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Weigh Gain After Surgery
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Weigh Gain After Surgery

About five years ago, I was on a nasty cocktail of medications and gained 110 lbs in a few months.  Not long after that, I began insisting my thyroid be tested.  Finally, all this time later, I've found I have multiple thyroid nodules.  I am pregnant, and waiting to hear my biopsy results to find out if we are doing a thyroidectomy now or post-delivery.

At any rate, I've maintained that initial weight gain through two pregnancies.  I can completely stop eating and workout like a crazy person and I can't lose weight.  The 110 lbs, as one would imagine, has made me overweight whereas I previously weighed the same as I did in high school (a healthy weight for my size).

I am very concerned that after the surgery, I still won't be able to lose weight.  It is a constant source of embarrassment for me and anxiety that I will develop weight-related issues, even though I eat a reasonable diet and exercise.  

Did anyone find they were able to lose weight after surgery?  Or that they had more energy?  I'm just very concerned that this isn't really going to benefit me and may possibly make things worse.
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Many people have thyroid nodules with no thyroid disease.  Do you have any other symptoms?  The number one symptom of hypothyroidism is fatigue.
My blood tests came back clean.  So, whatever that indicates.  I'm pregnant and have a long term struggle with depression, so my fatigue could come from other sources.  I also have insomnia, my hair falls out in clumps, I'm cold when no one else is, and am sluggish with muscle pains.  Which, I suppose any of this could be explained by other sources.  

Right now, all I know for sure is that I have nodules.  
Please post the actual results of the thyroid tests they did.  FREE T3, FREE T4, TSH, TPOab and TGab would be of especial interest.  Please include reference ranges as they vary lab to lab and have to come from your own lab report.  If you're in the US, your doctor has to provide these to you upon request.

For a number of reasons, thyroid test reference ranges are very flawed, so if you are "clean" or "normal", but in the lowere ends of these ranges, you can still be hypo.  Are you on thyroid meds?

Your symptoms sound very hypo.  How pregnant are you?

I agree...nodules are very common and are usually only watched unless they are large or have suspicious characteristics.  
I have never been on thyroid medications.  I do not have the test results, just that nothing was "in range".  But I'm sure I could obtain them.  I've had my thyroid tested for years, it's always "normal".

I'm 22 weeks pregnant.

I really wish they could do the surgery sooner as my neck/throat really bother me pain-wise.
Untreated hypothyroidism during pregnancy can cause miscarriages, stillbirths, and developmental brain defects. If you don't have hypothyroidism now, you will be hypothyroid after your thyroid is removed and you really want to avoid dealing with that when pregnant if you can help it.  I would recommend testing for a full iron panel (ferritin, % saturation, TIBC and serum iron) if you haven't already as all your symptoms are also listed possible symptoms of iron deficiency.
I didn't realize that.  I feel so completely uninformed.  I'll bring up the iron panel with my OB, she's far more helpful as far as explaining things and being receptive to what I say.  

No one mentioned that the thyroid issues could cause any pregnancy problems at all.  It was never even insinuated.  I was told that the anesthesia during surgery was something they wanted to avoid.  

So, you all are saying that even though my blood work was "clean" or "normal" that I may still have hypothyroidism?  
At this point, i would be asking for what labs have been done.  I'm terrible at maths so other members can see if you are in good % range with your free T4 and free T3. Thyroid labs i would include in a work up: TSH, free T3, free T4, thyroid peroxidase antibodies, thyroglobulin antibodies, reverse T3.  Are you taking a pregnancy formulated multivitamin?
I take prenatal vitamins, yes.  

I hate to sound stupid (as I'm truly not, but I am very ignorant about this), but why would I request these tests? What am I ultimately trying to find out?  I *know* they did three labs... I believe it is TSH, T3, T4.  

I don't even see the surgeon again until July right before delivery to schedule a surgery, unless they call and tell me my biopsy went awry.  I do not have an endocrinologist or GP.  I will have to ask my OB for all the results.
There are no stupid questions. Knowledge is power after all. :)

The official recommendations are for thyroid function tests to be checked every 6 to 8 weeks during pregnancy. It is recommended that TSH is below 2.5 mU/L in the first trimester of pregnancy and below 3 mU/L in later pregnancy.

T4 and T3 are thyroid hormones and you want these hormones in good supply.  T4 needs to convert to T3 before the cells can use it. At the cellular levels only free T3 does all the work at keeping up metabolism.  When reverse T3 is too high it blocks the action of free T3 because it's sneaky and is a mirror image of T3 and fits into the locks in reverse.  Is this getting complicated or what? LOL

Okay if that wasn't enough, thyroid antibodies may cause symptoms without affecting any other thyroid labs.  In a 2011 study published in the British Medical Journal researchers conducted a review of 31 studies involving 12,126 women that assessed the association between thyroid antibodies and miscarriage. Of the 31 studies, 28 separate studies found thyroid antibodies increased the risk of miscarriage by 290%.

In short, you are trying to find out if you are at risk of harming your baby.
It *is* complicated, but I'm taking notes to ask my OB.  She's really fantastic and I have no doubt she will help me navigate this.  But she's not an endocrinologist, of course.  

I just know nothing about it.  I've never had health problems outside of my mental health (which doesn't revolve around blood tests and biopsies) so this is completely uncharted territory for me.  

I had the nodules during my other pregnancies, but I just got blood work and was dismissed.  I often am because doctors seem to think an anxiety disorder makes you a hypochondriac and depression makes you crazy.  But the nodules were obviously there, I mean, you can *see* my neck.  Even my surgeon was like "How in the hell has no one listened to you before?"


I will definitely take all of this information to my OB.  This is very very concerning to me, especially at this point.  The stress and anxiety are already a major concern and I think I'd be less anxious (about this) if I had more answers.  I will ask for the thyroid results and do some more research on my own using the info you guys have given me so I can better prepare myself.

I'm very grateful for all of the information.  I just want this to be taken care of in a way that does not impact the baby.  
These tests are not just for your baby's health but your own mental and physical health of course. And by locks i mean T3 intra-cell receptors.

The number one cause of depression is serotonin deficiency. Anti-depressants drugs are known as SSRI's (select serotonin reuptake inhibitors) however they aren't as effective as made out (2008 anti-depressant scandal) and have a black box warning: risk of suicidal thoughts and actions.

There are many supplements you can find in health food stores to help increase neurotransmitter deficiencies. For example: L- tryptophan and 5-HTP (5 Hydroxytryptophan) for serotonin and L-glutamine for GABA.

"Change your body and you will change your mind. It doesn't work the other way around." - Dr Mark Hyman from the video "The truth about antidepressants". Very true.

Factors which reduce serotonin levels (symptoms of low levels include depression and anxiety):

* Poor diet
* Stress and anger
* Lack of exercise
* Lack of sunlight/lack of vitamin D
* Hormone imbalances (thyroid, adrenal, estrogen, progesterone)
* Problems with digestion (eg: low stomach acid/GI inflammation)
* Under-methylation - folate, vitamin B6, vitamin B12 deficiency
* Iron, calcium, magnesium, zinc, B3, B6, folate & vitamin C deficiency
* A lack of omega oils
* Ecstasy, diet pills, and certain medications
* Hypoglycemia
* Insulin Resistance
* Diabetes
* Inflammation
* Infections
* Problems converting tryptophan to serotonin
* High cortisol levels (stress hormone)
* Excess caffeine
* Cigarette smoking
* Chronic opioid, alcohol, amphetamine & marijuana use
* PCB's, pesticides and plastic chemicals exposure
* Artificial sweeteners (aspartame)
* Glutathione deficiency
* Genetic serotonin receptor abnormalities
* Human growth hormone deficiency
* Impaired blood flow to brain

Factors which reduce GABA levels (symptoms of low levels includes anxiety):

Glutamine (precursor) deficiency
B1, B6, zinc, manganese & iron deficiency
Chronic stress
Chronic pain
Inadequate sleep
Progesterone deficiency
Mercury and lead exposure
Alcohol withdrawal
Excess caffeine
Excessive electromagnetic radiation
Excessive loud noise exposure
Anti-depressants have never worked for me.  It would be a dream come true if this thyroid thing were taken care of and it reduced my depression (I was diagnosed long before this came to light).  
Anti-depressants often don't work for people whose depression is caused by hypo.  In fact, anti-depressants often make it worse.  Mild depressants, like alcohol or opiates, actually make hypos less depressed because they flood the brain with T3, a natural mood elevator.  
The depression diagnosis predated the thyroid issues by about 20 years (I was in therapy as a child for it).  But even if it diminished some of the depression or anxiety, I'd be grateful.

However, if I gain another 100 lbs that I can't lose, there's really not going to be anything that's going to make me happy.
"However, if I gain another 100 lbs that I can't lose, there's really not going to be anything that's going to make me happy."  If your thyroid levels were right for you, you might not have so much trouble losing the weight.  Weight gain is a prime symptom of being hypo.  

I agree with the others that you really need to know what your thyroid test results are, particularly, TSH, FT3 and FT4.  
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