Absolute inability to lose weight over a year...what am I am I missing?

[fsacc350]

I am a 32yo male with Hashimoto's.  I first found out that I had a problem with my thyroid in September of 2010.  I had routine bloodwork done by my primary and my TSH was 21.7.  He had me see an endo. My endo. did addtional bloodwork a couple weeks later and my TSH was around 11, and I had the typical thyroid antibodies associated with Hashimoto's, as well as an enlarged thryoid (about 2 times normal size).  At the time of all of this I was 31.  I weighed according to records 151 pounds, 5 ft 5.  I've always been in the 150 to 155 pound range.  I've been working out my whole life, and eat healthy.  At that time when I was first diagnosed I was extremely lean, no belly fat, abs, muscles, etc.  I ran and lifted 6 days a week.  I had no hypothyroid symptoms at all.

My endo started me on 50mcg of Synthroid and had me come back in a month or two later for more blood work.  With no changes to diet or excercise I began gaining weight.  By January I weighed 175 pounds.  In Nov. I was increased to 75mcg of Synthroid.  By Feb I was on 100mcg, and steady at 175 pounds.  I addressed my concerns with my endo but he didn't really address it.  

At this time I decided to try a new workout program.  I had been doing about 35-45 min of mod-heavy cardio along with weighlifting (lighter weights w/higher reps) 6 days a week.  I knew a few people who had gone through the 2 month Insanity fitness program, so I borrowed the DVD's and started Insanity.  After 2 months of doing Insanity, which is nothing short of insane inhome bootcamp I saw no change in body weight, body measurements, or in the mirror.  I was however in unreal physical condition.  I also had more bloodwork done around March/April 2011.  For some reason my TSH shot up again.  My endo started me on 137mcg of Synthroid.  

I had been researching hypothroidism throughout this time and had been hearing a lot about treatment with t3 and having my free t3 tested.  I had a different doctor run my bloodwork including free t3 in June 2011.  The results are as follows:  
Free T3 - 2.66   Range is 2.57-4.43pg/mL
Free T4 - 1.64   Range is 0.64-1.77ng/dL
TSH 4.94

I showed my Endo the results and he increased me, to 137mcg 8 times a week, meaning on Sunday I took it twice.  While all of this was going on I had also done a 3 month fitness program called P90X.  This program was awesome yet brutal, and at the end of 3 months I saw no changes in overall weight.  I did put on a bit of muscle in my shoulders and back however I saw no difference in stomach, love handles, and chest where all of this weight seems to have gone to.  

I typically take in 1800-2000 calores depending on the day.  Based on my activity level this should be right where I need to be to lose weight yet in the last year, I've literally been stuck.

My latest bloodwork in November 2011 is this:
TSH - 1.40
Free T4 - 1.59 (0.8-1.76 range)
T3 Total - 126 (81-178 range)
My endo started me on 175mcg of Synthoid, and also 2000iu of Vitamin D3 as it was low.

As of today, I'm up to 178 pounds from 151 a year ago.  I was in great shape physically and asthetically when I was diagnosed, however now I'm just flabby and workout twice as much and count calories but see no results.  If I stopped working out a year ago and started eating crappy I could understand how one could gain roughly 25 pounds, however I managed to gain weight while while working out and dieting.  I am literally at my wits end and don't know what to do.  Everyone I know has lost anywhere from 20-35 pounds doing either Insanity or P90X yet I have not dropped a pound and actually look worse because I did put on a little muscle but did not lose fat so I look even bulkier.  I've been lean my whole life and always very active.  I work out now 6 days a week, and 3 of those days I work out twice doing 35-45 minutes of cardio in the morning as well.  

I realize this story is all over the place, however I think it should give some good backround.  I just don't know what to do at this point.  I will never get used to having a gut or being as flabby as the front of my body has become, I just don't understand how I got it and at this point how to get rid of it.  How is it possible to gain 25 pounds while I'm on a strict weight reduction diet and excercise program?  The doctors I've dealt with really don't offer much accept eat less and work out more...I can honestly say at this point there is something else going on.  

Can anyone point me in the right direction?

[Barb135]

The first thing that jumps out at me, is that in June 2011, your FT4 was above mid range, but your FT3 was at the very bottom of the range.  That would indicate that you aren't converting the FT4 (storage form of hormone) to FT3 (active hormone).  

In Nov, you were tested for Total T3, which is considered obsolete and of little value, but even that's not up to even mid range, so I would surmise that FT3 (which is only a very small portion of the total), would also be very low again.

I'd suggest that after you've read the information gimel gave you, you might want to ask your doctor to add a source of T3 medication.  This can be one either by adding synthetic T3 (cytomel or generic) to your dose of Synthroid; or switch to a dessicated thyroid medication, such as Armour, ERFA or some of the others.  These are T4/T3 combos, produced from pig thyroid. Dessicated medications have much  more T3 in them, than the body normally produces.

[gimel]

Please start with reading the post I made for Bailadiva in this thread, then ask whatever questions you might have.

http://www.medhelp.org/posts/Thyroid-Disorders/Hyperthyroidism-and-weight-gain/show/17497#post_7504285