Hyperthyroidism and Obesity?

[DonnaGB]

My husband has just recently been diagnosed with hyperthyroidism which we were told, in his case, was caused by Grave's Disease.  However, I am very confused because my husband weighs 420 pounds and falls in to the morbidly obese category.  Everything I have read says that hyperthyroidism and Grave's Disease causes unintentional weight loss.  How is this possible?  His blood test results are TSH - 0.008 UIU/ML, Total T3 - 79.67 NG/DL, and his Free T4 is 1.81 NG/DL.  I also read for a diagnosis of hyperthyroidism, one or both the T3 or T4 must be high.  However, his TPO test came back high which is why, I'm guessing, the endocrinologist believes he has Grave's disease.   The TPO result was 47.5 IU/ML.  I'm baffled as to how someone who is obese can have hyperthyroidism.  Could there be something else here that is causing the hyperthyroidism besides Grave's Disease?

[zahu19]

A related discussion, hyperthyrodisim was started.

[DonnaGB]

Dr. Lupo,

Here's the test results with the labs range.  
TSH  [L]  0.008 UIU/ML         0.300-5.100

FREE T4    1.81 NG/DL    0.73-1.95

TOTAL T3   [L]  79.67 NG/DL    90.00-200.00

THYROPEROXIDASE (TPO)   [H]  47.5 IU/ML   <35.0

Most recent test or Total T3 fell into the normal range.  

Hope this helps.

[DonnaGB]

Maria,

Thanks for your response.  I will definitely look into the silent thyroiditis. My husband did have the uptake and scan and they were both normal.  However, his levels of TPO were elevated but I read that this can be seen in both Hashimoto's disease and Grave's disease.  If you don't mind me asking, what kind of treatment have you had?  Thanks!

Donna

[DonnaGB]

Dr. Lupo,

Thanks for your response.  The uptake and thyroid scan came back normal.  The Endocrinologist my husband saw did not do the TSI test and that was a concern of mine since I had read that the TPO can show up in Hashimoto's and Graves disease.  The information I have read stated that in order for a person to have Grave's, either the T3 or the T4 have to be high.  This is not the case with my husband.  Before he undergoes any type of treatment, I would like to have the TSI tested. Is there a chance that my husband could have problems with his pituitary which could cause the TSH levels to be low?  We just want to be certain.  :-)  Thank you!

[Mark Lupo, M.D.]

Obese patients can get Graves and there is not always weight loss.  The Free T4 looks to be high-normal but the TT3 may be low-normal -- would need to look at reference range for that lab specifically.  TPO is not specific for Graves, would suggest confirmation with TSI blood test and or I-123 uptake scan.

[mtkst13]

Hi.  i get episodes of "hyperthyroidism" caused by "silent thyroiditis".   after the thyroid hormones get depleted, i become "hypothyroid".  look up "silent thyroiditis" to get more info on this condition.  

i believe, but i'm not a doctor, that the way one can determine the cause of the "hyperthyroidism" is to do an iodine uptake scan.  if the thyroid does not uptake the iodine, then it's thyroiditis.  it the thyroid takes up an abnormally high amount of iodine, then it's graves disease.

did the doctor do any additional tests?

good luck.

maria