Should I go on levothyroxine?

[hummingbird88]

Hello all!

After having a bit of a struggle for the last 8 months, I've found both a primary and endocrinologist who are helpful and open to solving my problems. Last June/July, I rapidly gained 10-15lbs (also sorry for units, am American!) in 2 months. In the 6-9 months prior to that, I had been more slowly gaining weight (about 5 lbs) and was eating healthier than ever and exercising as a result, when I put on the 10-15lbs. At the same time I had massive fatigue, and was diagnosed as B12 deficient, then pernicious anemia, took B12 shots, fatigue improved, but then was told it was just the deficiency again and not the anemia. The fatigue overall improved, but now about 5-6 months later, seems to have come back a little, even though I've continued B12 oral supplements after ultimately being told I didn't have a B12 absorption problem.

I was also on Prozac for anxiety, and thinking that could be the source of the weight gain, went off it in early January (with knowledge and assistance of my primary doctor). My weight decreased by about 2lbs (which it hadn't done before, no matter how much I dieted), but now is in a position where it won't change again. I'm more frustrated than ever with the weight, and nervous now that the heavy fatigue is creeping back. I went to an endocrinologist for the first time yesterday. My blood tests from November showed a TSH of 3.23 uIU/mL (free T4 1.17 ng/dL with range from .82-1.77, so normal/// and Thyroid Peroxidase(TPO) Ab 11.00 IU/mL with range 0-34). My endocrinologist said my TSH was high, but he didn't think it would cause weight gain, much less very rapid weight gain. However, he said because of some family history with hypothyroidism, I could take 25 mcg of levothyroxine and see how I felt and go back in 6 weeks for blood tests. He also said I could go to the medical center weight center.

I'm a bit torn, because I'm not keen to go on medication, but I also don't want yet another person to question my diet/exercise habits and insist that I somehow must be eating more than I realize (trust me, I'm not). How much would 25 mcg affect me? Side effects? If I didn't have a thyroid problem, would it hurt me? I tried to ask my doctor, but he was in a rush and didn't answer my questions as thoroughly as I'd like. Does anyone have experience with this? Thanks so much!

[shaws Administrator]

How little do professionals really know!

Unexplained weight gain is one of the clinical symptoms (I doubt they kow any) and the commonest query on the forum.

thyroiduk.org.uk/tuk/about_...

medlineplus.gov/druginfo/me...

I am not medically qualified but when you've read as many posts as I have, you realise that doctors, if we are hypo, don't know any clinical symptoms at all but are apt to prescribe for each of our symptoms, instead of ensuring that our thyroid hormones are optimal, i.e. near the top of the range.

The fact is that if you are hypothyroid, your Free T4 and Free T3 may be very low. T4 is an inactive hormone and has to convert to T3. If your T3 is low it will affect you in lots of ways as it is the Active Thyroid Hormone and we have millions of T3 receptor cells and brain and heart need the most. This is a list of symptoms. Thankfully we don't get them all.

thyroiduk.org.uk/tuk/about_...

All blood tests for thyroid hormones have to be at the earliest possible, fasting (you can drink water). If you were taking thyroid hormones you'd allow a gap of 24 hours between dose and test and take it afterwards. This keeps the TSH at its highest as that seems to be all they take notice of. TSH is highest early a.m. and drops throughout the day and may mean the difference between being daignosed or not:-

TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. Also vitamins/minerals should be optimal, i.e. B12, Vit D, iron, ferritin and folate.