Hypothyroidism and Weight Management
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Pamela_Sue wrote: »@CSARdiver Thank you for the great post. A question for you. I am on the generic levothyroxine but heard from a pharmacist years ago that the name brand Synthroid is better. The reason being that, with the generic, you won't consistently receive the same generic and it can effect a person. Therefore the Synthroid provides consistency.
Any thoughts on this? I have a long-standing struggle with low mental energy. Probably from my depression, but I am always looking for any micro-mini improvements I can make in my life.
Normally I'm all about the generics - simply because they are cheaper and identical. Synthroid is a bit different to the challenges associated with manufacturing. The safety profile on Synthroid is just better, so if there isn't a price difference - opt for the branded name in this instance.
Excellent post! And I wish I could get some doctors to read this; I have a time getting my endos to do full thyroid panels. Both of the endos I have seen in recent years have claimed that free T3 and T4 tests don't tell you anything and that TSH is the gold standard. I too had thyroid cancer and my endo was keeping my TSH way, way low, but I was still feeling sluggish and all the hypo symptoms. I've got a really good GP and she agreed to order the full panel, and while my TSH was very low, my T4 was normal, my T3 levels were below normal. My endo finally noticed this and after a synthroid adjustment didn't fix the problem (T3 dropped even lower), she finally put me on a T3 suppliment as well. Thankfully, my new endo didn't give me any trouble when I requested that she check the other levels as well.
On the topic of generics: I had a serious allergic reaction to a generic a couple of years ago. I had been on the name brand but moved and switched doctors, and didn't realize the new doctor's office had sent in my refill request as the generic. Within about a week of starting the generic, my hands started swelling and got to the point where I couldn't even bend my fingers. The only thing that had changed was the thyroid medication, so I called their office after vising med-express for a round of prednosone and got the name brand sent in. I've been on name brand ever since and never had a problem since. I know that my reaction was to something that was in the fillers, but since I have no way of knowing what manufacturer made that particular generic (since I know pharmacies switch a lot) or what particular ingredient it was that I had the reaction to, my doctor just made sure to note my chart with an allergy and keeps me on synthroid. thankfully, my insurance has not bucked us on it....yet.....
Also, on the interference front: I do know that metformin is known to interfer with synthroid uptake and was aware that I needed to take them separately at least 4 hours apart. Last year, my GP started me on Wellbutrin as an effort to restart my weight loss (I was stuck on a plateau). I had labs done about 9 months later, and found that my TSH was well into the hypothryroid range. My endo upped my dosage of meds and re-tested 9 weeks later. Meanwhile, I did a lot of research trying to find out if wellbutrin was known to interfere with synthroid uptake, but could find nothing on the subject at all. The endo still suggested I stop taking them together, so I switched the wellbutrin to the same time as the metformin. 9 weeks later, my labs had my TSH way down into the hyperthyroid range, so my endo backed the medication off.
So while there doesn't seem to be any definite study to show that wellbutrin interferes with synthroid, and this all falls into the n-1 personal experience thing, if might be beneficial to you if you get started on wellbutrin while being on synthroid to keep an eye on your labs. Of course, this is probably true of any new medication you start. For me, the key takeaway has become don't take anything else when you take the synthroid medication......3 -
Best post EVER award! I’m subclinical hypo. Not quite low enough to be diagnosed with hypothyroidism but low levels. I get most of the symptoms. Fatigue, freezing and hair falling out mostly. Love this post, thank u1
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How did you loose weight? I had my thyroid removed but am still having hormone problems with T4 and keep gaining weight. I’m so fed up with it1
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@sassone68 68
you lose weight by eating less than your body needs, period. The problem comes in that both sides of that equation are variable and change. With thyroid issues and problems getting your T4 regulated, you are probably experiencing some slow down of the metabolism, though that won't come close to explaining all of it (the only way to kill your metabolism is to be dead; it must work within a band for you to remain living).
The biggest issue with thyroid issues is the increased lethargy that keeps you tired, sluggish, and just wanting to lay down; this decreases the calories your body burns while increased hunger increasing what you're taking in. Water retention can be a problem that masks your weight, making it look like you are gaining fat when you're not.
But it absolutely is possible to lose weight with thyroid problems - there is nothing out there that will keep you from losing weight if you can maintain a deficit; starvation mode is a myth, and its also a myth that some people just can't lose weight. It's never easy, but it can be done!
1) keep working with your doctor to get your levels corrected so that the symptoms start to be successfully dealt with. This way, you get to feeling better, moving more, and perhaps tone down the hunger some.
2) get a food scale - you need a food scale to be completely accurate on how much you are eating. Eyeballing is notoriously off base, as are cups, spoons, etc. Use correct entries for the food products you are consuming.
3) start by using MFP's entry for your age, height, weight, and activity level to get an idea of where your maintenance calories are. I'd suggest starting there and just practice eating at that level for a while, understanding that you may need to adjust one way or the other for your actual body and getting a better idea of what a portion size looks like.
4) start decreasing your calories a little at a time, maybe in 250 calorie increments, working to lower your intake while at the same time feeling satisfied; don't try to force yourself to do it all at once, don't try to strong-arm it; it won't work that way, not in the long term. Work with your body to find what foods satiate and what level of calories you can take in a day and still feel satisfied; this is a marathon, not a sprint, and the speed doesn't matter; getting to the goal does. You can experiment with different eating styles, foods, time of eating, whatever, to find what helps you stick to your deficit the best with the least amount of pain - don't think you MUST cut out sugar, carbs, fat, etc, etc, etc - everyone is different and there are a million and one plans that people have successfully used to lose weight; find the one that you can live with the easiest and works with your particular health status.
5) be patient! It takes a while, sometimes, before people start seeing success, especially if you are having trouble with water retention. Also, give a particular plan a couple of weeks chance before deciding it isn't working and moving on to something else. Know how it you need to wait 8 weeks to see the results of a new medication level? Treat your diet the same way.
There's a lot of good threads here with a lot of extremely helpful information from those in the know when it comes to thyroid problems; I'd highly encourage you to look them up.
It is most definitely possible to lose weight with a thyroid condition - I have lost over 110 lbs so far and I don't even have a thyroid anymore, and I was managing to lose weight back in the summer even though I was extremely hypothyroid at the time.13 -
^^^ Totally stellar advice from @bmeadows380, speaking as a fellow hypothyroid person who's lost weight.
If you'd like a little more detailed suggestion about #4, as far as fine-tuning eating within calorie goal to achieve your nutritional objectives, the OP of this hypothyroidism thread, @CSARdiver (whom I haven't seen around the forum lately, sadly) said the post linked below was "Gold!". **
http://community.myfitnesspal.com/en/discussion/10636388/free-customized-personal-weight-loss-eating-plan-not-spam-or-mlm/p1
** Yes, it was my post, and quoting him (although accurately) is therefore shameless self-promotion.
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I've got a question, but @CSARdiver hasn't been seen for a while, but I'll ask anyway.
I'm wondering how much weight loss can play in regulating my thyroid medication. Back in September, my bloodwork showed that my TSH was around 8 and my T4 was in the normal range, as I mentioned in an earlier post. Doctor raises my synthroid. Meanwhile, I changed to taking my thyroid meds at night with no other medication at all - I had been taking wellbutrin with the thyroid meds to try to jumpstart my weight loss.
In November of 2019, the next rounds of bloodwork showed my TSH was now down to 0.06, T4 had gone up some but was still normal, T3 was normal. My doctor lowers my meds as now my TSH is too low.
This week, I had the next round of bloodwork. Nothing has changed in the meantime - the doctor lowered my meds in November, and I've been taking everything the same way I was when I made the initial change in September - thyroid meds taken at night by themselves, everything else taken at least 8 hours later in the AM. However, the new bloodwork (done by the same lab as the last 2) shows that my TSH is now even lower at 0.04 and now my T4 levels are too high. T3, however, didn't change and is still normal.
The only thing different between November and March is that I've dropped about 20 lbs in the meantime, and was wondering if that had an influence on this? But I had lost right at 100 lbs before, going from 375 to 280, and my meds were fine. My PCP had added the wellbutrin after I had been on plateau for a year. The need to change my thyroid meds didn't happen until after I'd been on the wellbutrin and taking it with the thyroid meds.
I'm scratching my head at this one, trying to figure out how my TSH and T4 levels actually got worse when medication was lowered, especially since I don't have a thyroid to provide interference. I was just wondering if perhaps that 20 lb weight loss could be a factor. Not that I intend to stop losing weight; if this is true, that just means I need to keep a closer eye on thryoid levels as the weight comes off.
On the other hand, I think this gives credence to my suspicion that I"m one of those people whose body does not make the T4-T3 conversion well; my T4 kept rising, but my T3 levels didn't change at all (I'm also on T3 meds)0 -
What is your dose of wellbutrin? I do know that as you lose weight you normally need less medication (I'm not a doctor, just what I've been told by a doctor) Do you think the wellbutrin has helped in your weight loss? I'm on T3 only meds because I do not convert so both my tsh and FT4 are suppressed. Are these your Free or regular T4 and T3? I also have hashimoto's so it's a bit different than just being hypo.1
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bmeadows380 wrote: »I've got a question, but @CSARdiver hasn't been seen for a while, but I'll ask anyway.
I'm wondering how much weight loss can play in regulating my thyroid medication. Back in September, my bloodwork showed that my TSH was around 8 and my T4 was in the normal range, as I mentioned in an earlier post. Doctor raises my synthroid. Meanwhile, I changed to taking my thyroid meds at night with no other medication at all - I had been taking wellbutrin with the thyroid meds to try to jumpstart my weight loss.
In November of 2019, the next rounds of bloodwork showed my TSH was now down to 0.06, T4 had gone up some but was still normal, T3 was normal. My doctor lowers my meds as now my TSH is too low.
This week, I had the next round of bloodwork. Nothing has changed in the meantime - the doctor lowered my meds in November, and I've been taking everything the same way I was when I made the initial change in September - thyroid meds taken at night by themselves, everything else taken at least 8 hours later in the AM. However, the new bloodwork (done by the same lab as the last 2) shows that my TSH is now even lower at 0.04 and now my T4 levels are too high. T3, however, didn't change and is still normal.
The only thing different between November and March is that I've dropped about 20 lbs in the meantime, and was wondering if that had an influence on this? But I had lost right at 100 lbs before, going from 375 to 280, and my meds were fine. My PCP had added the wellbutrin after I had been on plateau for a year. The need to change my thyroid meds didn't happen until after I'd been on the wellbutrin and taking it with the thyroid meds.
I'm scratching my head at this one, trying to figure out how my TSH and T4 levels actually got worse when medication was lowered, especially since I don't have a thyroid to provide interference. I was just wondering if perhaps that 20 lb weight loss could be a factor. Not that I intend to stop losing weight; if this is true, that just means I need to keep a closer eye on thryoid levels as the weight comes off.
On the other hand, I think this gives credence to my suspicion that I"m one of those people whose body does not make the T4-T3 conversion well; my T4 kept rising, but my T3 levels didn't change at all (I'm also on T3 meds)
I asked a similar question in a thread I started here:
https://community.myfitnesspal.com/en/discussion/10650324/thyroid-meds-dose-reduction-in-weight-maintenance/p1
Page 2 CSARdiver goes into a more detailed explanation...2 -
abbeyann18 wrote: »What is your dose of wellbutrin? I do know that as you lose weight you normally need less medication (I'm not a doctor, just what I've been told by a doctor) Do you think the wellbutrin has helped in your weight loss? I'm on T3 only meds because I do not convert so both my tsh and FT4 are suppressed. Are these your Free or regular T4 and T3? I also have hashimoto's so it's a bit different than just being hypo.
My PCP has me on the highest dose of wellbutrin and I can say with absolute certainty that is is not having any effect whatsoever; it was months after she upped it to the highest dose that I started finally losing again, and I think that is more related to the swing from badly hypo thyroid back into badly hyper thyroid I experienced from Sept 19 to Nov 19, though I really started losing in January. The wellbutrin doesn't help at all with my depression episodes, either. However, since I"m currently losing at a reasonable rate, I"m not going to have her take me back off the wellbutrin yet; I don't want to change anything right now (other than getting my thyroid meds worked out).
I don't have a thyroid at all due to cancer. those are the free values, I think. With my TSH sitting at 0.04 I can see why my T4 levels are high.cmriverside wrote: »
I asked a similar question in a thread I started here:
https://community.myfitnesspal.com/en/discussion/10650324/thyroid-meds-dose-reduction-in-weight-maintenance/p1
Page 2 CSARdiver goes into a more detailed explanation...
@cmriverside Thank you! I figured it had to be here somewhere, but MFP's search options leave much to be desired.
The thing with me is that I don't really notice symptoms when I'm hyper or hypo, so I have a really hard time defining what is supposed to be "normal". 0.04 is definitely considered hyperthyroid, though in the first few years after the cancer surgery, my endocrinologist kept my TSH down to 0.01 as we did not want any stimulation of any remaining thyroid cells. But even at that extra low level, I didn't feel any different and the only hyper sign I had was a bit of an intolerance to heat. No shakes, no racing heart, no increase in blood pressure, none of the typical hyperthyroid signs.
In fact, I tended to still have what is typically associated with hypothyroidism: chronic constipation issues, brain fog, thinning hair. I've been struggling with those especially this winter, even though I'm actually hyperthyroid.
I hadn't noticed a needed change in my thyroid meds as I lost my first 100 lbs, but at the same time, my doctor was still keeping me ultra low, too. It's only been in the last 2 years that they have allowed my levels to come up closer to normal since all my cancer scans have come back in the best percentile you can be in for predicted non re-occurrence (we caught my cancer very early), so this may have masked the fact that my lowering body weight was affecting the level of medication I needed.
My weight loss really finally took off again in January 2020, and this was about 3 months after the medication change that dropped my TSH from 8 to 0.06. Before, as my TSH rose to the 8, I was taking the wellbutrin at the same time, but when bloodwork showed that the TSH was extremely hypothyroid, I switched it around and started taking my thyroid meds at night and the wellburtin in the morning with my medformin. That's when my TSH dropped from 8 to 0.06 in 3 months. In November, my doctor lowered my meds and nothing else has changed since then until now except that I dropped 20 lbs. Which was why I was surprised to see that my levels had actually dropped further!
I had wondered why I had suddenly been able to stay within my calorie limit when for the last 2 years, I had plateaued because I felt hungry all the time, even when I knew my body wasn't really hungry and it was just a mental drive. I had wondered what it was that was switching my ability to stick to a diet on and off - never thought about hormones being driven by thyroid levels being that switch!
I can't blame the wellburtin completely for the plateau; I had plateaued at the end of 2017 and she didn't suggest the wellburtin until the fall of 2018, but over the course of 2019, she had been increasing the wellburtin in attempts to get me started losing weight again, but it wasn't working at all; I did finally start losing again this past summer, but it was a mental fight the whole way - now I know why. Apparently, the wellburtin was messing with my thyroid medication uptake, pushing me into being hypothyroid which in turn was actually making the weight loss harder!
So it seems that getting my TSH levels back down made much more of a difference than the wellbutrin.
With the virus thing, my appointment with my endocrinologist is going to be over the phone on the scheduled day. I'll discuss this with her and see about keeping me on the lower end of the TSH spectrum - not at 0.04, perhaps, but definitely down around that 0.2 range and have her keep an eye on levels as I continue to lose weight. AFter I talk to her, I may request that my PCP start lowering me back off the wellbutrin - no point in taking a medication that isn't doing any good at all and may be causing more problems.
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I was diagnose with hypothyroidism in 2008 and 2016 Sjogren's syndrome was put on immunosuppressive drugs because I had anemia and my hemoglobin levels were low. Has anyone have anemia from hypothyroidism and Sjogren's and what was the treatment plan?0
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I am going to get my new prescription for a higher dose of synthroid today. Will this help my weight loss? I've been trying to lose the same 30 pounds for months. I am taking the medication first thing in the morning before my eyes are barely open and only having water for at least an hour or more after. Any input is greatly appreciated! ❤❤❤😍😍😍👍👍👍0
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@jdh419
it could help with the weight loss, if you are having problems with lethargy and hunger. Those can come along with hypothyroidism, so getting your levels under control can give you energy and help with hunger control. A bad thyroid cannot prevent you from losing weight at all but it can cause water weight gains, lethargy which in turn means you are burning less (lowers the CO part of the equation), and can down regulate your metabolism to a small extent-not enough to cause mythical "starvation mode" because that is physically and scientifically impossible (or else no one would starve to death), but it can mean that you aren't burning as much as a person with normal levels, though we're talking the tune of only a small number of calories strictly from metabolism. So the water weight could be masking real fat loss, or the hormonal imbalances can mess up the CICO equation either by driving you to eat more than you think you are or making you tired so you aren't burning as much as you were before and therefore your deficit from the calculator isn't accurate to your situation.
The biggest culprit by far with bad thyroid, though, is the lethargy, puffiness, and just hormonal imbalances causing hunger issues, water weight gain, etc. So very much yes, getting those levels under control can help with weight loss and many people find the weight coming off much easier once they have their levels in the right area.
For me personally (and this is my n=1), it took a while to figure out that my thyroid levels were having a big impact on my "brain hunger" or that drive to eat that was mentally disconnected from my physical hunger cues - that part of my head that was still starving even though I could tell my stomach wasn't hungry. I lost a bunch of weight in 2017 but plateaued in 2018 into the first part of 2019 and regained 30 lbs. In that time frame I tried and tried to restart calorie counting as I knew it worked, but I just could not stick to my deficit at all. I finally got going again in June of 2019, but it was at a crawl and was a battle the entire way. Then in October 2019 I found out my TSH was extremely high, meaning I was severely hypothryoid. My doctor changed my medication and by December, I was starting to lose at a good clip and wasn't having nearly the trouble with mental hunger I was before - when I had my thyroid levels check, it had dropped back down to below 1 where I personally need to be for medical reasons.
So I learned an important lesson about myself - if I find mental hunger starting to really give me trouble, I should see about having my thyroid levels checked!
Course, now since I've lost 50 lbs since December, I'm having the opposite problem - the weight loss causes the TSH levels to drop naturally, so my doctor is now having to decrease my medication!4 -
I am going to get my new prescription for a higher dose of synthroid today. Will this help my weight loss? I've been trying to lose the same 30 pounds for months. I am taking the medication first thing in the morning before my eyes are barely open and only having water for at least an hour or more after. Any input is greatly appreciated! ❤❤❤😍😍😍👍👍👍
bmeadows gave a great rundown, which sounds reasonable to me as a long-term hypo person who'd been through quite a number of dosage changes for various reasons over the years.
FWIW, recent personal experience in the other direction: I recently reduced my dose, for reasons having nothing to do with the hypothyroidism**. It's been long enough to have the new dose settle in (but not quite long enough for a retest in the time of pandemic), so I don't know my new numbers. But I've seen no difference in my maintenance calorie level, while logging carefully. I'm not saying it's zero - no sure way to know - but it's not noticeable via careful tracking.
** It turns out my osteopenia has progressed, perhaps all the way to osteoporosis. For that and other reasons I won't belabor (but they're weren't standard hyper symptoms or thyroid test results), I want to see if I can happily tolerate a lower thyroid hormone level. My doctor is humoring me.
I'm sure you'll see some positive changes from getting your dosage dialed in better, maybe some big/surprising ones. I hope you feel better, and more energetic, and get benefits on the activity/appetite side that will pay off, and help you get past the difficult phase you've been in!2 -
I doubt it will make that much difference, unless you were really undermedicated. My doctor has been changing my dosage every three months this year, from 114 mcg to 125 to 114 to 88. My weight has stayed the same. I still don't know whether this new dosage is right - I'll find out in October. I feel like I have less energy with the lower dose, but that may be for a lot of other reasons, and I'm still doing the same exercise, so I am stable weightwise.2
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I've been on synthroid for 25 years and also have osteopenia that has progressed to osteoporosis. No doctor has ever mentioned a connection between thyroid function, the medications used to treat thyroid issues and bone loss.
It's complicated and since I'm not a health professional all I will say is make sure to ask your doctor about it. Also I was never instructed on when and how to take synthroid and although I took it daily I was haphazard on how I took it That has changed.3 -
I was so relieved to read this discussion. I have two thyroid masses to be biopsied and was concerned about how it might affect my weight loss goal. I've lost 12 lbs but have 20 to go. Glad to see if worst case happens and I have thyroid removed I can continue to work on weight with success. I know my weight is not because of the current issue as I've battled it for over 50 years. Just call me a slow learner.à
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Thanks for taking the time to comment .I have lost 15lbs using MFP and fitbit over 12months then gained same weight back doing exactly same thing ! Now stuck calories 1500 yes I am honest no point kidding myself average 16000 steps per day and weight won't budge. Fit ok can handle hills etc no challenge but scales wint budge .1
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I have Hashimotos. I have managed to lose 45 lbs in a year. It has been a journey that has taken dedication in getting to the gym , eating the right foods via process of elimination, and taking synthroid. My dosage started at 75mcg, and went up to 125mcg. After gradually losing weight, I have dropped back down to 75mcg, which is likely where I will stay - even if I lose more weight. What auto immune event that caused my Hashimotos is unknown, and might even be genetic in nature. What I do know is that it is harder to lose weight than before, but I expect age plays a role in that as well. I have 30 more lbs to lose. I am in a plateau, which has been debunked in another article on this site, but scientifically, plateaus exist. The body is a wonderful thing and can adapt to all types of deprivation in order to function as normal. With Hashimotos, and the unknown factor involved, it gets a little testy at times, but that has allowed me to educate myself on the things my body needs to accomplish my goals. Somebody mentioned that they have a lack of vitamin B 12. I do too, and take a monthly shot to get it back into a normal range. I would suggest that you get tested for Hashimotos - most doctors don't do this - as it is not hypothyroidism in itself, but an auto immune disorder. It is thought that the underlying cause, might be the reason some things never get fully back to normal. The problem with that underlying cause is that even an endocrinologist isn't going to hunt for the culprit. They are just going to have you take your medicine, such as synthroid, for the rest of your life, and hope you are lucky enough to not get thyroid cancer, or the auto immune part doesn't attack some other organ. Sorry. I don't mean to sound pessimistic. It has been a learning experience. I consider myself lucky to only have this to deal with - well this and a bum knee. But, as stated, yes! Even having Hashimotos doesn't give you an excuse not to lose weight, and you will feel so much better for doing so.6
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Pamela_Sue wrote: »@CSARdiver Thank you for the great post. A question for you. I am on the generic levothyroxine but heard from a pharmacist years ago that the name brand Synthroid is better. The reason being that, with the generic, you won't consistently receive the same generic and it can effect a person. Therefore the Synthroid provides consistency.
Any thoughts on this? I have a long-standing struggle with low mental energy. Probably from my depression, but I am always looking for any micro-mini improvements I can make in my life.
Normally I'm all about the generics - simply because they are cheaper and identical. Synthroid is a bit different to the challenges associated with manufacturing. The safety profile on Synthroid is just better, so if there isn't a price difference - opt for the branded name in this instance.
this is terrifying to me. how could a pharmaceutical company do this to people! im on the generic and i am always going through it with the mood swings and the fatigue and dry skin. my numbers are still the same ( i had a total thyroidectomy two years ago) I have heard this from my grandmother as well, but i have also heard about consistency. that once you start one brand you need to stay on it so that it will work better ,1 -
lizzythepixie wrote: »Pamela_Sue wrote: »@CSARdiver Thank you for the great post. A question for you. I am on the generic levothyroxine but heard from a pharmacist years ago that the name brand Synthroid is better. The reason being that, with the generic, you won't consistently receive the same generic and it can effect a person. Therefore the Synthroid provides consistency.
Any thoughts on this? I have a long-standing struggle with low mental energy. Probably from my depression, but I am always looking for any micro-mini improvements I can make in my life.
Normally I'm all about the generics - simply because they are cheaper and identical. Synthroid is a bit different to the challenges associated with manufacturing. The safety profile on Synthroid is just better, so if there isn't a price difference - opt for the branded name in this instance.
this is terrifying to me. how could a pharmaceutical company do this to people! im on the generic and i am always going through it with the mood swings and the fatigue and dry skin. my numbers are still the same ( i had a total thyroidectomy two years ago) I have heard this from my grandmother as well, but i have also heard about consistency. that once you start one brand you need to stay on it so that it will work better ,
All pharmaceutical drugs, generic and name brand, are subject to the same oversight. Unfortunately, no medical companies have to declare what other ingredients they use, aside from the active ingredients. This is definitely a problem with how pharmaceutical companies are allowed to function. Along with insane pricing, of course.1
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