for thyroid hormone to work properly we need optimal nutrient levels, have you had Vit D, B12, Folate and Ferritin tested?
I am not 100% sure but I normally take my meds in the morning and my blood test that day was 8.30am.
Do you think I may have had my Levo just before my blood test?
I can't answer that question but if you had taken your Levo before the test I would have expected to see a higher FT4 level unless you'd only just taken it. Levo peaks in the blood 2-4 hours after ingestion which is when FT4 level would be highest of the day.
In future, when doing thyroid tests, it would be best to follow the advice we generally give here:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day.
In fact, 9am is the perfect time, see first graph here, it shows TSH is highest around midnight - 4am (when we can't get a blood draw), then lowers, next high is at 9am then lowers before it starts it's climb again about 9pm:
If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Nothing to eat or drink except water before the test - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Certain foods may lower TSH, caffeine containing drinks affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw. If taking NDT or T3 then last dose should be 8-12 hours before blood draw, split dose and adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 3-7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).These are patient to patient tips which we don't discuss with phlebotomists or doctors.
This then means that the results will be as accurate as can be and you can compare them.
Also, those % you mentioned, what does that mean in simple terms?
As mentioned, hypo patients generally tend to feel best when TSH is below one with FT4 and FT3 in the upper part of their ranges. You may feel better with a lower TSH and FT4/FT3 both over 50% through range - exactly where is impossible to say as we are all individual but possibly 60-70% might be better for you.
Here is a calculator which you can use to work out percentages:
Your current results suggest that you might benefit from an increase in your Levo. I would have word with your GP, mention any remaining symptoms of hypothyroidism (not just your weight) and suggest trying an increase in dose. You could try for 25mcg extra daily but if GP is reluctant see if he will compromise on 12.5mcg extra.
Do try and get the nutrients tested, levels to aim for are
Vit D: 100-150nmol/L
B12: top of range for Total B12, if Active B12 is tested then 100 plus
Folate: at least half way through range
Ferritin: half way through range although some experts say 90-110ug/L and this post was made a few days ago:
I have requested to have my thyroid bloods done again along with all the other suggested tests. I will follow the advice on here to in relation to when to have my medication prior to blood test.
Interesting reading through all of this as I realise I have no idea about what can impact my condition and the meds that I take for it. Most significantly is my intake of caffeine throughout the working day.
How much medication are you on? Your lucky your 6 foot tall and still slim and can exercise . I had thyroidectomy and my body went crazy and brought a friend to the party (Psoriatic arthritis).
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