I eventually got diagnosed with hypothryoidism last year after struggling for 10years and am overweight. I exercise about 3-4 times a week currently (swimming, yoga, body combat, walking) and work a full time (vet nurse so on my feet and mobile all day). I take 50mcg levythroxine once a day normally in morning an hour before food or caffiene. Recent blood results TSH 2.62mU/L (ref range 0.27-4.2). I've previously had high thyroid peroxidise antibiodies. Only one doc would check
I am still symptomatic - hot flushes, cold episodes, occasional depression/mood swings, no energy, tired, not sleeping great and struggling to lose weight.
I need to lose weight as I have chronic arthritis, a labral tear and femoroactebular impingment in my hip. I've tried many different weight loss diets but nothing works. Has anyone got any advice ?? Thanks for your input
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JayneRaison
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50mcg of Levothyroxine is usually given as a starter dose and your current symptoms (including increased weight) are most likely linked to being under-medicated. TSH should be under 2, with most forum members feeling best with this significantly under 1.
For a complete picture of your thyroid health, it’s good to share blood test results (with ranges in brackets) for FT3 and FT4 alongside TSH. In addition key thyroid vitamin tests (ferritin, folate, vitamins D and B12).
If your GP is unable to complete all the above (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:
Thank you! Oh I didnt know that I was started on 50mcg levy a year ago and I've had to nag to have my bloods rechecked. They just started the meds and told me to go away.
My T4 is 18.3pmol/L (11-26).
B12 is 504pg/ml (197-771)
Ferritin is 65ug/L (12-233).
Folate is 15.9ng/mL (2.4-26.8)
Vit d is 52.4nmol/L less than 50 is deficient.
Do you have any articles/info recommending tsh below 2? I'll try talk to my doctor. Thanks
I would self medicate with NDT (NDT will suppress your THS and the GP will freak out cuz they don't know it's a worthless test) or I would beg my doctor for T3. I would not allow a medical person dictate my weight any longer. You derve to benefit from all your exercise and hard work. Easy
It is important to remember (and relay to others) that the vast majority of people with hypothyroidism can achieve optimal thyroid levels via the correct dose of Levothyroxine, together with optimal key thyroid vitamins (ferritin, folate, B12 and vit D).
I've finally become successful in with weight loss by doing the following things:
1) get my thyroid medication right (see Buddy's advise) - it won't work unless your medication and vitamins are right.
2) go gluten and dairy free. I couldn't imagine myself doing this as I loved both bread and cheese, etc. but it really has made a difference. These food items seems to cause inflamation for me and eliminating them both made me lose a lot of the water retention in my body.
3) I walk as my exercise - ideally at least 45 minutes before breakfast/first meal and 45 minutes after my last food in the evening. I don't beat myself up if I don't get my goal, but my minimum is 30 minutes a day.
4) I eat and cook good food - with the following foundation that seems to work for me - more simple carbs in the morning (fruits), complex carbs (pasta/root vegetables) at lunch, light carbs (vegetables/salad) at night; protein at each meal - leaner in the morning, fattier in the evening. Less fat in the morning, more towards the end of the day. A simple low gylcemic snack between breakfast & lunch and another one between lunch and dinner.
5) have at least a 12-14 hour window where I don't eat (this was hard, as I had a habit of snacking after dinner while watching a movie)
6) drink 3 to 4 liters of water a day
7) give myself a calorie surplus day at least once every two weeks - I puposefully eat at least 100kcal in carbs at each meal/snack to increase the days calories by at least 500. It seems to keep my body out of that calorie deficit response, and I have learned how to occasionally eat more and not make it a big deal.
8) get a good nights' sleep - every night if possible
9) be kind to myself
I had almost given up on myself - and thought that obesity, diabetes and other health issues were just going to be a part of my life. I finally found a coach that helped me figure our what worked for me - so - my final advice is to
10) keep looking and trying, even if it seems hopeless - you will eventually find something that works for you.
I speak with 90 pounds less of me since diagnosed with hypothyroidism in April 2021.
This is great advice. I would add avoid processed food as much as possible, especially products labelled as low fat or healthy - they often have ingredients like emulsifiers to replicate the normal product. I have a rule that if it's got more than 3 ingredients on the label then it's got stuff in it that isn't good for you.
I also have dropped my carbs, and having believed that fat makes you fat, now have full fat milk, yoghurt etc. Same with low sugar.
That is really good advice Recon - pretty much exactly what I was going to say to JaneRaison myself.
A GP referred me to a group called Second Nature when I was in the pre diabetes range - their system is amazing - it works on the ‘whole person’, covers all the areas Recon has mentioned and for me it’s a way of life now that has been really successful. I went totally GF about 10 years ago and found that made a huge difference.
I also go by what StanleyThyroid says, avoid processed foods - I don’t buy anything with additives in it - if I can’t pronounce the ingredients on the back of a packet then I definitely don’t want to eat them, cut back on carbs - potatoes and bread were my downfall.
But get your thyroid meds and vitamin levels sorted out first.
50mcg is only the standard STARTER dose levothyroxine
Bloods should be retested 8-12 weeks after each dose increase in levothyroxine
You are currently under medicated and in need of next dose increase in levothyroxine to 75mcg
Which brand of levothyroxine are you currently taking
ALWAYS do 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)
High thyroid antibodies confirms autoimmune thyroid disease
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.
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Currently your vitamin D is too low
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
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
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.
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.
hey there! It sounds like you have been doing your very best. My GP did the same, thought starting me on 25mcg would fix me and I got worse.
It’s taken me quite some time to discover I can pretty much eat/exercise the same and my body weight fluctuates with my thyroid hormone dose/hypothyroidism symptoms.
I have chosen a paleo (ish) diet which works for me. I’ve always been a carb dodger so it’s not that hard for me.
Giving up gluten helped with aches and pains.
Giving up dairy helped with upset stomach.
Giving up (mostly) sugar helped with exhaustion.
Have a read of Izabella Wentz, I have all of her books, her thyroid pharmacist website is good, between her and SlowDragon and advice from others here I’m back in my size 10 jeans.
As said already by others, check all your vitamins and especially ferritin. Mine were all rock bottom. As they’ve come up, my body’s ability to use the thyroid hormone has improved and I’ve been able to do more and 11kg dropped off steadily over 12 months.
I used to struggle with my weight in my early 20’s long before I was diagnosed. I found the only thing that worked alongside regular exercise was weighing my food portions. I followed a programme called Team RH and have maintained a healthy weight ever since, didn’t matter how much exercise I did eating portions of food that were too big was literally it for me. 😅
Hi I’ve been struggling with my weight for years , been hypothyroid since age of 12 , on 200 mcg I’m now 56 . 9 months ago I joined slimming world weighing 20st 8 lb I follow their simple eating plan ( you can eat loads) I’m now 15st 5 .. still a way to go but definitely feeling the benefits with my joints energy levels , state of mind . Best decision I ever made .
Hi Jayne -thyroid issues - such a pain and difficult to get right for some people. I’m seriously undermedicated so I’m even finding it hard to exercise to loose weight ( I’ve gained 2 stone 😞 and feel like crap… where as I use to run 3 miles 3 times a week I now walk it at least 4days a week - which is really frustrating for me and leaves me extremely fatigued next day for my full time stressful job, but I’m determined to do it.. so I’ve just started the Keto diet - 1 month in - I feel really good and have started to loose a bit of weight (which is unheard of being so under medicated) tho I admit it takes a lot of reading up on and home cooking or purchasing keto food online.. well worth the hassle tho I’m starting to feel I’m back in the drivers seat.
If you need any further advice or info in Keto just inbox me I’d be more than happy to help.
Hope you get your issue sorted but sounds like u too could be under medicated 50mg thyroxin is not a lot.
I've followed a low carb diet on and off for years. It's the only thing that works well for me. However, when I was first diagnosed with underactive thyroid (later found out I had Hashimoto's) it completely stopped working. No matter what I did, I couldn't lose weight. In fact I actually put on 4 stone at the beginning of my thyroid journey.
To cut a long story short, it was only when I added in T3 medication (having tried and failed with levo from 25mcg - 150mcg to get any kind of relief from my symptoms) that the low carb diet started working for me again. I've now lost that 4 stone, but don't get much below that (even though I need to!) as I keep on going on holiday where I eat all the rubbish!
I am also gluten free. I did try dairy free too, but had no relief from symptoms, so went back to dairy (I am vegetarian already, so didn't want to cut dairy from my diet if I didn't need to).
Whilst doing all of the above, I also made sure I was getting my important vitamins in range with supplements. They're all in a good place now and have been for a while.
I'd start with the idea of how important your gut it, being your 2nd brain, and the foundation of good health begins there.
I recommend Dr Michael Mosley's books - the clever guts diet and the fast diet ones, not read the others. The books are about one's diet, not dieting as such.
Exercise is also key but it depends on how you do it. I'd also recommend 'The Body Coach' Joe Wicks who combines great food and recipes with High Intensity Interval Training (HIIT).
He has 3 books that take you through various stages/changing exercises as your body gets into shape. Some info about him here:
I ‘ve been in a similar situation for years. I’d work out, eat a 200-300 daily calorie deficit off my TDEE allowance and still not loose weight.
The real game changer for me was when I started doing intermittent fasting on-top of what I was doing already (same food, same calorie deficit, same exercise, still some treats). I started skipping breakfast and eat from 12pm and stopping eating about 8pm then stop until lunch the next day, so 16:8 split. The bulk of it is overnight or after you’ve eater your days food so it’s only really a few hours in the morning where you feel hungry for the first few days until you adjust.
The weight started coming off, it’s not a cure all, you still have to eat healthy and exercise, but for me it made all the difference!
Just be sure your thyroid levels are optimal for you before to make it a whole lot easier.
It's interesting that there's been a recent increase in posts about weight loss on this forum. Maybe a pre-Xmas effect? Apologies for using similar/same response to these different posts.
I don't advise on hypothyroidism as I've never been diagnosed. I leave it to experts on this forum to advise on that and it does seem sensible to firstly optimism thyroid levels, where possible.
But I do have link(s) to qualified Nutritional Therapists (NTs) that develop and provide safer, healthy protocols which should always be personalised as each patient is unique. This should include guidance for hypo patients & weight loss - especially from those specialising in weight management.
Whilst I can't personally recommend any of many NTs listed, I'd be happy to send the details to anyone who contacts me. Otherwise, I sincerely wish you all the best in your weight-loss journey.
You may be under-treated. I know that I meet the requirement for "full replacement", I am doing well, and my TSH is about 0.6. BTW, the requirement for full replacement via levo-only is about 1.7mcg/kg body weight. Once you get your TSH down further, I would recommend what worked for me: a modified Paleo diet (low carb, very low sugar, focus on protein and vegetables) accompanied by an intermittent fast of ~14 hours (from 8pm, to 10am next day).
50mcg is just a starter dose you are under medicated hence all the symptoms. TSH should be well under 1 and the freeT4 (not even tested it would seem 🙄) and free T3 (nhs hardly ever tests for it despite it being the most important to know 😬) should be in top third of their ranges - they are unlikely to be that high.
You need to get a dose increase from your GP. NHS choices recommends Thyroid U.K. for support and info so you can say they advise TSH should be much lower until symptoms cease. My endo aimed for 0.2-0.5, as recommended by Professor Toft an eminent endocrinologist (now retired) who was also surgeon to the Queen when she was in Scotland. There is an item in Pulse (a medical publication) magazine where these numbers are quoted by Toft in question 6. Thyroid Uk admin will send a copy if you email them and ask. You can highlight the relevant bit and show it to the GP as evidence that your TSH is too high if you’re taking thyroid hormone therapy and an increase is in order. (And another in 6-8 weeks etc until the TSH is much lower and you should feel much improved).
I would try going gluten free but aim to avoid wheat and barley rather than get a lot of gluten free junk - a lot of it is very unhealthy and very expensive. It should help with the weight but you do need to be optimised on Levothyroxine and it can still be hard to shift it, if your free t3 does not properly recover. I’d also ditch soya if you are eating it, it’s not supposed to be good for people with hypothyroidism. Take you meds before bed they will be better absorbed then. Don’t have any food with them.
Hope that’s helps, the dose increase is paramount.
You’re definitely under medicated as others have suggested.. until you get optimal dose of Thyroxine you’ll be getting all the weird symptoms. Only then can you sort out what’s what and move on. You’ll need FT3 and FT4 not just TSH. Please don’t be fobbed off if you don’t feel right.
Can't comment on the weight loss but just to offer some hope if the hot flushes are getting to you as much as they were me; I've just done (probably my final) dose increase about 4 weeks ago and the hot flushes and sweats seem to have stopped about 2 weeks ago. They can have many causes of course so it's not guaranteed that if you do need a dose increase that will sort it but it seems it might
I also had femoroacetabular impingement and made a determined effort to lose weight because of it, to ease the burden on my joints, I’ve now had a total hip replacement.
As others have mentioned, your dose sounds like a starter dose, so my first port of call would be a return to the GP and say you still have symptoms and ask for dose increase. (My TSH is less than 1 on 100 micrograms, also with antibodies)).
I managed to lose weight by following a calorie controlled diet and used the free version of the MyFitnessPal app on my phone to record my calories. It was an effort to record them at first but after a week or so, it became easy. I learned a lot by exploring the forum on there e.g. fats can make you feel full, and low fat foods often have more sugar. Also if you don’t eat enough calories, you won’t lose weight, and ideally you should have a fasting period - I realised I naturally had this as I didn’t eat between 7pm and 7am. (You may know all this already, I didn’t). I found it very motivating that at the end of each day it would tell you…. ‘If every day is like today, in 5 weeks time you will weigh…’ There are other similar apps.
I know it doesn’t work for everyone, but it did for me. I’m now over 2 years in and have stayed at 8Kg less. I still mostly weigh myself daily, but don’t obsess over food, just keep an eye on portion sizes and the extras if it starts to veer upwards.
It sounds like you’re doing really well to keep so active with the impingement, well done! In the end I could only manage swimming.
Lizzie122, If your thyroid medication is not optimal for you, this can contribute to both weight and T2 diabetes problems.
Why not start your own post asking for help? Just click this link to write your own post, and hopefully get support from members who can offer help. healthunlocked.com/thyroidu...
If possible, include details of your current thyroid medication type and dose, and the results of your most recent thyroid blood test.
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