So doctor increased my levothyroxine dose to 75mcg once a day a few months back (on my request). He told me bloods were fine.
Had a blood test last week to check dosage.
TSH 0.09m/uL (only one they checked)
Is this now too low? I'm still really struggling to lose weight. Sleeping much better but still having hot flushes. I'm currently trying to reduce my food intake - trialling not eating after 8pm (I like late night snacks) and nothing before 10am. Not intermittent fasting just trying to cut out bad habits. I work shifts so this is actually quite easy this week. Is there a certain plan that works well for people, I find I can't stick to diets long term.
I've just moved house so registered with a new doctor, wanting to get some advice on here before I go in and talk to them.
Thanks 😊
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JayneRaison
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When were vitamin D, folate, ferritin and B12 last tested
What vitamin supplements are you taking
Is your hypothyroidism autoimmune, usually diagnosed by high TPO and/or high TG antibodies
Also stress of moving house may cause upset
Let it all settle for a few weeks
Then get FULL thyroid and vitamin testing done
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG 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.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
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 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)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
I didnt think it was. I havent had anything else tested in a while. Hoping the change of doc might be a good time to get a full thyroid profile run. They've never said it is, but when I had tpoab ran years ago was high.
The 25mcg and 50mcg tablets are just levothyroxine tablets. Same as when I was just taking rhe 50mcgs.
The 25mcg and 50mcg tablets are just levothyroxine tablets. Same as when I was just taking rhe 50mcgs.
Look at the boxes the levothyroxine comes in
Many people find different Levothyroxine brands are not interchangeable.
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz
Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots,
Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets
Lactose free brands - currently Teva or Vencamil only
Teva makes 25mcg, 50mcg, 75mcg and 100mcg
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Teva is the only brand that makes 75mcg tablet.
So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Aristo (currently 100mcg only) is lactose free and mannitol free.
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
No IF isn't great for Hashi/hypo people although will certainly work well for weight loss.
You would be better off waiting to do any kind of dieting until you reach your final dose. When you get there, try portion control and reducing processed foods and carbs, just eat healthily really.
I have been intermittent fasting since April and wasn’t aware it might affect TSH,, free T3/4 results…have you a reference as I am currently aware my Falls/ syncope consultant is writing to my private endo about my low TSH and tachycardia?
Thanks, I am surprised there weren’t more human studies as intermittent fasting ( IF) has been fashionable quite a few years … your first ref from 70s has participants with ‘10 days with total energy deprivation’… sounds a bit extreme even for IF. When I looked up refs to this got ‘rats’ study and daft alternative US health sites where drinking gee-type laden coffee was regarded as not breaking a fast! My thyroid bloods on T4/T3 combo have not obviously changed since IF, my TSH has always been a cause for concern except my endo, and free t3/4s lower than I would like, but balanced in high 40%. Perhaps surprisingly my hospital ( as opposed to surgery based) diabetic team are quite happy to support IF!
yes, my TSH at 0.002 is the lowest my endo allows but he prefers it nearer 0.006, so doesn’t entertain adding any more levo or T3 to raise my levels into the 70% area. At 0.002 have had arguments with GPs and non endo consultants out of all proportion and ruining appointments for other conditions!
Hi Jayne long fasting isn’t good for people with Hashis and women in particular suit shorter fasting such as leaving a 12-16 hour window which is what you’re trying at the moment. You want to avoid anything extreme.
I’ve been looking at Dr Sarah Myhill’s weabite; it’s not easy to navigate but what she suggests diet wise I think is pretty good advice for most of us with thyroid issues. If you stick to a paleo type diet that means you won’t be eating any modern day ingredients that cause inflammation, basically highly processed food. She’s got a shopping list suggestion so you can have stuff in your fridge for snacks because that’s when most people start falling off the healthy eating wagon, certainly for me! As a first step if you haven’t already you could try going strictly gluten free. You might find the weight loss quite satisfying and you’ll probably feel miles better, most people do. Dont be tempted though to eat the substitute gluten free produce that contain a lot of rubbish and calories. drmyhill.co.uk/wiki/The_Pal...
Last tip! It’s amazing how much we underestimate portion sizes. In the old days when I was growing up and there wasn’t a lot of money, food was divvied up by my parents before being brought to the table and that was that. Serving bowls on the table are much harder to resist.
Do go and get a good full blood panel and what you’ll probably find is that there isn’t one massive piece in the jigsaw but very many small ones you’ll need to fit into place to start feeling good again. All the advice on this forum will help you put those pieces in place. Good luck
Thanks for the advice, no not planning on doing these day long fasts! just trying to cut my evening snacking habits out - so far lost 1kg in a week. So obviously working. I was planning on just staying as I have been so no food after 8pm and then waiting til i'm hungry the next day usually around 10am to eat. Trying to listen to my body more.
I cannot give much advice as I'm new to all this and there are plenty here with much more knowledge.
I just wanted to tell you that in my experience, the relationship between weight and thyroid is not as black and white as GPs / the internet would have us believe.
5 years ago, I suddenly gained 4 stone in a year. For 5 years, I have dieted, struggled, and ended up even bigger.
I have hyperthyroidism, likely caused by Graves disease (awaiting antibodies result). I now know this is what caused the weight gain, as I learn to understand the symptoms and can see where it started.
In the 6 weeks my thyroid levels have been somewhat under control with medication, I have lost almost 2 stone without changing a thing. I have actually been off work and slept most of that time due to issues with blood pressure. Zero exercise, eating what I want, and the weight is dropping off.
My GP had originally said my symptoms were not consistent with a thyroid problem and refused to test. This is because I had the symptoms of hyperthyroidism but gaining weight.
Now, under the care of an endocrinologist, they brushed this off as 'quite common' and said 'people rarely fit the textbook symptoms'.
So don't get too caught up in using weight loss / gain to determine your thyroid levels. Hopefully you will find, like me, when they are under control, your weight will be too.
I was diagnosed with hypothyroidism as a child over sixty years ago and had battled my weight for very many years due to NHS stopping NDT and prescribing Levo instead. I have done every form of dieting. I know know that the extreme 300 calories a day so beloved by medical professionals sone decades ago was the worst thing for me. My body grew to accept this as standard making raises calories a nightmare. With a degree in Nutrition I should have known better. I was diagnosed as T2diabetic about 12 years ago and soon found intermittent fasting and low carb was the best option for me. I always have a minimum of 12 hours fasting in any 24 hour period. I prefer to go 14:10 or better still 16:8. I honestly do not believe that affects my thyroid results in any way. Possibly because I have to all intents and purposes had no thyroid for decades.
Apart from a cup of coffee with milk I don’t usually eat anything until lunchtime. I’m prediabetic (hbA1c 40-43). Was just reading that I ought to eat within an hour of waking to balance blood sugar. Is this advice outdated? It would mess up taking my Levo in the morning.
Well what a person eats affects how much it will affect blood sugar levels. I’ve never heard any advice to eat within an hour of waking. Where did you that in relation to pre diabetes or T2 ? It’s possibly necessary for T1 however prediabetes has nothing to do witn T1 so irrelevant in you4 case I assume. Have you spoken to th3 diabetes nurse at your surgery or looked at Diabetes UK website for advice. They are your best sources. There are countless T2 plus hypothyroid patients around, if any eating plan affects timing of levo, just change levo time. It’s easily done. I take 13 prescription meds + thyroid hormones every day and have done for years. It just needs a plan, and possibly an odd alarm thru the night. Good luck
Hi JayneRaison I have found intermittent fasting to be the only thing that helps me lose weight.
I have Hashimotos and started fasting and eating low carb high fat in 2019 on 16:8. I also cut out sugar and ate only berries when I wanted fruit. I lost 3 stone 10lbs in 6 months this way and then began to plateau. I moved to 18:6 and now I try to do 20:4 Mon - Fri. 18:6 at weekends.
Mixing it up a bit helps to keep the metabolism on its toes.
I still have 2 stone to lose and 20:4 and eating strictly low carb high fat diet is the only thing that works for me. No rice, pasta, bread, potatoes, grains. When I do, I start to put on again. Its definitely trial and error and worth starting with 16:8 and seeing if you lose weight that way..
Gluten free also helped me to lose inflammation/puffiness in face, hands, feet etc.
Getting your blood tests done regularly and monitoring how your hormones are affected would be a useful way to know if fasting adversely effects you.
Ah ok, thanks for the adivce. I've just been cutting out late evening snacks and waiting til i'm hungry the next morning before I eat - normally about 10am but does depend on work shift. I've lost 1kg in a week so we'll see what happens in week 2. I do have a real weak spot for bread! I'm going to try and limit carby things like bread, pasta etc to maybe a couple of times a week and see if that helps. I've tried Gluten free before and it made no difference, also tried dairy free once too. (both trialled seperately and for a month at a time).
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Good Bloods but Still struggling. 
Still struggling with sleep on Naturethroid
Still struggling ... 
Still gaining weight?
