Overexercising/Under-eating/Hypothyroid MESS

[mhanan4]

Hello everyone! SO here is my story..

I'm a 22 y/o female currently in college. I had my blood tested last summer (August 2014) to check my hormone as well as my thyroid levels and everything was good. I went to the doctor late August 2015 after spending the past 6 months of the year feeling like absolute crap- fatigue, sudden weight gain, and depression. At first I thought it was all in my head, but was diagnosed at the beginning of September 2015 with Hypothyroidism.

My TSH level was a 6.0. I don't believe my doctor (PCP) tested my antibody levels or free t3/t4 levels. At least all the information given to me was that my TSH was high and corresponded with the symptoms I'd been having.

I was put on Levothyroxine 25 mcg the first week of September, and it is now October and do not feel much difference. Less night sweats/better temperature regulation overall but no weight loss, or energy increase. The first few weeks my brian fog was even worse. I have another doctor's appt on the 16th of October where we will retest my blood work.

I'm very concerned, because as a Health Science major I research EVERYTHING. My doctor didn't test my adrenals or my Estrogen, and I'm very unhappy about this. I majorly overexercised/took pre-workout and a lot of coffee daily/underate and became VERY thin (107-115 lbs at 5'6) and maintained this for about 4 years before everything hit the fan and things started going downhill in 2015.

I gained weight rapidly going from about 115 to 145, I still consistently worked out 5-6 days a week (bodyweight circuit training/running/sprints/walking per usual) and ate VERY clean (absolutely no processed foods/mostly produce/lean proteins/no grains/caloric intake around 13-1500 calories) the whole year and still gained this weight. At first, it looked really just like muscle gain and very little fat gain, like it was "sticking to my bones more" and not jiggly, now I have noticed some fat gain (mostly in hips) that bothers me greatly when I kept all other factors the same.

I feel as though I should mention that I went to the doctor initially in 2014 to get my blood tested due to having secondary amenorrhea for 3 years (lack of menstruation). My gyno said it could be due to low BF and intense exercising, put me on birth control to kick it back into gear (which I also think was the wrong solution, I didn't want to force my body to have a period, clearly it was in fight or flight mode where it didn't feel I was strong enough to menstruate) and that's when things started to go HAYWIRE.

I was on the pill for 3 months, and that is when I had the sudden weight gain, night sweats, random hot flashes, depression etc. I thought going off the pill would solve this- and while it did bring back my period for good (which is GREAT) my fat gain/fatigue did not go away no matter what I did, I tracked all my food, exercised, no grains etc as stated above.

So, now I am hypothyroid. I cannot help but think that my low functioning thyroid was caused by my years of under- eating and stressing my adrenals, I don't know if the influx of Estrogen in the BC made a difference, either. My doctor pretty much does not listen to me or give me a chance to express my opinion, she was so quick to just diagnose me hypo and put me on this medication without even explaining the other options (Armour/Synthroid). I understand she is the doctor, but I am very frustrated as I think testing the adrenals is so important.

I am mostly scared I won't feel better on Levothyroxine, (or lose the weight after trying for MONTHS).  Of course I researched everything I could about the medication and saw very mixed reviews. Maybe I will feel better after she ups my dose of it. I was really just wondering if ANYONE has experience with Hypothyroid with a history similar to mine and what happened to them, if they felt better on Levo, what symptoms they had for low adrenal function, etc.

I'm truly sorry this was so long I had to get it all in there. Thank you so much for reading and am very much looking forward to getting responses. Trying to figure this out and being in my senior year of college is NO fun. All I am thinking about lately is my health and I want to fix it so badly.

Ps. She recommended I go see a nutritionist- I am scheduled to see one, HOWEVER I am very knowledgeable about a healthy diet esp when it comes to my body, I'm very very in tune with it (I'm a nutrition/wellness major in Health Science) and I highly doubt my diet is the culprit of the weight gain. I also take Vitamin d3, multivitamin, fish oil, selenium from whole foods such as brazil nuts, and was unsure if I should supplement with Iodine or any other thyroid support vitamins.

[gimel]

Please click on my name and send me a PM with the doctor's name.  I may be able to give you some info.

[mhanan4]

UPDATE
Hello everyone!

I've been on Levo 25 mcg now for 7 weeks, and just had my follow up appt to re-check my blood-work. My TSH has dropped from a 6.4 to a 1.6 in just that amount of time.

My PCP said I will come back in 3 months to see how I'm doing, but she wants me to continue on the 25 mcg. I'm very surprised since I've read most maintainence dosages are around 75-150 mcg depending on what's needed.

I am feeling better, more energy and my face is much less puffy. I'm hoping soon I will be *able* to lose the weight I've put on due to my thyroid through healthy diet and exercise.

I talked to the dietitian, who took a look at my diet and blood-work (no deficiencies, good cholesterol, great vit d3, selenium, calcium) and said I just need to wait for a metabolic response which typically takes a little longer even though my TSH is in a good range.

I pushed my PCP for more testing, responded that she could gather enough information from my TSH and free t4 and didn't want to do unnecessary testing.

However, I would really love to get my antibodies, free t3, cortisol and estrogen tested just to make sure I don't have an adrenal problem or an estrogen dominance imbalance, so she referred me to a really great Endocrinologist in MI that will dive in a little more extensively. I tried to get in with this Endo last month but it would have been almost a 6 mo wait without the referral. I'm very excited about that.

It really bothered me she didn't confirm if it was due to autoimmune, she just said that "4 out 5 people's hypo is due to autoimmune".

Thank you all for reading and all the great information.

[mhanan4]

I will definitely check those video's out. I am very interested in steps he took to recover. Thank you!

[Red_Star]

There are 3 youtube videos (still more episodes he has to upload on his journey back to recovery) on Diet Induced Hypothyroidism. He didn't eat enough and exercised too much and caused hypothyroidism. He too had a TSH of 6 and high reverse T3.

[mhanan4]

I will definetly write these  down and have her test them when I go in on the 16th and report back with my results. I'm so glad I know what to ask her to test so everything is covered.

I will be deciding on a new doctor tomorrow after I look into their insurances and respond back in the PM with whom I can go to. Thanks again.

[gimel]

Even if you don't end up with your current doctor for treatment, you should go ahead and insist on being tested for Free T4, Free T3, TPO ab, TG ab, Vitamin D, B12 and ferritin.  Then we can help interpret results and advise further.  

I just sent a PM with doctor info.  To access, just click on your name and then from your personal page, click on messages.  

[mhanan4]

Thank you so much for the information. I am going to my primary care physician in my hometown. I reside in Flushing Michigan 48433 and go to school in Rochester, MI 48439. I have always just gone to my PCP and was relatively healthy. I am thinking I'll keep my appointment but will make an appointment with a good recommended doctor if anyone knows of one.

My doctor didn't tell me whether I had Hashimoto's, and I've had to research all of this myself. I wish I could have gotten a copy of the blood work instead of the very vague "you have a low functioning thyroid and this will help" Since it can be due to a multitude of reasons including as you said b-12, ferritin and vitamin D. I'm assuming she must of tested for the basic deficiencies associated with hypothyroid, she just didn't inform me.  

I have an appt in a week and will make a point to insist for her to explain more to me and test my free t3 and t4.  

I'm just so concerned that more needs to be done and I don't know all the information I should about what's going on.

[gimel]

First thing to understand is that TSH is a pituitary hormone, not a thyroid hormone.  TSH is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, Free T4 and Free T3 (not the same as Total T4 and Total T3).  That said, your TSH result was high enough that it should have triggered at least a test for Free T4 and tests to check for the possibility of the main cause for diagnosed hypothyroidism, which is Hashimoto's Thyroiditis.   There are two tests for that,  Thyroid Peroxidase antibodies and Thyroglobulin antibodies.  Both are necessary.

With Hashi's the autoimmune system erroneously tags the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland.  As this proceeds, the output from the gland is diminished and the pituitary produces more TSH to try and stimulate the gland.  

So your doctor started you on thyroid med, at 25 mcg.  That is directionally correct but for the wrong reason, since it was only because of the elevated TSH.  More testing should have been done.  You should insist on being tested for both Free T4 and free T3 each time you go for tests.  In addition, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, which can cause symptoms that mimic hypothyroidism.  Low D or low ferritin can also adversely affect metabolism of thyroid hormone.  D should be about 55-60. B12 in the upper end of its range, and ferritin should be about 70 minimum.

I am not surprised that you do not feel any difference since starting on the T4 med.  Serum thyroid levels are a sum of both natural thyroid hormone and thyroid med.  As you start on med, the TSH will go down and that will reduce your output of natural thyroid hormone.  Net effect is often no significant change until the med dosage is high enough to suppress TSH below range so that serum thyroid levels are totally dependent on thyroid med.  Even then symptom relief tends to lag somewhat behind changes in serum thyroid levels.  Members frequently say that symptom relief required Free T4 at the middle of its range, at minimum, and Free T3 in the upper third of its range, or as needed to relieve symptoms.  Note the following quote from a good thyroid doctor.

"The free T3 is not as helpful in untreated persons as the free T4 because in the light of a rather low FT4 the body will convert more T4 to T3 to maintain thyroid effect as well as is possible. So the person with a rather low FT4 and high-in-range FT3 may still be hypothyroid. However, if the FT4 is below 1.3 and the FT3 is also rather low, say below 3.4 (range 2 to 4.4 at LabCorp) then its likely that hypothyroidism is the cause of a person's symptoms."

By good thyroid doctor I mean one that will treat clinically by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  Since you are in college I assume you are going to the student health clinic or similar.  If that is the case, I seriously doubt that you can get the testing and treatment you need there.  You need to find out if they will do the necessary testing and treat clinically, as described.  If not then you need to find a good thyroid doctor that will do so.  If you will tell us your location, perhaps we can suggest a doctor that has been recommended by other thyroid patients.