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Thyroid Disorders Community
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Avatar universal

Any Help or suggestions with battling weight, depression, and medications

I have been mildly depressed for a while because of my weight gain. I went to physician weight loss two years ago and loss 75 pds. I have since gained 38 of the 75 pds. Never did my first doctor suggest to go to an endo/thyroid specialist. I complained about my weight, fatigue, and tiredness before but it fell on deaf ears. I thought it was something that I was doing wrong. So when I got off of physician weight loss I thought all I had to do was continue with exercise and a controlled diet. I was wrong. I started balloning back up and now I am 215 pds and am very embarrassed about it. I finally started to take a proactive approach and started pushing to find out what was going on with me. Finally, my previous doctor scheduled me with an endo/thyroid specialist. Of course, I left my previous doctor and now with a second one (I still don't know about this one as I discussed my concerns while waiting on the endo/thyroid specialist but it wasn't positive). The suggestion was made to go to a weight loss center after lab results were done that ruled out Vitamin D, B12, TSH (normal), iron, prediabetic, etc. I continue to talk about my metabolism because I truly believe that this is where the problem lies but again it fell on deaf ears. I went to the endo/thryoid specialist on today (10/5/11) and he suggested to try Cytomel 5mcg and changing my levothyroxine to 100 mcg. ( I was originally on 125mcg levothyroxine). He is running additional test on my thyroid and stated that he will inform me as to when I can go forth and order the Cytomel and Levothyroxine. I questioned him about the metabolism issue but didn't receive a good response. I don't know of what else to do as it seems that this is my last option before I go back to the weight loss centers. I hate to go back because it a short term solution, in addition, to paying a lot of money only to have to go back again because my body is out of balance. Any suggestions that you all have will be welcomed. I never heard of taking adrenal for hypothyroidism. I will do more research on that. However, it seems my ideas of what can be done to combat my hypothyroidism was not received with a warm welcome by this endo/thyroid specialist. By the way, I exercise like crazy!!!! I have been trying to lose these pounds for a year and 8 months. Anyone have any suggestions??

Here are my current lab results:

T3- 84

T4 - 1.6

Hemoglobin 5.5

Vitamin D (Normal)

Ferritin 20

Iron 62

B12 1000
28 Responses
649848 tn?1534637300
COMMUNITY LEADER
If you have the lab report, can you tell us if the T3 and T4 are "Free" or "Total"?  And what the reference ranges are - these ranges vary from lab to lab, so must come from your own report. The T4 looks like it could be "Free", but I'm wondering about the T3...  please confirm whether these are Free or Total - if your lab report doesn't specify Free or FT, then the results will be total.

Also, please post the reference ranges for the other tests - "normal" for vitamin D can be anywhere between 30 and 100, but if your levels are closer to 30, you won't feel as well as if they are closer to 100.  Same goes for iron and B12.  What was your TSH level, and reference range?  Again, "normal" doesn't mean "normal for YOU". AND many labs, therefore, doctors are using outdated ranges for TSH.  The new range, as recommended by AACE about 8 yrs ago, is 0.3-3.0.  

Your thyroid basically controls your metabolism, so, yes, if you are hypo, you have a metabolism problem.  

Do you know what other tests the endo ordered?  Do you know if you have Hashmoto's Thyroiditis?  

Looking at your labs, I suspect that the endo thinks maybe you aren't converting the T4 to T3 properly, which is keeping your metabolism low, since T3 is the only hormone the body actually uses.  FT4 is a storage hormone and must be converted to FT3, prior to use. It's customary to reduce T4 medication, when adding a source of T3.  

In my opinion, your endo is taking the proper approach by testing and possibly changing your medication.  Do be aware, though, that some of us still have to work very hard to get/keep weight under control, even after our meds are adjusted properly.  Before becoming hypo, I never had a weight problem and I'm at a point, now, where I "can" lose weight, but I do have to work at it.

I'm not a strong believer in weight loss doctors/clinics.  Yes, you lose weight, but, like most "diets", once you stop, the weight comes back.  I'm a firm believer in adopting lifestyle changes that you can live with from now on vs short term solutions.  I'm also a Co Leader on the Weight Loss and Dieting forum, so I'll take this opportunity to invite you on over to take a look..
Avatar universal
Thank you Barb 135......Here is the further breakdown of my lab results:

Total T3

T3, Total         84                         Normal Range: 76-181


Free T4
T4 Free         1.5                                               0.8-1.8


TSH
TSH, 3rd Generation                 0.34           Doesn't give a range


Hemoglobin A1c                  5.5                    1000

Normal  >240
Borderline 205-240
Low <205




649848 tn?1534637300
COMMUNITY LEADER
Total T3 is considered obsolete and is of very little value; however, it's relatively low in its range, which indicates that Free T3 might also be low in its range, but it's hard to say without having the actual test.  Do you think you could get your doctor to do one.

Your FT4 is above mid range, so that, along with the low T3, tells me that you might not convert FT4 to FT3 properly and FT3 is the only hormone the body can actually use.

It appears that you could definitely use a source of T3, such as cytomel, but I'd sure like to see a Free T3 result.  Without adequate amounts of T3, your metabolism will not normalize and you will have a hard time losing weight.

Hemoglobin A1c is good - that's used to test for diabetes.  What are the ranges for the ferritin and iron?  
Avatar universal
I agree 100% with Barb135.

you either do not convert T4 to T3 well or you have a reverse T3 issue.  Either way you need to get your FREE T3 test done.

T4 is a "storage"  hormone.  It remains in the blood stream until the body senses it needs more Thyroid and it then converts the T4 into the usable  Free T3 hormone.  It is only the FREE T3 that is used by the body's cells.  The term Free comes from the ract that it is NOT attached to a protein which renders it useless.  The conversion process produces the mirror image of the T3 molecule.  This Revers T3 (RT3) is troublesome in that the body's receptors will accept this molecule. But it does no good.  It is like a piece to a jig saw puzzle that is the exact right shape but when you put it in the spot only the blank cardboard side is seen and thus doesn't complete the picture although it fits perfectly.  RT3 problems is a bit more rare but it does happen and sometimes can be "cured" by purging the RT3 out.  

In either of these 2 cases, the problem is solved by the addition of a T3 medication.
Avatar universal
Okay....thank you so much. I just got the results back from the endo/thyroid specialist and he has informed me to go forth and obtain the prescription for cytomel. I got the generic form liothyronnine. I hope the generic brand is just as good. I will go back and request a lab test for Free T3. Thank you all for the guidance. I hope this will help with the metabolism in addition to, losing weight.

I am so very glad for this community. I will be lost without it.
Avatar universal
Forgot to include....

Iron      62                                  normal range: 40-175

Ferritin    20                               10-154
649848 tn?1534637300
COMMUNITY LEADER
Both your iron and ferritin are pretty low in their ranges; did your doctor suggest supplementing?  
Avatar universal
No...he didn't suggest anything ( regular doctor nor endo/thyroid specialist). I can ask whether or not iron supplements can be added. Do you know of any good iron supplements?
649848 tn?1534637300
COMMUNITY LEADER
There are a lot of good choices for iron supplements; maybe even a good multi w/iron would be sufficient.  

I'd suggest that if your doctor(s) approve of supplementing, you should ask them which brand they prefer, or go to your favorite health food store - there are tons of them - major chains, such as Vitamin Shoppe, Vitamin World, Mother Earth, GNC, along with smaller independent health food stores.... talk to the people at the store and ask for their recommendation - the chains, of course, will recommend store brand, and that's not always the best choice.... but I have had some employees recommend different brands, depending on the needs.
Avatar universal
Hello,

I spoke with endo/thyroid specialist and was informed to try prenatal iron supplements. However, he said that he does not diagnose the iron issue and to contact my family doctor. (That is frustrating to hear)  I am going to try the prenatal supplement, in addition to, taking my fishing oil, Vitamin C (I do it to boost my immune system), and multivitamin. How far apart can i take these supplements after I take the second dose of my cytomel. The endo/thyroid specialist suggest I should take the second dose prior to 3:00 p.m. no later....
Avatar universal
Forgot to ask....do you all know of a good fiber supplement besides benefiber?
649848 tn?1534637300
COMMUNITY LEADER
You should separate vitamins/minerals from thyroid medication by approximately 4 hours.  This means if you take your second dose of cytomel at 3:00 pm, you could take your vitamins around dinner/bed time.  

I agree with your endo, not to take cytomel after 3:00 pm because it could likely interfere with your sleep.

For fiber, I take Fiber Advance Gummies - they taste good and are fun to chomp on; be careful starting out with them, though; you don't want too  much fiber, too quickly.  I also take an enzyme supplement, which helps with digestion issues.
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