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Any Help or suggestions with battling weight, depression, and medicatio...
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This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

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Any Help or suggestions with battling weight, depression, and medications

I have been mildly depressed for a while because of my weight gain. I went to physician weight loss two years ago and loss 75 pds. I have since gained 38 of the 75 pds. Never did my first doctor suggest to go to an endo/thyroid specialist. I complained about my weight, fatigue, and tiredness before but it fell on deaf ears. I thought it was something that I was doing wrong. So when I got off of physician weight loss I thought all I had to do was continue with exercise and a controlled diet. I was wrong. I started balloning back up and now I am 215 pds and am very embarrassed about it. I finally started to take a proactive approach and started pushing to find out what was going on with me. Finally, my previous doctor scheduled me with an endo/thyroid specialist. Of course, I left my previous doctor and now with a second one (I still don't know about this one as I discussed my concerns while waiting on the endo/thyroid specialist but it wasn't positive). The suggestion was made to go to a weight loss center after lab results were done that ruled out Vitamin D, B12, TSH (normal), iron, prediabetic, etc. I continue to talk about my metabolism because I truly believe that this is where the problem lies but again it fell on deaf ears. I went to the endo/thryoid specialist on today (10/5/11) and he suggested to try Cytomel 5mcg and changing my levothyroxine to 100 mcg. ( I was originally on 125mcg levothyroxine). He is running additional test on my thyroid and stated that he will inform me as to when I can go forth and order the Cytomel and Levothyroxine. I questioned him about the metabolism issue but didn't receive a good response. I don't know of what else to do as it seems that this is my last option before I go back to the weight loss centers. I hate to go back because it a short term solution, in addition, to paying a lot of money only to have to go back again because my body is out of balance. Any suggestions that you all have will be welcomed. I never heard of taking adrenal for hypothyroidism. I will do more research on that. However, it seems my ideas of what can be done to combat my hypothyroidism was not received with a warm welcome by this endo/thyroid specialist. By the way, I exercise like crazy!!!! I have been trying to lose these pounds for a year and 8 months. Anyone have any suggestions??

Here are my current lab results:

T3- 84

T4 - 1.6

Hemoglobin 5.5

Vitamin D (Normal)

Ferritin 20

Iron 62

B12 1000
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649848_tn?1357751184
If you have the lab report, can you tell us if the T3 and T4 are "Free" or "Total"?  And what the reference ranges are - these ranges vary from lab to lab, so must come from your own report. The T4 looks like it could be "Free", but I'm wondering about the T3...  please confirm whether these are Free or Total - if your lab report doesn't specify Free or FT, then the results will be total.

Also, please post the reference ranges for the other tests - "normal" for vitamin D can be anywhere between 30 and 100, but if your levels are closer to 30, you won't feel as well as if they are closer to 100.  Same goes for iron and B12.  What was your TSH level, and reference range?  Again, "normal" doesn't mean "normal for YOU". AND many labs, therefore, doctors are using outdated ranges for TSH.  The new range, as recommended by AACE about 8 yrs ago, is 0.3-3.0.  

Your thyroid basically controls your metabolism, so, yes, if you are hypo, you have a metabolism problem.  

Do you know what other tests the endo ordered?  Do you know if you have Hashmoto's Thyroiditis?  

Looking at your labs, I suspect that the endo thinks maybe you aren't converting the T4 to T3 properly, which is keeping your metabolism low, since T3 is the only hormone the body actually uses.  FT4 is a storage hormone and must be converted to FT3, prior to use. It's customary to reduce T4 medication, when adding a source of T3.  

In my opinion, your endo is taking the proper approach by testing and possibly changing your medication.  Do be aware, though, that some of us still have to work very hard to get/keep weight under control, even after our meds are adjusted properly.  Before becoming hypo, I never had a weight problem and I'm at a point, now, where I "can" lose weight, but I do have to work at it.

I'm not a strong believer in weight loss doctors/clinics.  Yes, you lose weight, but, like most "diets", once you stop, the weight comes back.  I'm a firm believer in adopting lifestyle changes that you can live with from now on vs short term solutions.  I'm also a Co Leader on the Weight Loss and Dieting forum, so I'll take this opportunity to invite you on over to take a look..
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Avatar_f_tn
Thank you Barb 135......Here is the further breakdown of my lab results:

Total T3

T3, Total         84                         Normal Range: 76-181


Free T4
T4 Free         1.5                                               0.8-1.8


TSH
TSH, 3rd Generation                 0.34           Doesn't give a range


Hemoglobin A1c                  5.5                    1000

Normal  >240
Borderline 205-240
Low <205




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649848_tn?1357751184
Total T3 is considered obsolete and is of very little value; however, it's relatively low in its range, which indicates that Free T3 might also be low in its range, but it's hard to say without having the actual test.  Do you think you could get your doctor to do one.

Your FT4 is above mid range, so that, along with the low T3, tells me that you might not convert FT4 to FT3 properly and FT3 is the only hormone the body can actually use.

It appears that you could definitely use a source of T3, such as cytomel, but I'd sure like to see a Free T3 result.  Without adequate amounts of T3, your metabolism will not normalize and you will have a hard time losing weight.

Hemoglobin A1c is good - that's used to test for diabetes.  What are the ranges for the ferritin and iron?  
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Avatar_m_tn
I agree 100% with Barb135.

you either do not convert T4 to T3 well or you have a reverse T3 issue.  Either way you need to get your FREE T3 test done.

T4 is a "storage"  hormone.  It remains in the blood stream until the body senses it needs more Thyroid and it then converts the T4 into the usable  Free T3 hormone.  It is only the FREE T3 that is used by the body's cells.  The term Free comes from the ract that it is NOT attached to a protein which renders it useless.  The conversion process produces the mirror image of the T3 molecule.  This Revers T3 (RT3) is troublesome in that the body's receptors will accept this molecule. But it does no good.  It is like a piece to a jig saw puzzle that is the exact right shape but when you put it in the spot only the blank cardboard side is seen and thus doesn't complete the picture although it fits perfectly.  RT3 problems is a bit more rare but it does happen and sometimes can be "cured" by purging the RT3 out.  

In either of these 2 cases, the problem is solved by the addition of a T3 medication.
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Avatar_f_tn
Okay....thank you so much. I just got the results back from the endo/thyroid specialist and he has informed me to go forth and obtain the prescription for cytomel. I got the generic form liothyronnine. I hope the generic brand is just as good. I will go back and request a lab test for Free T3. Thank you all for the guidance. I hope this will help with the metabolism in addition to, losing weight.

I am so very glad for this community. I will be lost without it.
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Avatar_f_tn
Forgot to include....

Iron      62                                  normal range: 40-175

Ferritin    20                               10-154
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649848_tn?1357751184
Both your iron and ferritin are pretty low in their ranges; did your doctor suggest supplementing?  
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Avatar_f_tn
No...he didn't suggest anything ( regular doctor nor endo/thyroid specialist). I can ask whether or not iron supplements can be added. Do you know of any good iron supplements?
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649848_tn?1357751184
There are a lot of good choices for iron supplements; maybe even a good multi w/iron would be sufficient.  

I'd suggest that if your doctor(s) approve of supplementing, you should ask them which brand they prefer, or go to your favorite health food store - there are tons of them - major chains, such as Vitamin Shoppe, Vitamin World, Mother Earth, GNC, along with smaller independent health food stores.... talk to the people at the store and ask for their recommendation - the chains, of course, will recommend store brand, and that's not always the best choice.... but I have had some employees recommend different brands, depending on the needs.
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Avatar_f_tn
Hello,

I spoke with endo/thyroid specialist and was informed to try prenatal iron supplements. However, he said that he does not diagnose the iron issue and to contact my family doctor. (That is frustrating to hear)  I am going to try the prenatal supplement, in addition to, taking my fishing oil, Vitamin C (I do it to boost my immune system), and multivitamin. How far apart can i take these supplements after I take the second dose of my cytomel. The endo/thyroid specialist suggest I should take the second dose prior to 3:00 p.m. no later....
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Avatar_f_tn
Forgot to ask....do you all know of a good fiber supplement besides benefiber?
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649848_tn?1357751184
You should separate vitamins/minerals from thyroid medication by approximately 4 hours.  This means if you take your second dose of cytomel at 3:00 pm, you could take your vitamins around dinner/bed time.  

I agree with your endo, not to take cytomel after 3:00 pm because it could likely interfere with your sleep.

For fiber, I take Fiber Advance Gummies - they taste good and are fun to chomp on; be careful starting out with them, though; you don't want too  much fiber, too quickly.  I also take an enzyme supplement, which helps with digestion issues.
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Avatar_f_tn
I feel alot better now that I have the cytomel. I am still a little sleepy though. I can feel my brain battling between whether or not I am sleepy or not (If that makes any sense). It feels like a blanket is covering the part of my brain sometimes. I'm thinking if it it does not go away, I will want the endo/thyrpid specialist to maybe up the dosage on the cytomel. (Is this a good idea?)   Also, I may be anxious or impatient but I just weighed myself and noted that I am still at 215.2. I measured myself and in some areas I went up an inch. I don't know if I gained weight during the two weeks that I did not go to the gym and was not on my new medication or if it's because of the new medication. I just don't know. I am getting a little sad again. Am I being impatient? I am still exercising and on a controlled diet so will I see results in weeks to come. I'm just so suprised that I haven't gone down yet. Do I need to take phentermine, in addition, to the new medication. My current doctor did suggest this but he wanted me to go to a weight loss clinic. I don't have the money anymore to waist but it is pushing me in that direction... I just don't know. Please help.....
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Avatar_m_tn
Many report that until you get into the sweet spot with Thyroid which generally means somewhere about mid range on FT4 and upper 1/3 of the range in FT3 it is nearly impossible to lose weight.  Your FT4 was mid range or above.  So now it may be to just tweak the FT3 to get it right for you.

I think this is my wife's problem.  She is taking meds and responding but never to our knowledge has gotten to the sweet spot for her and she is unable to lose weight either.

I think you are being a little impatient at this point.  That is completely understandable.  That is why they call patience a virtue, not a common trait!  Getting the correct Thyroid balance is a difficult time consuming process for most people.  Which of course most often = frustration.

And even when in your sweet spot.  Don't be surprised if it still takes a lot of effort to lose weight.  Unfortunately that seems to be the way it is.  I've not yet seen how to lose weight without some sort of pain, frustration or discomfort in one form or another.
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Avatar_f_tn
Okay.....I really understand how your wife feels. It is so hurtful sometimes. I will do some yoga to help with my anxiety...
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Avatar_f_tn
Any suggestions to decrease thyroid belly?. I keep going down and going back up in weight. I guess I haven't found the balance yet.

How many calories to eat? I am trying to stay within 1000 - 1200? Do I need to go lower because of my thyroid? I count my calories on sparklepeople.com.
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649848_tn?1357751184
It's not uncommon for weight to fluctuate - mine can vary as much as 5-6 pounds/day.

Your calories need to be based on your current height, weight and activity level; not just an arbitrary figure like 1000 or 1200.  Your body needs so many calories/day just to function and if you don't give it enough, you will have trouble losing weight, plus you will stay tired.

Feel free to check out the Weight Loss and Dieting Forum also; there are some good ideas regarding both diet and exercise.  The important thing, though, is making sure your thyroid levels are right for you.  

Do you know when you will be retesting again?
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649848_tn?1357751184
Forgot to mention -- when you retest, insist on getting the FREE T3 test, not total....
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Avatar_f_tn
Yes, when I joined the sparklepeople website, my weight, height, age, etc. was calculated. They have my caloric intake at 1200-1500. I just feel I need to go lower after researching additional information on the web. Some say to be at a 1000 when you are having low thyroid issues.

I will be retested on 12/15/11. I will request the free t3 test. I feel better on my new meds but I still have the symptoms. I don't feel heavily sleepy and draining in the mornings but I still feel a little sleepy still. I am not 100% yet in where I feel totally good.

I am trying to eat coconut oil every day as well. I read in where this helps in losing weight and increasing the metabolism. I do this four hours later from my medications, etc.

I will go and look at the weight loss and dieting forum as well.
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649848_tn?1357751184
Not sure where you heard that you have to only eat 1000 calories/day when you have thyroid issues -- not true.  Calorie intake is as individual as everything else; it depends on what YOUR body needs; what works for one, may not work for another.  

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Avatar_f_tn
Hi,

I went to the endo/thyroid specialist on last week and will post the results once received. The doctor did tell me that my levels were good but it always been good....I still have the symptoms of being sleepy. Some of my symptoms have improved like the brain fogginess and feeling like I got run over by a truck in the mornings.  The doctor did listen to me about increasing the cytomel and I reviewed some of the DQs on this site that suggested changing to tirosint.I approached him with this suggestion as well.  He has changed my medication to tirosint and kept the cytomel dosage as is. I will be getting my new medication on tomorrow. I hope it will work well for me.

I must admit that I fell off the wagon due to being frustrated about this weight. In my binge I lost two inches off my waist. My waist doesn't look so bloated as it did before. (Gold figure on that one). So I am now back to fighting the weight. Hopefully, I can continue to lose the inches. I will not get on the scale as it fluctuates back and forth but never out of the 200 range yet....
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649848_tn?1357751184
Don't forget that it's normal for weight to fluctuate, depending on when you last ate, went to the bathroom, whether or not you're retaining fluid, etc.  Mine can fluctuate as much as 5-6 pounds in a day's time.

It's good to be measuring vs weighing all the time; you can see the inches go away!!

Hopefully, the Tirosint will work for you; it really made a difference for me, as to the way I feel, though I still haven't been successful at losing much weight, but then I haven't worked at it real hard either.

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Avatar_f_tn
Thank you so much.... I have been doing good on it. I still have the sleepy thing going on so next time I go (which is in 3/12), I will let him know to increase the cytomel. I haven't lost any weight though but my sides have come in a little bit.. The doctor is saying that my levels are normal. I wish he could he tell me how to lose this weight or I will be forced to go back to a medical weight loss center just to lose 15 pds.

Here are my results from 12/16/11: (I requested the Free T3 test also)

TSH    

     0.48  (Result Value)                            

Reference Range

> or = 20 years    0.40 - 4.50

Pregnancy Ranges

First Trimester          0.20 - 4.70
Second Trimester     0.30 - 4.10
Third trimester          0.40 - 2.70

******I am not pregnant so I am unsure why this test was done.


T4 Free

Result Value (1.1)               Range 0.8-1.8

T3 Free

Result Value (3.5)            Range 2.3 - 4.2                            



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Avatar_f_tn
I am looking through the weight loss alternative thread and seeing alot of people talking about the b6, b12, and lipotropics. I am wondering what is your take on this. Is this something that the endo can prescribe or do I go back to my physician to inquire about this.

There are some people with thyroid problems that is very exciting about this along with taking their meds. They said that they have loss a lot of weight from this. How will this be taken with the meds, if this is something to do versus to going to a weight loss center. Is it is something that have to be taken 4 hours after the second dose of cytomel or is it safe to take it within the timeframe of taking the medication.

I have taken b12 before (injections--the oral ones do not work well for me) and it cleared up the tiredeness, sleepiness, etc. I am just wondering including the b6 and lipotropics will actually help in fighting this weight (in addition to taking my current meds).
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Avatar_m_tn
Do  you take your meds in the morning before blood draw for thyroid testing?  The reason I ask is that taking T3 meds before testing will tend to give you a higher Free T3 level, and it will not really be indicative of the average effect.  

Also, your FT3 can still be increased as necessary to relieve symptoms, including low metabolism.  If you look at this list of 26 typical thyroid symptoms, which ones do you have, other than low metabolism?

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

There is some controversy as to whether B12 can increase metabolism or not; however, it is very beneficial to get your B12 into the higher end of the range anyway.  

I am not sure what your doctor's response might be on your lab results and your intent to get your Cytomel dose increased.  Keep in mind that a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for those patients that he consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

Note this statement in the letter.  "The ultimate criterion for dose
adjustment must always be the clinical response. I have prescribed natural dessicated thyroid for your patient (Armour or Nature-Throid). These contain T4 and T3 (40mcg and 9mcg respectively per 60mg). They are more effective than T4 therapy for most patients. Since they provide more
T3 than the thyroid gland produces, the well-replaced patient’s free T4 will be around the middle of its range or lower, and the FT3 will be high-“normal” or slightly high before the AM dose."






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Avatar_f_tn
Yes, I do take my medication before I go to get my thyroid checked out.
Thank you for the information, I reviewed it. I have some of the symptoms like the brittle hair, cold feet, cold hands, stubborn weight, sleepiness, fatigue (not so much now), brain fogginess (very little now since the cytomel came into play), mild depression, and irritability.

It is so frustrating because given that I was on a weight loss program over two years ago, I was on b12 weekly shots and just taking levothyroxine (sand filler) and my symptoms were eliminated. Plus, I was losing weight. Grant it I was on a 800, 900, and 1,000 calorie with supplemental drinks for continuous metabolism burn but it did the trick. I just don't know anymore and I am trying to figure out  a way but I understand what the doctor is doing.  I guess increasing the tirosint first before the cytomel will be best practice?


I don't want to get on the phentermine. I think taking the b12, b6, and the lipotropics will be a safer practice.  I just don't know of what else to do. Two years of going to the gym hard core and not seeing results is getting hurtful.



I know this is getting personal but I am hurting right now. I feel good about myself but I will feel even better if I was again at a good weight level. The guys of today are not looking for overweight women and therefore no dates for me. It's frustrating to here someone say just lose 10 pds and this is all I have been trying to do.
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649848_tn?1357751184
I've taken vitamin B12 shots for the past 5 years and as long as  my thyroid levels are not where they need to be, I still don't lose weight.  Vitamin B6 is necessary for protein digestion; however, too much of it can cause sleep/dream issues - it does for me - so be careful, there.  I've never tried the lipotropics, so can't comment on that.

Too  much of any good thing can cause problems.

Even though I have to work at it, I find that I "can" lose weight, when my thyroid levels are right for me.
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Avatar_m_tn
I think you will really enjoy reading this old post from pickdaisies.

pickdaisies |  Apr 18, 2009

You know your body best!!!!!!!!!!!!!!!!!!!!!!!
I was having some major problems with my metabolism.  I am a nurse and I thoroughly researched all the scientific research on the internet and at the medical library.  I, too was going to see doctors who would not help me.  Fortunately, I found a doctor who gave me armour thyroid despite "normal" levels. I brought him a RMR test that showed my BMR in 750-900 range which is very low, I was cold all the time. I was fatigued. When you have to get in the tub 2-3 times a day to warm up your body, you got a problem  I have fake nails and suddenly I wasn't needing to go as normally to have them filled they had really slowed in growth. I put together my own research on my body.   I started taking the medication as prescribed and he adjusted accordingly until I was free of symptoms.  I documented all the thyroid lab work before and after treatment.  I went and had metabolic testing to test my bmr and it measured normal for my age and weight and I was symptom free.  I then tapered myself off the thyroid and within 2 months all symptoms returned and metabolic testing once again was done, and BMR was extremely low. Back on meds. normal. You know your body best and I am not afraid to put the research in front of a doctor's face.  The human body is not black and white.
______________________
This is not an isolated case.  Many of our members report the same problems with low metabolism and other hypo symptoms, until their Free t3 is in the upper end of the reference range.  You may not recall this info from this link I gave you earlier.   http://hormonerestoration.com/files/ThyroidPMD.pdf

"The ultimate criterion for dose adjustment must always be the clinical response. I have prescribed natural dessicated thyroid for your patient (Armour or Nature-Throid). These contain T4 and T3 (40mcg and 9mcg respectively per 60mg). They are more effective than T4 therapy for most patients. Since they provide more T3 than the thyroid gland produces, the well-replaced patient’s free T4 will be around the middle of its range or lower, and the FT3 will be high-“normal” or slightly high before the AM dose."
________________________________

I think you need to get your FT4 level increased to around the midpoint.  .   Also remember that your FT3 was somewhat higher because you took your meds before the blood draw.  So, with your FT3 level of 3.5, there is plenty of room to raise your FT3 level as necessary to relieve those hypo symptoms

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