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Increased dosage for weight loss?
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Increased dosage for weight loss?

Hi all, this is my first post here... I'm looking for some advice. To give you all some background, I am 24 and was diagnosed with hypothyroidism six months ago. I have had symptoms since high school (namely fatigue, although by last year I was sporting the full spectrum), but never knew what to do or what to call it until my mother found out she was hypothyroid. I guess it runs in the family! My TSH tested at 4.55 initially, and after only a month of 50 mcg of levothyroxin (levothyroxine) I dropped right down to 1.18. Over the last six months, my fatigue has vanished, I've stopped having menstrual problems, and I've just generally began feeling like a better person.

Having said all that, when I was diagnosed with hypothyroidism I had just reached 200 lbs. My weight has remained constant since then, which I expected. I haven't made much of an effort to lose weight, but I haven't gained any. My six month checkup was earlier tonight, and my doctor was more frustrated about my weight than I was! He had previously called me extremely healthy for my size (my cholesterol and blood pressure are perfect), but obviously there is some concern about me remaining 5'3" and 200 lbs. He said he would be increasing my levothyroxin (levothyroxine) dosage from 50 mcg to 75 because he wanted it to stimulate weight loss.

I am a little alarmed by this. I feel absolutely normal on my current dosage and am VERY scared of losing that. But more importantly, my doctor (who is a family doctor, and has been seeing me since birth) did not ask me any questions about my diet or exercise prior to writing the new prescription. I will be the first to admit that I have fast food 1-2 times a week and drink soda much more often than I should (which is a lasting effect of an ongoing need for caffeine to get through the day, back when I was constantly fatigued). I also don't exercise often enough to stimulate weight loss. My weight IS staying constant, which is a sign that I am doing something right, and while I would love to lose 20 or 30 pounds, I don't know if this is the way to do it. I protested the prescription and reminded him that my TSH was still at 1.18, but he insisted that the dosage be increased.

Should I really be taking more thyroid medication purely for the purpose of weight loss? If I end up taking too much to treat my thyroid, what side effects should I expect? I will be seeing the doctor again in a month, so we can obviously discontinue this quickly if something bad happens, but I don't even know if a month will be long enough for him to see results. Can anyone give me some advice? Thank you!!
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798555_tn?1292791151
1)Should I really be taking more thyroid medication purely for the purpose of weight loss? Definitely not!  Your TSH looks 'good', but the actual hormones your body uses need to be checked - called Free T3 and Free T4 testing. TSH is a messenger hormone - not a body 'consumable'.

2) If I end up taking too much to treat my thyroid, what side effects should I expect? Feeling hot, shaky, sweaty, insomnia, high heart rate, possible heart palps, fast and inadequate digestion, sore muscles, theres more........

If your doc is basing the higher dose on weight alone, I'm very surprised.  Has he looked at the free T3 and T4 hormones? Proper diet and exercise (as you seem to know) is the key to weight loss, not more hormone.
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798555_tn?1292791151
1)Should I really be taking more thyroid medication purely for the purpose of weight loss? Definitely not!  Your TSH looks 'good', but the actual hormones your body uses need to be checked - called Free T3 and Free T4 testing. TSH is a messenger hormone - not a body 'consumable'.

2) If I end up taking too much to treat my thyroid, what side effects should I expect? Feeling hot, shaky, sweaty, insomnia, high heart rate, possible heart palps, fast and inadequate digestion, sore muscles, theres more........

If your doc is basing the higher dose on weight alone, I'm very surprised.  Has he looked at the free T3 and T4 hormones? Proper diet and exercise (as you seem to know) is the key to weight loss, not more hormone.
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1340745_tn?1276396903
Thanks for your response. I felt like I was going crazy! No, the T3 and T4 were not looked at with my last blood test, only the first (if I remember correctly--I had a lot tested at once). I did not have a test immediately before this appointment.

I have a full month's worth of 50 mcg pills left... I think I will ask the pharmacist tonight what I can do about not taking the higher dosage, if it is available for me to pick up. Maybe I should look for another doctor...
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Avatar_f_tn
I think you need to find an endocrinologist.  I was treated by my family doctor for my hypothyroidism for 14 years. I had regular bloodwork every 6 months and my tsh never changed from 4.0 and I felt fine.  For 14 years.  Then one day my tsh came back at 5.5, doc increased my meds without doing any kind of exam or any further bloodwork other than tsh. I had a gut feeling something wasn't right so I went to an endocrinologist, he found a nodule and it turned out to be cancer.  Not that you have cancer, I just think when you are dealing with thyroid issues you need someone who specializes because half the docs out there do not know what the are talking about.
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1052292_tn?1274460692
I think you should strongly consider finding a new doctor.  I have been losing weight and as a result my dosages of Levo have gotten too strong and had to be lowered.  I have now lost 44 pounds.  The times that my medication was too strong and I became Hyper instead of Hypo were absolute misery!  Hot flushing feelings, rapid heart rate, extremely high BP, anxiety and nervousness, depression, hair loss, etc.  The first time it happened I didn't know what was wrong until someone here on the forum told me.  I then called my doc and she lowered my Levo from 100 mcg. to 50 mcg.  Then a few months and a few more pounds lost later, it happened again.  Now I am taking 25 mcg. of Levo.  I can't believe your doctor raised your dosage to make you lose weight.  Sounds very scary to me.

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1340745_tn?1276396903
Thank you to everyone for the replies. I think I will start looking for an endocrinologist as was suggested. I felt a little silly considering that at first because I am perfectly healthy aside from my now-minimal thyroid problems and the occasional migraine, but I think it may be time. My mother is also having problems with her dosage (she is taking the same as I am, but still experiencing hypothyroid symptoms) so maybe we can go together.

I feel a bit bad for my doctor as I have been going there since birth, 24 years now, and the nurses are so lovely and nice... but this is my health we are talking about, so I really can't joke around. He is an older gentleman and I've heard several of my family members sadly admit that his medical knowledge is becoming outdated. With any luck there is someone local who can help me safely reduce my weight without increasing my dosage. :)
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649848_tn?1357751184
I totally agree that thyroid hormones should not be used for weight loss.  You do need to get your Free T3 and Free T4 tested as LazyMoose suggested.  

It's fine if you want to find an endo, keep in mind that most endo's (and/or insurance companies) will require a referral from your pcp.  In addition to that, it's not absolutely critical that you have an endo to treat you; you can use any type of doctor, so long as they knowledgeable with thyroid issues and are willing to look at the FT's and dose so as to alleviate symptoms.
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1340745_tn?1276396903
Thank you. Yes, I'm sure an endo would not be 100% necessary, but I've had some concerns regarding PCOS in the past (showing all symptoms with the exception of insulin resistance, which is GREAT considering diabetes runs very rampant in my family), so two birds with one stone and all that. I really am just not sure where to start as far as finding another doctor, endo or otherwise.
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798555_tn?1292791151
I assume your advice was for the poster "manycolors" and addressed it to me by mistake. I was answering manycolors quoted questions if it looked confusing.
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Avatar_f_tn
Good for you for being alarmed by this! My sister had hyperthyroidism and even though I had a hard time with my weight when I was younger, and really have to watch it now, I would not sacrifice feeling good for a questionable weight loss method.

I have the metabolism of a reptile, and dropped 100lbs the healthy, old fashioned way. I had to eat a very strict diet, go to the gym 2 hours a day, five days a week, and felt like I was going to collapse the whole time, but I did it, and I'm sure you can too. Just take it 2lbs at a time.

A lot of these doctors get so fed up with people who are overweight and can't seem to make the lifestyle changes needed to lose it the healthy way, that they figure the only way to get the person to a healthy weight is by "force". I was horrified when my roommate came home with a bottle of what was essentially speed, from his doctor. I can tell you straight up, he doesn't need speed. He needs to turn off his playstation for 30 minutes a day and go for a walk.



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1340745_tn?1276396903
Just wanted to follow up--went to pick up my prescription today and the doctor apparently did not increase the dosage, as my regular 50 mcg bottle was waiting for me. That... or the prescription wasn't called in according to the notes I saw him write. Either way, I will be looking for a new physician. I was prescribed two additional items for migraine prevention and discovered right away that one of them is not recommended for usage with hypothyroid patients! But that's another story. I'm going to try fixing up my diet and getting some more exercise--the old-fashioned way. Thanks again to all for the helpful advice!
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Avatar_f_tn
I dont know about other countries but T4 med here in Australia doesnt come in 75mcg tablets and you have to take 1 1/2  x 50mcg tabs to get the 75mcg.
Just thought I would mention it.
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1340745_tn?1276396903
You may be right--but the dosage instructions on the bottle are still the same, and there are still 30 tablets inside. :)
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Avatar_n_tn
Question the pharmacy about it and if it came through differently than what you saw him write down, question the doctor's staff to find out what might have happened.  One thing might have been written down in the notes but another written on the Rx, perchance out of habit or assumption.

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649848_tn?1357751184
It will say on the label of the bottle, what the dosage is.  In the US, we can get T4 med in 75 mcg tablets; I have some in medicine cabinet.  We can get all different ones -- I'm currently on 88 mcg tablets. Even with a different dosage the instruction will be the same, and there will be 30 tablets.  

Do look carefully at the bottle and if the dosage is not what you think it should be, check with the pharmacy and your doctor, to make sure you are taking the proper med.

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Avatar_f_tn
Wow Barb!
Here we get 50mcg, 100mcg and 200mcg but we also get ours in a 200 tablet blister strips box (foil) which we have to keep in the fridge.
The fridge rule came out in 2008 as they said that potency is lost if not refridgerated.

I wish ours come in different strengths like yours as I have to split mine to get a 62.5mcg dose (1 1/4 tab).
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649848_tn?1357751184
Deb, I have quite a few different strength in my medicine cabinet from times my dosage was changed before I used up a script.  I was just looking at my "stash" this afternoon. I have them in 25, 50, 75, 88 and 100 mcg tablets.  I also know we can get them in 125, 150, 175 and 200; I'm not sure if they go higher than that or not.

My endo writes my script for 90 tablets, refillable 3 times, so *if* I stayed on the same dosage, the script would last me for a year.  He does the same for both the levo and T3, which I get in 5 mcg tablets, but I know they come in various strengths as well.

My tablets come in a regular prescription bottle and no one has ever told me to keep it in the fridge.  I don't.

It must be a real pain in the behind to have to split them like that.  I don't think I'd like that, especially being used to getting the specific dosage I need.  There was a while, though that I needed a bit more than 75, but not quite 88, so I alternated them - 75 one day, 88 the next, to get 81.5.  Eventually I had to bump up to 88 daily, now I'm ready to go up again.
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1340745_tn?1276396903
Thanks all for the replies. The new bottle is completely identical to my old one... 50 mcg pills, instructions to take 50 mcg once daily. The included instructions also do not show anything different--identical to the old ones. So it looks like a goof, but as we've already established, it's more than likely that I didn't need to be going to 75... so it's a good goof.
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