Weight gain despite thyroid tests being within normal range

[Emslass]

Back in 2000 (age 39)I was diagnosed with hyperthyroidism. (weight 147lbs)The carbimazole didn't rectify this, and in 2002 I had radioactive iodine. This was successful, and my thyroid levels have been within the normal range ever since, and I haven't had to take any form of thyroxin.
But, Oct 2004 despite my levels being within the normal range, my weight began to rocket. In one year I have gained 42lbs all on my abdomen. I have the appearance of being pregnant but I certainly am not. I must state that I am no couch potato and I am extremely aware of what I eat and I exercise regularly. I have plenty of fresh veg, chicken and fish, homemade veg soup and salads, no alcohol, no cakes or cookies.
As you can imagine I am not a happy bunny. I had a host of blood tests done in the summer 2005, and nothing came up as being abnormal. Cortisol was slightly low, parathyroid slightly high, but nothing significant acording to my GP(doctor).
I have stiff sore joints, ankles, elbows and very painful shins. I have terrible gas in my stomach.
I am on the waiting list to see the enochrinologist, but I may not get an appointment this year(this is the UK!) My doctor has told today me it's an age thing and that I should get used to my shape.I am not satisfied with that answer.
My question is, what could possibly be causing this weight gain, gas and soreness am I hypothyroidic?

[Mark Lupo, M.D.]

When the thyroid is hyper - the metabolic rate is falsely elevated, making it easy to lose/maintain weight.  Once corrected, the metabolism falls back to "normal" and unless eating habits also adjust many patients gain weight.

The RAI can make a patient hypo even 1-2 years after treatment -- what is your TSH -- a level above 2.5 might be "hypo" for your body and getting on some thyroid medication may be appropriate.  Many docs don't endorse this concept and will wait for the labs to be frankly abnormal before treating.

How was the cortisol measured?  A random low cortisol on a blood draw is tough to interpret.  Also why is the parathyroid elevated?  Was your calcium elevated -- that could cause some of your painful joint symptoms and cause constipation, etc...

Good luck.

[doodlebug1]

Hi emslass. You know, I've never known anyone who had RAI to not eventually get hypothyroid. And when you mentioned weight gain, stiff joints and gas, I did find myself wondering if you indeed had gotten there, but the docs aren't doing the right tests to confirm it. In my opinion and by what I have observed and personally experienced, docs are way too dependent on the TSH and believe too strongly in it's range. So they call you "normal" based on ink spots on a piece of paper, when your symptoms scream hypo.

I have found there are other ways to detect if one is hypo. One--your temp. You are generally looking for a before-rising temp of 97.8 - 98.2 and a mid-afternoon temp of 98.6, using a mercury thermometer. And testing the FREE T3 (not just T3, but FREE T3) is VERY telling. If it's low in the range, bingo.

Also, to tuck away in the back of your mind---docs are trained to put folks on thyroxin, but there appears to be huge growing body of us who have found desiccated pig thyroid (called Armour, for example, in the US) to be a FAR superior treatment than thyroxin. You even have an advocate group out there who are strongly questioning your docs as to why they aren't more routinely putting folks on Armour. Anyway, it's something to remember for future reference, because I do know you'd love to have an answer for your current situation!

[ArmourGal]

I wish I had a dollar for everytime I've heard that a doc used "age" as an excuse to not treat obvious hypothyroidism. Other times they'll tell younger women "of course you're tired, you have kids"....or some variation on this theme. I do not think they would tell a man these things.

Why they can not recognize obvious hypo symptoms I do not know.  What I do know is that untreated hypothyroidism can have longterm adverse health effects.  

For example your gas problem.  I started with IBS symptoms way back in the 90s.  The gasternonologist never mentioned that digestive ailments could be thyroid related.  After finally getting diagnosed hypo in 2004, I have had a difficult time getting my digestive system back to some semblance of normalcy. I doubt it will ever be completely right because it is too damaged from long term untreated hypo.  It did NOT have to happen.  

You should have Free T4 and Free T3 checked.  If they are in the lower 1/3 of the range, it is probabe that your symptoms are hypo related.  

Your TSH is just not reliable after RAI from what I've heard from others. It may stay suppressed for a long period of time.

Please don't take "age" as the reason for your symptoms without further investigation.
Cindi

[ancientmariner]

When I read your post, my first thought was "I don't remember posting that"! You could have been talking about me! I had the RAI, and although it did make me hypothyroid, and I was put on Synthroid, as soon as my blood tests were "normal", I was told that the "buddha belly" wasn't related to my thyroid, and the knee and ankle pain was because of the extra weight I was carrying. And all the other odd problems that started with my thyroid suddenly couldn't be my thyroid any more because my bloodwork was NORMAL! So, normal bloodwork doesn't mean you aren't hypo - after RAI, the TSH test most doctors use is not reliable, for some reason. But they still use it, and make us doubt ourselves by telling us it's all in our heads, we just need to exercise and eat right, and oh, here's a pill for the high cholesterol and one for depression and one for the joint pain.

All of the symptoms you described are HYPO symptoms - I've had them all, too! Keep after the doctors - you're more than a lab report and your symptoms are more important than the numbers!

[LowMac]

Ladies, I'm posting under this heading, the other was really filled up. Thanks for response to my description of low cortisol. This is not a new revelation to me, I've looked into it for more than three years, knowing it can affect thyroid function etc... What I'm actually looking for is more specific advice for my case in particular, which I know is very difficult to do via written posts. Dr. Mark may not see my posts under the other heading and may not can answer due to forum policy anyway.
The disrupted sleep patterns, has always been a possible cause but another thing that caught my eye, was the ZRT info. sheet which also listed bacterial, fungal and viral pathogenic infections, can be a cause of chronic low cortisol.
I've always felt like I had a viral or other type infection running around in my body. For example, last night my mother came over for dinner last night and gave me/my wife a sample of wine she has just started drinking in small shots, just before bedtime, for blood and relaxation purposes (also has toe pain-recent gout surgery) and as I do with a few other things (like chocolate), I had bad reaction to it (almost never drink). I felt fine until an hour later, I had symptoms flare-up. Before the flare up was over, I had strep throught type symptoms, not as severe as real strep throat. Stange huh? I know a Dr. hearing this would probably think I was a nut but I've been through it enough times to know there is a definate pattern. I'm getting Hepatitis C tested for and should have results in about two weeks. None of the ways websites list that it is contracted, apply to me but I want to get it done anyway.
I've harped a little about lousy Dr.s on here and hope I especially haven't offended Dr. Mark because I feel he is one who is called. My disgust is the Docs who try to say pyschosomatic/emotional as cause of my flare-ups. How in the world do emotions cause chemical sensitivities? Or Othostatic Hypotension? Or joint aches/with crunchy,poping sounds? Also, I have read numerous websites, stating that emotional disorder, anxiety/depression, results in high cortisol levels, except for PTST (Posts Traumatic Stress Disorder), which can supress cortisol but I definately don't have PTSD. Any emotional symptoms I do have, are mild.
This has been tough for me because I've always been healthy and strong. I'm 6-ft, 215 to 220 lbs, actually told I was too muscular in shoulders/neck area. I just want to be able to work even moderately hard, without symptom fare-up. That's another thing, anxiety/depression suffers, benifit greatly from exercise, with me, I get post exertional malaise that can last a whole day or two to recover from.
Anyway, I've rattled on too long. I'll never give up finding answers and eliminating the possibles, until I satisfactorally get to the bottom of this. Thanks again everyone.
Jim

[doodlebug1]

Interesting post, Jim. I want to do more research on what ZRT told you--namely that bacterial, fungal and viral pathogenic infections can be a cause of chronic low cortisol. I see low cortisol in a LARGE amount of the hypo folks on the forum I'm on, and it's surprising. And Jim, if you do decide to take low-dose cortisol, you might then be able to raise your Armour, and get past that malaise you have! Please let us know what you find out from the Hep C test! My stepdaughter has it, and it's no fun. I wish you'd join the Natural Thyroid group!! LOL.

[LowMac]

I just want to say this as well; People or even Dr.s who do not understand why someone has to research their own illness, either is not thinking it through or is very one-sided in their thinking. You cannot get enough info, to even fill a thimble, at a 10 to 15 minute office visit. I have been to two endocrinologoists, plus three GPs before that. To think I can make huge numbers of office visits, in order to begin connecting info together is simply ludacris. I don't know of a Dr. who will sit and go over information with you for an hour at a time, though Specialists will come a little closer to it. The main thing I've done at Dr. visits, is to specifically describe symptoms in detail.
I'm venting now, but here goes.... The fact is, the Dr.s I've been to so far, were burnt out and could care less If I was diagnosed properly or not. I am not stupid enough to think all Dr.s are bad, just like I do not believe all Cops or Ministers or Car Salesman etc, etc..., are bad but I will say that any Dr. who denies this problem is going on, is a pencil-neck runt, who is probably in the same catagory as they are. I do truely, sincerely believe there is a terrific Dr. out there for me but the expense in trying to find him, has been astonomical.
Those of you who are believers, pray for me, Ar1281a (my good friend), TNT, ShannieK and all the others who have/are going through SO MUCH, to find proper treatment. I believe in Divine Intervention, have seen it/experienced it. But I do believe God works through Dr.s too. He will judge those who put on a front but really do not care, I wish them all true repentance.
(note: I didn't use specific names of religious figures, religions, denominatione etc.., just a generalized thought!)
Thanks to all the sincere hearted!
Jim

[LowMac]

What's the web address? You can give it on here, many have done so in the past, as long as it might be a helpful and informative site for thyroid patients.
I'll certainly check it out.
Thanks

[doodlebug1]

Is it OK to give a link? I thought it wasn't. Well...ok, here goes (and Cindy, LowMac told me it was OK. :o)) If he's wrong, I won't do this again: http://health.groups.yahoo.com/group/NaturalThyroidHormones/

[ArmourGal]

I appreciated your comments above.  I have learned very little, if anything, from docs about my condition.  I spent hundreds of hours reading about it...and then sharing info on an Internet forum is quite informative.  I don't know why so many docs resent a patient being informed...it's weird.

On the sleep patterns...I remember reading that one good indicator of hypo being under control was that sleep patterns returned to normal.  Hmm...that means I'm not quite there.  Although I had high cortisol when first diagnosed, I'm not sure what it is now.  But not being able to fall asleep at night was really getting to me.  I've started using 1 mg. of Melatonin.  It's supposed to be helpful for restoring the circadian (sp?) rhythm.  It's really working for me...so if you haven't tried that, it might be helpful to you.  

btw, I'm a believer too.  
Cindi

[Emslass]

Hi there, thanks for all your comments, they have cheered me up,as it's good to know that there are some who believe me. I am so frustrated that my GP has decided not to listen to me and is now offering diet meds.
My TSH has never registered. The reading was so small it was less than 0.01, and it has never improved even after taking the RAI.
All the blood tests get sent to the hospital for analysis, and the pages of readouts get sent to my local GP, who admits that unless things are really unusual, it's a mass of information that needs a specialist to interpret, and it's the expert that I am still waiting to see.
BTW, I am not constipated, I am just full of gas, I belch constantly.

[ArmourGal]

The thread above that you started is not letting me post.  It says the thread is no longer active.  Weird.
Sorry to cross post like this...but here's my post to yours on the other thread:

The way I have understood it from a clinical text on the thyroid gland is that antibodies appear when someone has Hashimoto's...but not everyone gets antibodies...and not everyone gets both of them.  But that if you test over the range for one of them, then it IS a dianostic indicator that you have Hashimoto's.  Evidently the disease itself causes some damage apart from the antibody damage.

So, I was over range in both types of antibodies and so I was diagnosed Hashimoto's.  But even though you were only over range in one of them, you would still be given a diagnosis of Hashimoto's.  However, I do see you have some TPO antibodies, and I would think that without treatment, it might be likely those would rise in you.  

Now...that 2.83 TSH. Too high gal.  And please learn from my experience.  I was so tired with a variety of ailments way back in my 30s with a TSH of 2.33.  The doctors just told me I was normal.  I was SICK....and they allowed me to stay in a hypo condition causing PERMANENT DAMAGE from untreated hypo. Hypo can affect everything in your body.  So don't go untreated!  Find a doc that realizes a TSH of 2.83 is too high.  The new recommended top of the range is 3. And that 4.99...geez...this is why folks have to self-medicate, when docs refuse to treat obvious hypo.  

Which reminds me just how unreliable this TSH is anyway.  Way back when, I think they started with a top end of the range of 10.  And now they're down to 3.  Geez, how many people do you think suffered - and died from heart failure and other ailments - because of an unreliable TSH test.  

Yes, I used to have swollen lymph glands frequently.  Believe me, if you start researching hypo symptoms, you'll realize you probably have lots of things that you had no idea were related.  And the tight feeling, that is quite common.  Hashimoto's folks often can not wear a turtleneck sweater or choken necklace for this reason...just can't have anything around their neck. Heck, I don't even like to touch my neck...it's just a real sensitivity there.

[Heather123]

Thanks so much!  I kept looking for my post and couldn't find it - weird.  I was wondering how I could have been offensive or something...??
Yes from what you've been saying and what I've read, even 2.83 is high.  Plus, I've had many symptoms for quite a while.  The one I'm most concerned about is infertility.  I'm wondering if I should go to a different RE that thinks 6.3, 4.99, and even 2.83 are too high to conceive.  I would think this RE, head of a large fertility clinic with several offices, would know that TSH s/b much lower in order to conceive.  If I've read that my numbers are too high in several books, why wouldn't this RE be up to date on levels?  I do understand how some people self-medicate.  Hopefully they all have researched the thyroid!  
Yeah the neck thing is really weird - I will reach for my shirt to pull it off my neck and it won't be there.  The last few months I can barely stand having covers on my legs and feet (esp) when I sleep, and my ankles are really stiff and painful when I get up.  This morning was the first time in several months that I woke up and my ankles weren't killing me (they hurt a little) - hoping that is a good sign!

[ArmourGal]

I have stopped wondering why so many docs don't appear to know much about low thyroid.  I certainly can't change the world on that one, so I just concentrate on helping those I can.  As for self-medication, gosh - sometimes I think it's probably safer than what I hear docs are doing.  Besides keeping so many folks hypo, they change the doses up and down all the time which is just crazy to me.  TSH changes thruout the day...and I'm always wondering if the person had gone in later that day, would their dose have remained the same?  It's all sorta bizarre to me.  But for those folks who do self-medicate with dessicated thyroid extract, it's a relatively safe and established protocol.  The only problems would be if someone had adrenal problems or undiagnosed heart problems for example.  Of course even going to a doc doesn't seem to get those diagnosed until it's too late.  So, it's a personal decision folks have to make. Some folks just don't have another option...and self-medication is certainly safer than a slow death.

What I might recommend to you is to go to the Armour Thyroid site (sorry, they wont' let me post the link because they said it was advertising) and there is a doctor search feature.  Most docs who use Armour (or Naturethroid or other for that matter) seem to know a bit more about how a low TSH can indicate hypo.  Also, some folks have had success in calling their local pharmacy and asking if the pharmacist could tell them who in the area prescribes Armour.  Looking around for a holistic type doc might also be beneficial.  Mary Shoman's site also has a top thyroid doc list that you can check.  So - it is sometimes hard to find the good docs, but don't give up.  I sure wish I had known way back when to pursue this...but I just didn't have enough information then.

[Heather123]

Thanks!  I wish I had known about the thyroid two yrs ago when I decided to try to get pregnant, and of course before then when I felt crappy all the time!

[Heather123]

I was sent an email about my post that disappeared - apparently I somehow violated their agreement. ?????????  They told me to NOT post in the forum and allow others to post.  ???????
Very strange.  All I did was re-post something in a new thread b/c I thought my first post didn't work b/c I couldn't find it (and that was related to the thread).  As you know I just asked for an opinion on what the resukts could mean, just like everyone else does.  No swearing, anything bad.  ?????
So, I don't know what the problem was but I don't need to be given **** for nothing, and then to be told to stop posting????  Oh boy give me a break.
Thanks for all your help!  I am going to check out everything you said.  Good luck to you!

[Heather123]

Apparently I was hogging the forum - I didn't realize I was to only direct questions to the physician.  I was told I asked 4 questions since October 5th and that, believe it or not, others wanted their questions answered also.  Well, I am not the type of person to be a "forum hog" and certainly didn't intend to be.  I didn't realize how this forum worked.  I was told this place was not for chit chat.  I wasn't trying to chit chat, I thought we were all helping each other and I was merely trying to find out more about the thyroid and my problems with it.  Guess I should thoroughly read sites before I post :C)
So anyway, I am off to other sites, and wish all of you luck with your thyroids! :c)

[ArmourGal]

I'm sorry you got hurt...but hopefully some information from here has helped you.  I got a warning type email today too...and it is all a bit confusing as to the real purpose of this forum.  I was going by the words of one of the owners in an interview, but perhaps I am mistaken. Maybe they don't want folks to post back to each other when there's a doc available.  But here's what they said previously about MedHelp:
One other point to note is that we've been building these communities of visitors who have similar conditions such as heart problems or neurological problems. They tend to attract people with chronic diseases, so that these people are logging on daily, chatting with each other, sharing information. So from these communities, we have an awful lot of repeat business, if you will.