Thyroxine and weight gain: Is it possible that... - Thyroid UK

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Thyroxine and weight gain

Funkycherry profile image
24 Replies

Is it possible that despite being hypothyroid taking Levothyroxine is what is causing me to gain weight?

I know in theory it shouldn't, but when I take it religiously, at the same time every morning, just with water and 2 hours before any food, I seem to GAIN weight.

I'm so depressed of being a fat, 43yr old frump with rubbish skin and it's really getting me down.

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Funkycherry
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24 Replies

Have you had your blood work done recently? You are taking t4.. personally not a big fan of it myself

SeasideSusie profile image
SeasideSusieRemembering in reply to

You may not be a fan of T4 but apparently you don't have a thyroid problem whereas the OP does and she needs thyroid replacement hormone to address her hypothyroidism.

in reply to SeasideSusie

That is why I asked if she has had a blood work done..

From what I have heard t4 takes a lot longer to effect and in some people it won't effect them at all, so they have to be moved to a diff compound

SeasideSusie profile image
SeasideSusieRemembering in reply to

As you don't have a thyroid problem, then you don't actually know what the best advice is for the OP. There's a lot more involved than just "blood work" assuming you mean TSH and FT4. Experienced thyroid patients on this forum, not a bodybuilder abusing thyroid meds, will be in the best position to help the OP and there's a lot more to be explored before "moving on to a diff compound".

SlowDragon profile image
SlowDragonAdministrator

How much Levothyroxine are you currently taking?

When was Thyroid and vitamin levels last tested?

Far too frequently patients are left on inadequate dose of Levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Ask GP for full Thyroid testing including antibodies and vitamins

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

Majority of patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

Dose should be increased slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range

NHS guidelines

including what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

* This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

I have often come across the advice that in order to calculate the appropriate dose of T4, take your body weight and multiply by 1.6.

When I was on T4 only, that was the best replacement dose for me, resulting in symptom-relief without feeling over- or under medicated.

Like others have pointed out, patients are often kept on too low doses of T4, resulting in hypothyroidism and impaired metabolism. For some reason, many doctors will not prescribe more than 100 mcg daily, regardless of symptoms.

So you could be under medicated and would benefit from a dose increase.

StitchFairy profile image
StitchFairy in reply to

Interesting, but what body weight measurement - pounds or kilos? I'm sure I've read that the dosing by weight idea should only be used as a starting point following thyroidectomy and the dose fine tuned over the following months.

helvella profile image
helvellaAdministratorThyroid UK in reply to StitchFairy

Completely agree with you. My document, which includes several formulas, is available here:

dropbox.com/s/779n1uycxtujx...

The simple fact that several formulas exist shows that there is no consensus as to the optimum calculation. Further, anything that negatively affects absorption will automatically imply that a higher dose is required than has been calculated.

StitchFairy profile image
StitchFairy in reply to helvella

I was also thinking that when hypo, it's common to get fluid retention which would make you weigh heavier. And something I saw on TV the other day talked about muscle containing more fluid than fat. Presumably fluid doesn't need thyroid hormone, so dosing by weight when part of your weight is potentially excess fluid doesn't seem right.

in reply to StitchFairy

Kilograms.

I agree, we need what we need and that is highly individual. But I do think that many doctors tend to keep patents under medicated.

Funkycherry profile image
Funkycherry

Thanks for all the replies. I'll try to answer the questions.

I used my private health care to be referred to an endo' last year. All levels checked and she advised an increase of 25mg to 75mg levothyroxine once daily.

She also re-checked my vitamin D that had previously been deficient. Now on 2000 D3 daily. Also prescribed folic acid.

Last time I was checked my TSH was below 2.

I have had 2 miscarriages and struggled to get pregnant since. That is no longer my primary concern as I feel like I'm getting on a bit now at 43 and need to consider myself lucky that I have one healthy 8yr old.

I have horrendous skin these days and look very old before my time. Combine this with the weight gain and tiredness and I know you can all understand my misery.

london81 profile image
london81 in reply to Funkycherry

you may be one of the many people who need t3 or NDT which is a t3 and t4 combination, many people in my family do better on this. with hashimotos it’s trial and error often.If you haven’t yet tried simple calorie counting that is a good way to see if it’s your condition causing weight gain. if you eat 2000 calories and burn 2500 calories you should lose a pound a week ( you can estimate this by using a fitbit and logging food in my fitness pal), if you don’t lose weight despite being in a calorie deficit then it’s likely you need to look further at your thyroid, antibodies and gut health. as a lot of people don’t cover the basics first it’s a good place to start.

t3 levels are very relevant and as per the post above you probably need to look at further testing of all relevant blood work

good luck

Funkycherry profile image
Funkycherry in reply to london81

I definitely need to try harder with my food choices. I tend to do well on higher protein diets.

in reply to Funkycherry

The only time in my life that I gained weight was after my TT when I was put on Levo for 8 months. I joined this site and started medicating with NDT the weight dropped off withing two months. I still use NDT and am the same weight as I was 50 years ago, eating around 2000 calories per day.

Funkycherry profile image
Funkycherry in reply to

I'm in UK, so thinking it will be difficult to get prescribed this. happy to buy online if I could find a reliable supplier.

SlowDragon profile image
SlowDragonAdministrator in reply to Funkycherry

So first step is to get FULL Thyroid and vitamin testing

Come back with new post once you get results and ranges

You are likely under medicated and/or low vitamin levels

75mcg is only one step up from starter dose

Majority of people need somewhere between 100mcg and 200mcg Levothyroxine

Essential to test vitamin levels regularly

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Absolutely essential to test FT3

We frequently need addition of small dose of T3, but getting Levothyroxine dose high enough first and vitamins optimal FIRST

PCOS almost certainly means you also have autoimmune thyroid disease diagnosed by high thyroid antibodies

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Funkycherry profile image
Funkycherry in reply to SlowDragon

Great info thanks.

I've had coeliac test and was negative.

Marz profile image
Marz

Can you post the actual results with ranges ? Maybe time for new tests. Skin often reflects the health of the gut - how is your diet ? Was B12 tested ? If Folate was low then often B12 can be too.

Funkycherry profile image
Funkycherry

Just trying to find a copy of my results.

Had fertility hormones checked at the same time and it is likely that the bad skin is down to PCOS.

The good news is that the vitamin D really helps eliminate the joint pain.

High intensity exercise makes me feel like death, but walking seems to help and luckily the dog makes me get out daily.

Will look into B12. Thanks.

Marz profile image
Marz in reply to Funkycherry

I only caught your Reply by chance as you had inadvertently forgotten to click Reply beneath my post to you :-)

Funkycherry profile image
Funkycherry in reply to Marz

Ah thanks. Quite new to this. Posted a couple of years ago, but not since. Sorry.

Marz profile image
Marz in reply to Funkycherry

No problem 😊

Funkycherry profile image
Funkycherry

Thanks Everyone.

I've decided that my next course of action is to ask for up to date blood tests. I think it's been at least a year since my last lot.

You've all provided great links for me to read through too. Many thanks.

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