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Gaining Weight. Confused
Hello there!
I hope all is well. Just a quick question. I had a Total Thyroidectomy in 2012. Tryiing to get back to normal...So I switched to Tirosint - now using 100mcg and 20mcg Liotironine. (was using 125mcg Tirosint and 10mcg Liotironine before bloodwork below. I noticed that I've been gaining weight,and it is not budging. I am doing strength training and cardio, and somehow I am bloated still and the energy levels still vary. On Sunday, I forgot to take the 2nd split dosage of liotironine, and boy yesterday I felt horrible-sleepy, lethargic!!!
The T3 reverse went down a bit - but not enough! Any suggestions? Thanks much!
Labs in Apr-16 Jul-16 Change is Higher/Lower Range
T4, free 1.6 1.2 0.4 (range 0.8 -1.8)
T3, free 3.4 3.2 0.2 (range 2.3 - 4.2)
TSH 0.3 0.13 0.17 (range 0.4 - 4.5)
T3Rev 27 25 2 (range 8-25)
I hope all is well. Just a quick question. I had a Total Thyroidectomy in 2012. Tryiing to get back to normal...So I switched to Tirosint - now using 100mcg and 20mcg Liotironine. (was using 125mcg Tirosint and 10mcg Liotironine before bloodwork below. I noticed that I've been gaining weight,and it is not budging. I am doing strength training and cardio, and somehow I am bloated still and the energy levels still vary. On Sunday, I forgot to take the 2nd split dosage of liotironine, and boy yesterday I felt horrible-sleepy, lethargic!!!
The T3 reverse went down a bit - but not enough! Any suggestions? Thanks much!
Labs in Apr-16 Jul-16 Change is Higher/Lower Range
T4, free 1.6 1.2 0.4 (range 0.8 -1.8)
T3, free 3.4 3.2 0.2 (range 2.3 - 4.2)
TSH 0.3 0.13 0.17 (range 0.4 - 4.5)
T3Rev 27 25 2 (range 8-25)
You had been on the same dosage since at least last August. Now you have "weird" awful feelings for the last 3 weeks. The feelings that you got just don't seem like they would be directly related to T3 med, even though you got some relief by cutting the dose.
Prior to those symptoms, it appeared as if you would benefit from adding back some T4 and increasing the T3 dose. So I think your doctor is correct that it is likely something else and he should do some further testing
Prior to those symptoms, it appeared as if you would benefit from adding back some T4 and increasing the T3 dose. So I think your doctor is correct that it is likely something else and he should do some further testing
1 Comments
Yep. Thank you much.
When did you first notice those "weird" awful feelings?
1 Comments
About 3 weeks ago.
Hello Gimel, weird awful feeling - felt really, really bad - as if I had no energy to move, a sinking feeling, heavy, almost as if I would faint, there was also a tiredness in my upper arms/biceps. weird.
Yes. My T3 dosage was 20mcg. 10 at morning and 10 in the afternoon.
**Today I used only 100mcg Tirosint. I was a bit tired this morning until I ate breakfast. Then this evening, I was quickly crashing, so stopped for some coffee on my way home. Not ideal, but...***
Thank you.
Yes. My T3 dosage was 20mcg. 10 at morning and 10 in the afternoon.
**Today I used only 100mcg Tirosint. I was a bit tired this morning until I ate breakfast. Then this evening, I was quickly crashing, so stopped for some coffee on my way home. Not ideal, but...***
Thank you.
Please describe in more detail the "weird awful feelings" you mentioned.
Your T3 dosage was 20 mcg, correct?
Your T3 dosage was 20 mcg, correct?
1 Comments
Hello Gimel, weird awful feeling - felt really, really bad - as if I had no energy to move, a sinking feeling, heavy, almost as if I would faint, there was also a tiredness in my upper arms/biceps. weird.
Yes. My T3 dosage was 20mcg. 10mcg at morning and 10mcg in the afternoon.
**Today I used only 100mcg Tirosint. I was a bit tired this morning until I ate breakfast. Then this evening, I was quickly crashing, so stopped for some coffee on my way home. Not ideal, but...***
Yes. My T3 dosage was 20mcg. 10mcg at morning and 10mcg in the afternoon.
**Today I used only 100mcg Tirosint. I was a bit tired this morning until I ate breakfast. Then this evening, I was quickly crashing, so stopped for some coffee on my way home. Not ideal, but...***
Hi Gomel,
I hope all is well. So I visited my doctor and he seems to think that something else may be the cause of my symptoms. He wants me to do GI tests.
Meanwhile, I had a hunch thst I should come off the T3 for a day. I figured the T3 is temporary, and the T4(Tirosint 100mcg) is in my system for a few days. Well--wouldn't you know I felt SO much better!!!! No weird awful feelings at all! Yesterday was the 2nd day of my experiment. I took only 1(5mg) of the T3-liothyronine.
I felt good again yesterday. I also had coffee. Only things I noticed were slow descent of pills in my throat, and my bowel movements slowed a bit.
Could it be that I don't tolerate the T3 well, or is it that the dosage was too high? I'm confused.
I hope all is well. So I visited my doctor and he seems to think that something else may be the cause of my symptoms. He wants me to do GI tests.
Meanwhile, I had a hunch thst I should come off the T3 for a day. I figured the T3 is temporary, and the T4(Tirosint 100mcg) is in my system for a few days. Well--wouldn't you know I felt SO much better!!!! No weird awful feelings at all! Yesterday was the 2nd day of my experiment. I took only 1(5mg) of the T3-liothyronine.
I felt good again yesterday. I also had coffee. Only things I noticed were slow descent of pills in my throat, and my bowel movements slowed a bit.
Could it be that I don't tolerate the T3 well, or is it that the dosage was too high? I'm confused.
Glad to hear from you again. It's been a while.
Many of our members have found that their Free T4 needed to be at least at mid-range (1.3), and their Free T3 in the upper 1/3 of its range, and adjusted from there as needed to relieve symptoms. So both your Free T4 and your Free T3 are lower than optimal for relieving hypo symptoms. Since the Thyroidectomy, your sole source of thyroid hormone is your med, so to increase your Free T4 to mid-range would probably take about 25 mcg of T4. In addition, I think you will need to increase your T3 med to 25 mcg.
Since that would put you back to 125 mcg of T4, like prior, I wondered what was your med/dosage consistent with the April 16 test results?
In addition, your Reverse T3 and ferritin levels are okay. A good multi vitamin would take care of your zinc level. Your Vitamin D needs to be at least 50, so I expect that 2000 IU of D daily would take care of that.
Have you tested for B12? That is important for energy. B12 should be in the upper end of its range to be optimal.
So you need to discuss all this with your doctor and get the increases in med dosages. Also to find out about B12 and supplementing for D. Do you think the doctor will be okay with all this?
Many of our members have found that their Free T4 needed to be at least at mid-range (1.3), and their Free T3 in the upper 1/3 of its range, and adjusted from there as needed to relieve symptoms. So both your Free T4 and your Free T3 are lower than optimal for relieving hypo symptoms. Since the Thyroidectomy, your sole source of thyroid hormone is your med, so to increase your Free T4 to mid-range would probably take about 25 mcg of T4. In addition, I think you will need to increase your T3 med to 25 mcg.
Since that would put you back to 125 mcg of T4, like prior, I wondered what was your med/dosage consistent with the April 16 test results?
In addition, your Reverse T3 and ferritin levels are okay. A good multi vitamin would take care of your zinc level. Your Vitamin D needs to be at least 50, so I expect that 2000 IU of D daily would take care of that.
Have you tested for B12? That is important for energy. B12 should be in the upper end of its range to be optimal.
So you need to discuss all this with your doctor and get the increases in med dosages. Also to find out about B12 and supplementing for D. Do you think the doctor will be okay with all this?
1 Comments
Hi Gimel!!
Geeze! That was super fast! Thank you for your prompt response! :)
I have an excellent traditional/natural doctor who actually introduced me to T3. He is very helpful. I go to see him soon...he is open to conversation about this - and I am sure he will be okay with it.
Below are the April results-when I was using 125mcg Tirosint and 10mcg lithyronine.
I did B12 test in April 2016. It was VERY high. Don't know why..I need to retest it.
Labs in Apr-16
T4, free 1.6 (range 0.8 -1.8)
T3, free 3.4 (range 2.3 - 4.2)
TSH 0.3 (range 0.4 - 4.5)
T3 Reverse 27 (range 8-25)
Vit B12 1389H (range 200-1100)
Ferritin 86 (Range 10 - 232)
I actually take a Vit. D supplement of 5,000IU about 3X weekly. Dont know why it is not moving up faster.
I will look for a good multi to take care of the zinc.
Thank you much!
Geeze! That was super fast! Thank you for your prompt response! :)
I have an excellent traditional/natural doctor who actually introduced me to T3. He is very helpful. I go to see him soon...he is open to conversation about this - and I am sure he will be okay with it.
Below are the April results-when I was using 125mcg Tirosint and 10mcg lithyronine.
I did B12 test in April 2016. It was VERY high. Don't know why..I need to retest it.
Labs in Apr-16
T4, free 1.6 (range 0.8 -1.8)
T3, free 3.4 (range 2.3 - 4.2)
TSH 0.3 (range 0.4 - 4.5)
T3 Reverse 27 (range 8-25)
Vit B12 1389H (range 200-1100)
Ferritin 86 (Range 10 - 232)
I actually take a Vit. D supplement of 5,000IU about 3X weekly. Dont know why it is not moving up faster.
I will look for a good multi to take care of the zinc.
Thank you much!
Hi Gimel,
Thank you for the great support and info. that you share in this forum!
I am back at the drawing board. Did labs recently. I have the following symptoms: very dry skin, tablets VERY slowly going down throat, weight gain...AGAIN. I gained 8 lbs since August 2016, spasms in eye and sometimes other parts of body, still slow memory, not motivated to do much other than the normal - and that is not like me at all, bloating and some mild swelling in feet.
I am working on managing my stress, and cut back on my activities so that I can get adequate rest. I do feel more energy than last August, but generally still not where I think that I should be.
Any advice based on these recent labs and symptoms? I really appreciate it!! :)
LABS Jan-2017 Range
T4, free 1 (range 0.8 -1.8)
T3, free 3.1 (range 2.3 - 4.2)
TSH 0.2* (range 0.4 - 4.5)
T3 Reverse 17 (range 8-25)
Ferritin 97 (Range 10 - 232)
Vit. D-25OH-total 35 (Range 30-100)
ZINC, RBC 7.4* (Range 9.0-14.7)
IRON 91 (Range 40-190)
Iodine,Serum/Plasma 58 (Range 52-109)
DHEA SULFATE 82 (Range 19-231)
CORTISOL (AM) 13.2 (Range 4.0-22.0)
CORTISOL (Free) 0.43 (Range 0.07 - 0.93)
Thank you for the great support and info. that you share in this forum!
I am back at the drawing board. Did labs recently. I have the following symptoms: very dry skin, tablets VERY slowly going down throat, weight gain...AGAIN. I gained 8 lbs since August 2016, spasms in eye and sometimes other parts of body, still slow memory, not motivated to do much other than the normal - and that is not like me at all, bloating and some mild swelling in feet.
I am working on managing my stress, and cut back on my activities so that I can get adequate rest. I do feel more energy than last August, but generally still not where I think that I should be.
Any advice based on these recent labs and symptoms? I really appreciate it!! :)
LABS Jan-2017 Range
T4, free 1 (range 0.8 -1.8)
T3, free 3.1 (range 2.3 - 4.2)
TSH 0.2* (range 0.4 - 4.5)
T3 Reverse 17 (range 8-25)
Ferritin 97 (Range 10 - 232)
Vit. D-25OH-total 35 (Range 30-100)
ZINC, RBC 7.4* (Range 9.0-14.7)
IRON 91 (Range 40-190)
Iodine,Serum/Plasma 58 (Range 52-109)
DHEA SULFATE 82 (Range 19-231)
CORTISOL (AM) 13.2 (Range 4.0-22.0)
CORTISOL (Free) 0.43 (Range 0.07 - 0.93)
More sources for into for you. Within each link there are multiple subjects.
http://www.hormonerestoration.com/Thyroid.html
https://www.nahypothyroidism.org/why-doesnt-my-doctor-know-all-of-this/
http://www.hormonerestoration.com/Thyroid.html
https://www.nahypothyroidism.org/why-doesnt-my-doctor-know-all-of-this/
1 Comments
wonderful. Thank you very much! :)
Your last ferritin test was marginally okay. Your B12 is higher than necessary. If supplementing you could cut back some. You do need to test for D and supplement as needed to get it over 50.
Probably the most effective approach to reducing your Reverse T3 level is of course to work on the stress, and also to cut back on your T4 med in order to reduce the amount available for conversion to Reverse T3 and Free T3. Along with that you would also need to increase your T3 med dosage. So you are going to need a doctor that understands all this and is willing to work with you. Do you think that might be possible with your doctor? If so, following is a link within which there is another link to info that you could use to help persuade your doctor. I highly recommend that you read at least the first two pages of the paper. Later in the paper there is also info on Reverse T3.
http://www.medhelp.org/user_journals/show/2019570/Diagnosing-Treating-Hypothyroidism-A-Patients-Perspective?personal_page_id=12021
Probably the most effective approach to reducing your Reverse T3 level is of course to work on the stress, and also to cut back on your T4 med in order to reduce the amount available for conversion to Reverse T3 and Free T3. Along with that you would also need to increase your T3 med dosage. So you are going to need a doctor that understands all this and is willing to work with you. Do you think that might be possible with your doctor? If so, following is a link within which there is another link to info that you could use to help persuade your doctor. I highly recommend that you read at least the first two pages of the paper. Later in the paper there is also info on Reverse T3.
http://www.medhelp.org/user_journals/show/2019570/Diagnosing-Treating-Hypothyroidism-A-Patients-Perspective?personal_page_id=12021
Your last ferritin test was marginally okay. Your B12 is higher than necessary. If supplementing you could cut back some. You do need to test for D and supplement as needed to get it over 50.
Probably the most effective approach to reducing your Reverse T3 level is of course to work on the stress, and also to cut back on your T4 med in order to reduce the amount available for conversion to Reverse T3 and Free T3. Along with that you would also need to increase your T3 med dosage. So you are going to need a doctor that understands all this and is willing to work with you. Do you think that might be possible with your doctor? If so, following is a link within which there is another link to info that you could use to help persuade your doctor. I highly recommend that you read at least the first two pages of the paper. Later in the paper there is also info on Reverse T3.
http://www.medhelp.org/user_journals/show/2019570/Diagnosing-Treating-Hypothyroidism-A-Patients-Perspective?personal_page_id=12021
Probably the most effective approach to reducing your Reverse T3 level is of course to work on the stress, and also to cut back on your T4 med in order to reduce the amount available for conversion to Reverse T3 and Free T3. Along with that you would also need to increase your T3 med dosage. So you are going to need a doctor that understands all this and is willing to work with you. Do you think that might be possible with your doctor? If so, following is a link within which there is another link to info that you could use to help persuade your doctor. I highly recommend that you read at least the first two pages of the paper. Later in the paper there is also info on Reverse T3.
http://www.medhelp.org/user_journals/show/2019570/Diagnosing-Treating-Hypothyroidism-A-Patients-Perspective?personal_page_id=12021
1 Comments
Hi Gimel, thank you. Yes indeed!! I have a doctor that understands and is working with me. He suggested using T3, and last visit lowered T4-Tirosint, and upped T3-Liotyronine.
I am certain he will work with me further on this.
I will work on the Vit. D and do labs. I'm not taking B12 suppl. now. Not sure why it is so high. I will read the entire paper. If you have more credible sources, I appreciate those also.
I am determined to get to the bottom of this and reach a point of feeling "normal" again! :)
I appreciate you!!
I am certain he will work with me further on this.
I will work on the Vit. D and do labs. I'm not taking B12 suppl. now. Not sure why it is so high. I will read the entire paper. If you have more credible sources, I appreciate those also.
I am determined to get to the bottom of this and reach a point of feeling "normal" again! :)
I appreciate you!!
Hello Gimel, Thank you for your thorough response!! I really appreciate you!
A few things... 1. Yep - I had my lab work done 5-6 hrs after taking thyroid meds the last time. I will ensure that I have at least 24hrs gap next time.
2. I will test for Vitamin D, Ferretin and B12 at next labs
Last labs in April 2016:
Ferritin 86 (range 10-232)
B12 - 1389 (range 200-1100).
3. Regarding the possible reasons for RT3: Stress-lots of stress (I am exploring ways to manage the stress), most likely leptin resistant (bodyfat about 47%-belly fat about 11 lbs), most likely inflammation (NF kappa-B), dieting, need to test for nutrient difficencies.
**I noticed some itching after taking the 2nd split dose of liothyronine (10mcg). Actually I think whenever I use it I itch a bit. Not sure it is related - but possible.
Thank you again for all your support!!
A few things... 1. Yep - I had my lab work done 5-6 hrs after taking thyroid meds the last time. I will ensure that I have at least 24hrs gap next time.
2. I will test for Vitamin D, Ferretin and B12 at next labs
Last labs in April 2016:
Ferritin 86 (range 10-232)
B12 - 1389 (range 200-1100).
3. Regarding the possible reasons for RT3: Stress-lots of stress (I am exploring ways to manage the stress), most likely leptin resistant (bodyfat about 47%-belly fat about 11 lbs), most likely inflammation (NF kappa-B), dieting, need to test for nutrient difficencies.
**I noticed some itching after taking the 2nd split dose of liothyronine (10mcg). Actually I think whenever I use it I itch a bit. Not sure it is related - but possible.
Thank you again for all your support!!
Your most current test results show a Free T3 of 1.2, which is 40% of the range. Based on personal experience and that of our members we usually recommend a minimum of 50%; however, with your Reverse T3 level, I would not suggest adding back any T4. Also, your Free T3 result is only at 47% of its range. We typically find that Free T3 should be in the upper third of its range, or as needed to relieve symptoms, which of course is the prime objective. So with your Free T4 at only 40% it appears that you need to ask for an increase in your T3 med, most likely up to 30 mcg of T3, perhaps in two steps. Keep in mind this quote from a very good thyroid doctor.
"....in tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range." Your med dose proportions are close to that of NDT, so this seems to apply. He further stated,
"In the best tradition of clinical medicine, a physician should prescribe thyroid hormones as needed to eliminate the symptoms and signs of
hypothyroidism without producing any symptoms or signs of thyroid hormone excess." This also brings up the question of whether you took your thyroid med in the morning before the blood draw for tests. If so, that can give false high results.
Also keep in mind that symptom relief lags somewhat behind changes in serum thyroid levels. So even when your levels are good, you may need to allow some time for symptom relief. And any weight loss from optimizing your thyroid levels will come slowly. You will need to be patient.
Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. I suggest testing those and then supplementing as needed to optimize. D should be 50 min., B12 in the upper end of the range, and ferritin should be at least 70, and some sources say 100.
Causes for excess Reverse T3 include stress, leptin resistance, inflammation (NF kappa-B), dieting, nutrient difficiencies such as low iron, selenium, zinc, chromium, Vit B6 and B12, Vit D and iodine, Low testosterone, low human growth hormone, Insulin dependent Diabetes, Pain, Stress, environmental toxins, Free radical load, Hemorrhagic shock, Liver disease, Kidney disease, Severe or systemic illness, severe injury, Surgery, Toxic metal exposure. Anything here that might be a contributor?
"....in tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range." Your med dose proportions are close to that of NDT, so this seems to apply. He further stated,
"In the best tradition of clinical medicine, a physician should prescribe thyroid hormones as needed to eliminate the symptoms and signs of
hypothyroidism without producing any symptoms or signs of thyroid hormone excess." This also brings up the question of whether you took your thyroid med in the morning before the blood draw for tests. If so, that can give false high results.
Also keep in mind that symptom relief lags somewhat behind changes in serum thyroid levels. So even when your levels are good, you may need to allow some time for symptom relief. And any weight loss from optimizing your thyroid levels will come slowly. You will need to be patient.
Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. I suggest testing those and then supplementing as needed to optimize. D should be 50 min., B12 in the upper end of the range, and ferritin should be at least 70, and some sources say 100.
Causes for excess Reverse T3 include stress, leptin resistance, inflammation (NF kappa-B), dieting, nutrient difficiencies such as low iron, selenium, zinc, chromium, Vit B6 and B12, Vit D and iodine, Low testosterone, low human growth hormone, Insulin dependent Diabetes, Pain, Stress, environmental toxins, Free radical load, Hemorrhagic shock, Liver disease, Kidney disease, Severe or systemic illness, severe injury, Surgery, Toxic metal exposure. Anything here that might be a contributor?
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