Thyroid Removed - Weight Loss Help

HELLO!

Resident "No Thyroid, been through all the crazy hormonal symptoms you can think of" MFPer, here! There's others, too.

If your weight is going up despite diet and exercise, it's very likely your levels are not being regulated correctly. What dose of Synthroid are you on? What has your most recent bloodwork revealed? Are you seeing an endo for these issues, or a primary care (see an endo)?

The most common solutions to issues of weight + thyroid issues (especially no thyroid) is correcting/changing dosage OR even changing the thyroid pill (to Armour, Levoxyl, etc.).

I also had issues TWICE with cortisol because, at one point, my thyroid dose had been too low (resulting in outrageously high TSH, cortisol levels flatlined resulting in adrenal insufficiency), and at one point, my dose was too high, resulting in SUPER high cortisol levels which we caught before they flatlined.

Both times... I gained roughly 30 pounds. Which is the number you gained. Could just be a coincidence, and could very well be more related to uncorrected thyroid issues... but uncorrected thyroid issues, when without a thyroid, end up taxing other parts of the endocrine system, the adrenal glands being #1. It might be worth getting a cortisol screening (saliva test, urine test, blood test, though the last is the least effective for measuring cortisol) and seeing if issues are there.

Good luck and PM if you have further Qs; I've been dealing with this **** over a decade, so I feel your frustration!

No problem!

Yeah, like with many other hormone replacement meds, you'd be surprised at how a change in meds (even Levoxyl--brand name-- to generic--Levothyroxine) can make a difference; many, many people swear by Armour, particularly if they're without a thyroid.

You mentioned you were on too high a dose of Synthroid and had high TSH... TSH is actually from the pituitary and is the hormone that stimulates thyroid activity, so higher TSH = hypo symptoms (meaning the pituitary is having to pick up the slack of reduced or no thyroid function), while lower TSH = hyper symptoms (the thyroid is doing so much the pituitary is sitting back and doing nothing, essentially). You and I are always forever going to be hypo since we have no thyroid, however, we can manifest hyper symptoms (I went into thyroidtoxicosis, in fact, and only didn't go into a thyroid storm because... I have no thyroid. Wee!).

It doesn't make sense that you had high Synthroid dosage WITH high TSH; it should have been the opposite (ex: Synthroid of 137 mcg with a TSH of .2, or conversely, Synthroid dosage of 50mcg with a TSH of 10).

.112 of Synthroid, or 112 mcg, is considered something of a higher dose (according to my endo, anything over 100mcg is, but it's very dependent on an individual), so I'd be curious what your most recent TSH and T4 (and even your T3, if you have it) read. You might need a higher dose, but if you truly had a higher dose before, perhaps that isn't a good bet, and a change in drugs would be in order. Otherwise, again... those pesky adrenals can cause trouble, and often have incredibly similar symptoms to hypothyroidism, which is why many people never even realize they have cortisol issues.

No problem!

Yeah, like with many other hormone replacement meds, you'd be surprised at how a change in meds (even Levoxyl--brand name-- to generic--Levothyroxine) can make a difference; many, many people swear by Armour, particularly if they're without a thyroid.

You mentioned you were on too high a dose of Synthroid and had high TSH... TSH is actually from the pituitary and is the hormone that stimulates thyroid activity, so higher TSH = hypo symptoms (meaning the pituitary is having to pick up the slack of reduced or no thyroid function), while lower TSH = hyper symptoms (the thyroid is doing so much the pituitary is sitting back and doing nothing, essentially). You and I are always forever going to be hypo since we have no thyroid, however, we can manifest hyper symptoms (I went into thyroidtoxicosis, in fact, and only didn't go into a thyroid storm because... I have no thyroid. Wee!).

It doesn't make sense that you had high Synthroid dosage WITH high TSH; it should have been the opposite (ex: Synthroid of 137 mcg with a TSH of .2, or conversely, Synthroid dosage of 50mcg with a TSH of 10).

.112 of Synthroid, or 112 mcg, is considered something of a higher dose (according to my endo, anything over 100mcg is, but it's very dependent on an individual), so I'd be curious what your most recent TSH and T4 (and even your T3, if you have it) read. You might need a higher dose, but if you truly had a higher dose before, perhaps that isn't a good bet, and a change in drugs would be in order. Otherwise, again... those pesky adrenals can cause trouble, and often have incredibly similar symptoms to hypothyroidism, which is why many people never even realize they have cortisol issues.

^^^ This.

The thyroid produces two hormones - T4 and T3. T4 is basically inactive and acts more like a "storage" hormone; your body then converts it into T3. T3 is the "active" thyroid hormone that is like the key in the ignition for your cells.

Having no thyroid at all already puts you behind in T3 levels; plus many people post-surgery have issues converting T4 into T3, putting you even further behind. Unfortunately the go-to med for all hypothyroid issues is current a synthetic T4 like Synthroid or Levothyroxine. There are two problems with this:
1. If your body is struggling to convert the T4 you won't have sufficient T3 levels.
2. If your T4 is too high your body needs to get rid of it, and starts converting more into Reverse T3. RT3 fits into the same receptors as T3 but doesn't do anything, and blocks T3 from doing its job, making you ever more hypo.


Over 99% of T3 and T4 is bound to carrier proteins, that move it about your body. When protein-bound these hormones are biologically inactive - therefore when you ask for labs you need to ensure they test the "free" hormone levels (just the unbound amount that is available for use).

You need to ensure that your doctor is testing both free T3 and free T4; TSH becomes immaterial once you're supplementing with thyroid meds because it interupts the feedback loop between your blood levels of thyroid hormone and your pituitary (source of TSH).


You don't just want your free T3/T4 "within normal range", you want those levels OPTIMAL. Optimal free T3 is in the top 1/3 of the range (or higher, there is evidence that the top of the range is too low). Free T4 should optimally be about mid-range.


Meds: I can pretty much guarantee that if you're symptomatic and on a T4-only med that your free T3 is too low. You have two options to increase your free T3:
1. Add in a synthetic T3 like Cytomel.
2. Switch to a natural dessicated med like Armour or Nature Thyroid, that contains both T3 and T4 (and T2, T1, calcitonin etc). I know people who have tried both options, and all feel INFITINTELY better on the dessicated meds.


I would also encourage you to get your Vit D levels tested, as Vit D is required for the T3 to act on your cells. You want the levels optimally at 60-80, not just "within normal range" (30+).


(Me: hyperthyroid for 20+ years, thyroidectomy Oct 2012)

I had 1/2 of mine removed 4 1/2 years ago. I gained 20lbs in about 6 weeks. Since then I have struggled to lose the weight. My endocrinologist and my pcp consistently tell me my levels are good and the dose of levothyroxine I take is correct. It wasn't until the last 8-10 months that I've lost any weight and it was all due to busting my butt in the gym and tracking my calories. I can't attribute it to anything else, since that is the only thing that's changed for me.

It's hard...

Thank you for all the help and support everyone! Yes I do agree that 112 is low since I had both sides removed.

I was previously on 125 but the doctor told me that meant I was too high and that I could eventually feel symptoms of hyperthyroidism so they dropped me to 112.

I will go get tested again and see what changes can be made

I can pretty much guarantee that your free T4 was too high but your free T3 was too low. Were you getting the jitters, a racing heart, high BP? Ya, I got all that with T4-only meds, and it is definitely NOT like hyperthyroid (which I had for 20 years before my thyroidectomy).

Go get your free T3 and free T4 tested. Your free T3 should be in the top 1/3 of the range; if it's anywhere near the bottom you need different med.