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Hashimotos, gained 20 lbs in 3 months
Hello,
I am new to the forum but I have been reading posts for a while. I have kind of a long story but a common question.
In August I was told my TSH was a little high, it was 4.93, my free t4 was 1.16. My doctor said it was subclinical and didn't want to treat right away, she wanted to run another test in a few months. In November I had my TSH and free T4 tested again and my TSH was 5.56 and my Free T4 was 1.14. At that point we decided I should go on .25mcg of Levothyroxine. I almost immediately started gaining weight. In August I weighed 142 lbs, the same at the end of November. By the beginning of January I was up to 150 lbs but my TSH had dropped to 3.8 and my free T4 was 1.1. At that time I had my TPO Antibodies checked and they were 1506. That is when my doctor diagnosed me as having Hashimotos. She upped my medication to .50mcg of Levothyroxine.
In February my TSH was 2.24 and my Free T4 was 1.24. My weight had gone up again to 155 lbs. My general practitioner then referred me to an endocrinologist. The endocrinologist did not believe that the levothyroxine had anything to do with my weight gain and even tested my Human Growth Hormone levels to see if there was an issue there because I sweat a lot and my hands and feet are always swollen. I do not have my results from the first visit with the endocrinologist, I lost the paperwork, but my HGH level was fine. I do know after that visit he raised my medication to .75mcg and I switched to Synthroid.
I went back to him about 3 weeks ago and he basically said that I was just eating too much and not exercising enough. I was now up to 160 lbs. He did check my iron for my hair loss but other than that he said he would check my thyroid again and go from there. I got my results back and my TSH was 1.44 and my Ferritin was 15. I have heard nothing from him other than a note saying my TSH was fine and my iron was low. No instructions. He did say to call him if I wanted to discuss the results when I was leaving the appointment. I am planning on doing that tomorrow.
In the meantime I went to see a naturopath. She did a ton of tests, I won't list all the results, but she checked my estrogen, testosterone, cortisol, cholesterol, iron, folate, leptin, insulin, ect... (ps. I am now up to 164)
The summary is my TSH is .934, T4 is 10.1, T3 1.19, Free T4 2.0, Free T3 3.4.
Here is what she suggested:
- I have gone on a gluten free diet
- I am cutting back on dairy
- my lipids are off course, vitamin D and Ferritin is very low so I am on vitamin D drops and iron supplements
- Thyroid looks good. Stay the course on the meds I am on.
- She is targeting my inflammation with the gluten free diet and has put me on Thyrotrophin PMG.
- She says I am estrodominant and suggested different dietary and lifestyle changes.
- She also put me on fish oil
So my question is, when I talk to my endocrinologist tomorrow, if I can get through, should I ask for T3 to be added to my medication. I have heard that can help with the weight gain. It is not that I expect to instantly drop weight, but I don't want to keep gaining. Through all of this my diet (until the gluten free) has not changed, nor my activity level (if anything that has gone up). I am still trying to figure out about all this stuff.
I am getting so tempted to stop with the synthroid even though I know I shouldn't. I just can't stop this weight gain that has started since the medication. It is embarrassing and I feel terrible.
Any thoughts?
Sorry this was so long.
I am new to the forum but I have been reading posts for a while. I have kind of a long story but a common question.
In August I was told my TSH was a little high, it was 4.93, my free t4 was 1.16. My doctor said it was subclinical and didn't want to treat right away, she wanted to run another test in a few months. In November I had my TSH and free T4 tested again and my TSH was 5.56 and my Free T4 was 1.14. At that point we decided I should go on .25mcg of Levothyroxine. I almost immediately started gaining weight. In August I weighed 142 lbs, the same at the end of November. By the beginning of January I was up to 150 lbs but my TSH had dropped to 3.8 and my free T4 was 1.1. At that time I had my TPO Antibodies checked and they were 1506. That is when my doctor diagnosed me as having Hashimotos. She upped my medication to .50mcg of Levothyroxine.
In February my TSH was 2.24 and my Free T4 was 1.24. My weight had gone up again to 155 lbs. My general practitioner then referred me to an endocrinologist. The endocrinologist did not believe that the levothyroxine had anything to do with my weight gain and even tested my Human Growth Hormone levels to see if there was an issue there because I sweat a lot and my hands and feet are always swollen. I do not have my results from the first visit with the endocrinologist, I lost the paperwork, but my HGH level was fine. I do know after that visit he raised my medication to .75mcg and I switched to Synthroid.
I went back to him about 3 weeks ago and he basically said that I was just eating too much and not exercising enough. I was now up to 160 lbs. He did check my iron for my hair loss but other than that he said he would check my thyroid again and go from there. I got my results back and my TSH was 1.44 and my Ferritin was 15. I have heard nothing from him other than a note saying my TSH was fine and my iron was low. No instructions. He did say to call him if I wanted to discuss the results when I was leaving the appointment. I am planning on doing that tomorrow.
In the meantime I went to see a naturopath. She did a ton of tests, I won't list all the results, but she checked my estrogen, testosterone, cortisol, cholesterol, iron, folate, leptin, insulin, ect... (ps. I am now up to 164)
The summary is my TSH is .934, T4 is 10.1, T3 1.19, Free T4 2.0, Free T3 3.4.
Here is what she suggested:
- I have gone on a gluten free diet
- I am cutting back on dairy
- my lipids are off course, vitamin D and Ferritin is very low so I am on vitamin D drops and iron supplements
- Thyroid looks good. Stay the course on the meds I am on.
- She is targeting my inflammation with the gluten free diet and has put me on Thyrotrophin PMG.
- She says I am estrodominant and suggested different dietary and lifestyle changes.
- She also put me on fish oil
So my question is, when I talk to my endocrinologist tomorrow, if I can get through, should I ask for T3 to be added to my medication. I have heard that can help with the weight gain. It is not that I expect to instantly drop weight, but I don't want to keep gaining. Through all of this my diet (until the gluten free) has not changed, nor my activity level (if anything that has gone up). I am still trying to figure out about all this stuff.
I am getting so tempted to stop with the synthroid even though I know I shouldn't. I just can't stop this weight gain that has started since the medication. It is embarrassing and I feel terrible.
Any thoughts?
Sorry this was so long.
I second Sally's comment.
Most people take the second dose late morning to early afternoon. After about 3:00 pm (on a "normal" wake/sleep schedule), some find that it will disturb sleep. You can play with the timing to see what works best for you. I'd start with early afternoon. If you experience an energy lag before it kicks in, just move it to a somewhat earlier time.
The advantage with the synthetic combo is that T3 and T4 can be manipulated separately for a custom fit. With NT you get what you get. However, for some people nothing but desiccated seems to work. You've started down this path; perhaps it would be a good idea to see how it plays out before switching again???
Most people take the second dose late morning to early afternoon. After about 3:00 pm (on a "normal" wake/sleep schedule), some find that it will disturb sleep. You can play with the timing to see what works best for you. I'd start with early afternoon. If you experience an energy lag before it kicks in, just move it to a somewhat earlier time.
The advantage with the synthetic combo is that T3 and T4 can be manipulated separately for a custom fit. With NT you get what you get. However, for some people nothing but desiccated seems to work. You've started down this path; perhaps it would be a good idea to see how it plays out before switching again???
By the way, do not take your thyroid meds before your monitoring blood test (if you do, it will give you false high levels for FT3 and FT4).
Take your thyroid meds after your blood test.
Take your thyroid meds after your blood test.
So far no symptoms from the T3 but I have a couple new questions.
First, If I take my first dose in the morning with my T4 how long should I wait to take the second?
Also before I knew if my endocrinologist would change my medication or even get back to me at all I sent a message to my naturopath. She said she would switch me to NatureThyroid. She was going to have me take 1 grain of that. Now I am conflicted.
I had not planned on going back to my endocrinologist because he just didn't seem to believe that my weight gain was not just from poor eating habits and laziness. So honestly I thought I wouldn't hear from him, or that he wouldn't agree to switch me. So I am not sure if I should stay with the synthetic T4/T3 combo or go to the NatureThyroid.
Does anyone have any experience with both?
First, If I take my first dose in the morning with my T4 how long should I wait to take the second?
Also before I knew if my endocrinologist would change my medication or even get back to me at all I sent a message to my naturopath. She said she would switch me to NatureThyroid. She was going to have me take 1 grain of that. Now I am conflicted.
I had not planned on going back to my endocrinologist because he just didn't seem to believe that my weight gain was not just from poor eating habits and laziness. So honestly I thought I wouldn't hear from him, or that he wouldn't agree to switch me. So I am not sure if I should stay with the synthetic T4/T3 combo or go to the NatureThyroid.
Does anyone have any experience with both?
T3 works much more quickly than T4, but it still can take a while. I don't know how fast iron works.
T3 can also take a little getting used to. If 5 mcg twice a day is gives you any symptoms, consider cutting back a little until you get used to it.
T3 can also take a little getting used to. If 5 mcg twice a day is gives you any symptoms, consider cutting back a little until you get used to it.
I spoke with my doctor today. They put me on 50 mcg of Levothyroxine once a day and 5mcg of liothyronine (T3) twice a day. I am supposed to go back in two months to have my labs checked. I also started taking an iron supplement last week. I am not sure how quickly I will start to feel a difference. I have heard that it can take 3-6 weeks. I haven't felt any difference or symptom relief with any of my other doseage changes. The only difference was rapid weight gain.
Yes, you typically lower T4 meds by 20-25 mcg for every 5 mcg T3 you add in. Your FT4 is high, so I think you should ask your doctor about lowering T4 meds.
TSH is a pituitary hormone. As such, it's subject to many influences other than just thyroid hormone levels. Once on meds, TSH becomes pretty unreliable as an indicator of thyroid status. Also, the pituitary converts T4 to T3 for itself, separate from the way it's converted by the rest of the body. That's what it uses to gauge if more thyroid hormone is needed or not.
I think ferritin may be key in your case. Be sure to discuss supplementing that as well. We can measure serum FT3 and FT4 levels, but we can't measure tissue levels. Ferritin has to be present in sufficient quantity in cells for T3 to get in and do its work.
TSH is a pituitary hormone. As such, it's subject to many influences other than just thyroid hormone levels. Once on meds, TSH becomes pretty unreliable as an indicator of thyroid status. Also, the pituitary converts T4 to T3 for itself, separate from the way it's converted by the rest of the body. That's what it uses to gauge if more thyroid hormone is needed or not.
I think ferritin may be key in your case. Be sure to discuss supplementing that as well. We can measure serum FT3 and FT4 levels, but we can't measure tissue levels. Ferritin has to be present in sufficient quantity in cells for T3 to get in and do its work.
I called and left a message with his staff yesterday and they said he would call me back today.
I also sent a message to my naturopath and told her I was thinking about adding some T3. She said she could help me with that and would email me today because she was out of town.
I think I have read before that if you are going to go on a T3/T4 regimen that it is customary to lower the T4. Is that correct? Why is my Free T4 so high if my TSH is at a pretty decent level? I am still figuring all this stuff out.
I also sent a message to my naturopath and told her I was thinking about adding some T3. She said she could help me with that and would email me today because she was out of town.
I think I have read before that if you are going to go on a T3/T4 regimen that it is customary to lower the T4. Is that correct? Why is my Free T4 so high if my TSH is at a pretty decent level? I am still figuring all this stuff out.
Your FT4 is above range and too high, but your FT3 is at 58% of range, which is low for some people, although nicely into the top half of the range. If you do decide to add in some T3, be sure to drop your T4 dose a bit.
Ferritin is way too low. Ferritin is necessary for thyroid hormones to get into cells. You can have perfectly good serum FT3 and FT4 levels and still be hypo at the cellular level.
If I were you, I'd drop my T4 dosage a bit to get FT4 back into range, and I'd work on ferritin. Did you call him today?
Ferritin is way too low. Ferritin is necessary for thyroid hormones to get into cells. You can have perfectly good serum FT3 and FT4 levels and still be hypo at the cellular level.
If I were you, I'd drop my T4 dosage a bit to get FT4 back into range, and I'd work on ferritin. Did you call him today?
That is really interesting, thank you. I may need to take a closer look at that book.
Sorry, for some reason the post did not list the reference ranges as I typed them. I will try again:
T4: 4.5-11.7 mine: 10.1
T3: 0.80-2.00 mine: 1.19
Free T4: 0.9-1.7 mine: 2.0
Free T3: 2.0-4.4 mine: 3.4
TSH 0.27-4.2 mine: 0.934
T4: 4.5-11.7 mine: 10.1
T3: 0.80-2.00 mine: 1.19
Free T4: 0.9-1.7 mine: 2.0
Free T3: 2.0-4.4 mine: 3.4
TSH 0.27-4.2 mine: 0.934
Here are my reference ranges for the latest tests:
T4: 11.7 mine: 10.1
T3: 2.00 mine: 1.19
Free T4: 1.7 mine: 2.0
Free T3: 4.4 mine: 3.4
TSH 4.20 mine: 0.934
Although a week ago when my endocrinologist tested my TSH was 1.44 and my T3 was 1.86. He didn't test anything else. The naturopath said they can fluctuate a lot.
None of these tests were done fasting.
All my other tests came back great, other than the ones I mentioned, the vitamin D, iron, and estrogen. Apparently I am estrogen dominant, estrogen/progesterone ration is 1/38.2 and she likes it to be more like 1/a few hundred. And my cholesterol (bad) was high at 162. I do have a little vascular inflammation but I couldn't really re-explain those tests.
My heart function was great, she gave me a gold star for all my glucose and insulin levels. My cortisol was good. Magnesium, calcium, and all those things were in line.
I hope this helps explain a bit more. I did send her an email today about being put on Armor thyroid. She seemed like she would but she was out of town and said she would email me to talk about it more tomorrow.
T4: 11.7 mine: 10.1
T3: 2.00 mine: 1.19
Free T4: 1.7 mine: 2.0
Free T3: 4.4 mine: 3.4
TSH 4.20 mine: 0.934
Although a week ago when my endocrinologist tested my TSH was 1.44 and my T3 was 1.86. He didn't test anything else. The naturopath said they can fluctuate a lot.
None of these tests were done fasting.
All my other tests came back great, other than the ones I mentioned, the vitamin D, iron, and estrogen. Apparently I am estrogen dominant, estrogen/progesterone ration is 1/38.2 and she likes it to be more like 1/a few hundred. And my cholesterol (bad) was high at 162. I do have a little vascular inflammation but I couldn't really re-explain those tests.
My heart function was great, she gave me a gold star for all my glucose and insulin levels. My cortisol was good. Magnesium, calcium, and all those things were in line.
I hope this helps explain a bit more. I did send her an email today about being put on Armor thyroid. She seemed like she would but she was out of town and said she would email me to talk about it more tomorrow.
I am in class all day but I will post the reference ranges when I get home. Thank you.
Please post your FT3 and FT4 reference ranges. Ranges vary lab to lab and have to come from your own lab report. We can make suggestions once we see where in the ranges you fall.
Excerpt from the book Running On Empty by Robyn Koumourou...
"It is not uncommon to start thyroid hormone therapy and find that your symptoms become worse before they get better. When you begin taking thyroxine the areas in the brain that control thyroid hormone production sense the increase in T4 levels within the blood stream. This feedback system will then cause the thyroid glands natural production of thyroid hormones to slow down.
Less natural T4 and T3 will then be produced and released and blood levels may remain stagnant or even decrease temporarily. Less free T3 hormone available to the body will slow down cellular metabolism. The symptoms of hypothyroidism may become worse until an increase in thyroxine is taken or an optimal dose is found."
"It is not uncommon to start thyroid hormone therapy and find that your symptoms become worse before they get better. When you begin taking thyroxine the areas in the brain that control thyroid hormone production sense the increase in T4 levels within the blood stream. This feedback system will then cause the thyroid glands natural production of thyroid hormones to slow down.
Less natural T4 and T3 will then be produced and released and blood levels may remain stagnant or even decrease temporarily. Less free T3 hormone available to the body will slow down cellular metabolism. The symptoms of hypothyroidism may become worse until an increase in thyroxine is taken or an optimal dose is found."
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