hypothroidism

[Danne556]

My husband is 64 years old and had cancer in his tonsil and lymph nodes in 2000 and was aggressively treated for a year with radiation and chemo after surgery to remove the tonsil, saliva gland, and strap muscle in his neck.  He has routine exams every 3 to 6 months and has always gotten a clean bill of health.  In a routine blood test last week, he was diagnosed with hypothyroidism and was given meds to treat it.  In the last 6 months or so he has lost 27 pounds but he also started taking morphine pills for the pain in his neck and shoulder about that time. He had been taking hydrocodone but his dosage had gotten so high the dr feared for liver damage. Could the morhpine be why he has lost weight rather than gaining weight?  If the thyroid is not active, shouldn't he be gaining?

[Mark Lupo, M.D.]

Most of the time, weight changes are not related to thyroid (despite popular thought).  Would test thyroid levels to see if the dose is appropriate but if the levels are fine, would need to evaluate for tumor recurrence or a gastro-intestinal cause for weight loss.  The other endocrine problem that causes weight loss is adrenal insufficiency - testing cortisol may be appropriate in this setting.

[Danne556]

He is scheduled for an ultrasound of the thyroid to check for cancer but the doctor told him that his thyroid was not producing anything. He had colon cancer in 1993 and 1/3 of is colon was removed and there has been no reoccurance so hopefully there are no other gastro-intestinal problems. I will ask the doctor to check his cortisol levels.  You did not mention the morphine, so do you not see that as a possible reason for the weight loss?