Low thyroid function may be a factor in weight gain despite ‘normal’ tests
Posted on 4 April 2008
When I was studying medicine I was even more cynical than I am now and so, I think, were quite a few of my friends. We had all established firmly in our minds the notion that eating few calories than the body
Published April 4, 2008 . Filed under: Weight Loss
I was on 150 mcg Thyroxine for a few years and not being sent for regular blood tests. Recently I WAS called in for a Thyroid blood test and the GP was concerned to find my T4 was 28.
I have just had a further blood test, prior to, as I understand, a prescription for lower dose of Thyroxine.
Vivienne.
April 4, 2008 @ 7:34 am
Very interesting reading. I once saw a nutritionist who suspected my thyroid was causing weight gain and she had me check my underarm body temperature every morning before rising. My temperature was coming out at between 35 and 36 degrees C and she said this indicated slow thyroid function. What do you think of this test?
April 4, 2008 @ 8:36 am
I first displayed signs of hypothyroidism as a teenager. I had test after test, and all the levels of T3 and T4 were low (so I was told).
But, no doctor or specialist would prescribe thyroxine, giving one reason after another for their decision.
My levels were very low after my second child was born and I went to see a specialist who I was told would look at this sympathetically, but she just said “Well, you have children don’t you? So it can’t be that low” – even with the results!
I eventually was prescribed thyroxine at the age of 39. I got the results in my hand (it was private healthcare abroad) and the TSH was pretty high.
All of this was because my cholesterol levels were dreadful (yes, triglycerides again) and they wouldn’t respond to statins (thankfully).
So my GP there started me on thyroxine and I actually need 150 mcg per day.
Blood sugars and triglycerides were improved (along with a low-carb diet) and I no longer felt that I had to run very fast just to stay still, in terms of weight.
I think that doctors are/were reluctant to treat patients with obvious hypothyroidism for a number of reasons.
Levels may improve on their own.
Patients will get free prescriptions.
Most are women and are looking for an excuse to blame their weight gain (or lack of weight loss)on something else (just lazy/lying).
Not all hypo symptoms are present. The same goes for many other conditions, but too many specialists/GPs think that people should display all the range of symptoms.
In my case, they said that it was ‘familial’ and that there was no point in treating me.
I do hope things are better nowadays. Especially after this week’s ‘Casenotes’ on Radio 4. A specialist stated that he thought that the children of untreated hypothyroid women were at risk of having low IQs (80) and that women who have hypothyroidism should be treated.
Again, there must be a large range of influences. My children don’t have low IQs, but I do wonder if this affected them.
I do hope that things will improve.
April 4, 2008 @ 9:07 am
Hi, I found this fascinating as I am having my thyroid levels checked every six months because I have high antibody levels. However, despite having all the symptoms of hypothyroidism my results have remained normal apart from antibody levels going up hugely every time. I’m finding it all a bit depressing!!
April 4, 2008 @ 11:04 am
Thank you Dr Briffa for highlighting the plight of ‘mild’ or ‘subclinical’ hypothyroids such as myself. Doctors specialising in this problem such as Dr Barry Durrant-Peatfield and Dr Gordon Skinner in the UK and Dr John C Lowe in the States believe that ‘subclinical’ hypothyroidism is massively underdiagnosed and undertreated. Furthermore, they say that its incidence is increasing fast and is likely to become just as much a major public health issue as heart disease and diabetes. They say that failure to recognise hypothyroidism is consigning large numbers of people unnecessarily to long term ill-health, in addition to wasting precious health service resources. For instance, they believe that untreated low thyroid is the real cause of many cases of depression and also of high cholesterol levels.
These doctors treat large numbers of us who continue to have weight problems and other symptoms on the traditional ‘replacement therapy’ (which consists of giving us synthetic T4 at a dose which must be ruled by the TSH blood tests rather than our clinical symptoms). Unfortunately, they must currently practise outside mainstream medicine, since the mainstream endocrinology fraternity still does not accept their views, despite mounting evidence in the literature.
For those new to the controversy surrounding the diagnosis and treatment of hypothyroidism, I recommend starting with the following hypothyroid sufferers’ support and information sites:
http://www.stopthethyroidmadness.com
http://www.tpa-uk.org.uk/
http://thyroid.about.com/od/hypothyroidismhashimotos/Hypothyroidism_Underactive_Thyroid_Hashimotos_Disease.htm
http://www.thyroiduk.org.uk/tuk/pages/articles/dholmes_polemics.pdf
And my own blog at http://gooddietgoodhealth.blogspot.com
Dr Briffa, I absolutely recommend you read Dr Peatfield’s book ‘Your Thyroid and How To Keep It Healthy’, and Dr Lowe’s paper on the treatment of hypothyroidism at
http://www.thyroidscience.com/Criticism/lowe.dec.2006/lowe.critique.T4.T4&T3.Studies.pdf. The latter is long and detailed, but explains everything that is wrong with the treatment of hypothyroidism or underactive thyroid today, and what needs to be done about it.
April 4, 2008 @ 1:29 pm
I was slim & in my early 30s when my thyroid ‘packed up’. Back then (early 80s) it took 3 weeks for tests to be processed. When the first test results came back, my GP thought they’d got it wrong as I was ‘too young’. So the process was repeated. The diagnosis/prognosis of a failing thryroid came back again. Weeks later after first presenting with the symptoms, I was put on thyroxin & levels were monitored; sure enough, it packed up completely within the year. (I consider myself lucky to have had such a good GP at the time) However, the weight did start going up for the first time in my life – despite having had 3 children. At one point in the 90s I was on 300 mcg but when I moved home, my new GP cut it to 150 & my weight shot up even further. Because of this, after a while, I increased it myself to 200mcg, which is what I am still on. – & periodic test results come back ‘normal’.
I have been unable to resume my original much lighter weight, so wonder if it would be advisable to increase it again to, maybe, 250mcg? Your comments would be welcomed.
April 4, 2008 @ 2:23 pm
Harriet: the endocrinologist who initially treated my hypothyroidism has theorized that approximately 80% of people with ‘clinical’ depression have underactive thryoids. My own experience of it was pretty miserable, including fatigue to the point where I couldn’t get through the day without a nap, and weight gain despite a net 900 calorie/day diet.
Dr. Briffa: Are there any natural remedies and/or supplements you would recommend if you suspect/know you have an underactive thryoid? I am currently on 137 mcg Synthroid daily but still feel a little physcially and mentally sluggish from time to time, even though my blood work is all within normal limits. I did manage to lose a lot of weight (also thanks to a low-carb diet and plenty of exercise), and my hair has stopped thinning as much. Thanks.
April 4, 2008 @ 2:23 pm
Excellent post! I’m one of those peri-menopausal women who probably has had undiagnosed mild hypothyroidism for more than 15 years, beginning with a sudden weight shift from chronically underweight to a few pounds overweight at age 29. In my 30s my weight crept up very slowly, and my energy level went down.
Despite numerous routine TSH tests (my lab uses an “outdated” reference range), years of infertility, and a long list of symptoms including obvious chronically low body temps, my GP insisted it wasn’t my thyroid because of the lab results. I got a copy of my 10 years of records with her and my TSH, while technically still in the “normal range” (the upper range has been controversial and that’s where my TSH was) had steadily increased incrementally for 10+ years, as did my cholesterol levels (same exact curve and time frame, when I graphed it).
When I switched doctors, the dose she gave me was much too low, though a couple symptoms improved (my temp raised, I perspired again, I slept better). The the new GP was happy with the new lab results and wouldn’t raise the dose, despite daily afternoon “crashes” in energy and mood. Instead she suggested an anti-depressant, which I decided not to take until I thought the hypothyroidism had truly been treated adequately.
I finally had to go outside my HMO system and pay out of pocket to see a doctor who specializes in hypothyroidism. It was worth evey inconvenience and penny! He prescribes the typical T4 prescription, but he also prescribes a compounded timed-release small dose of natural thyroid extract, to result in an approx 98% T4 / 2% ratio (natural thyroid extract from porcine sources, like Armour, is about 80% T4/20% T3, which is not a human physiological ratio). He also makes small seasonal dose adjustments, as the reduction in natural winter sunlight makes many patients require a bit more hormone. He listened to me and treated me like an intelligent person, not a hysterical (now I know how that word came to be), middle aged hypochondriac.
Every symptom has improved greatly and many symptoms have gone away. Some symptoms come have come back the last two autumns (he noted in my file that my calls about the some symptom increases were timed at nearly the same time in mid-September), so a slight dose increase takes care of them, then it is lowered again in the late spring. I also now make sure I get more outdoor light in the darker months (I live in So California, so that isn’t too hard, if I get outdoors enough).
I wish I could go back and do things differently with the knowledge I have now, but of course that isn’t possible. I did manage to have one child, with the help of a fertility drug to boost ovulation. We had wanted a larger family, but it wasn’t to be despite additional fertility drug atttempts. Now I wonder if thyroid treatment would have been a simpler, better way to restore my fertility and to avoid the ovulation stimulation drugs. I also worry that my son’s IQ might have been affected by my low thyroid function during pregnancy. His IQ seems to be in a normal general range, but it doesn’t seem anywhere near the generally high level on either side of our families.
Thanks very much for shining a needed light on this confusing and timely subject. While I don’t think that every weight problem is thyroid related (blood sugar and insulin abnormalities are also a big cause of weight gain), it is important to accurately assess the thyroid function treatment options, or at least make a decent attempt to rule it out (the full range of tests or a trial period on thyroid hormone). Even then, treating hypothyroidism isn’t a slam-dunk proposition. T4 supplementation alone is often not sufficient enough to resolve the many quality of life and health issues that hypothyroidism presents, yet it is the standard treatment protocol and patients are left stranded too often when some symptoms remain.
April 4, 2008 @ 5:51 pm
Could I point to the work done by Ray Peat on TSH (and on many other subjects)
http://raypeat.com/articles/articles/hypothyroidism.shtml
He is, to my eyes, very concerned about the harmful effects of polyunsaturated oils
April 4, 2008 @ 7:50 pm
Harriet says:
Hi, I found this fascinating as I am having my thyroid levels checked every six months because I have high antibody levels. However, despite having all the symptoms of hypothyroidism my results have remained normal apart from antibody levels going up hugely every time. I
April 5, 2008 @ 5:32 am
Another book to read is called Tears behind closed doors by Diana Holmes who suffered for over 20 years with hypo as her tsh was fine.
We need to educate our gp’s and Endocrinologists that they should listen to the patient as we are suffering with dreadful symptoms and not to just look at the tsh blood test result. This is for the diagnosis and management of hypothyroidism.
Also levothyroxine does not suit everyone, we would like to have the choice of natural thyroid but most GP’s are too afraid to prescribe it.
The worst thing is – GP’s and Endocrinologists tell us hypo patients that we need to lose weight!! and yet they want to lower our dose of medication, rather than increase it!!
April 5, 2008 @ 10:10 am
I had symptoms in my teens, and this go so much worse after giving birth, my first child is very intelligent, the second had problems at school.
Every symptom I reported, and I now know I have adrenal problems as well as hypothryroidism, were dismissed by my doctor or treated as something else. I battled with my weight for years.
I got so ill despite being treated on a very low dose (50mcg) of T4 for the past 7 or 8 years, although I have been ill for at least 30 years. My GPs wouldn’t change the dose as I was in the normal range, I saw an Endo who treated me for mild depression which made me much more depressed.
When I got signed off by the Endo I felt so ill I had trouble getting up in the mornings to go to work, my husband had to sit me up on the side of the bed or I couldn’t wake. My weight had ballooned to an all time high, I had trouble walking due to painful joints, terrible concentration and memory and my balance was awful, and was being offered water tablets, blood pressure tablets – not the answer and I felt I would be either dead or disabled if I didn’t do something. I went to see Dr Peatfield last August, and I am now on Armour and adrenal supplements and feeling much better although there is a long way to go. I can do a working day without sleeping through it, I can get up and go on my own, I have lost 10 kilos so far, my blood pressure is now fine, the water retention is nearly gone, I have far less joint pain.
I am paying for all of this, and my doctors aren’t too happy with what I am taking it seems. Just had a blood test which will be interesting but will only show TSH I am sure!
The more doctors who think like you do Dr Briffa the better, maybe the world will change for the better!
April 5, 2008 @ 2:09 pm
Source:
http://rense.com/general57/FLUR.HTM
The Effects Of Fluoride On
The Thyroid Gland
By Dr Barry Durrant-Peatfield MBBS LRCP MRCS
Medical Advisor to Thyroid UK
9-9-4
There is a daunting amount of research studies showing that the widely acclaimed benefits on fluoride dental health are more imagined than real. My main concern however, is the effect of sustained fluoride intake on general health. Again, there is a huge body of research literature on this subject, freely available and in the public domain.
But this body of work was not considered by the York Review when their remit was changed from
April 5, 2008 @ 9:41 pm
I have been taking thyroxine for 20+ years, and my gp adjusts the dose according to the ‘normal’ range – whereas I think how the patient feels is a consideration. I am now on 100mcg instead of 150mcg (which suited me better), and the feeling cold etc. symptoms have returned.
I also have autoimmune disease, and a raised IgG immunoglobulin, anti-DNA, smooth muscle antibodies, and anti-nuclear antibodies, and I think my thyroid problems are all related to these problems. If only I could find a gp to see me as a whole person and treat accordingly, and put down the wretched ‘normal’ figures for thyroid diseases.
April 5, 2008 @ 11:35 pm
I have an underactive thyroid and agree with Dr Briffa nd previous posts. I am also co-founder of http://www.dietfreedom.co.uk where we focus on eating a low GL diet. Our experience is that people who are hypothyroid find it difficult to metabolise carbs and a low GL / lower carb diet is the best option. With diet plus 50 mcg of thyroxine for the last 7 years I have managed to get back to my normal size 10 and stay there. I also have lots of energy now and am very active. In our experience a low body temperature is a good indication that your thyroid is not functioning properly and should be the first thing you do if you suspect you have a problem. Dr Andrew Wright in Bolton is a specialist in both thryoid and CFS and is excellent at diagnosing difficult cases. It is an area that desperately needs more funding and research but as it is not considered life threatening it seems to be way down the priority list despite causing so much distress and misery for so many. I also feel that it is linked to depression as untreated you feel very low indeed and do not have enough energy to exercise or take an active interest in life in general. After researching the subject when I originally suffered my GP said I knew more about it than he did! He also admitted that as their is a dire shortage of endocrinologists in the UK they cannot refer people even if they wanted to!
April 6, 2008 @ 12:19 am
Hello
I have been underactive for the past 10 years and proberly in my teens , when i had my blood test in 1998 my TSH was 58.7.
I am now on 200mgs of thyroxine and my last bloods My TSH was 0.03 i still get symptons and the worst is when i work it drain of energery that bad i have to take time off ,its a nightmere.
One question i would like to know is why i never put weight on even before i was diagnosed i thought that was a classic sympton of hypo and recently i have lost weight .
jason
April 6, 2008 @ 6:09 pm
Soy is the biggest enemy of the thyroid there is – Theodore Kay of the Kyoto University Faculty of Medicine noted in 1988 that ‘thyroid enlargement in rats and humans, especially children and women, fed with soybeans has been known for half a century’.
thyroid problems associated with soy were also well known to bird-breeders, Well known, but that fact seemed to escape manufacturers of the first commercially available soy formulas. Those formulas were known to cause in goitre in infants and one can only wonder how many other infants were left hypothyroid or suffering from permanent thyroid damage by soy formulas – For more info on soy and the thyroid check out this sity soy is not the great protein alternative to meat that the advertisers & meat haters think it is, it is a very dangerous toxic product.
http://www.soyonlineservice.co.nz/04thyroid.htm
April 7, 2008 @ 1:27 am
This is all so interesting but the subject is such a mind field that I just don’t know what to do.
For the last 10 years every GP I have seen has commented on the size of my neck and wanted to investigate the goitre at the base. They’ve only done the normal blood tests and one utlra sound and always come up with the ‘oh its just one of those things, nothing is wrong’ conclusions. But recently I have become really tired even though I fall asleep within 5 minutes of my head hitting the pillow, and I sleep for 9 hours sold every night. I’ve also developed excma (dry skin) on my calfs which I find slightly strange. My weight is a slight issue, I’m a little larger than I feel I should be based on the amount of excercise that I do and my general fitness, but I’m not obese.
But this whole thyroid thing is weighing on my mind. I recently registered with a new GP due to moving house, and he again wanted to do tests and of course they came back ‘normal’. I now don’t know whether just to leave it or ask for more tests – but I don’t know what tests! – they did a liver function and T3 and T4 tests. Any advice greatly appreciated.
Sophie
April 29, 2008 @ 8:11 pm
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May 8, 2008 @ 9:54 am
Ive suffered underative for 8yrs and ive had bad deppresion and have put on 9stone in weight and have no enagy at all my memorys so bad and i dont feel 37 at all,ive been to doctors with bad constepation and had weeks of being unable to go to toilat the doctors have not a clue thay told me iam not drinking lots of water if i did id proubably drown,now i take flaxseed works a treat,doctors have given me no advice at all.
May 16, 2008 @ 9:09 pm
I’ve been taking thyroid since I was 14, when I developed Hashimoto’s and had a thyroidectomy. Last year my dentist recommended applying a prescription-strength fluoride gel daily to strengthen my teeth. I now think that’s the cause of my 12-lb. weight gain in 9 months (!!!), despite exercise and a good diet. I’m usually not someone who gains weight so dramatically.
After reading that fluoride is a thyroid suppresent, no more fluoride gel or toothpaste for me!
August 23, 2008 @ 9:01 pm
I have been having my thyroid levels checked for the past year first they were 9.2 now they have gone down to 2.2
what causes this
February 23, 2009 @ 8:29 pm
I find all this really fascinating. I have been hypo since birth and thankfully as the last of three children my mother realised something wasn’t right – there wasn’t any screening as I was born in Peru as my family were moved there for I believe the last 6 months of my mum’s pregnancy. She believes we’ve all been blessed with good, strong teeth because of higher flouride levels out there but I’m wondering now if this is the reason for my thyroid problem?
I’ve been on thyroxine therefore since I was about 3 months old and more or less it has been stable. It was put up to 200mcg when I was on the Pill and when I was pregnant but generally has been 150mcg or 175mcg – the latter seems to be the ideal. About 15 months ago I came off the Pill again and the GP reduced my dose to 175mcg again. I feel I’ve been having weight problems ever since, I put on about 3/4 of a stone but I was going through a period of drinking more wine than I perhaps should have and in the past alcohol seems to have been the only thing that has made me put on weight. So towards the end of last summer I stopped drinking for 2 weeks and was reasonably careful about what I ate and I lost half a stone in about 3 weeks.
The weight crept up again slowly and in February I decided to try and watch my diet again and do as I did before but my weight is completely static. This is very unusual, I have been told growing up that I would never have a problem with putting weight on and have been the envy of many friends watching me scoff biscuits and cakes and not put on a pound! Maybe it’s the past catching up with me!
I started reading up on hypothyroidism as I had my last lot of blood tests around Sept/Oct last year and there were “fine” so I didn’t think it could be that however stumbled across all this research that blood tests are by no means conclusive and patients should be treated more individually. I talked to my GP who was good to a point and ordered a blood test but said it was probably my metabolism slowing down naturally (I’m 34) and I probably needed to exercise more (only exercise I get is looking after my 4 year old son).
Surprise surprise the test has come back normal for TSH and the GP said if that was the case the lab won’t even look at the T4. I only spoke to a receptionist today when I got the results and she said, when asked, that the TSH level was 246 – doesn’t make much sense – seems a very high figure so not sure she was looking at the right one? Could it be 24.6, would that make more sense possibly, or 2.46?? Trying to find somewhere on the Internet that gives the approximate ranges for these tests but no luck so far, nothing that corresponds to such a large figure anyway.
So still none the wiser, as we can’t afford to see anyone privately I guess I’ll have to just go with my blood test results and keep trying to lose the weight by upping my exercise but I am very interested and might monitor my temperature in the mornings.
April 2, 2009 @ 10:54 pm
First off I want to explain that I have a 15 month old daughter that still nurses about 2-3 times a day, I’m not sure if this has anything to do with it or not. I recenlty went to the dr to have my thyroid checked and all she ordered was the tsh and that came back normal, it was 25. My cholesterol is high also. At my appt my temp was 96.4, which is even low for me because it is usually 97.4. However, I do have low body temp. BP is low as well. I explained that I gained 9 lbs in less than 2 months. Before the weight gain I started exercising hoping it would give me more energy but it did the opposite and made me more tired. I have very bad memory and a hard time concentrating ( I am taking college classes online and am struggling!) I have absolutely no interest in sex and even though I can get 9 hours of sleep I wake up and feel like I was ran over by a mac truck. Also when I get up in the morning I feel “swollen”, especially in my hands and my face, I feel puffy. I don’t eat salty foods because of the fact that I retain water very easily. My doc was insistent that I am depressed (well who wouldn’t be when all this is happening and don’t understand why and don’t know what to do?) all she wanted to do was shove anti-depressenants down my throat! I just don’t know what to do next. I just hate feeling so run down all the time and not fitting into my clothes!
April 11, 2009 @ 8:37 pm
I made a mistake on my previous post…my testosterone was 25 and my TSH was 1.51
April 12, 2009 @ 2:21 am