under-active thyroid and weight gain

I am hypo too, and it is extremely hard. My recommendation is when you get the test results back that you set up an appointment with your doctor to go over it. I've been researching and trying to further explain my symptoms and why they haven't gone away. I now believe it to be because I'm on the wrong thyroid medication.

Ask the doctor to explain how the TSH is determined, and if it's a combination of both T3 and T4, and ALWAYS, EVERY single time, request to check BOTH T3 and T4. Many doctors will tell you that you do not need the T4/T3 test, but be persistent. TSH does not always show everything (and vice versa). It may contain more information than just the TSH test.

Also, one of the most important things is this: Do not. I repeat, do NOT let the doctors tell you that you are fine even if the levels are in the "normal" range if you do not feel fine. Really...this is the most important thing to remember, YOU want to feel good and you are more than a "range" on paper. You're a person and deserve to feel like one again. I have been having issues with my thyroid for almost 2 years, and my doctor and I are still trying to figure out what works (and hopefully will be switching medication soon). A good doctor NEVER gives up, and never listens to the ranges. It's all about how the person feels.

I ended up having to switch doctors when I was first diagnoised because she was trying to "mask" the symptoms and not really treat them or wouldn't listen to me.

Me: I want a T4 test
Doctor: You don't need that. Most insurances don't pay for it.
Me: Do it anyway. (thinking: this is the last time I'm visiting you...)

End result: T4 test. And fyi, most insurances DO pay for it.

When I'm properly medicated, I'm able to lose weight like normal. I'm on Armour thyroid, if you're looking for a recommendation on meds. You can Google other desiccated thyroid meds as well. But here is a link to an About.com article on why some people do better on desiccated than on synthetic thyroxine. http://thyroid.about.com/b/2009/01/27/the-desiccated-thyroid-controversy-why-endocrinologists-dont-like-armour-thyroid.htm

Otherwise, be sure that you're counting all of your calories (even when you're way over) and logging all of your exercise. In the past I've found that weight easily creeps up on me when I'm at the upper end of my healthy weight and what my meds can do. It isn't difficult for me to gain enough weight to make my thyroid meds ineffective.

True story. I have heard good things about Armour. Really discuss with your doctor about what medication is right for you. Levothyroxine is so commonly (and wrongly) prescribed that it's an automatic go-to for hypothyroidism.

Wish I could take you with me to my doctor. She just won't listen to me. The fact that I gain weight just by looking at a delicious-looking piece of chocolate mousse cake doesn't bother me as much as the constant fatigue and sensitivity to cold. Even if the temperature is 74 degrees, I have to put on a jacket because I feel cold.

Early last year I was on levothyroxine and managed to convince the doctor to at least switch me to the brand name drug, Synthroid. Well now Synthroid doesn't seem to be effective, but because blood tests keep showing numbers "within normal range" the doctor keeps telling me I should just increase my exercise. I do a minimum of 40 minutes four (4) times a week and keep track of everything I eat on MFP. The scale has not budged in 2 1/2 months! Where can I find a good internist who will work with me?

Mary Shomon is a great thyroid advocate and a wealth of knowledge. She has a couple of books and is at about.com/thyroid. She has a newsletter too and there is a community of message boards there as well.

Different labs use different numbers to determine hypo. Ranges from 3-5. Important to know by which standard you're being measured. Free T3 and Free T4 are crucial. Your body is supposed to convert T4 into T3. Mine doesn't. I take a T3 supplement as well and that made the difference for me.

I am not on Armour, but have known many people who have flourished on it.

It takes a lot of time and patience to figure out what works best for your body. Don't hesitate to be your own advocate and to change docs if one won't listen.

Wish I could take you with me to my doctor. She just won't listen to me. The fact that I gain weight just by looking at a delicious-looking piece of chocolate mousse cake doesn't bother me as much as the constant fatigue and sensitivity to cold. Even if the temperature is 74 degrees, I have to put on a jacket because I feel cold.

Early last year I was on levothyroxine and managed to convince the doctor to at least switch me to the brand name drug, Synthroid. Well now Synthroid doesn't seem to be effective, but because blood tests keep showing numbers "within normal range" the doctor keeps telling me I should just increase my exercise. I do a minimum of 40 minutes four (4) times a week and keep track of everything I eat on MFP. The scale has not budged in 2 1/2 months! Where can I find a good internist who will work with me?

Oh, I so sympathize with you. Those were my two biggest hypo symptoms -- the fatigue and being cold ALL the time. I even had a space heater next to me at work and literally always had my merino hoodie/cardigan on. I can't tell you how much better I feel now getting the proper medication -- and my doctor looked far beyond just thyroid issues. He checked adrenal issues, certain key vitamin deficiencies (magnesium, vitamin D, iodine, etc.), glucose metabolism issues, liver issues, etc. I had some and were fine on the others -- for me, I had severe deficiencies in vitamin D and magnesium along with a sugar issue (insulin resistance that was so high as to be considered pre-diabetic!).

We got all that sorted out, along with the thyroid, and I feel so, so much better. My whole idea of "normal" has completely shifted. It feels amazing not to be cold all the time, or randomly fatigued or not sleep well (previous to treatment I don't think I ever slept an entire night through -- always woke up at least once, often several times). Not to mention to finally be losing weight like a normal person!

I specifically started looking for docs from other thyroid folks in my area. I personally found stopthethyroidmadness.org immensely helpful, and as silly as it sounds, yelp. There were a lot of reviews about docs in my area on yelp (I live in the SF bay area, so it may be more popular here) and searched for thyroid and metabolism specialists. I also looked at functional medicine recommendations as I found the MDs or endos that looked at problems in a more holistic or functional way, tended to look beyond just TSH and lab levels to the overall situation of both thyroid and other interactions.

I ended up finding someone out of state that specializes in what I was looking for. I still have my primary care physician and she's been looped in to my treatment, but she's one of the ones that said I was "within range" last year. It's been quite an experience watching her learn so much more through this process -- and I give her major props to being open to it instead of getting into a pissing match over which doctor was right. And, as she said, hey, the proof is in the pudding in how you're feeling, the weight you're losing and your lab tests.

Sadly, the treatment has been expensive since I pay out of pocket for the consults and then later submit to my insurance, who only covers part of the expense. But, they have been covering the lab tests and medication (which has been actually very affordable). But, even the $1500 or so I've spent on the first three consults have been worth EVERY penny as I'd gone to 4 different doctors before this over the last 10 years and they didn't check for most of the things this current doc checked and corrected -- not only the thyroid (he was the first to even check for antibodies!), but also the insulin resistance and vitamin D deficiency (which I now know is a pretty big thing in this whole picture). If you want his name (he does consult out of state), PM me.

Thank you for the info. My local hospital's lab has the range anything under 5. It helps to validate the the way I'm feeling is not nuts! The 2 family members that I have with thyroid conditions were at a point much worse than I am when theirs was finally looked into. I believe both of theirs were in the 'teens when it was caught. My Mom said hers was at a really bad point and it took them a long time to even question Hashimotos. My sister has other contributing factors - PCOS and Type 2 Diabetes but they didn't even check hers until her levels were much higher. I know thyroid can contribute to both and as of right now my sugar levels are fine. I think I'm definitely going to see an endocrinologist next then and ask for those tests.

Finding it very difficult to work against the above and not being able to exercise due to being disabled. Wish I could find something to speed my metabolism up. Go to see the Doc next Monday for a check on my bloods, still very depressing when most days I am under my cal intake!!!

Getting medication right is the first step. I have found that exercise is key for being able to lose with this condition. Are there any exercises you can do? Even some arm exercises or just walking can help.

Hey I am a 21 year old female and I have an under active thyroid and I am Hypoglycemic, on top of all that I am 181 and I can't loose weight which is making my asthma worse. I have not got my thyroid checked since last time I got checked my levels were normal. Need help please I can't do this on my own.

You have the first part down by getting your medication correct and your numbers where they should be. It is very import for you to check your macros and have a good balance of carbs to protein to fat at each meal and snack and to have a regular eating schedule. ( I use 45%/ 25% /30%.) This will keep your blood sugar more level. Also avoid processed carbs and sugar that enter the blood stream too fast. For weight loss I have found exercise to be my only hope. If I don't exercise at least 3 hours a week, I do not lose weight no matter what else I do.

Thank you so much for the info. I previously never associated low Vitamin D, magnesium or sleep problems with my thyroid problem. Years ago while I was still working back in New York, my then internist had recommended supplements of Vitamin D and Iron. At that time I did not continue on Iron because it constipated me, but I felt pretty good without it taking the other stuff. I also did not have the cold sensitivity then but I did find it hard to lose weight, even on thyroid med.

I now live in Georgia. The temperature presently is 84 outside and 76 in my family room, but I am sitting at the computer feeling cold. I am also getting progressively more upset at my doctor as I remember that she had me go for an in-depth ultrasound of my liver and abdomen to clear up something that didn't "look right" on a previous workup. This was three (3) weeks ago, and I still don't know the results! I can almost never get through by phone and when I do get them and get an appointment, I wait for up to 3 hours before she sees me. And she never has current results, I have to bring up the tests and she has to go out again and ask the staff to look up and print out the tests. I really should get a new doctor.

Thanks again. I am going to try your leads.

This is probably a dumb question, but I have a ton of possibly-thyroid-related symptoms and I think my GP just thinks I'm some kind of whiny woman. I pretty much just feel "off," which is hard to explain to most doctors. Can I just make an appointment with an endocrinologist, walk in and ask them to test my levels?

Yes. The issue will be your cost. Depending on your insurance, you may require a referral. If you have a PPO, you usually don't need one but the cost will vary whether they're an in-network or out-of-network provider. And, if you're willing to pay out of pocket (and hope to be reimbursed -- which is what I did), then you can go anywhere to anyone.

I'd just really stress setting up an appointment with someone that looks beyond the tests. Someone that listens to symptoms and not just blood test ranges. Not all endos are created equal -- some are very old school and just as dismissive. I was dismissed by 3 of my 4 former docs (2 were endos) over the years (1 doc was very receptive, just didn't know much about thyroid issues -- and I didn't either at the time so just took his word for it that everything was "fine" based on just my TSH level). Also be sure to speak with someone that looks to find your optimal range not just get you "within range". I found this makes a HUGE difference as I still had many symptoms when I was just below the range or on the lower end of it -- when I was brought up to the top third of the range, I improved 1000X.

Also, if you want, you can even get the blood tests done yourself. You can get them done at both Quest Diagnostics and MyMedLab, among likely others. You've just got to pay out of pocket -- then submit to your insurance and hope for reimbursement. You really want to get as a bare minimum, TSH, Free T3, Freet T4 and both antibodies tests.

Here are some good sources on the tests that I found helpful:
http://www.stopthethyroidmadness.com/recommended-labwork/
http://www.stopthethyroidmadness.com/recommended-labwork/

Hey I am a 21 year old female and I have an under active thyroid and I am Hypoglycemic, on top of all that I am 181 and I can't loose weight which is making my asthma worse. I have not got my thyroid checked since last time I got checked my levels were normal. Need help please I can't do this on my own.

You have the first part down by getting your medication correct and your numbers where they should be. It is very import for you to check your macros and have a good balance of carbs to protein to fat at each meal and snack and to have a regular eating schedule. ( I use 45%/ 25% /30%.) This will keep your blood sugar more level. Also avoid processed carbs and sugar that enter the blood stream too fast. For weight loss I have found exercise to be my only hope. If I don't exercise at least 3 hours a week, I do not lose weight no matter what else I do.

Where did you learn about the macro value? I'd never heard that for thyroid. I limit my carbs for my insulin resistance and make sure I get sufficient protein to maintain as much lean body mass in caloric deficit, but I'd never heard of a macro balance for thyroid. Mine is autoimmune in nature so I avoid gluten to avoid triggers affecting my thyroid (I know gluten affects me, though dairy seems to be fine). As a result, I eat primally and it hits all my points for me (a less restrictive version of paleo where I can include dairy) but I don't follow a meal or daily macro close to what you're suggesting. I tend to have 15% carbs, 30% protein and 55% fat and that seems to work great for me.

Mine is just trial and error. If I go under 45% carbs, I have no energy. I have read tons of different articles though that say to keep blood sugar stable you need to eat balanced macros each meal or at least try to. Everyone is different as far as what macros work for them.

For purposes of diagnosis, TSH levels don't vary by lab. I know one of the other posters said that, but I believe it's incorrect -- at least for diagnostic purposes. It's that the old reference ranged used by labs was 5.0 (and still is for most labs). However, the the American Association of Clinical Endocrinologists lowered the diagnostic value to 3.0 because they noticed that in the old reference range of 5.0 many in the upper range of that old reference range had hypothyroidism, so the results of the reference range was skewed. That's why they changed the upper level to 3.0 (and may change them to 2.5 -- there is talk of this being the appropriate level).

Unfortunately, the AACE recommendation is just that--a recommendation, not a mandate (and it was not a unanimous agreement to lower the recommended standards from 5 to 3). Labs still use other standards--Kaiser Permanente uses 4 (my health provider). This is a hotly contested topic (by people who treat and don't usually suffer from this disease) with some docs saying no treatment is necessary until you hit 10 or higher. It's important that your doc consider your quality of life and even more important for you to be your own advocate in your care. Go the the AACE website and print off the article summary about the change in recommendations and talk about your continuing symptoms as a reason to have your doc look at a change in meds.

Luckily my doc goes by a range of numbers as well as how I'm feeling in deciding medication levels. Hang in there and do some online research, you'll find some great info to help you get your point across.

MFP has a Hypothyroidism and Hyperthyroidism group: http://www.myfitnesspal.com/forums/show/770-hypothyroidism-and-hyperthyroidism

I have Hashimoto's (autoimmune thyroid disease) and lost weight more slowly than most, so be patient! But I did it just like everybody else—by eating at a deficit. Read this: http://www.myfitnesspal.com/topics/show/1080242-a-guide-to-get-you-started-on-your-path-to-sexypants