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Facing The Hypothyroid Problem And Gaining Weight. Looking For Proper Diagnosis?

Posted on Thu, 1 Nov 2012

Question: Hello,

I am facing the HypoThyroid problem from my 12 years old. I am now 26 years old. 4 months back I went to check the thyroid status. And suddenly I gained my weight. And the doctor didnt tell about the thyroid anything. And concluded that I am a Obesity patient. My height is 5.2 and the weight was 69.8.

And the doctor has tested TSH and suggested me to take the medicines 150Gr per one day and 175Gr on the next day.

And I am taking the same quantity of the Electronix daily at 6AM.

And recently I went to the doctor again, and he has given the report as "Obesity". And not talking about the thyroid and just taking the TSH test. Now my weight is 67.

Please suggest me whether I need to continue with the same doctor?

Thank You.

Answered by Dr. Shehzad Topiwala (31 minutes later)

I would like to know the results of the TSH test and preferably others like free t4 and CBC and rest of the metabolic panel.

It would be ideal to know the thyroid antibody status also such thyroid peroxidase and thyroglobulin antibodies which are typically positive in individuals who truly have permanent hypothyroidism. If these antibodies are negative then is likely that you do not have hypothyroidism. However sometimes if it is possible to have negative antibodies and still truly have hypothyroidism, especially if you have a family history and thyroid enlargement

So assuming your diagnosis is correct and you have chronic lifelong hypothyroidism, the next question is whether your dose is correct. Most women need around 100-112 mcg of levothyroxine daily. However this requirement also varies by body weight so the best way to determine the appropriate dose is by looking at the TSH value. The goal is to make sure the TSH is between 0.4 to 2 with free T4 levels closer to the higher side of the normal range. It is important to ensure there is no secondary hypothyroidism which is a rare condition and an endocrinologist is the most qualified person to rule that out.

Finally obesity is a complex condition that requires a systematic evaluation. An endocrinologist is the best specialized physician to assess this too.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (6 hours later)

Thank you for your reply doctor. My TSH test report measuring 4.12 uIU/ml. And the doctor didn't suggest me to go for T3 and T4 tests.

And the TSH tested on 4 months back.

Now my tablets are over, So I want to go for the check up and check my thyroid level.

Could you please let me know is this a behaviour of Thyroid or OBESITY?

Please check this and help me on my problem.

Answered by Dr. Shehzad Topiwala (2 hours later)

As mentioned previously we need to be certain that the diagnosis of hypothyroidism is correct. Once that is settled we can proceed to determine what is the right dose for you.
Assuming that you truly have the condition, let us discuss your dose requirement. I believe by electronix you are referring to some brand of l-thyroxine. I am aware of a brand that sounds similar called eltroxin

With a TSH of around the dose change that your doctor made was appropriate ie going from 150 daily to alternation with 150 and 175.

It is unlikely at this level of TSH for you to be gaining weight from hypothyroidism alone.

For more information please review WWW.WWWW.WW

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (30 minutes later)

Thank you for your reply.

Can I go for the same dosage or can I consult any other doctor to check the thyroid level. Is it compulsary to take the T3 and T4 tests with TSH?

Answered by Dr. Shehzad Topiwala (10 hours later)

The dose change appears reasonable. TSH is a very reliable indicator of the appropriateness of the thyroid medication dose. However sometimes it helps to check the free T4 levels perhaps along with total T4, total t3 and t3 uptake
Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (10 hours later)

Thank You Doctor.

I am going to test T3, T4 and TSH today.

Thank you very much for you patience.

Answered by Dr. Shehzad Topiwala (29 hours later)

Thank you too.

Take care.

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar