Gained 10 lbs in 1 month on desiccated thyroid

[Jenn1302]

I've had Hashomoto's for 8 years and 8-9 months ago my thyroid went out of whack. I experienced strange symptoms, such weight gain, palpitations and extreme sleepiness but at some point my weight went back to normal. Most of my symptoms went away when I was put on desiccated thyroid and I’ve been on this medication since September. I feel a lot better, but now I’m gaining weight again :(.

The thing is that my test results are pretty normal (except for the tg which is usually negative) and I really don’t get why I’m gaining weight. Over the past month I’ve worked out approx 6 hours per week and my workouts have been relatively intense. I generally eat less than 2000 calories per day. Heck, I’ve been consuming less calories than I was the last time I gained 10+ lbs and I've been putting on weight a lot faster. Based on this calculator: https://www.thecalculatorsite.com/health/bmr-calculator.php I'm supposed to be eating 2000+ calories per day to maintain my normal weight. Something’s definitely off.

Here are my most recent test results, from 2-3 weeks ago:
TSH: 0.05 L (0.3-4.0)
FT3: 3.6 (2.5-5.9), bottom 32%
FT4: 14 (9-19) , right at 50%
TPO: 380 H (<40)
TG: 130 H (<40) <- this antibody was negative in August

Has anyone experienced this? What did you do?

[Red_Star]

I gained almost 6 kg in 3 months with untreated Hashimoto's thyroiditis. I found this article very interesting...

Excerpt from Hormones Rule Your World! Weight Loss – Staying Young – Sex Life – Your Health...

"With weight loss, hormone balance is the real master of your results – no matter how much dieting or exercise you do. For example low thyroid levels can cost you between 300 and 900 calories per day. Compare that with the fact that an average workout burns 500 calories and you can see the difficulties.

Similarly high levels of the stress hormone cortisol (a very common feature of modern day life) can cost you 200 to 300 calories per day.

High levels of the hormone insulin can stop fat burning cold no matter what you do. Many insulin taking diabetics can testify to this. However high insulin levels are becoming a feature of many people’s bodies due to our excessive intake of sugars, refined carbohydrates and alcohols.

Incorrect hormone levels can mean that you spend the whole day dieting and get very little results. You can get 2 people of the exact same size and weight, doing the exact same exercise and one gets way better results than the other – it is all down to hormones."

[Jenn1302]

Thank you Red_Star. I guess I'm going to have to wait until I reach my maintenance dose for my weight to be normal and stable gain. I just hope that the weight gain is reversible and that I'm not 1000 lbs by then.

[Red_Star]

lol.

[Jenn1302]

Thank you Red_Star. I appreciate your help but I read the article and I only have 1 of the 10 symptoms. Also I'm gaining weight at an alarming rate, a lot faster than Aquila Norazman's client. The 10 lbs I gained in 1 month make up 8.5% of my body weight. I actually have a lot of energy and I keep getting stronger. I really enjoy my workouts and it would really suck to have to cut back :(.

[Red_Star]

Wow you can handle a lot more exercise than I can. I was toast! *cries* lol

[Red_Star]

I forgot to mention I had numerous symptoms of overexercising when I was weight training 2 hour sessions every second day. I had to cut back to 1 hour sessions 3 times a week.  

There is an indepth article on overtraining is from Jason's Take - Never Ignore These 10 Signs Of Overtraining...I can't post much because he cusses a lot lol. Here are a few paragraphs...

"Body Fat Storage
Overtraining creates body fat storage – period.

And no amount of fueling is going to prevent it.

As Aquila Norazman shares about a client who was lifting all the time and training for a marathon:

She came back to me the next day with a scanned copy of her results, markedly showing that she has gained 10% body fat in six months."

"Hard bouts of exercise release cortisol.

Contrary to popular belief cortisol is not always a horrible villain.  Don’t believe everything published.

The problem becomes when cortisol is elevated for extended periods of time.  Ummm…. like when you are in idiot mode and putting yourself in an overtrained state."

lol. I know.

[gimel]

I am surprised at your FT4 and FT3 levels.  I say that because your TSH is suppressed (not that it is a problem) so your thyroid gland is not being stimulated to produce hormone.  Yet, your FT4 is mid-range and FT3  at 32% of their ranges.  Your 45 mg of desiccated thyroid med is nowhere near enough to account for those levels.    I wonder if your thyroid gland, even with no TSH stimulation,  might be leaking hormone due to the continuous attack from the autoimmune antibodies.    An ultrasound of the gland would identify its condition, but it would not really change what you need right now, which is to increase your medication and get your Free T3 high enough to relieve hypo symptoms.  

From your symptoms and test results there is no need to fear going hyper.  You are a long way from that.   I suspect that your doctor reduced your meds because of your TSH level.   That is unfortunate that he does not recognize the difference between a suppressed TSH in the treated state versus a suppressed TSH in the untreated state.   In the untreated state our bodies are used to a continuous low flow of thyroid hormone.  When you take your daily thyroid med in only one or two doses, it tends to suppress the TSH for a full day.  So when taking thyroid med  a TSH test is basically  a waste of money.  This is the reason for the quote above,"Hypothyroid  symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range."  

Several possibilities I can think of for the FT3 being lower than FT4.  One is that T4 is being converted to Reverse T3, rather than T3.   RT3 is an antagonist of T3.  Excess RT3 can cause hypo-metabolic effects.  I would use that argument to push for the test.   Another possible cause could be low ferritin levels.  Hypothyroid patients are frequently deficient in  ferritin.  Ferritin is important to good conversion of T4 to T3.  So that needs to be tested.   Vitamin D is also important.  How much are you supplementing daily?

Since your doctor reduced your med, I am concerned that he might be one that thinks TSH is the best indicator of thyroid status, and treats accordingly.   In actuality a good thyroid doctor will treat clinically, for symptoms, by adjusting FT4 and FT3 levels as needed to relieve symptoms, without being influenced by resultant TSH levels.   Symptom relief should be all important, not just test results.  So you may have to give the doctor enough info to persuade him to treat clinically.    I suggest that you click on my name and then scroll down to my Journal and read at least the one page Overview of a full paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.   You can give this info to your doctor also.   If the doctor refuses to do these things then you will need to find a good thyroid doctor that will do so.

[Jenn1302]

Thank you Gimel. Why would T4 be converted into RT3 instead of T3? Is this related to Hashimoto's somehow? If that's the problem what can I do to make my body convert it to T3 instead or to stop producing it?

Ferritin - I keep forgetting to get a ferritin supplement. I really need to do that. Most females have low ferritin levels, so I'm assuming mine are too.
Vit D - I use a cream because my body can't absorb vitamin D from capsules. It's 10000 IU.

I downloaded and read "Overview of a full paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective" back when I was trying to convince my cardiologist to to do a thyroid medication trial for the PVCs. I used this article to convince my PCP to check my FT3 and FT4.

My thyroid doctor temporarily lowered my dose because my body was responding really fast. She said that the effects are supposed to be cumulative so lowering the dose for a little bit wouldn't make my thyroid worse. If I'm still having symptoms in 4-5 weeks she'll up the dose. She also wants to recheck my levels before my next appointment.

[gimel]

No, conversion of T4 to RT3 is believed to be due to the following abnormalities:: “Leptin resistance; Inflammation (NF kappa-B); Dieting; Nutrient deficiencies such as low iron, selenium, zinc, chromium, vitamin B6 and B12, vitamin D and iodine; low testosterone; low human growth hormone; Insulin dependent diabetes;pain; stress; environmental toxins; free radical load; haemorrhagic shock; liver disease; kidney disease; severe or systemic illness; severe injury‟, surgery; toxic metal exposure”.   Take your pick.  From the list, for a hypothyroid patient  I am usually suspicious of the B vitamins, Vitamin D, and ferritin.   You can supplement for ferritin with a good iron supplement like Vitron C, which gives you 65 mg daily.   For Vitamin D you could increase the cream.  1000 IU is not very much.    It is good to optimize those anyway, even if RT3 is not a problem.  

[gimel]

I also meant to mention that you will find the above info on RT3 on page 13 of the full paper that is linked in the Overview.  

[Jenn1302]

Oh, ok. Thank you Gimel.

[Jenn1302]

I finally got an iron supplement. They don't sell the one you recommended here in Canada so I got Jamieson Gentle Iron (it also has vitamin C in it). I decided to get a gentle form of iron because my stomach is very sensitive.

I went to see an MD a few days ago (my PCP wasn't there that day) and I was able to convince her to do a full thyroid panel (FT3, FT4, TSH, TPO, TG) + ferritin. It wasn't easy since she's not my doctor and I recently had blood work done so I didn't want to push it. I tried to ask for Reverse T3 but she said she'd never heard of that.

[gimel]

How much iron is in a tablet of the Jamieson Gentle Iron?    

Reverse T3  was not included in her studies at the med school where she went?  

By the way, for the future, there is no need to keep testing for the autoimmune antibodies, or really TSH either.   Further tests don't really provide any info that helps in your treatment.    Treatment must be to achieve symptoms relief, not test results.  

Please let us know results of your tests.

[Jenn1302]

Thank you Gimel. There's 28 mg of iron in Jamieson Gentle Iron. I have gastric issues that affect my heart (roemheld syndrome/gastric cardia). I don't think I'm going to be able to tolerate more than 28 mg. Is there an iron patch I can get?

The medical system is very different here in Canada. Maybe RT3 isn't included in the curriculum unless you specialize in endocrinology (she's an internal medicine doctor). Most of the internal medicine doctors I've seen around here didn't seem to know much about thyroid health and related blood work. That's why they keep trying to convince me to see an endocrinologist.

My thyroid ND asked to recheck the antibodies. I don't know why.

[Jenn1302]

Thank you Gimel.

Current symptoms:
Rare heart PVCs (they're significantly less frequent than the ones I had before and they don't wake me up anymore)
Relatively mild memory issues (they used to be severe)
My "Hashimoto's face" is almost gone
Mild sensitivity to touch where the thyroid is located (in the past I couldn't touch it at all without it feeling extremely uncomfortable). I think this is as good as it can get.
Weight gain - 10 lbs within a month
NOTE: I'm deathly scared to go hyper because of my past experiences

I'm currently on 30 mg once a day (I was on 45 mg until last week) but other than the extreme weight gain I feel well (for the first time in like forever...). I'm going to try to get my PCP to check my ferritin and cortisol levels, but I'm not sure it's going to happen.
Reverse T3 - this test too expensive. I don't think my insurance covers this.
Vitamin D - I take a supplement anyway so checking this probably won't change anything
B12 - my B12 was recently checked and it was the upper half of the reference range.
FT3, FT4 - my thyroid doctor wants to retest those and the antibodies, so that's definitely happening

I didn't take my thyroid medication before the blood draw.

My FT3 was the main problem before I was put on medication. It was at 12%. My FT4 was at ~30%, 18% higher than my FT3. My levels may be higher now but my FT3 is still 18% lower than my FT4, just like it was before.

[gimel]

I don't agree that your test results are normal.  First thing to be aware of is that hypothyroidsim is not just "inadequate thyroid hormnoe".  Instead it is insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone.   So a patient's thyroid status is related to TISSUE T3 EFFECT.   Since there are no direct measures that are adequate diagnostics of TISSUE T3 EFFECT,  indirect measures are necessary.  Of those the most important are symptoms that occur more frequently with hypothyroidism, supported by expanded blood tests for Free T4, Free T3, initially Reverse T3, cortisol, Vitamin D, B12 and ferritin.  The latter 4 have a direct effect on the response to thyroid hormone and related symptoms.  So please tell us about all the symptoms you still have.  

Your FT4 is adequate.  Your Free T3 is too low to relieve hypo symptoms,for many people.  There is a recent scientific study that concluded, "Hypothyroid
symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range."  Your FT3 is a long way from that, which is somewhat surprising since FT3 is usually higher in range than FT4 when taking desiccated thyroid med. So that raises a couple of additional questions.  What is your daily dose of desiccated med?   Do you take your thyroid med in the morning before the blood draw for thyroid tests?   What could be the cause for your relative FT4 and fT3 levels?

Obviously you need to raise your FT3 level, but before making a decision about how to proceed, you need more information  to help understand why your FT3 is lower than FT4, within their ranges.   Tests for RT3 and ferritin might help clarify that.   So do you think you can get those seven tests done, while postponing your morning dose of thyroid med until after the blood draw?  If so, please do so and then post results and reference ranges shown on the lab report and we will be happy to help interpret and advise further.