I’m looking for some guidance/information as I haven’t been able to get much clarity from my GP and endocrinologist. I started having all the usual hypo symptoms about 2 years ago; feeling cold, fatigued, weight gain, low moods, brittle hair and nails, skin itching, night sweats, tinnitus, aching joints. I got tested twice by my GP over a 6 month period and my bloods came back normal each time so I got a Medichecks test in November 2022 which showed all my results were within range except for my TPO which was elevated;
TSH: 1.73
Free T3: 4.3
Free thyroxine: 17
Thyroglobulin: 62.1
Thyroid peroxidase: 104.9
I saw an endocrinologist who told me that I had markers for autoimmunity and that all I could do was “keep an eye” on it as once I turn 40 I could be more at risk for developing Hashimoto (I’m a 36 yo female). He gave me no further advice on how to try to manage it. He also told me my weight gain was not related to my thyroid and recommended I eat less (1200 cal a day) and move more and if that doesn’t work I could consider weight loss injections or gastric bypass surgery. To be clear, I haven’t been gaining weight from overeating so I’m frustrated and disappointed at his suggestions and also have no further clarity on my condition.
I have been taking supplements for the last 3 months (vit D, fish oil, Curcumin, an adrenal support vitamin, thyroid support vitamin, magnesium and a probiotic). I have been trying to cut out gluten, dairy, caffeine and sugar although I’m probably not as strict as I could be. I have started feeling better and most of my symptoms are alleviating although I still have the tinnitus, cannot lose weight and my periods are starting to become irregular.
My questions are: as I have elevated TPO and have been having some of the typical hypo symptoms, does this mean that I am already hypo? Do I need medication? Is there anything that I can do to keep myself from getting worse?
Is there any way I can lose some of this weight I’ve gained? I have tried all sorts of diets, Keto, counting calories, in the gym 6 days a week and nothing has worked. I’m not sure if I’ve been making things worse for myself by restricting so much.
Any advice would be highly appreciated as I don’t feel I’ve received any real help from any of the medical professionals I’ve seen over the last 18 months and I’m trying to get to the bottom of what is going on with me!
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TiggyWi
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Doctors don't know enough to be of any real help - as you've found out!
For example, your endo told you were 'at risk' of developing autoimmune thyroiditis. False. You already have it. Otherwise you wouldn't have those high antibodies.
But, you are not yet hypo, according to your TSH. Can't say anything about the Free T4/3 because you haven't given the ranges, but the FT3 does look a little low, which would account for your symptoms.
I'm afraid there's nothing much you can do to stop it getting worse. It will have to take its course. Although best to stop the 'thyroid support vitamin', which won't do a single thing to help, but could be dangerous if it contains iodine. What is in the adrenal support you're taking?
Did you get your vit D tested before supplementing? Excess vit D can be toxic because it is fat soluble, rather than water soluble, which means that it builds up in the body. And, if you're taking vit D, you should also be taking vit K2-MK7. Taking vit D increases absorption of calcium from food, so you need the K2 to make sure that extra calcium goes into the teeth and bones, and doesn't build up in the soft tissues and arteries.
Ignore anything a doctor says about weight-loss. They haven't got a clue! This old chestnut about calories in vs calories out is just rubbish. If you are hypo - and you possibly already are at times, given that with Hashi's levels will fluctuate - depriving yourself of calories, and then using up what you have on exercising will negatively affect your conversion of T4 to T3, making you more hypo. And it won't make you lose weight - will probably make you put more on! As for weight-loss injections and by-pass surgery... Is he trying to kill you off? Not a good idea to go down either of those rabbit-holes. And, for the moment just put up with the increasing weight, because it just can't be helped - no matter what you complacent, ignorant endo says.
As for 'medication' (thyroid hormone replacement, as there is no treatment for Hashi's) unlikely you would ever get a doctor to diagnose and prescribe with those labs. They don't know even about thyroid to understand the complexities and only look at the TSH. Your TSH is good (but irrelevant). They know nothing about symptoms. They would want you to have an over-range TSH on two consecutive blood tests, three months apart. Which, will more than likely happen in the not too distant future. But, until then, there's not a lot you can do. Just be kind to yourself. Make sure you get plenty of rest - I'd cut out (or down) the gym if I were you - and that you get plenty of nourishing food - don't cut calories, you need them! And, get your vit D, vit B12, folate and ferritin tested, and post the results here. Let's see if you need any other supplements.
Forgot to add that your weight-gain is probably not fat, that can possibly be reduced by diet and exercise (although not always!). It's more likely to be water-retention, and diet and exercise won't do anything for that!
Thank you for your reply this is already lots of help. For reference, my ranges are:
TSH: 1.73 mIU/L (0.27 - 4.2)
Free T3: 4.3 pmol/L (3.1 - 6.8)
Free thyroxine: 17 pmol/L (12-22)
Thyroglobulin: 62.1 kIU/L (0-115)
TPO: 104.9 kIU/L (0-34)
Testing was done first thing in the morning before 9am and fasted and vitamin supplements were stopped for about a week before testing. I was tested for vitamin D and found to be deficient:
Vitamin D: 43 nmol/L (50-150)
B12: 948 ng/L (197-771)
Folate: 15.7 ug/L (3-20)
Ferritin: 72 ug/L (13-150)
I take a low dose of vit D + K2, the adrenal supplement contains quite a few different minerals. I will try to post a picture of the ingredient list as there are too many to write down here
My weight seems to have stopped coming on for now but I still can’t shift any of it which is concerning as it is mostly around my lower abdomen and thighs which worries me. My sleep is getting better because it was very disrupted before and no digestion issues although since I have been avoiding gluten I find that I am more constipated.
OK, so that 'adrenal support' is just a bog-standard multi with a few adaptogens thrown in. It is not going to help your adrenals, pretty sure of that - for 'support' always read 'stimulate', which is rarely a good idea. You won't even be absorbing most of the ingredients because of the iron content.
It contains things you more than likely don't need, like the B vits - your B12 is high and your folate is already good. The adrenals need plenty of B vits but the amounts in this multi are not high enough to be of any use, even if you needed them.
And calcium. Never a good thing to take unless you absolutely have to.
And iodine is an absolute no-no, and could be making your hypo symptoms worse because it is anti-thyroid.
The adaptogens could be reducing your cortisol, so do you know if your cortisol needs reducing? Has it been tested? There's a lot of 'false publicity' about adaptogens, and remember, if something sounds too good to be true, then it probably is. How could any one substance both reduce cortisol if needed AND raise it, if needed. The don't. They do one or the other, but you can't always tell which they're going to do.
So, all in all, you're just throwing your money down the drain with this supplement. Really not worth it. What adrenals need is plenty of rest, as little stress as is humanly possible, plenty of good salt, good B vit levels, and a high protein breakfast on waking.
Free T3: 4.3 pmol/L (3.1 - 6.8) 32.43%
Free thyroxine: 17 pmol/L (12-22) 50.00%
So, your FT4 is euthyroid, but your FT3 is quite low, as I thought. And that would be causing the symptoms. But, I doubt if you'd ever find a doctor capable of understanding that. Especially as your TSH is fine, as far as they're concerned. Maybe edging towards hypo, but a doctor wouldn't know that.
Why does it particularly concern you that you've gain weight around your lower abdomen and thighs?
I don't know of any connection between going gluten-free and constipation. That is probably due to low stomach acid and a sluggish gut. What sort of magnesium are you taking? Magnesium citrate is good for constipation.
You probably need to increase your dose of vit D. Is it doctor-prescribed or do you buy it yourself? And it looks like you need more iron-rich foods in your diet because your ferritin is lowish - should be more like 100. Do you like liver, liver paté or black pudding?
I’m pescatarian and have been for many years so I probably need to look into getting more iron into my diet. My GP actually told me I don’t need to take any vitamin D supplements as I would probably get what I need from the sun as it’s coming into “summer” now, but seeing as I work an office job 5 days a week and I’m fair skinned, I don’t stay out in the sun for too long so I decided to get a supplement just to help myself.
As to the weight gain, I underwent some fertility treatments last summer which I didn’t respond to very well and I was advised my weight needed to come down to help and me carrying it so heavily around my abdomen was not ideal.
It's a bit of a myth that you can get all the vit D from the sun. I've seen people on here from Greece and Australia that spend a lot of time out in the sun and are still vit D deficient. We get a lot of vit D from out food, so hypos are often deficient. But, for a supplement to help, you have to take enough of it.
It's more likely that your fertility treatment failure was due to your increasing hypothyroidism than the weight around your stomach. Doctors are very fond of saying this causes that - then changing their minds and saying that causes this! What they ignore is the possibility of a third factor that causes both. In our case, hypothyroidism.
Thank you for all the advice so far! I’m getting retested this week as it’s been a few months since my last results so hopefully I will know more if things are getting worse or staying the same
I’m just retesting my thyroid hormones and antibodies to “keep an eye” on things as my endo had recommended. I have been feeling better the last few months so I’m also curious to see how that translates across in my blood work or if I’m going to be in for another shock!
Well, the question really is: are they testing your FT3? Because that's the most important number. But most doctors only test the TSH which tells them very little.
Really not much point in retesting antibodies. Once you've had a positive result you know you have Hashi's, and that's all they can tell you. The actual level doesn't matter because it doesn't affect anything. And, as I said above, they might go down really low - they fluctuate all the time - but that doesn't mean your Hashi's has disappeared. It's still there, and the end result will be that you will become 100% hypo and totally reliant on thyroid hormone replacement. The level of the antibodies can't change that.
I know that you're not actually classed as hypothyroid right now, but with your history, it's worth noting that being hypothyroid does cause a problem with fertility.
Hello TiggyWi. Your story sounds familiar am afraid. I too had symptoms & had results simular like yours and they would not treat. Actually the best you can do currently is to ensure vit D is increased to around 100 or over. Yours is currently too low. The effects of low vit D are non restorative sleep, aching bones and relentless fatigue. Your GP can prescribe vit D3 course and then should recheck with a blood test.... Though they may decline the second blood test. Also worth looking at Websites Vitamin D Council & Grapevine. They give information & advice on dosage of vitamin D levels.
As for 'go out in the sun... That'll sort it.' If you are like me & are very fair skinned this isn't likely. As when the sun is at its best for absorbing vit D I burn in a few mins. Infact I burn in spring sunshine now. Sun creams block the process. I pointed this out to my GP & said so you want me to burn to get sufficient vit D & risk skin cancer instead! He changed his mind then & prescribed vit D.
I think correcting your vit D levels will help with some of the symptoms.
As for weight gain. I do sympathise. I was always naturally slim till my thyroid played up. For me mine finally settle when I had optimised my vits & minerals & went GF as well as my thyroid treatment. I am bigger round my waist but I'm older. And it's true not cutting calories but eating less carbs and more protein does help. Western diets tend to be very high in carbs these days. However do not cut carbs out!!
On the baby front my thyroid may have been at time lower but in range I had two healthy children who are now frown up and doing well. My troubles really kicked in post having children.
Hopefully you will be better informed and aware than I was.... No Internet back then!!
I’ve been battling with my weight since before going onto treatment for hypothyroidism. Tried everything till I joined SlimmingWorld and have lost a stone so far. I asked for a referral from the doctor, which gives you 12 weeks of free access.
The Dr tested you previously - can you find out those results? You should have them for your records anyway. I didn't get treated til I was 38 but certainly wish I had been treated earlier. Had abdominal weight, history of PCOS and I suspected thyroid was part of the problem but was treated dismissively and told to just lose weight by dr.
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