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1649405 tn?1366257026

Does Hypothyroidism mean a life time of weight problems?

As some of you know my 13 year old daughter has Hypothyroidism as part of her POTS.  My question that I have had mixed answers on is about weight gain.  My daughter is beautiful and is a dancer.  She is physically fit but we have noticed a continued change in her weight and she has become very concerned about it.  Can anyone give me some info about whether or not this will always be an issue for her.  She is currently on Atenolol, Synthroid, Lexapro and Vitamin D.  Just thought it could even be from one of these meds. Also my Aunt has struggled with Hypothyroidism for 40 some years and has ALWAYS been over weight.
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Avatar universal
I am so sorry to hear that the doctor won't test for Free T3.  And he is supposed to be a Top Thyroid Doctor,  NOT!!!   Was there any  excuse give as to why they would not test for Free T3?  How hard did you push it with the doctor?

I am going  to keep looking for a good thyroid doctor in your are.  

What were the actual test results and their reference ranges, as shown on the lab report?

Hypo patients taking thyroid meds frequently find that they are not adequately converting the T4 med to T3.  If I was on my home computer I could give you some good references that talk about the lack of conversion when taking T4 meds.   Since Free T3 largely regulates metabolism and many other body functions, it is very important to know the actual level.  In addition, scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.  
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1649405 tn?1366257026
It has been a long while.  I'm not sure if you even remember me from past conversations.  Short story my daughter has hypothyroidism associated with POTS.  I have not been able to get a doctor to check her freeT3 but they do check her free T4 and TSH.  Her numbers have been getting somewhat better but she is still having extreme problems with gaining weight.  She is 14 about 5'3 and now weighs 140 lbs.  She does dance so she stays constantly active but it is hard to explain to her that she comes from a family that is genetically small but yet she is struggling so bad.  She has stretch marks that have appeared on her legs, chest, and arms I believe do to such a sudden change in weight.  What can I do?
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Avatar universal
Dr's are so busy that they do not have time to keep up with every condition's latest and best information.  That is kind of scary but it is the truth.

It also amazes me that Dr's will NOT test for the ACTUAL hormone that does all the work (Free T3).  Instead they seem to rely on a brain secretion to determine your thyroid condition and adjust medication off of that secretion (TSH) rather than the ACTUAL hormone that does all the work.

Below is a layman's explanation I'd written up a while back that sometimes helps people understand how this thyroid things works.  Maybe you'll find it helpful.

Here it is:

If you don't know how the whole pituitary/thyroid system works I'll try to explain it at least how I think about it.  I put it in terms of a home’s heating system.  TSH is a pituitary hormone.  It tells the Thyroid to produce the thyroid hormones.  TSH I compare to the signal from the thermostat in the house.  It triggers the furnace to turn on.  And the TSH hormone tells the Thyroid to turn on.  The Thyroid if it is able then produces hormones.  Both T3 & T4 but mostly T4.  It is the "Free" T3 that the body actually uses.  (“free” means that the hormone is unattached to a protein and can be used by the body.  Once attached or combined with a protein molecule, that combined molecule is essentially useless) The body (mostly in the liver) converts the T4 produced by the Thyroid (or taken as a medication) into T3 so that the body can use the T3.  Some people have a conversion problem where their body doesn't covert the T4 into T3 very well.  This would be analogous to the furnace being kicked on by the thermostat, but just the fan starts but blows only cold air, because the furnace doesn't light the burner to produce any heat. So in those individuals the medication used may have a component of T3.  Most people convert just fine so the most common medication prescribed is a straight T4 med.

So what most Dr's tend to do is rely solely on the TSH test.  But this is a pituitary (thermostat signal).  It is only a trigger.  It does very little really to tell what is happening to the furnace.  You can have a properly operating thermostat and if the furnace doesn't work, the signal will get stronger and stronger.  And this is what TSH measures.  The strength of the signal.  Because the pituitary senses that there is not enough "heat" in the house so it keeps asking for more by putting more and more TSH out!

As you can see, since the body uses only the free T3 and that is made from converting the T4 into T3, then you can see why it is so important to test for the Free T4 and Free T3.  And since the TSH is only a trigger hormone and is not actually used, you can see why that is not quite as important.  It can be initially as a indicator that something is wrong.  (ie the thermostat says we need heat but the heat is not coming out of the vents). When the thermostat works correctly in your house but you still have no heat, you KNOW you need to get something fixed.  But once the fix begins,  It is more important to evaluate the RESULTS of the heat that is coming out of the vents (ie your symptoms and the measurement of the volume of air and the temperature of the heat actually coming out of  the heat vents)  This is what the Free T3 and Free T4 tests provide.  Monitoring TSH (the thermostat) is OK to do, but what you are really after is monitoring the ACTUAL heat output.

Keep in mind that the "normal" range for any test is created by testing the general public. Then throwing out the upper 2.5% and the lower 2.5% of the test results.  This then supposedly gives a "normal" range.  Well that is a "normal" definition in terms of mathematical statistics.  It absolutely does NOT mean that if your lab tests within those range that this is a normal situation or that it is healthy for any one individual.  

You see, it is possible that upwards of 20% of the population has low thyroid and are symptomatic.  However since only the bottom 2.5% are removed from the "normal" range, this means that what many Dr's and people believe to be normal results in about 17.5% of the population that are chronically low thyroid that Dr's refuse to treat because they fall within the lower part of the "normal" range.  Well is it a good thing that 20% of the population are "normally" chronically low in thyroid for their body to function properly???  I don't think so!

This explains why symptoms seem to fade away when people actually test above mid range because of the prevalence of hypothyroid people that make up the "normal" range.  Because what the body needs and what the range say, are two different things.  This is why it is important to treat Thyroid based upon symptoms and backed up with lab tests.

Also know that if you are put on higher doses of a straight T4 medication, it can totally suppress (overcome) the TSH value.  And many times a Dr's response to this very low TSH is to believe that the person has become Hyper (overactive thyroid) and thus want to cut back on medication. Which puts the person on a roller coaster ride of hell.  However the TSH reading can be false and suppressed by the T4 meds.  It is most important to track and monitor the FT 3 and FT4 levels.  TSH then becomes more of an interesting bit of information but not hugely important but only a minor monitoring role.

I hope you find this helpful,  Understand that I'm not a Dr.  I'm just relaying what I've learned here trying to put it into my own words.
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649848 tn?1534633700
COMMUNITY LEADER
Most doctors don't want to FT3 because they believe they can determine thyroid function based on TSH and/or FT4.  FT3 is the active thyroid hormone, which best correlates with symptoms, and is the main factor in controlling metabolism, heart rate and other body functions.  

FT4 must be converted to FT3 and if there's an issue with the conversion process, the patient will not get well until a source of T3 is added.  

Yes, your daughter's T4 levels are "normal", but, as I said before, if your lab uses ranges that we often see, they would be very low in the range, and most likely not "normal" for your daughter.  That's why it's so important to have the FT3 test done.

Many of us find that we don't get appreciable symptom relief until FT4 is at least mid range and FT3 is in the upper 1/3 of its range.  

It's always important to know and specify whether the T3 or T4 is free or total, though because if Total T3 and Total T4 are tested, they don't tell the whole story, since some of those hormones will be bound by protein and unusable.  
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1649405 tn?1366257026
I believe she was tested for that but I have asked and no answers yet.  I am caught between 3 different doctors and basically they are each telling me different things so right now it has been hard getting straight answers.  I have decided after talking to each of you to go and get copies of all of her bw.  I do have one copy and it shows that along with her TSH 3rd Generation being high that her Potassium is low.  I did alittle research and found that the potassium level can be related to the thyroid. Is this true?  Also why is it that everyone talks about the importance of the free T3 being checked but doctors don't want to do it?  Her T4 has been .870 in April and .96 in June.....these are normal right?
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Avatar universal
Somehow I did not ask the question about whether your daughter has ever been tested for Hashimoto's Thyroiditis?  Hashi's is the most common cause of hypothyroidism.  It is an autoimmune system problem.  Members with Hashi's have reported having rashes.   If she hasn't been tested for the thyroid antibodies, TPO ab and TG ab, that would be a good idea.  

If you want to read some of the old threads about this subject, just plug in Hashimoto's and rash in the search area at the top of the page.

Here is one such thread, just as an example.

http://www.medhelp.org/posts/Pediatric-Endocrinology-/skin-rashes/show/376465
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1649405 tn?1366257026
She has been taking it since the around the 27th of June.
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1649405 tn?1366257026
I am not sure about the T4.  Gimel also told me to make sure her free T3 is checked. She is actually on Levothyoxine which I believe is generic for Synthroid.  Her dosage is .025MG.  Can you tell me the important questions that I need to have answers for and what I need to look for as far as labs and symptoms.  Thank you for your time.
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649848 tn?1534633700
COMMUNITY LEADER
The TSH is certainly high, and if the range for the T4 (is that Free? or Total?) is like most we see, 0.93 is pretty low in the range.  It would really be best to know the Free T3, as well.  What dosage of synthroid is your daughter on, and how long has she been on it?  
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1649405 tn?1366257026
I forgot about the ranges.  All I know is that the doctor told me anything over 3. on TSH was not good and hers has been 5. and higher on each test.  Does that make sense?
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1649405 tn?1366257026
Thanks for your response.  I am new at this so I will try to give you the info that I can.  Her last bw they only checked her freeT4 and TSH.  Her TSH was 6.19 and her T4 is .93   They told me that they also checked her thyroid hormone level but I haven't been able to get a answer as far as that.  As for other symptoms that is hard because some of her POTS symptoms can overlap with the thyroid.  I know that her weight and growth has changed, her hair has become very brittle, she has horrible times with her sleeping and fatigue, she was struggling with depression and anxiety, she has been having problems with her eyesight,  and terrible problems with muscle pain, & currently she has started with a rash that looks almost like acne on her legs(that is new).  Any suggestions would be helpful.
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649848 tn?1534633700
COMMUNITY LEADER
I agree with gimel that weight doesn't "have" to be an issue while hypo....... once the proper levels of FT3 and FT4 (not just "normal", but right for your daugher) are reached, she should be able to lose weight.  

While it works out for some that the weight just "falls off" (I have a sister that was lucky); there are others of us who have really "work" at losing (that's me), but once the proper thyroid levels are reached and diet and exercise are maintained, weight loss is possible.

Can you tell us what her latest thyroid labs were, along with reference ranges (which vary from lab to lab, so must come from her own report).  Does she have other symptoms of being hypo?  
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1649405 tn?1366257026
Well my daughter has just recently started on Synthroid but is was given to her by her cardiologist because the Peds Endo at UAB wouldn't up her appt from Feb unless she reaches some MAGICAL number on her bloodwork.  But gimel gave me the name of another doctor in Birmingham and they are going to see her in the first of Oct.  It has just been difficult being that my daughter has always been in good shape.  She just abruptly stopped getting taller and started gaining weight.  We didn't know what was going on and she started to withdraw.  Some well meaning family members made little remarks about her body changing and that didn't make things better.  Luckily her Ped did bloodwork and included the thyroid in it.  Now we have alittle better of an understanding about why things changed so fast but I am not very aware about the thyroid so this has been a learning process for me.  I could use as much good info as I can.  To be honest I have received more info from this site than anywhere else.  So thank you all:)
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Avatar universal
My wife has had weight problems for years. And has Hypo for years.  But we also believe that she is NOT yet into her sweet spot medication wise.

This despite being on weight watchers AND walking between 3 and 7 miles a day for weeks on end. She would see like 10 lb weight loss and then NOTHING.  Even bumping the walk from 3 miles a day to 7 did NOTHING.  This frustrates and depresses her to no end.

She is about to have blood drawn again.  We have had TERRIBLE time getting the Free T3 & Free T4 tests done.  But the Dr has been willing to raise the dosage based upon my wife requesting.  If we don't get the results we're happy with this time we may have to go outside of the HMO insurance Dr's and pay out of pocket to find a Dr who will work with this issue.
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Avatar universal
Euthyroid means having enough thyroid hormone that you are neither hypo nor hyper.  In other words, in the "sweet spot" where you have no thyroid related symptoms.
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1649405 tn?1366257026
Thank you and I will keep you guys posted....and I am sure I will have many more questions.
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1649405 tn?1366257026
Okay thank you....but what does euthyroid mean?
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168348 tn?1379357075
Hi,

WELCOME .. I agree with Gimel above ...

Keep us posted.

C~
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Avatar universal
In my opinion, and based on my own experience, the answer is no.  If she finds a good thyroid doctor that will treat her clinically by testing and adjusting Free T3 and Free T4, without being constrained by resultant TSH levels, then she can become euthyroid.  After getting her metabolism to a normal level, then weight is dependent on her calorie intake and calories burned.  In other words, at that point it will truly be up to her.

Your aunt was probably never given an adequate amount of the right thyroid meds, to enable her to control her weight in the normal manner.
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