My wife has hypothyroidism and has been taking tablets for this. A few months after giving birth to our son, she has gained a lot of weight and is unable to lose it. This is despite exercising regularly, being cautious of her diet and completing intermittent fasting, only eating limited amounts of food during the day. In fact, she eats so little sometimes that I worry that she's not eating enough. She's in her late 30s, experiences fatigue, regularly has low iron and low vitamin D (as soon as she stops the supplements, her vitamin D drops) and is borderline diabetic. Whenever she has a blood test, everything appears to be normal including her TSH, T3 and T4 levels. Does anybody have any tips on what else she can do to lose weight? Thank you
Weight loss and hypothyroidism: My wife has... - Thyroid UK
Weight loss and hypothyroidism
Welcome. Do you have numbers on the TSH T3 and T4 plus ranges, they will help people give advice. Symptoms ? fatigue, feeling cold, aches and pains ?
Forum seems to advise vit D and B12 , ferritin and folate are optimised.
Brain fog is a given with little ones so likely not a useful symptom, I seem to remember.
We had our last about this age and its tough.
My wife had gestational diabetes at this time too, I am a couple of years into autoimmune underactive thyroid and I think my prediabetes is related to this. I used a patch linked to phone to track blood sugar level for 2 weeks which put my mind at rest I can process sugar and it is not too bad. I found finger prick tests pretty useless as levels move about so much in the day.
Good luck to you all.
Thank you. Yes, she's taking Vitamin D. Her ferritin was very low once (dropped as low as 3) so there was a time when very much all she was doing was sleeping and even when she was awake she was half asleep. Fortunately, she is much better than that now but its mostly the weight gain that's a concern
Her ferritin was very low once (dropped as low as 3) so there was a time when very much all she was doing was sleeping and even when she was awake she was half asleep. Fortunately, she is much better than that now
What’s her ferritin level now
Low ferritin extremely common when hypothyroid
Low ferritin tends to lower TSH
Aim to maintain ferritin at least over 70 minimum
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
Low Iron implicated in hypothyroidism
healthunlocked.com/thyroidu...
Really interesting talk on YouTube, link in reply by Humanbean discussing iron deficiency and weight gain and towards end how inflammation can also be an issue
healthunlocked.com/thyroidu...
Inflammation affecting ferritin
healthunlocked.com/thyroidu...
Updated reference ranges for top of ferritin range depending upon age
healthunlocked.com/thyroidu...
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Hi ghost_writer, welcome to the forum. 
Weight-gain and inability to lose it are hypo symptoms. And it's highly unlikely that it has anything to do with what she eats or how much she exercises. In fact, low-calorie diets and over-exercising can make things worse because she needs those calories to convert T4 to T3. If her FT3 is low (never mind being 'in-range', that is meaningless) then she will be more hypo and put on even more weight. Water-weight, unlikely to be fat so diets won't help anyway. What will make her lose it is getting her FT3 optimised. But we'd need to see her results to see if that is happening. What is she taking? And how much?
BTW, just having a result in-range does not make it 'normal'. It has to be in the right place within the range for the individual - we're all different. But doctors don't understand that, and will call any result that falls anywhere within the range 'normal'. Don't be fooled by that!
Thank you. Yes, the range issue is quite useless as her T3 and T4 are almost always in range so the doctor just says that its OK but I can see the symptoms. She's taking Euthyrox 25 mg
OMG! No wonder she's putting on weight on such a tiny dose! Her GP ought to be shot! He's keeping her sick. She needs an immediately increase in dose. Give this GP this article to read and tell him to get the hell back to med school! He hasn't a clue what he's doing!
helvella.blogspot.com/p/the...
Can you post the actual numbers: results and ranges?
Is she taking vit K2-MK7 and magnesium with her vit D? It won't do much for her if she doesn't.
For B12 and folate she would be best off taking a methylated B complex, containing all the BS, because they all work together. Thorne Basic B is a good one and Igennus is another.
She's taking Euthyrox 25 mg
You mean 25mcg
That’s only half the standard STARTER dose levothyroxine
Levo doesn’t “top up” thyroid output….it replaces it
Guidelines of dose Levo by weight
approx how much does she weigh in kilo
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 somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
cks.nice.org.uk/topics/hypo...
bnf.nice.org.uk/drugs/levot...
nhs.uk/medicines/levothyrox...
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
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).
sciencedirect.com/science/a...
The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.
welcome to the forum
How much Levo is she taking
Is it always same brand at each prescription
Very important to test FULL thyroid and vitamin levels and to test EARLY morning
Is her hypothyroidism autoimmune
What vitamin supplements is she taking
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
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 hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
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)
NHS only tests TG antibodies if TPO are high
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)
Essential to test vitamin D, folate, ferritin and B12
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
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
Post all about what time of day to test
healthunlocked.com/thyroidu...
Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Only do private testing early Monday or Tuesday morning.
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Thank you for the detailed response. Are there any supplements you would recommend for B12, Folate or ferritin that I can get without prescription (preferably natural ones so that they don't have side effects)? She's taking Vitamin D right now
All B12 is manufactured (albeit by sort-of fermentation process). And there are only a tiny number of factories where it is made.
Your choices are the four forms (methyl, hydroxo, cyano, adenosyl) - precise form, and what else is in the product.
Most people choose methyl cobalamin as a supplement. Typically 1000 micrograms.
Please add actual vitamin D, folate, ferritin and B12 results
Always test BEFORE starting supplements
A) if extremely deficient GP is obligated to treat
B) don’t supplement if not needed
vitamin D
Test twice yearly when supplementing
Can test via NHS private testing service
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7.
One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average
Vitamin D tablets should be at least 4 hours away from levothyroxine
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once Improve level, very likely will need on going maintenance dose to keep it there.
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Recipe ideas
bbc.co.uk/food/articles/mag...
Interesting article by Dr Malcolm Kendrick on magnesium
drmalcolmkendrick.org/categ...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
Iron
Never ever supplement iron unless done full iron panel test for anaemia
retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Iron is toxic in excess
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 5-7 days before testing
Medichecks iron panel test
Gluten intolerance is a major issue with underactives. Inflamation could result.
Often does not show on blood tests.
Weight loss with hypothyroidism 
Possible secondary hypothyroidism 
Is this hypothyroidism?
GP, results and not increasing levothyroxine 
