feeling miserable

[Gilbert2023]

saw a different gp today , had a conversation about symptoms and all that’s happened in the last year , her comment in my notes talks about risk to health associated with overweight and obesity, general advice on healthy weight and lifestyle, plus some videos on weight management and needing to walk more , feeling fraustrated and arguing with husband who want me to follow nhs advice inspite me wanting to go private over 6 months ago , blames me inspite of me asking for better help last year , I’m struggling now mentally and physically, where to I go now , with no support !

[humanbean]

You might find this thread of interest :

healthunlocked.com/thyroidu...

And a personal anecdote... I've found that eating more protein, particularly at breakfast, has helped me to control my appetite a bit better.

[Gilbert2023 in reply to humanbean]

Thanks , my iron levels are actually pretty good 254 ish in the medichecks test and my inflammation is 0.89 , all my vitamins are good , I’m just starting trying being gluten free , my arguments are around nhs advice not always bring the best whereas inspite of all my explanations my husband is thinking thyroid is resolved , follow gps advice to loose the weight

[Buddy195 Administrator in reply to Gilbert2023]

Can you please share thyroid test results/ and key vitamins, with ranges in brackets after results (as these can vary between laboratories)

Have you had a coeliac test (whilst still eating gluten)? If not you could ask GP for this prior to a GF trial. Once you start a GF trial you do need to fully eliminate all gluten for 2-3 months to see if this benefits you.

[Gilbert2023 in reply to Buddy195]

also I’ve had the coeliac test a few months ago whilst eating gluten , it was negative

Latest results

[SlowDragon Administrator in reply to Gilbert2023]

which brand of Levo are you taking

Presumably you tested as recommended

How much levothyroxine are you taking

You’re going to need to reduce Levo a little and add small doses of T3 alongside

Personally I found gluten free to be astonishing improvement - been strictly GF since 2016 (after negative coeliac blood test) - private endoscopy showed damage as if coeliac

And went (very reluctantly ) dairy free in 2022…..this really reduced my mucin and enabled slow steady weight loss

I would never go back on either

My TPO antibodies have reduced from higher than yours are currently to be below range for first time last year

[Gilbert2023 in reply to SlowDragon]

Currently on accord 100 , told the gp that even if she reduces dose I want to stay on this brand and I’ll cut tablets if necessary, really appreciate all the advice from you just feeling like banging my head against a wall as I can’t through to anyone in real life including my husband

[Gilbert2023 in reply to Gilbert2023]

How long after stoping gluten did you notice improvement?

[SlowDragon Administrator in reply to Gilbert2023]

Some improvement immediately on GF but it went on improving over 1-2 years especially brain fog fading took 9-12 months to be noticeable

I had T3 added on NHS prescription a year after stopping gluten

Dairy no obvious immediate improvements but after 2-3 months leg (and arm) swelling noticeably reduced and that is still continuing 3 years later

Down from 95kg to 80kg

Would like to loose another 5kg

[humanbean in reply to Gilbert2023]

It might seem over the top to suggest that you get an iron panel done given that your ferritin level is quite high in range, but having a good level of ferritin isn't a guarantee that you have a good level in your bloodstream.

It is possible to have a good level of ferritin and yet other markers related to iron might be low (or high, depending on the test).

The fact that the results you posted 9 days ago show that your CRP (C-Reactive Protein - a marker of inflammation levels) is below 1 is good news and reduces the chance that other iron-related results might be low (or high, depending on the test). But if you ever decide to get an iron panel this is the one I use :

medichecks.com/products/iro...

and the discount info :

thyroiduk.org/testing/priva...

During their sales they may supply higher discount codes.

[Gilbert2023]

better photos of results

Results

[Gilbert2023]

and rest of results

Results part 2

[Buddy195 Administrator]

What dose of Levothyroxine are you taking and how long in this dose? Have you been advised to reduce, to get FT4 within range? Personally, I would not want FT4 over range, due to adverse risks to health.

As your FT3 is lower in the range, it is likely you have conversion issues and, as such, may benefit from combination treatment in the future. However, Liothyronine can only be prescribed by an endocrinologist, willing to sanction a trial.

Regarding vitamins, SlowDragon always gives comprehensive advice

[Gilbert2023]

I’m on 100 of levothyroxine for over 6 months , I thought it might be too high at Christmas ( no specific reason just felt like I had too much energy ) can’t really explain , gp test showed 0.35 so just about ok but retest now , told a different gp ( looking for a new opinion ) about my medichecks test and I’m being nhs tested next week , I expect my Levo will go down …….. so my thyroid is fixed ? and if I want to loose my extra weight I need a calorie deficit diet and exercise ? So she says and she’s sent videos on obesity and comfort eating today

[Gilbert2023]

to me it’s my bowels that are struggling but I know that it could still be thyroid related ( or not ) and my previous gp wasn’t interested in t3 and didn’t think the consultant at the local hospital would be willing

[Buddy195 Administrator in reply to Gilbert2023]

I would reduce Levo slowly to get FT4 within range- eg 12.5mcg per day at first - I find a pill cutter useful for this (but tricky if you only have single 100mcg tablets).

GPS cannot prescribe Liothyronine, so to address poor conversion via combination treatment, you will need to see an endocrinologist who would support this (not all do!)- ask for TUK list of practitioners to consider options in your area. thyroiduk.org/contact-us/ge...

As a first step though, I would look to get FT4 within range and retest thyroid levels to see how this affects your FT3.

Regarding weight loss and thyroid levels, this is not an area I personally know much about. However, greygoose and others regularly post that that weight loss in hypothyroidism is difficult to achieve without first addressing any issues with thyroid levels.

[Gilbert2023]

Which figure does ft4 relate to

[Tina_Maria in reply to Gilbert2023]

FT4 (free thyroxine) - 26.6 146%

This is quite a bit over range and you should try to get this down. It will also affect your conversion to T3 as the excess T4 (free thyroxine) is converted to an inactive metabolite (reverse T3).

I can attest to that, I was running my T4 quite high as well (116% over range), to get a decent T3 value, however my conversion has gone worse, so a couple of months ago I reduced my 100mcg levothyroxine by 25mcg a week (I cut one 100 mcg accord tablet to make one dose of 75mcg). As a result, my free T4 is now within range and interestingly my T3 has increased, so it has helped with the conversion. So it is worth a try. Go slow though, otherwise you will suffer the reduction quite dramatically and you will still have a couple of wobblies along the way, but persist with it as it will resolve again and your body gets used to the lower dose eventually.

Try that first to see if it will make a difference, but as your conversion looks not that good, you may need some T3 added to your levothyroxine in the future.

And currently, it will be the low T3 that is giving you the symptoms

T3 4.4 31% through the range

This is quite low and also the reason for your inability to lose weight. If your T3 is low, your metabolism is slowed down, so your body is not as efficient in metabolising dietary components such as lipids (cholesterol) and glucose and these levels can increase. This is not connected to your diet and even with reducing calories and exercising often, you will not be able to achieve much, as you need sufficient T3 for your metabolism to process all this. It is like when you have a car that is running on reserve petrol all the time, yes you can still get a few miles out of it, but after a short run, it will grind to a hold as it is lacking fuel. So if you want to go longer distances and do more, you need at least half a tank, better even if it is 75% full, as you have a lot more fuel.

[Gilbert2023 in reply to Tina_Maria]

Thankyou

[Gilbert2023]

I’m upset , how to a respond to a gp who I consult about my weight who gives me all the generic advice about calories and exercise as if my thyroid is irrelevant? I listen and think that won’t work but I don’t know how to say it ?

[SlowDragon Administrator]

I would suggest trying Vencamil Levo it seems to work better for many people even if not lactose intolerant

Vencamil do 50mcg and 25mcg (and 75mcg) tablets

Was last dose of levothyroxine definitely 24 hours before this blood test

If you have to reduce to get Ft4 within range get 50mcg and 25mcg tablets

Suggest Initially reduce to 87.5mcg daily

You may see Ft3 improvement when Ft4 reduces as Ft4 is currently too high

[Gilbert2023 in reply to SlowDragon]

Thankyou

[Gilbert2023]

my biggest issue is finding a gp who listens and understands , I’m not really a confrontational person and whilst I could ask to change brands I’d struggle if they said no

A lot of what the gps say seems to make sense when I’m in the room but I know they aren’t really making me feel better , I had more fight in me 6 months ago

[humanbean]

Taking excess T4 could be partly to blame for your weight issues. I did think your conversion wasn't great.

Free T4 was 146% through the range

Free T3 was 31.14% through the range

Ideally both your Free T4 and Free T3 would be in range, and for many of us having a percentage through the range for T4 and T3 that is not vastly dissimilar e.g. 60% and 70%, is helpful.

There may come a time when you want to source your own T3 and try T3 only. But I don't know how long you've been trying to optimise your dose and are still feeling awful.

I was on T3 only for several years, but eventually found that I did better with a combination once I could actually tolerate Levo/T4. Other people have things happen the other way around.

If you were to reduce your T4 dose just one day a week it will probably noticeably affect your results - and would increase the chances that your Free T4 drops back into range, and just might improve your conversion. If you leave it up to a doctor to do that they might do something stupid like reduce your dose by 25mcg per day. Thyroid hormone intake requires a delicate hand on the dose, not a sledgehammer like doctors use, so I would suggest that you drop dose by 25mcg one day a week, then test in 6 - 8 weeks. If your Free T4 is still too high then you might need to reduce dose by 25mcg twice a week rather than just the once.

I currently take a smaller dose of T4 two days a week than I do the other five. I spread the effect over the week by reducing on a Monday and a Thursday.

I've seen some doctors tell patients to reduce dose on a Saturday and a Sunday. I wouldn't do a reduction on two consecutive days. I think it would make it more obvious that you might be under-dosed on the second day. But by spreading the "short dose" days across the week I don't really notice it.

[Gilbert2023 in reply to humanbean]

Thankyou

[Gilbert2023]

I have a blood test on Wednesday as I told the gp my medichecks results so I know I’ll be a bit stuck after that , I don’t know what to do , advice on here is really helpful but getting my gps support is challenging

[silverbelle51]

I don't know your obesity issues, but if your thyroid is out of wack then everything and you will be fighting yourself . Walking is a good thing it helps the body to relax and lymphatic fluids to flow . Recommend you get yourself a log book . Here in the US Mead makes them . It is a small spiral note book with lined pages. List your medications , then list their side effects if you have too much and if you are deficient . Check off any symptoms you may have . It gives you a place to start. Do a baseline of yourself at least once a week . Sadly when it comes to diet we are affected by the preservatives that are in food, the pesticides the foods are exposed to while they are being grown . There is no such things as purely clean foods our environment is polluted air, water, soil. Many , many seeds are GMO which means they have been adversely affected. The best we can do is to reduce our exposure ! Soy is a HUGE hormonal disruptor and it is in everything ! There is a great site ( gutzy girl) something girl that lists all the sources or thing that actually are soy ! Our bread is even affected cause our wheat products are GMO affected . What you drink is important avoid soda and dilute your juice and drink them with no sugar added. Avoid flooding yourself with too much fluid which will only flush out nutrients before they get absorbed . Make sure your bowel movements are regular. Good for that is a breakfast of : 1/4 cup unsweeten apple sauce with like 2 tbsp flax seed ( I use the ground flax seed) and like 1/4 to 1/2 c of yogurt with all that sugar laden fruit stuff. I some times alternate with oatmeal which I add the flax seed and maybe a tbsp of either honey or maple syrup. I microwave it and stay away from the oatmeal packets loaded with chemicals . Get the oatmeal that comes in the cylinder style container you have to measure out. Other option I like is a soft cooked egg I microwave it for 30 second in an egg cup I have for the microwave and a well microwaved baking potato here in the US I bake my potato after doxing it 3 minuets on one side and 3 minuets on the other side. I have found them to be healthy breakfast choices. I generally have coffee with real cream and sometimes a dash of cinnamon . Use reason with the rest of your meals and try not to over eat or starve yourself . Keep a in your log book what you have been eating to see what makes you feel the best . Also remember that thyroid replacement drugs are indeed hormones and hormones whether your own or chemical replacements are POWERFUL ! Everything you put in your body does indeed affect how your body functions and how you feel. I will be praying for you take care !

[Gilbert2023 in reply to silverbelle51]

Thankyou

[josephinius1]

I feel your pain. We are in the USA so the coverage situation is a bit different, and "going private" more often than not means going with a naturopath, though we are starting to have more that go outside the system. Whatever, of course he didn't want me to spend money for "care" we could get at no cost or which would at least apply to our deductible. I still saw a naturopath but that's been hit or miss, too. I also test drove a "functional medicine" MD who was outside the system ($559 for the consult,) who did give me some different perspectives and might have been more candid, but when I wanted him to follow up, he proved to be very difficult to track down and when I'd finally get him, it was like he too was just reading from the playbook, wasn't really SEEing my results, my chart.

All to say, I've come to the conclusion that I really am pretty much on my own. I do have a naturopath now who is fairly reasonably priced and who at least takes time, tries to offer something. And she did do a lot of tests no one else has ever suggested, has offered me some prescription and non-prescription options while watching how I respond in a way no other physician has. But though I actually do feel better (unfortunately I became desperate and defiant when I was diagnosed with severe osteoporosis which even my husband thinks is in fact tied to my thyroid/medication,) she is helpless to address severe/symptomatic bone issues (except to say, "heal the body, heal the bones,") and I know long-term, she's not going to be enough. (Though even my bones feel better than they did, just, not due to her interventions, exceot in the sense where addressing gut issues helps bones.) And once I'm 65, I'm going to be sucked into Medicare, and I'm really not looking forward to that.

Anyway, I'm sorry, and I do get it.

[Gilbert2023]

thankyou

[Popeye44]

I sympathize with your weight issues. I have struggled for 20 years since being given treatment for endometriosis and gaining 3 stone in 3 months. I've tried calorie controlled diets, I walk at least 3 miles per day with my two dogs but my weight was like a yo yo. Two years ago I tried the Zoe programme which isn't a diet but starts with a two week testing process to understand your metabolism better. Fats are my problem because I take longer to remove them from my system than others do. Some people are sugar sensitive and wearing a constant blood sugar monitor was an eye opener. I now practice intermittent fasting with an eating window in between 12 noon and 10pm. I don't snack because my meals are satisfying. I have reduced processed food to less than 15% of my diet. For the first time in a long while my weight has remained stable for 2 years and my bowels are A1. There are lots of videos on YouTube from Zoe (Prof. Tim Spector's team at UCL) which will help you organize your eating. A particularly good one is about calories with Dr Sarah Berry.

Hope you find this helpful.