Disillusioned
I have a low thyroid for many years. It was very low and this is 3 weeks with the new medication. I regained 40 pounds due to this. Very unhappy about that. I’ve counted calories and in 3 weeks have lost under 1 pound. I walk for exercise but have foot issues so it’s slow walking. Anyone else with thyroid that is low and feel hopeless?
Replies
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Having too low thyroid hormones makes you tired and exhausted, you might move less and even fidget less, and all those things decrease your calorie needs a bit. You might also be more hungry and even if you say you eat the same as ever there's any chance that the servings are bigger. Also: water retention. Many doctors are so bad at managing thyroid problems: "your bloods look (just about) fine, thus if you still feel miserable then I don't know how to help you" There's no reason to feel miserable with an underactive thyroid. But one needs a doctor that listens.
1 lbs of weightloss is a fab start though. Keep it up. If you can't walk then don't walk. Log your food carefully and chose correct database entries. Weightloss is totally possible. Heck I lost most of my weight while being totally unmedicated with hashimoto, and there are more people here. It's all about managing food intake.5 -
also an under active thyroid here.. meds are cumulative .. I was told it takes a few weeks to regulate. Now that you are on meds.. hopefully you should start feeling better. If not, I would ask the dr to check levels.
For me- I was advised to also support thyroid with diet including additional iron, D, selenium, zinc. some people with under active thyroids can be deficient. Hopefully your doc checked those levels out.0 -
It is also possible you need a higher dose of thyroid medicine. It took a couple of years to get mine right since they start low and increase if needed. I get it checked every year and the dose is increased from time to time. My original GP prescribed meds and told me to come back in a year. I knew that was wrong, so I found a different doctor who would see me every 3 months until we got the right amount.
That said, you can still lose weight. Just understand that your body needs fewer calories than the average woman your size, at least for now. Take whatever number MFP gives you and reduce your intake by 250 calories. Also be very careful to weigh or measure every bite you take. A lot of people say they aren't losing weight and it turns out they are not logging every bite or they are eyeballing amounts instead of measuring carefully. It makes a difference.
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My thyroid is severely low, but fully medicated. Others are correct, it takes time to get to the right dose, because doctors start us at a low dose. Why? Because a too-high dose is dangerous, and different people respond differently to the medications, so there's no formula to predict what dosage a person needs. It doesn't kick in instantly, it takes time. So the normal process is to start with a low dose - which typically will have some benefits - give the medication a number of weeks/months to take effect, test again, adjust further if necessary.
There is a good thread here about hypothyroidism, much more scientifically-based than most of the nonsense on the internet (much of which is trying to sell us something). It was written by a guy who is a scientist in the field, himself hypothyroid (thyroid gland surgically removed, IIRC), and who lost weight by calorie counting. I recommend it. It's here:
This next part may seem mean, but that's not where I'm coming from. I want you to succeed with weight loss, because losing/maintaining has been a huge quality of life improvement for me. I want that for everyone, you included. To get there does require some patience, persistence, and commitment. It probably requires being clear-eyed about facts, some of which aren't really what any of us want to hear. I understand why you're discouraged and feel hopeless: I was overweight/obese for around 30 years. I was severely hypothyroid, aging, menopausal - all things that are claimed to be weight loss doom . . . but aren't.
Yes, being hypothyroid is a challenge, maybe a speed bump, something that makes the process more difficult. It doesn't make the process impossible. You can succeed, if you commit, and stick with it.
Some facts:
You mention gaining 40 pounds over - if I read you right - "many years". Eating a mere 100 calories over maintenance-calorie needs would be estimated to add 10 pounds in a year. Gaining 40 in just one year would only imply eating around 400 calories over maintenance daily on average. That's like one medium mocha latte from McDonald's worth of calories, or an extra-big dollop of creamy salad dressing, or a peanut butter sandwich on hearty bread . . . not all of those things, just one. It's also "on average". Eating moderately most of the time, but going out once a week for an indulgent meal with drinks, rich appetizer, dessert can also do that. It's pretty easy to eat that much more without even realizing.
In addition, if there's any reason a person moves less, that can be part of the issue. We've had people here who couldn't understand why they gained weight, because they were eating and exercising like always . . . and it turned out that they'd moved from a big multi-level house/yard/garden with lots of chores to a one-story condo, or gotten a desk job instead of an on-their-feet job, or gotten a car so drive door-to-door for work instead of walking a few blocks to the bus or subway at either end. It doesn't take much to gain. It can be subtle.
Yes, a thyroid condition can contribute to that gain through fatigue, water retention, and slightly lower metabolism. But the effect from the thyroid condition isn't huge.
Second, a pound in 3 weeks isn't to be sneered at, but it's also not definitive. It takes 4-6 weeks to get a fairly clear idea of the effect of a new eating routine, or one full menstrual period for those who have them (to compare body weight at the same relative point in at least 2 different cycles).
It's not the common case, but some women here have reported only seeing a new low weight once a month at a certain point in their cycle. Until you go through a cycle or two, you won't know your patterns. If no cycles, the 4-6 weeks' average will usually tell the story. Changing eating style - plus starting new medications - affects water retention in weird ways, so can distort the results at first.
If you stick with your current routine long enough - that 4-6 weeks or one cycle - you'll have enough data to average, and get a personalized estimate of your actual calorie needs. You can use that to fine-tune your calorie goal if necessary, and see more predictable results going forward. (Add calories eaten over that time to pounds lost times 3500, divide by the number of days; subtract 500 calories per day per pound of weight it's sensible for you to try to lose weekly, and use arithmetic for fractional pounds.)
It takes patience to hang in there and get that personalized estimate, but it's powerfully helpful for moving forward successfully, IME. (For myself, I needed to make a significant adjustment based on experience, but my body weight has been very predictable since, looked at as a multi-week moving average).
Final fact: Yes, untreated or under-treated hypothyroidism can make loss harder. A little harder. Most everyone here has factors that make weight loss hard in one way or another: Things like hypothyroidism, mobility limitations, food-pusher family members, needing to eat food prepared by others all the time, aging, menopause, etc.
What differs - what determines success or not with weight management goals - is mainly whether they see those things as complete roadblocks and give up, or recognize that those things are factors that they can overcome. Personally, I think the only reason to think about those factors is to figure out how to get over, around, through or otherwise past them. Thinking of them as insurmountable is what makes them insurmountable.
You can do this. You can do this without exercise, purely on the eating side. As you get your thyroid meds tuned in, it'll get a little easier maybe, but honestly only a little. Sticking with it, determining your personalized calorie needs, figuring out how to stay mostly full and happy at your calorie goal . . . that patience and persistence is the necessary thing.
Hang in there. This can work. It'll be worth it. Don't make your plan - eating rules and such - any more difficult than it absolutely needs to be. Yes, it will be a bit of a test, but success will feel really empowering.
I'm cheering for you to succeed: Keep going.
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week 4 or 5 on new dose . I’ve had low thyroid for many years the weight gain is in the past year. Yeah still disappointed disillusioned and no loss. They will retest on a month
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She doesn't necessarily need fewer calories than other women her size. She just needs to make sure she sets her activity level correctly, logs her food accurately, and takes a look after 4-6 weeks to figure out if she needs an adjustment. Hypothyroidism tend to make us tired and less active so we burn fewer calories than we did before, but our bodies do not need fewer base calories to function.
My thyroid levels have been ALL over the place. When I was over medicated I did have more energy, and I was more easily motivated to move or workout. When I am under medicated, I'm like a slug and have to set my activity level to sedentary. When I am in the sweet spot 1-2 for me, I am predictably somewhere in between. Regardless of the issue, I was able to lose when I set the proper activity level, and logged my food and exercise accurately. It is very easy to over estimate exercise and under estimate intake.
Is it easy, no. Weight loss is rarely "easy", and when I don't log I gain. When I'm honest with myself, and put the effort in, I lose.
Best of luck!
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I think 4-5 weeks is maybe still a little early to see the effect of increased dosage. On top of that, is there certainty that a next dosage adjustment will be the final one needed?
But - and I hate to say it - if you've been at the same calorie intake, carefully logged every day, for 4-6 weeks or one full menstrual cycle, it may be necessary to cut a few more calories. If you haven't logged every bite, lick, taste, beverage, condiment, including cheat meal/day or oopsies, it may be more important to tighten up the logging and stick at the calorie level where you are for a while longer. Knowing our actual personal calorie needs is a powerful tool in the toolbox.
I'm sympathetic about the thyroid situation and slow-ish loss. Weight loss has challenges for most people though - it's just that the nature of the challenges differs. I feel like what matters is whether folks stick with the process, and make solid evidence-based decisions about how to proceed.
I feel like two of the commonest sources of failure to reach weight goals that I've seen here are giving up from discouragement when the first set of tactics don't give big results after a small number of weeks, or quickly over-reacting to minor and temporary waste/water retention distortions on the scale by cutting-cutting-cutting dramatically after any uptick/stall until the whole regimen becomes impossibly hard so they give up. At root, those are both things more on the psychological side of it than the physical side.
You can do this. Your meds will be adjusted, which may help. What's more important, though, is to recognize that this takes time and patience, and doggedly persist with sensible effort. Believe me, I understand that that isn't always easy.
Best wishes!
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just wanted to clarify - I am on thyroid meds… diet was secondary support.
Per my doc- it’s 4-6 weeks to see full benefits of thyroid dosing. If you still feel like a slug- I would follow up with doctor.
(hypothyroidism also creates more salt and water retention.. it was helpful for me to go less starches and sodium to hold less water )
Many people have thyroid issues and can lose weight effectively, I would also check that your weighing all food and accurately counting each calorie. I don’t know your calorie goals- but it’s all about deficit - even with thyroid issues..ps that’s .03 lbs weight loss per week which is not bad… if you cut x number additional cals.. see what the sweet spot is.
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Im sure other people have mentioned, have you considered biking or swimming as a form of cardio other than walking…. Im not a cardio but do love to walk and bike…. just ma 2cents… But you got this, we are all behind you 👊
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60+ male, and I'm on thyroid meds, too. I thought the process of finding the right dose went on way too long. I started at 25MCG/day and now I'm at 100MCG/day, which is maintaining my TSH in the acceptable zone. Getting to my current dose took at least 2 years. I was often tired and I gained weight.
My advice: if you feel tired and cold at a particular dose after a month or two, go get the blood test. Don't wait any longer than that. Doctors are busy, so it's up to you to push the issue and get to the right dose.
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Yes with menopause and thyroid, it's a challenge to lose weight even following my calories and exercise. I'm on a very low dose of Levothyroxine for a few years, but it is still hard to lose. I want to ask for a higher dose, but my blood work came out good, so they probably wouldn't. I just have to keep going day by day and stay consistent.
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If you have the feeling that your meds are not spot on then ask for a trial with an increase. You won't drop dead. It's totally possible to feel totally normal with being hypo or having hashimoto. And that should be the aim of the treatment. Also get print-outs of all blood tests and check whether they are just about good, just about not good, or really good. (or use a patient portal if this exists)
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Getting the right dose can be a challenge and takes time. It's definitely important to get regular blood tests to see where you fall in the normal range while figuring it out.
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For those already at a dose that produces normal TSH but feeling like treatment doesn't bring you to feeling normal: Depending on where you fall in the normal range, have you asked, even requested a try at a higher dose? Has not just TSH, but T3/T4 conversion been assessed?
If OP is titrating dosage upward, I understand that that does need to progress gradually with retesting along the way, so this comment may not apply to OP. Also from discussions with friends, the side effects of too high a dose can be quite severe and frightening - heart palpitations, anxiety, etc.
Reason I'm asking: I've been hypo for about 24 years. Early on, we - PCP and I - learned that I feel most like myself when way, way in the basement of the normal range, sometimes even just a touch below the lower end. I've never had hyperthyroid symptoms that would indicate being over-medicated.
My original PCP retired, and I have a new one. Both were focused on treating me, not a number on a test. Along the way, I've asked for levothyroxine dosing changes, even asking to reduce the dose at one point to see whether I could sustain feeling good on a slightly lower dose. It wasn't great subjectively, even though I was still in the normal range on that lower dose. I was put back at the higher dose simply because I asked for it, and had had no negative effects from higher doses.
At another point, we had a discussion because I did need a dose increase, but the next jump was a big one. After trying the lower end of that gap, I asked - no prompting from PCP - if it would be an option to combine two lower-dose pills daily to reach an intermediate total dose by taking 2 pills. They wrote me scripts for both, no problem (not even with insurance payments) and I took 2 pills (137+25mcg) for quite a long time. I'm now at 175mcg, back to one pill.
For clarity: I do notice some effect on calorie needs when under-medicated compared to my personal normal, but it's not a huge effect. What has led me to ask for retests or even for a higher dose is feeling draggy, sluggish, more brain-foggy than usual. My doctors have been receptive. I suspect that it's the sluggishness and NEAT reduction that accounts for the calorie needs effect, in my case.
I know some doctors aren't open to these discussions. (If mine weren't, I'd be looking for a new doctor.) But I also know, from speaking with friends, that some people are uncomfortable being assertive with their doctor, more inclined just to roll with what the doctor initially says to avoid controversy. I'm assertive, but polite, and my doctors have been open, receptive, responsive.
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Yeah, this!
I feel best if my TSH is below 1. In the past, earlier on in hashimoto I had a few hypers every now and then. For me, it manifested with the urge to clean my flat. Basically, I was just not able to sit around; I had to do something and for some reason that resulted in urgent cleaning. Shame I've not had one of those in ages because my flat would look so much better. Even with a very low TSH I sleep well, fall well asleep and am rested in the morning. My heartrate is not elevated, am able to concentrate on my work and am able to exercise. My gp thinks that's a good sign and he's happy with me being on this dosage at the moment and not at one where TSH would be.. say 3 or so.1 -
My TSH is just under 1, but I'm still cold all the time. Please sir, can I have some more? No you can't!
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As discussed elsewhere, that being-cold effect can be triggered by a history of relatively fast weight loss, or repeat weight loss, or by certain other health conditions, even in people with normal thyroid levels. I know you know that, but part of my reason for mentioning it here is that it's IMO always a good thing to consider whether the effects we attribute to hypothyroidism are really caused by the hypothyroidism. Bodies are complicated, and sometimes weird. 😆
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See, I can't stand being on the low end of TSH. Right now I'm at nearly 7, which is pretty far above the high end and my PCP wants me to take more levo and I'm not down with that. I finally feel like a human. Sleeping, eating 2000 calories a day, not feeling like the boogie man is breathing down my neck.
When I'm at 3 or below I have to eat massive amounts of food to maintain my weight, like 3000 calories a day, plus I can't sleep more than five hours at a time, and I'm so anxious I can barely talk to people. It's a battle for dosing though. They all go by the 0.5-2.5 standard numbers for "normal" TSH using levo. I've been through multiple PCPs lately due to location and retirements (theirs not mine) and none of them want me to be this high. I'm forcing it. If I have to I'll dose myself or just stop. Yes I know that's not smart. I'm tired of this battle though. 40 years I've been on it.
When I broke my femur that was the last straw. High doses of levothyroxine are bad for bones, full stop. I've had several broken bones in the last ten years even when I've been exercising regularly that whole time - and been at 1-3 TSH. Sure, I'm a menopausal woman, but I shouldn't have broken my femur just due to a walking fall. I'm now in full-on fight mode with my doctor about this. Not sure how it's gonna end.
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Honestly, I'm both not surprised to hear that, and am sympathetic. At either end of the so-called normal scale, the individual and even subjective side of it ought to matter IMO.
In my PP, I mentioned asking to reduce my dose at one point. I did that as a trial because of the bone-strength implications of higher doses. I'd still theoretically like to be taking a lower dose, but it doesn't work out well for me in practice.
Increasing dose solely to foster weight loss isn't IMO a great idea. Lots of factors create weight loss challenges. It's easy to assume hypothyroidism is causing slow loss, probably even in some cases where the main cause is elsewhere.
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Without even asking Mr. Google (or Ms. ChatGPT) I'm going to bet that TSH is not the final word on whether your levo dose is correct.
Actually, here's what Ms. ChatGPT has to say about it [edited]
"No, TSH (thyroid-stimulating hormone) is not a definitive measure of thyroid function, though it is often used as a primary screening tool.
It goes on to talk about also measuring "free T3" and "free T4" and, sometimes, "Reverse T3," and thyroid antibodies.
Bottom line:
TSH is important, but should not be the sole test—especially if symptoms don’t match the TSH result. Comprehensive thyroid panels and symptom tracking give a fuller picture.
Well, then! 😐️
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