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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Stuck on what to do
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Stuck on what to do
by adatay, Aug 14, 2009 12:28PM
I'm 41 years old and have had hashimoto's thyroidism for 10 years and have gained more weight on the medicine than off. Because of this, I do see an endocrinologist. He will run my T3 and T levels on the lower side of the spectrum, but the weight is still a major issue. I do see a nutritionist and personal trainer that are extremely frustrated along with me. When my thyroid was acting up recently, a dosage of 175mg of levothyroxine was given and that worked. I'm allegeric to synthoid. The weight was coming off and I didn't need to exercise 2 hours a DAILY (to still gain and maintain), my energy was up, and I could sleep all night without tossing and turning. My menstruation cycle was NORMAL. That has never occurred. I've always been 3-5 months (which no problems have been discovered in the past) In otherwords, I felt the best I have in the 10 years.
After 3 months, the levels were too low and so now I alternate dosage: 2 days 150 and 1 day 175. 2 days 175 and 1 day 150 results in levels too low. I'm exhaused, the weight is coming on (I'm back to working out 2 hours daily), and not sleeping more than 3 hours a night.
My body has never followed the range or sequence of anything and I truly feel 175mg is right for me. I wasn't haven't any increase in heart rhythm or blood pressure.
I have consulted with other endocrinologist that wouldn't really do anything else. I just know something needs done b/c I can't gain anymore weight and I'm at my limit of frustration. My general doctor wants to start me on a weight loss drug to assist with the weight issue, but my endo is against this. I'm only 5 foot so weight is an issue b/c I weigh 175lbs. Before the thyriod, I was 110-120lbs.
What can I do or where can I go?
After 3 months, the levels were too low and so now I alternate dosage: 2 days 150 and 1 day 175. 2 days 175 and 1 day 150 results in levels too low. I'm exhaused, the weight is coming on (I'm back to working out 2 hours daily), and not sleeping more than 3 hours a night.
My body has never followed the range or sequence of anything and I truly feel 175mg is right for me. I wasn't haven't any increase in heart rhythm or blood pressure.
I have consulted with other endocrinologist that wouldn't really do anything else. I just know something needs done b/c I can't gain anymore weight and I'm at my limit of frustration. My general doctor wants to start me on a weight loss drug to assist with the weight issue, but my endo is against this. I'm only 5 foot so weight is an issue b/c I weigh 175lbs. Before the thyriod, I was 110-120lbs.
What can I do or where can I go?
Doctor's Answer
by Mark Lupo, M.D., Aug 14, 2009 12:57PM
, Aug 14, 2009 12:57PM
would not recommend a weight loss drug
Exercise alone does not always produce weight loss (it certainly helps though) -- cutting calories to 1200/day is proven to work for most people -- small, frequent meals work best.
The other option for thryoid is to try a low dose of cytomel (5mcg 1-2x/day) in addition to the T4. Would need to decrease the T4 dose. This does not always help and the many endos do not use this. We find that about 15-20% of patients feel it makes a difference, but it is not a weight loss therapy.
Exercise alone does not always produce weight loss (it certainly helps though) -- cutting calories to 1200/day is proven to work for most people -- small, frequent meals work best.
The other option for thryoid is to try a low dose of cytomel (5mcg 1-2x/day) in addition to the T4. Would need to decrease the T4 dose. This does not always help and the many endos do not use this. We find that about 15-20% of patients feel it makes a difference, but it is not a weight loss therapy.
