But I haven’t lost any weight! It’s time to talk thyroid medication and weight loss.
When your thyroid is underperforming almost every part of your body becomes sluggish. Hypothyroidism triggered ‘go-slow’ can see the bathroom scales creeping up even if you have not changed what you eat, how much you eat or your exercise routine. The much-lauded weight loss math of calories in (eat less) - calories out (exercise more) = weight may be wrong in hypothyroidism.
So when you are told your thyroid levels are correct because you have enough thyroid medication in your body, based on your most recent lab test, it is devastating to continue to gain weight.
For most with hypothyroidism and Hashimoto’s the hoped-for, prayed-for begged-for thyroid medication miracle equation reads like:
• Hypothyroid = weight gain
• No longer hypothyroid as taking medication and have been told by my doctor I am taking enough medication = weight gain stops + possibly even weight loss starts.
If the thyroid medication miracle equation math fails and your weight is not normalised the first place to start is to make sure your medication matches your needs. Check out this article here for more information on what this means.
Scientists have been researching if the type of hypothyroidism medication can change the weight loss result and the answer seems to be YES.
In fact, the lab test used as the marker of thyroid function, ’TSH’, may not be a good marker of adequate thyroid hormone replacement therapy for the hypothyroid and those with Hashimoto’s thyroiditis. What research is showing is that whilst there may be enough thyroid hormone for the TSH lab test to be normal in those with hypothyroidism and Hashimoto’s their metabolism might still be sluggish which inevitably leads to weight gain with no change in either food or movement (Biondi & Wartofsky, 2012).
Make sure the medication you are taking is not only just showing up in lab tests but actually showing up in your fat cells where you want it working!
Talking with your Doctor
To help you in your conversation with your doctor here are two recent studies on weight and thyroid medication that might be a great place to start so you can choose whether or not the medication you are taking matches your weight loss goals.
Study 1: T3 synthetic thyroid hormone
T3 medication as compared with ‘gold standard’ synthetic T4 medication levothyroxine (L-T4) resulted in significant weight loss of 11.9kg with a significance of P = 0.009.
This study reported in the The Journal of Clinical Endocrinology & Metabolism included fourteen hypothyroid patients. T3 or L-T4 were administered 3 x day to achieve a target TSH from 0.5–1.5 mU/litre. Patients were randomized in this double-blind, crossover intervention (Celi, et al., 2011).
Study 2: Natural desiccated thyroid hormone
Desiccated thyroid treatment as compared with the synthetic T4 medication levothyroxine caused 3 lb weight loss with a significance of (P < .001).
This study again reported in The Journal of Clinical Endocrinology & Metabolism was done on 70 hypothyroid patients aged 18–65 years who had been on a stable dose of levothyroxine T4 (L-T4) for 6 months. Patients were randomised to either desiccated thyroid or L-T4 for 16 weeks and then crossed over for the same duration (Hoang, et al., 2013).
Talking Lab Tests
Make sure when you talk with your doctor you raise the topic of testing Free T4, Free T3 and ideally reverse T3 in addition to TSH as researchers Biondi & Wartofsky (2012) concluded: TSH even when within the reference range is not a sufficiently good marker of adequate thyroid hormone replacement therapy in hypothyroid patients. Whilst there may be enough thyroid hormone for TSH to be normal their ability to maintain their metabolism might still be diminished.
Bottom line:
If you are still gaining weight or struggling to lose weight but you have been told your thyroid is normal to make sure you have had tested:
1. TSH, Free T4, Free T3 and reverse T3. For more information check out this article that explains what these measures mean.
2. Talk to your doctor about whether or not trialling a different thyroid medication might work for you.
In health and hormone happiness,
Sonia x
References:
Biondi, B., & Wartofsky, L. (2012). Combination treatment with T4 and T3: toward personalized replacement therapy in hypothyroidism?. The Journal of Clinical Endocrinology & Metabolism, 97(7), 2256-2271. https://pdfs.semanticscholar.org/1f05/33af337382745a8e57b1c58f21c9cc082ee3.pdf
Celi, F. S., Zemskova, M., Linderman, J. D., Smith, S., Drinkard, B., Sachdev, V., ... & Pucino, F. (2011). Metabolic effects of liothyronine therapy in hypothyroidism: a randomized, double-blind, crossover trial of liothyronine versus levothyroxine. The Journal of Clinical Endocrinology & Metabolism, 96(11), 3466-3474. https://www.researchgate.net/profile/Rene_Costello/publication/51593751_Metabolic_Effects_of_Liothyronine_Therapy_in_Hypothyroidism_A_Randomized_Double-Blind_Crossover_Trial_of_Liothyronine_Versus_Levothyroxine/links/59074ec40f7e9bc0d5946ccd/Metabolic-Effects-of-Liothyronine-Therapy-in-Hypothyroidism-A-Randomized-Double-Blind-Crossover-Trial-of-Liothyronine-Versus-Levothyroxine.pdf
Hoang, T. D., Olsen, C. H., Mai, V. Q., Clyde, P. W., & Shakir, M. K. (2013). Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study. The Journal of Clinical Endocrinology & Metabolism, 98(5), 1982-1990. https://pdfs.semanticscholar.org/8a02/5f13a5c7bd8992475c21e5ad93d802c8546f.pdf