Hypothyroid and Weight Loss

[bmrugger]

I was recently diagnosed with hypothyroidism (test results below) and was prescribed 75 MCG Levothyroxine. Unfortunately, I still feel very tired and regardless of my diet and exercise I find it impossible of losing weight.  At approximately 1400-1700 calories and excercise 5x per week, I can't even lose an ounce of weight.  

My stats are 219 lbs, 5'9", former rugby player and Muay Thai fighter.  My fight weight is around 180.

Just wondering if anyone can offer me any advice? I wonder if my medication isn't right yet, and my thyroid is still not right.

2nd test- December 18, 2009

Tests: (1) TSH (2835)
TSH                       4.0 UIU/ML                  0.3-5.1

Tests: (2) FREE T3 (4273)
FREE T3                   3.0 PG/ML                   2.3-4.2

Tests: (3) FREE T4 (THYROXINE) (2823)
FREE T4 (THYROXINE)       1.27 NG/DL                  0.73-1.95

Tests: (4) LIPID PANEL (173)
CHOLESTEROL               121 MG/DL                   <200
TRIGLYCERIDES             138 MG/DL                   39
CALCULATED LDL CHOL       57 MG/DL                    <100
RISK RATIO LDL/HDL        1.59 RATIO                  10.0%         >251 MG/DL            >279 MG/DL
9.0%          219 MG/DL             243 MG/DL
8.0%          188 MG/DL             208 MG/DL
7.0%          156 MG/DL             172 MG/DL
6.0%          124 MG/DL             136 MG/DL

Tests: (6) MICROALBUMIN/CREATININE, RANDOM AND RATIO (4895)
CREATININE, URINE, CONC.
191 MG/DL
MICROALBUMIN, RANDOM      1.4 MG/DL                   </=1.8
CALC MICROALB/CREAT RND
7 MG/G                      60
eGFR NON-AFRICAN AMER.
[L]  55 ML/MIN/1.73              >60
CALCULATED BUN/CREAT      17                          6-28
SODIUM                    145 MEQ/L                   133-146
POTASSIUM                 3.9 MEQ/L                   3.5-5.3
CHLORIDE                  104 MEQ/L                   97-110
CARBON DIOXIDE            26 MEQ/L                    18-30
CALCIUM                   9.6 MG/DL                   8.5-10.5
PROTEIN, TOTAL            7.4 G/DL                    6.0-8.4
ALBUMIN                   4.8 G/DL                    2.9-5.0
CALCULATED GLOBULIN       2.6 G/DL                    2.0-3.8
CALCULATED A/G RATIO      1.8                         0.9-2.5
BILIRUBIN, TOTAL          1.0 MG/DL                   0.1-1.3
ALKALINE PHOSPHATASE      52 U/L                      30-132
SGOT (AST)                24 U/L                      5-35
SGPT (ALT)                39 U/L                      7-56

Tests: (3) HEMOGLOBIN A1C WITH INTERP (2707)
HEMOGLOBIN A1C            6.0 %                       4.0-6.0
MEAN PLASMA GLUCOSE EST
136 MG/DL

HGB A1-C    MEAN BLOOD GLUCOSE    MEAN PLASMA GLUCOSE
>10.0%         >251 MG/DL            >279 MG/DL
9.0%          219 MG/DL             243 MG/DL
8.0%          188 MG/DL             208 MG/DL
7.0%          156 MG/DL             172 MG/DL
6.0%          124 MG/DL             136 MG/DL

Tests: (4) MICROALBUMIN/CREATININE, RANDOM AND RATIO (4895)
CREATININE, URINE         260 MG/DL
MICROALBUMIN, RANDOM      1.2 MG/DL                   </=1.8
CALC MICROALB/CREAT RND
5 MG/G                      <30

Tests: (5) FREE T4 (THYROXINE) (2823)
FREE T4 (THYROXINE)       1.19 NG/DL                  0.73-1.95

[gimel]

I think that you will find that if you get your FT3 level into the upper part of its range and FT4 slightly higher then your symptoms will improve.  Since the AACE recommended over 6 years ago that the TSH range should be revised from .5 - 5.0 down to .3 - 3.0, I don't think you should have much trouble increasing your meds in the short term.

If, however, your doctor is an "Immaculate TSH Believer", then longer term you may run into trouble getting enough meds prescribed to get your FT3 and FT4 high enough to alleviate symptoms.  In that case you will have to find a good thyroid doctor that will treat your symptoms by testing and adjusting the levels of the "Frees" with whatever medication is required to alleviate your symptoms, without being constrained by resultant TSH levels.  When you find a doctor that will do that, you will be in good hands.  

I say that about TSH because many members report that their TSH becomes suppressed when on medication, yet they have no hyper symptoms.  In fact many still have lingering hypo symptoms until the Frees are high enough.  A doctor that is focused on mainly TSH usually will not agree with this and want to reduce meds when TSH is low/below range..

[LazyMoose]

Since your hypo, have you had the two antibody tests done?

Sleep apnea can sometimes improve with proper thyroid treatment. And if it does get better (apnea), diabetes can improve in some people as a result.

Do you really have apnea or are you 'borderline', therefore on the 'test' period with the machine to see if it helps?  

Under treated Hypo thyroid can result in insomnia and / or 'light' sleeping, affecting the body oxygen level and resulting in weight gain and daytime drowsiness, sometimes 'sleep attacks'.

[bmrugger]

no, I but I do wanna kick the diabetes meds, hypertension meds, and sleep apnea machine.

[chuckpiv]

Kicking the thyroid meds huh?  that's a new one.

[bmrugger]

Thank you both for your comments.

Barb, indeed I was diagnosed with Type II diabetes in July of last year.  I have managed to bring my A1C down to 5.5% from over 14% in 6 months.  Good catch on your part.

The first test was the initial diagnosis for Hypothyroid, the second test was a follow-up.  I have been on the hypothyroid meds since September 25, 2009. I started on Synthroid 50MCG and then in mid-December the dosage was increased to 75MCG.

I weight loss as a diabetic and hypothyroid patient this difficult?  It seems akin to squeezing blood out of a rock.  If it is, I'll be quite discouraged.  I mean how do I lose the weight in an attempt to become healthier in hopes of kicking the meds if I can't lose the weight despite a rigorous diet and exercise program.

[gimel]

Just to supplement the good info from Barb, you should also be aware that the ranges for FT3 and Ft4 are very broad, and have never been revised like was done for TSH.  If the data bases for FT3 and FT4 were purged of suspect hypo and hyper patient data, like done for TSH, then I am convinced that the ranges would be considerably different than shown.  From my knowledge of statistical analysis, I would estimate that the range for FT3 should be more like 3.2 - 4.3 and the FT4 range would be more like 1.0 - 1.55.  Do you think that might be the reason we hear from so many people that have FT3 and FT4 in the lower part of their ranges, yet continue to have lingering hypo symptoms?  I'd bet my last dollar on it.  

If this has interested you, then you might like to read this article by Dr. Lindner.

http://www.xxxxxxxxxxx.com/Thyroid.html  

[Barb135]

Please note: Your lab is using an outdated reference range for TSH -- the AACE recommended that the range be changed to 0.3-3.0, approx 6 yrs ago.......so according to that your TSH is still high; however, your FT4 and FT3 look okay, even though your FT3 is toward the bottom of the range.

Were these tests done before or after beginning the med?  How long have you been on the med?

It takes approx 5-6 weeks for the med to stabilize so you get the full benefit from it.  That could have something to do with your weight issues, but looking at your test results, it looks like your hemoglobin A1c is also "borderline" -- have you been diagnosed with insulin resistance (prediabetes) or Type II diabetes?  That will also affect your weight, so you may have more than one thing going on.