Gaining weight on less than 1000 calories

[JEN_F]

I have been diagnosed with hypothyroid.  I’ve been taking 75 grams of Synthroid for two years now.  I have gained 20 lbs and 2 dress-sizes in that time frame.  I am 46 years old and I am currently around 135 lbs.  Other than my pregnancy, I have never weighed this much.  My skin is extremely dry and fatty.  I have cellulite on my entire thigh!  I am a person that doesn’t eat that much at all.  I am a healthy eater (salad, balanced meals, etc.).  I exercise regularly.  I went to an endocrinologist to seek professional help for my weight gain (not trusting that my general practitioner had the in-depth knowledge).  She gave me a metabolism test that indicated I need to eat less than 1,000 in order to lose weight and my labs are where they should be.  She told me to go back to my primary doctor to investigate what else might be going on.  My primary says … “I’m just getting old.”  Since then, I put myself on an Ensure liquid diet for a week now.  Two Ensures a day (500 calories) and one Ensure clear (180 calories).  I did this to make sure I could count the amount of calories.  Total calories=680.  In the past week, I have added 2 lbs.  WTF?  Any thoughts/suggestions?  If my labs are where they need to be, why is my calorie level so much lower than the average woman?

[goolarra]

Your FT4 looks good in your latest labs, even a little on the high side.  Of course, what's missing is FT3.  Considering your hypo symptoms, your FT3 is most likely the culprit.  FT3 is the test that correlates best with symptoms.  Would your doctor order that (along with a repeat of FT4 and TSH) upon request?  If not, a thyroid panel is available online for about $85 (insurance doesn't pay for self-ordered tests, but you also don't need a doctor's order for them).  More about that if you're interested...

Even if your doctor refuses, at least if you complete your profile with FT3, you will know if that's the problem or not and can procede from there.  

[Sera20]

The labs while on Synthroid were the following:

Free T4: 1.1 (0.8-1.9)
Free T3: 3.1 (1.5-4.1)
TSH: 1.04 (0.40-4.00)

Now I agree that there was room for improvement, but I wasn't having hypo symptoms.  I was gaining weight every week, and I shudder to think what I would have gained had I not been exercising like a horse competing in the Derby.  My "feel good" numbers on Tirosint are the following:
T4: 1.3
T3: 3.2
TSH: 1.5 (same ranges as above apply)
My intention certainly is not to knock Synthroid, as it works quite well for some, but I certainly want to share the fact that there are other meds out there that may work better for others.  I was stuck with doctors who insisted that Synthroid was the only drug treatment available, sad to say.

[JEN_F]

Good to know.  Thanks for the info!

[JEN_F]

Does this help?

5/22/12:  Free T4 = 1.17 (0.73-1.95 NG/DL), TSH = 1.2 (0.3-5.1 UIU/ML)
4/22/12:  Free T4 = 1.04 0.73-1.95 NG/DL), TSH = 2.1 (0.3-5.1 UIU/ML)

[gimel]

Just out of curiosity, what were those lab results that were in a "decent range", when you were taking Synthroid?

[Sera20]

It is quite possible that your body is reacting to the fillers in Synthroid.  I experienced a similar situation when I first started that medication.  I'm normally 150 lbs, and at six feet tall, am pretty lean.  Had two kids, went right back to that weight, thanks to healthy eating like yourself, and exercise.  Started with Synthroid, due to hypothyroid issues, and started gaining weight immediately, with a low calorie diet, and an insane amount of exercise.  Nothing I did mattered.  Most of the weight was in my stomach (I looked 4 months pregnant), my thighs, and my hips. I hit 170 pounds, and it was a debacle, with the doctor insisting that I wasn't eating right, or being active.  How infuriating and exhausting.  Finally got switched to Tirosint and the weight came off with my same diet and exercise.  I changed nothing but my medicine.  The lab work showed my levels to be in a decent range, but the Synthroid just didn't agree with me.  Perhaps that's the case with you, as well...you never know.

[goolarra]

I just need to see the range for your FT4.  Ranges vary lab to lab depending on the test kits they use, so they have to be reported with results.

[JEN_F]

Thanks for taking your time.  Here is what I found from the Endocronologist (no T3 reading taken)  
5/22/12:  Free T4 = 1.17, TSH = 1.2
4/22/12:  Free T4 = 1.04, TSH = 2.1

I think I gave my prior results from my family doc to the Endocronologist.  If I find them, I'll follow up.  As far as other symptoms:  I just slept to 2 PM and woke up tired - could be because no calories to speak of.  I was constipated, but the diet alleviated those sysmptoms.  I have puffy eyes,dry skin, tired all the time, hair breaking off, CPA challenged by taxes (so could be foggy and not realize it).  So I think I do, but the doctors don't agree that I need an increase in dosage.  Your thoughts (assuming you have enough data).  Thanks again for taking your time!

[goolarra]

Most likely your labs AREN'T where they need to be.  Many doctors don't test adequately and adjust meds just so patients are "in range" when in reality FT4 often has to be midrange and FT3 upper half to third of range before symptoms (weight gain/inability to lose weight) are relieved.

If you post recent thyroid labs with reference ranges (vary lab to lab so have to be posted with result), we can take a look and maybe help you see what's going on.

Do you have any other hypo symptoms?