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Avatar universal

Weight loss

I am a 42 yo male.  I work out regular.y lift weights, do cario and try to be fit.  I recently had my first real physical where they measure cholesterol etc and cholesterol was high and tsh was 5.7.  I am and have been increasingly tired sleeping so much more and going to bed early works but I need ambien to get my 10 hours that makes me feel better. I have been also recently gaining weight even tho my diet hasn't changed and I'm working out more than ever.  I'm on clonidine 1mg for anxiety which I've had most of my life and my libido is gone. Not even interested in masterbating.  I have no other symptoms yet. I'm going back to the doc next week to get meds and more blood work so he can get more specifics since initially this was a routine blood work for a physical, my question is, if the doc starts me on synthroid and as we pinpoint the dosage over the normal period of time (I've read could take 6 months) could I actually see a change in my body?  Like loose weight, better sex drive, more energy, normal Hours of sleeping with no naps and lower cholesterol?  Because I feel I have been fighting hard to workout and live a productive life as a human and as a professional.  It would be encouraging to discover that my efforts will be made easier after being on correct dosage of meds to get thyroid levels back to normal.  I believe I may be subclinacal hypothyroidism but I am eager to find out what you all think of what the possibilities are after meds are stabilized. Thank you for this forum!
14 Responses
Avatar universal
Correction i am not on clonidine for anxiety but klonipin.
649848 tn?1534637300
COMMUNITY LEADER
Is TSH the only thing your doctor tested?   While TSH of 5.7 is out of range, TSH should never be used, alone, to diagnose or treat a thyroid condition.  You need to ask your doctor for the actual thyroid hormone tests, Free T3 and Free T4.  Those levels are the ones that need to be adjusted.  

You should also get tested for thyroid antibodies, to determine whether or not you have Hashimoto's Thyroiditis, which is an autoimmune disease, in which the body sees the thyroid as "foreign" and produces antibodies to destroy it. Hashi's is the most common cause of hypothyroidism in the developed world.  Diagnosis of Hashi's won't change your treatment, but it will give you an idea of what to look forward to.  As the disease progresses, you would need to adjust thyroid replacement medication, periodically, in order to keep up with the decline in thyroid function.

Once properly diagnosed, and started on medication, it can take a while to get things adjusted to where YOU need them, not just "in range".  Some people can accomplish this in 6 months, for others, that's way too optimistic, but it depends a lot on your doctor and the tests s/he runs.  Any doctor who adjusts diagnoses/treats thyroid conditions, based on TSH, alone, is most likely to keep you ill for a long time.

All of that said, once your levels are adjusted properly, for YOU, you should be able to return to a normal life; lose the weight, cholesterol levels should go down and you shouldn't feel so tired.

If your doctor is well versed in thyroid treatment, s/he will start you out on a low dose for several weeks, then retest and adjust medication based on symptoms and test results.  Do make sure you ask for the Free T3 and Free T4 tests EVERY time you test.  

It takes approximately 4-6 weeks for the medication to reach full potential in your body, but you might start to see small improvements before that. First thing I noticed was that the puffiness under my eyes was gone (and I hadn't even known that was a symptom of being hypo).

Avatar universal
thanks for your helpfulness.  Today I went to the doctor's again and he tested for T3 and T4.  I should know the results tomorrow or the next day.  So another concern I have is, is it possible for this high TSH (even tho its just elevated and not really high) to fluctuate without meds? For example the doctor said today (even tho he hasnt seen the results from teh T3 or T4 yet) that my slightly elevated blood pressure and headaches in the AM and low sex drive might be from Sleep Apnea.  The concern is, if the results come back that im borderline or "subclinical hypothyroidism" and not full-on symptomatic that he will not prescribe meds to address the hypo but instead give high blood pressure meds since BP numbers are not consistently high.  I am just anxious about the whole thing and waiting seems to be the hardest part right now.  My worst fear is that the symptoms that I do exhibit, weight gain, over sleeping, lethargy, high cholesterol, high blood pressure, low libido will be overlooked and not addressed when id rather see if a low dose of synthroid type meds will work instead.  Because from what ive read all these symptoms are associated with thyroid issues.  would it be appropriate to tell me doctor these thoughts and have some part in the decision making process to get prescribed thyroid meds?  your thoughts are appreciated!  I dont want to come across as insistent about it with him but rather well informed.  thank you!  
649848 tn?1534637300
COMMUNITY LEADER
I do hope those tests were for FREE T3 and FREE T4?  If not specified "free", you will get for total T3 and total T4, which are both considered obsolete and of little value. When you get the results, please post them, here, along with the reference ranges, which vary lab to lab, so must come from your own report.

Yes, it's possible for TSH to fluctuate without meds.  TSH varies greatly, even intraday, so whatever it is now, it could be different in a few hours. That's why it should never be used, alone, to diagnose or treat a thyroid condition.

Agree that some of your symptoms could be related to sleep apnea; be aware that sleep apnea often goes with hypothyroidism and the symptoms should go away once thyroid levels are optimal.

You have the right to take part in deciding your course of treatment; most of us have found that we have to be our own advocates and go in, not only informed, but ready to fight for what we need.  I certainly think it would be appropriate to ask for thyroid replacement medication, rather than blood pressure med.  Of course, I wouldn't recommend going in like block busters, but do stick to your guns.

I'll give you an example:  When I was hypo, my cholesterol shot up. My doctor wanted to put me on Crestor and I refused.  I told him that I'd start the thyroid med and if getting my levels right didn't bring my cholesterol down, I'd look at diet and exercise, and the Crestor would be the last resort.  That was over 4 years ago and I still don't take Crestor, or any other cholesterol drug.  I've since learned that my cholesterol goes up and down with thyroid levels. In all fairness, I also now have a different doctor!!

Nobody knows your body better than you do; sometimes, well informed doesn't cut it and we have to be insistent.
Avatar universal
I called the doctors office today.  The doctor is out until tomorrow so the results that I have to post today are from the nurse who is just reading raw data and here are the results.

TSH 4.47   (previous test was 5.7)
T3   74       (Normal range is 76-181) correct?
T4   1.1      (in Range for this test)

So there you have it. It appeared as tho my TSH is back under Normal range and but just barely.  It seems that these numbers fluctuate.  My T4 is below normal range, I assume that these numbers also fluctuate. And of course the T4 is in normal range.  I am going to be skillfully insistent to still get on some kind of treatment for this because of the fact of my high cholesterol and fluctuating blood pressure could be solved by thyroid medicine to get those numbers lower. What do you think Barb135?  With these numbers does it sound like (as it does to me) that Im Subclinical Hypo? and Meds will help bring it within normal ranges (even lower, Id like to see 1.0-2.0 personally).  what are your thoughts?
Avatar universal
Also, since these numbers are raw data said to me by the nurse, I do not know if these are Free or a total unfortunately.  Tomorrow I am calling the doctor to find out the particulars of the test and treatment options when he returns to the clinic.  thanks again!
Avatar universal
Also, since these numbers are raw data said to me by the nurse, I do not know if these are Free or a total unfortunately.  Tomorrow I am calling the doctor to find out the particulars of the test and treatment options when he returns to the clinic.  thanks again!
649848 tn?1534637300
COMMUNITY LEADER
Even though the TSH is within the lab's range, AACE recommended nearly 10 years ago that the range be change to 0.3-3.0.  Labs, therefore, doctors, have been very slow to adopt this change.  So, if we go by "our" range, your TSH is still too high.  As noted in a previous post, TSH fluctuates considerably, even intraday.  When it's all said and done, I barely give TSH a second thought, since it neither causes, nor alleviates, symptoms.  At best, it's merely an "indicator" of thyroid status.

It seems that you might have hit the jackpot with the T3 and T4.... the result of the T4, does appear to be free (whenever getting verbal results, it's always a good idea to ask this).  Based on ranges we normally see for FT, yes, that's in range, however, reference ranges do vary from lab to lab, so always have to come from your own report; again, it's always a good idea to ask ranges, when getting verbal results. That said, even though your FT4 is in range, it's quite low in the range. Rule of thumb is try to get FT4 at mid range.  Depending on the actual range, yours is less than that.

The T3 is the clincher, here.  I can't really tell if that's free or total, but either way, it's too low.  If that's total, then we can assume that FT3 would most likely, be even further out of range, since some of the total would be bound by protein, and unusable.  If it's Free, we simply know it's too low.

Since FT3 correlates best with symptoms, your symptoms are not a surprise, and it's quite likely that getting placed on a medication will go a long way toward alleviating them.

As for the subclinical hypothyroidism - I don't think so.  With subclinical, FT3 and FT4 are usually in range, with a high TSH.  Your FT3 is too low, which indicates an issue with the thyroid.  

I'd strongly suggest that you ask your doctor to test you for the thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) to confirm/rule out Hashimoto's Thyroiditis.  Hashimoto's is an autoimmune disease, in which the body sees the thyroid as foreign, and produces antibodies to destroy it.  If you have Hashimoto's your thyroid function will continue to decline, until it no longer produces any hormones, at all, and you will be completely dependent on the replacement medication (there are worse things).  The destruction process can take years or decades, or it can go quickly.

I'd also strongly suggest that you request a thyroid ultra sound, which will help confirm/rule out Hashimoto's and will determine whether or not you have nodules, which are common with Hashi's.
Avatar universal
Thank you so much!  I have never utilized a forum/thread before and this/you have been a great help. To clarify the T4 is "Free" and T3 is "Total" as with TSH I was given ranges that are considered "Normal" that the clinic has tested against.  I know the importance of finding out what you are comparing these numbers against "Normal" or "average" ranges.  My thinking is as well, because of this fluctuation of TSH (since it varies as you said) is still quite high according the endo's new AACE range and the Total T3 is 74 and Free T4 is seemingly according to the office to right dab in the middle indicates something is off.  If my doctor doesnt suggest treatment for this I will go to a endocrinologist specialist to get this resolved so I can get back to good, where he/she might, as you noted, do a thyroid scan or test of anti-bodies of Hashimoto's  which could end up worse as time passes or other irregularities/disease associated with this.  Thanks again and IAM going to insist on more than "clinical trial" of meds, I have read that 25 mcg is too low and that 50 mcg is minimum but we shall see.  You rock!! thanks! :) wish me luck.  I will post on here what the findings are and outcomes periodically so you and the community can support my actions if at least in spirt.  
649848 tn?1534637300
COMMUNITY LEADER
They gave you reference ranges?  Is that 76-81 what they told you for that lab?  If so, that's the range you're using, even though another lab will use another range.  That's why reference ranges always have to come from own report.  Did they give you a range for the FT4?  If I use the range my lab uses, you're result is  not right dab in the middle; it's only 30%, so they must be using a different range.

You will probably end up with an endo at some point, but your doctor can go ahead and order the antibody tests AND the ultra sound.  That doesn't have to be done by a specialist, and if he does it now, you go to the specialist already armed with the information and won't have to wait for further tests.

"I have read that 25 mcg is too low and that 50 mcg is minimum but we shall see."   Not sure where you read that, but be very careful.  25 mcg might be plenty for some people, while 50 mcg might be way too much.  
You might be fine with a starting dose of 50 mcg, but it would have been way too much for me.

It's always best to start with the lowest dose and work your way up slowly, giving your body time to adjust to the medication.  

When looking for an endo, be careful, there too.  Many endos specialize in diabetes and are not good thyroid doctors.  You will need to make sure the endo you choose, tests both FT3 and FT4 "every" time blood work is done.  You should also make sure that s/he's willing to prescribe meds containing both T4 and T3 (including both synthetic and desiccated), in the event that you find T4 med is not enough for you.  

You can often "pre-interview" doctors over the phone, usually through a nurse, to find out what tests they routinely run and what medications they prescribe.
Avatar universal
My doc put me on 25mcgs of synthroid  and after three days my body is trying to adjust to it. First two days lots of dizziness and vertigo. Today not so much. I'm curious how this will help me. I'm going back in three weeks to retest blood. This time I'll ask for free t3 and free t4. Thanks so much!!
649848 tn?1534637300
COMMUNITY LEADER
It takes 4-6 weeks for the medication to reach full potential in your body, and it's not unusual for people to notice worsening symptoms, when starting on medication, as the body adjusts to it.

It is odd, however, that your are reacting so quickly, since the medication must build in your system.  If those symptoms persist, you may be having a reaction to fillers/binders in the medication.

How will synthroid help you? It's a thyroid replacement medication -- it replaces hormones that your body can't produce anymore.

Your thyroid controls your metabolism, heart rate, body temperature and more, so when you don't have adequate hormones, you gain weight, become constipated, and any number of things.  You've gained weight; hopefully, once you have adequate hormones, you will be able to lose it.

If you have Hashimoto's Thyroiditis, you will most likely have to adjust your dosage periodically, to keep up with the declining output from your thyroid.  You really should talk to your doctor about testing antibodies.
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