Loss of appetite and hypothyroidism

[ChickieBaker]

I was just reading a post about how some people can't tolerate as much alcohol as they could before they were diagnosed with thyroid issues and it got me thinking. Recently ( last few months ) I've found that I can't eat as much as I used to ( not necessarily a bad thing 🤣 ) but wonder if it's related to being hypothyroid and having Hashies. I've gone down from eating from a dinner plate to a salad plate but still sometimes feel really full, margining on the nauseous after a meal, especially if it's a bit fatty. Anyone else finding the same ??Thanks.

[PurpleNails Administrator]

I have a unique perspective on this, as for many year I had elevated thyroid levels for a hyper nodule. So “mild” hyper in that symptom were not severe, this caused an enormous affect of increasing appetite and lowered my energy. This resulted in major weight gain.

When my thyroid levels are normal / low my appetite lowers and I do lose weight.

So the opposite of what you’d expect. I wonder if the affect on metabolism is mismatched to appetite.

I also say I eat better as can be more organised having better energy levels when in “normal” range. It’s possible I just have too low an appetite and don’t crave food in same way.

I’m not susceptible to great swings in levels like many with autoimmune so I can see this an a clear distinction.

[greygoose]

You probably have low stomach acid - most hypos do. Therefore it takes longer for what you eat to clear from your stomach into the gut. That would explain the nausea, too.

[JasmineJasmine]

From watching Youtube videos about nutrition it says that the gall bladder produces bile which enables us to digest fats (this enables us to absorb fat soluble vitamins as well.) So, if you can't tolerate fatty meals, it might suggest that you aren't producing enough bile. I don't have any personal experience with the symptoms you mentioned, but I just thought I would mention this and maybe it is something to look into. I just Googled it, and it says there is a link between hypothyroidism and poor gallbladder function. Something that can help apparently is taking bile salts. I don't know if that will help you or not but maybe you can look into it. Good luck :o)

[humanbean]

My appetite diminished years ago and I am convinced it is due to my untreated hypothyroidism causing my gut to slow down dramatically. As a result I have almost permanent constipation and a gut which empties very slowly (mild gastroparesis). If someone has a full gut why would they be hungry?

en.wikipedia.org/wiki/Gastr...

Also, due to ignored and disbelieved health problems decades ago I have chronic gastritis (inflammation of the stomach lining). To cope with that I am prescribed a PPI (Proton-Pump Inhibitor) to cut down on my stomach acid.

I hate taking PPIs because it I am perfectly well aware of the side effects and drawbacks of PPIs, but without them I have the indigestion and heartburn from hell.

en.wikipedia.org/wiki/Proto...

As a result of the problems I have I usually only eat once a day, and despite this I still get fatter and fatter. Treating my hypothyroidism and optimising my vitamins and minerals to the best of my ability helped me to feel better but hasn't eliminated my gut problems or my increasing weight.

[SlowDragon Administrator]

Looking at previous posts, you not long ago had dose increase to 75mcg

Unless extremely petite likely to need further increase in levothyroxine over coming months

[ChickieBaker in reply to SlowDragon]

Thanks for your reply. I did actually start at 75 and am due to see the doctor for my 8 week review shortly. Does the dose have an impact on my appetite then ?

[SlowDragon Administrator in reply to ChickieBaker]

Definitely

Hypothyroid patients often have poor appetite and/or struggle to digest food

Gut function badly affected by metabolism

Low stomach acid can be a common hypothyroid issue

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

stopthethyroidmadness.com/s...

thyroidpharmacist.com/artic...

How to test your stomach acid levels

healthygut.com/articles/3-t...

meraki-nutrition.co.uk/indi...

huffingtonpost.co.uk/laura-...

lispine.com/blog/10-telling...

Useful post and recipe book

healthunlocked.com/thyroidu...

But never assume you have low stomach acid

healthygut.com/4-common-bet...

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

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

[SlowDragon Administrator in reply to ChickieBaker]

Levothyroxine doesn’t top up failing thyroid, it replaces it

guidelines on dose levothyroxine by weight

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.