Is Hashimoto's possible without weight gain?

[DaveT81]

Having recently been diagnosed with autoimmune disorder/Hashimoto's, I have done a little reading and was curious as to whether it's possible to actually have Hashimoto's but with the total opposite of the weight gain symptom?

I tick a lot of the boxes, but weight gain seems a very, very common - almost unavoidable - symptom. In reality, I have lost almost 2 stone (without trying too hard) in about 8-9 months. It was actually one of the reasons I became concerned enough to go to see a new, private GP instead of my usual NHS one. His response tended to be that I had anxiety. After starting to experience gut probs, I quickly changed to a gluten free diet and this seemed to help the weight loss and my current private GP advised I had made the right choice and to stick with this now.

Other symptoms I have are fatigue, extreme tiredness (constant yawning) - even after long sleep - brain fog, fuzzy vision, gut issues, breathing issues that have come on suddenly and a handful of other things.

Just by pure luck or chance, the GP I had arranged to see specialised in this area and, despite many of my results being within (or just within) normal range, he recognised many of the symptoms.

Since our second meeting, he had prescribed me Levothyroxine, omeprazole, Vitamin D and folate. He also gave me a B12 injection. For a few days I think I was feeling somewhat improved and much more positive, and then I crashed. My breathing became worse and I had a visit to A&E and a walk in centre, who all sent me home after minor examinations.

I have since had spirometry, chest x-ray and paid for a heart echo and CT scan of abdo, chest and neck. Nothing alarming was reported on any and upon my return to the GP last week he said that all of my symptoms including the severe breathing issues which have developed rapidly - in about 3 months - are due to thyroid and autoimmune disorder. He upped my dose of thyroxine and prescribed another course of all the above.

So long story short - considering one of the symptoms is weight gain or at least the inability to lose weight, is it conceivable that this diagnosis can still be made considering how much weight I've actually lost?

[greygoose]

Yes, absolutely. There are over 300 known symptoms of hypothyroidism. You don't have to have them all to qualify.

I have Hashi's, have had it most of my life, I believe. Mostly, I put on weight, but when on a 'hyper' swing, I would lose a lot of weight, suddenly, and for no apparent reason.

And, quite apart from the swings, a lot of hypos do lose weight, although most do put it on, and some have no change in weight at all.

The thing that makes hypothyroidism so difficult to diagnose is that the symptoms are non-specific. Which is understandable when you know something about it all. Doctors define hypothyroidism as high TSH, but, it's actually low T3 that causes symptoms. T3 is the active thyroid hormone needed by every single cell in your body. When T3 is in short supply, the body shuts down T3 receptors in parts of the body that are not essential to survival - such as in the diaphragm - there are other muscles you can use for breathing. But the pattern of receptor closing is different for everybody, which is why people don't all have the same symptoms.

So, no, the fact that you've lost weight does not change your diagnosis. If you have high TPO/Tg antibodies, then you have Hashi's.

[DaveT81 in reply to greygoose]

Well, thanks for the reassurance. It had been playing on my mind a lot, and most of the other places I've picked up information all indicate weight gain, as opposed to weight loss.

Regarding my breathing issues, I have actually felt thay the problem seems to be coming from my diaphragm. It actually almost feels like it's going through the motions at the moment and working at half-speed. My exhale feel pitiful and exercise is out of the question. Walking more than 10-15 minutes without getting out of breath is most days too.

My new GP did mention something about T3, he wasn't happy that mine was relatively high, yet I was still presenting some obvious symptoms. I think he mentioned something about 'conversion'.

[greygoose in reply to DaveT81]

If you had a conversion problem, your T3 would be low. Judging by those results, you have good conversion. In fact, your TSH/FT4/FT3 are euthyroid at the moment. But, you didn't tell us when they were done in relation to starting levo, nor how much levo you are taking, which is why I didn't comment on them.

But, now I'm commenting, I will say that your B12, folate and vit D are too low. They need bringing up a bit. Ferritin looks low but your iron is high - I'm not very good with iron, I'm afraid. It's complicated.

Most of what you read on-line is very conservative in relation to symptoms, and tends to divide symptoms into hypo vs hyper, when in reality, a lot of symptoms cross over, so you can't rely on symptoms alone.

Your new GP obviously knows nothing about Hashi's. How much do you know about it?

Why were you prescribed omeprazole? That really is not a good thing to take, and will reduce your absorption of thyroid hormone and nutrients.

[DaveT81 in reply to greygoose]

Apologies, the bloods are from prior to starting thyroxine 25mg 6 weeks ago. I have since been back to the private GP and he upped the dose to 50mg.

Honestly, I know next to nothing about it but this is apparently his area of expertise and he has a good reputation from what I can gather.

The reason I started asking these questions is because, from the little I do know, the results would suggest that I wasn't hypo. He also has me on vit D and folate. Initially he gave me a B12 injection too about 6 weeks ago.

Also, it may have appeared I was being sarcastic with my 'thanks for the reassurance' but I actually meant it. Apologies if it seemed that way.

I've had symptoms piling up on me recently and although the GP's assurances that this is what it is and he'd get me back on my feet again were great, I still wasn't completely sure we were going in the right direction, due to the results above. What you've just mentioned there sort of confirms my worst fears re: the thryoxine/thyroid issues..

The omeprazole is for gut/reflux issues I'm also having. As with many of my symptoms, this came on me very suddenly too about 6 months ago. Prior to that, I'd had no issues at all and I could eat anything without a single problem. Now I'm gluten free and still regularly suffer reflux and discomfort after eating.

[greygoose in reply to DaveT81]

No, I didn't think you were being sarcastic.

I didn't notice any antibody results in those labs. But, if you were diagnosed with Hashi's, I imagine they were high. So, starting you on levo was the best thing to do, even though your labs appeared euthyroid. The thing with Hashi's is that levels can jump around. And, the thing with a blood test is that it's like a photograph - it just shows you what was at the time it was taken. Not how things were a week before, or how they will be the following week. If you have symptoms, then something must be causing them, so it's possible that your results would have been lower if they'd been tested at another time.

Acid reflux. A thorny problem. Doctors always assume that it is due to high stomach acid. Whereas, in reality, hypos usually have low stomach acid. The symptoms are the same. PPIs lower stomach acid even further, so they really are not the right thing to take. Try reading this article and try the home test at the end :

scdlifestyle.com/2012/03/3-...

PPIs should only be for short-term relief, but doctors tend to leave people on them for years, causing all sorts of other problems. They really are terrible things, and best avoided if you can. They won't help your problem, anyway.

[DaveT81 in reply to greygoose]

Yep, not too keen on the PPIs myself. After his initial prescription, I gradually weened myself down to 1 a day (from 2) and then stopped them altogether. Prior to that if been taking ranitidine every other day which had been helping a little.

Re: the antibodies, this wasn't actually something I'd had done at the time. So I guess his mantra that 'I treat symptoms, not test results' holds true in this instance. He was of the same opinion as you about blood results being a snapshot at one particular time and not showing the whole story.

I guess all I can do is go along with the meds for a while and, provided I suffer no adverse effects, just report to him in a month about how I am.

[greygoose in reply to DaveT81]

And how are you? Has the levo helped at all? I take it he will be doing labs at some point, though, won't he? As I said, you can't always rely on symptoms, you do need the back-up of the occasional blood test. And, it is important to test the antibodies, because not all cases of hypo are due to Hashi's. There other causes. And, you need to know if it's Hashi's, so that you are prepared for the inevitable swinging from hypo to 'hyper', through euthyroid and back again to hypo.

Well done for getting off the PPIs!

[Marz]

Why the PPI ? - most thyroid sufferers have low not high acid ...

[DaveT81 in reply to Marz]

I'm having reflux issues at the moment too, along with gut problems. Lump in throat after meals, tightness in throat too and occasional funny taste. Bloatedness and wind are issues too.

[jgelliss in reply to DaveT81]

I suffered with "Acid Reflux " when I was under dosed . And felt like a lump in my throat as well . Very unpleasant feelings to say the least . I had UTI from being under dosed too . I hope you get your thyroid meds sorted out very soon .

[shaws]

I have noted your severe breathing problems and will give you a link and hope it doesn't frighten you.

It is a fact that few medical professionals know how many clinical symptoms there can be with hypothyroidism and they are usually passing patients onto another department or only looking at blood test results alone.

web.archive.org/web/2010103...

[Baobabs]

My weight has remained fairly constantly low despite Hashi diagnosis two years ago and increases in T4 and the introduction of T3 meds. Also I have never experienced the symptom of feeling cold and despite my FT3 being reasonably high on T4 only meds, I still feel so much better with the addition of T3 ( Levothyronine). It seems there is no definitive standard fare as far as Hashi's is concerned.

[Tina_Maria]

Have you been tested for coeliac disease before you were diagnosed with hypothyroidism? This would perhaps explain your gut symptoms and absorption issues and why you would have lost weight.

There is a strong connection of thyroid disease and coeliac disease. There is a higher prevalence of coeliac disease in people who suffer from hypothyroidism - this is why in some patients adopting a gluten free diet will improve their symptoms. Unfortunately, if you have been on a gluten free diet for some time, the test will be inconclusive. But this could explain why you did not gain weight like most of the patients with an underactive thyroid.

Also, if you are under-medicated, you will feel extremely tired and that can include breathlessness. Once you are on an optimal dose / medication, your metabolism should improve and you should also not get out of breath easily when you are walking or exercising.

I might be wrong here, but I think your stomach problems could perhaps be anxiety? If you are not medicated correctly, this can leave you with a feeling of anxiety, that can feel like a funny feeling in your stomach and could be mistaken for acid. Again, once you are on the correct dose for what your metabolism needs to function properly, this should improve.

I hope that you will feel better soon!