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Suggest Treatment For Difficulty In Losing Weight When On Medication For Hypothyroidism
Question: I am hypothyroid & have been on medication for 30 years. My last labs: Free T3-3.14, Free T4-.93, Total T3 110, TSH .02 My TSH has been way too low for several years and no doctor can explain it. I am 57 yrs and extremely active. I have gained 10 lbs. in the last year and absolutely cannot lose it. I have stayed at 150 lbs. for most od my adult life. I ride 20 to 50 miles about 4-5x per week and burn 700 calories on an average ride of 30 miles. I am eating 1200 calories per day with only 40 net carbs (plus approx 57 carbs in Infinit Nutririon drink on bike ride). Mathematically speaking I am in a calorie deficit, yet I do not lose weight. I am extremely frustrated as I will need to buy an entire new wardrobe if I cannot get back to my normal weight. Besides biking I also swim, snow ski, hunt, fish and I live on a working farm. I am concerned about the low TSH as well as the inability to get back to my normal weight. I am female 5' 6".
Brief Answer:
Central hypothyroidism ( secondary hypothyroidism) and pituitary deficiency
Detailed Answer:
Good day,
Noted your concern. In hypothyroidism, low TSH is due to 2 reasons
a) Over replacement with levoThyroxine
b) Central hypothyroidism.
The first possibility is unlikely in your case as the Free T4 and Free T3 are normal. ( could you attach the actual report? Normal values can vary based on units used: eg: mcg, pmol etc)
The second possibility is likely in your case. This may indicate that your pituitary gland is not producing enough TSH. That would mean that many other pituitary hormones may be deficient incluing human growth hormone. Adult human growth hormone deficiency is associated with weight gain and central obesity.
You must discuss with your endocrinologist about this possibility and get yourself checked.
You must do tests like, IGF-1, CBC, 8 AM serum cortisol etc
Regards
Binu
Central hypothyroidism ( secondary hypothyroidism) and pituitary deficiency
Detailed Answer:
Good day,
Noted your concern. In hypothyroidism, low TSH is due to 2 reasons
a) Over replacement with levoThyroxine
b) Central hypothyroidism.
The first possibility is unlikely in your case as the Free T4 and Free T3 are normal. ( could you attach the actual report? Normal values can vary based on units used: eg: mcg, pmol etc)
The second possibility is likely in your case. This may indicate that your pituitary gland is not producing enough TSH. That would mean that many other pituitary hormones may be deficient incluing human growth hormone. Adult human growth hormone deficiency is associated with weight gain and central obesity.
You must discuss with your endocrinologist about this possibility and get yourself checked.
You must do tests like, IGF-1, CBC, 8 AM serum cortisol etc
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your answer! I have been telling my Dr. for several yeats that I feel there is something wrong. I have attached the lab reports you requested. Please advise what tests specifically you would recommend other than those you already mentioned. Shall I be fasting for the tests? Again, thank you for giving me hope.
Brief Answer:
Thank you
Detailed Answer:
Thank you for the reports. noted the blood reports. IGF1 need not be fasting. cortisol also need not be fasting, but timing is important. it should be drawn at 8 am.
no other tests other than what I mentioned earlier.
Based on the results you may require an MRI scan of pituitary.
Thank you
Detailed Answer:
Thank you for the reports. noted the blood reports. IGF1 need not be fasting. cortisol also need not be fasting, but timing is important. it should be drawn at 8 am.
no other tests other than what I mentioned earlier.
Based on the results you may require an MRI scan of pituitary.
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
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