Thyroid test results

[flowerchild73]

Hello doctors ..please help

I have had a goiter since 1997 and have been on levo 50mcg since with no problems. I do think I have always had some hypo symptoms but they are mild. Recently the symptoms have been pretty bad. It all started when I quit my 10 year smoking habit in Dec 2006. It's now 2008 and the hypo symptoms are getting worse! Now I'm always cold, and I have a body temp of 96.3F in the middle of the day. I have recently had unexplained weight gain even though I track all my calories and I eat no more than 1350 cals a day. I eat 50% protein, 30% carb (veggies only) and 20% fat. I'm a small boned 5'4 female and I used to weigh 135 pounds but I have no idea how I jumped to 145 in the span of 2 months without overeating.
I'm always afraid to eat and I've always had to resort to semi fastings or 3 hour workouts to keep myself from gaining weight. I just gain way too easily and I never seem to lose weight until I reduce my cals to 500 a day and the minute I eat 1200 cals a day I gain so fast!!  The worst symptoms I'm having since I quit smoking and all this weird thyroid stuff started is that my sex drive had taken a nose dive, which is not normal for me at all and my poor husband has obviously suffered too. I was also expereincing hair loss, which thankfully seems to have finally slowed down now.  I have been really confused as to how I always test within the normal range because I certainly don't feel normal. I had to finally beg my endo to run the free Ts test which he did by dialysis.
btw the only medication I'm on is levo 50mcg.

Test resultys from April 15th/2008
Fasting glucose is 66
TSH 0.03
Free T4 (They are still waiting for the results)
Free T3 is 221
T3 Total 100
Thyroxine 8.1
Testosterone bioavailable 15
Testosterone 59


Should I ask my doctor to add cytomel to my does of levo? I don't care if these tests are "normal" because I know  something is wrong with how I feel.

[flowerchild73]

Okay for anyone who might care--I went to the doctor today and she said it's very unlikely I have insulin resistence/pcos becuase my fasting glucose was 64 and I have a flat stomach and no facial hair or thinning head hair (Thank God I have thick hair because it was falling out for a while there) or skin markings, or bad skin whatever etc..the only problem is my mysterious weight!!
She'll be sending me to a metabolism specialist and boy oh boy am I ever interested to see what this metabolism specialist will say...I'm guessing it will be "You need a new metabolism." My doctor thinks that my metabolism is shutting out due to my caloric restricting. I often fast for days then eat "normal" around 1350 cals then I fast for half days and then nibble off my husband's plate at dinner etc...this can't be good for the metabolism considering all people who are into fitness do the opposite--eat frequent small meals.
I think i will be giving the 6 mini meals a try until my next appointment becuase I don't see what I have to lose.

Thanks for all your responses and patience

[flowerchild73]

Hi Dr.Lupo,

Okay thanks so much,  I certainly don't want thyroid toxicity. I have no idea why I can't shift my weight. I only seem to lose if I eat 500-750 cals a day and then it's back on the minute I increase my cals to 950-1100!! What is wrong with me?? Maybe I do have pcos and if I do have it does this mean I can't get rid of these 15 pounds?? Please help!!

[Mark Lupo, M.D.]

We tend not to suppress goiters so much these days....  the lowish T3 may be your body's effort to minimize the impact of the excessive thyroid hormone (ie more conversion to inactive reverse T3).  While I cannot explain the weight troubles, I am not sure it is thyroid related.   I doubt cytomel would help much, but you could ask your doctor for a trial.  The key would be to avoid thyroid toxicity.

[flowerchild73]

Dr.Lupo,
Thanks for your response! The thing is the weight must be related to my thyroid because I've been tracking all my calories for 1.5 years and the pattern seems to be that I do not lose any weight on 1200 and I gain eating 1300-1350. I was eating 1350 for 2 months and then that's when I noticed this weight gain. How slow is my metabolism that i gain weight so fast if I eat anything over 1150?!  Gosh I guess I just don't need much food? Also what about the hairloss I was experiencing over the year (it's finally stopped btw) and the low sex drive? And the body temp of 96.3F?? All these things point to thyroid probs. They tested my  fasting glucose and testosterone to rule out pcos. I know i don't have pcos--regular periods, no facial hair or body hair, 27 inch waist, weight is gained on the bottom not the tummy and excellent cholesterol and blood pressure.
So is it normal that i have to eat 500-800 cals a day to lose weight? Then I have to eat maximum 1200 to maintain?
I think the value of my free t3 is low. i know my tsh is practially being supressed and there is a reason for that--it needs to be that way to stop my goiter from growing. The free t3 suggests I'm a poor converter and could probably use some cytomel? No? What do you think?


Hey graywings!!
Thanks so much for your response. I know everyone raves about Armour, but it didn't react well with me. I tried Armour last summer for 3 months and my hair really started falling out like crazy, then my face and ankles swelled right up. My new endo hates the stuff and he took me off it and put me on brand name levo--it's been much better for me. Trust me the hair loss has slowed right down to normal hairloss now, but my weight is still a royal pain!! Grr! I take all my vitamins and eat really healthy.

Thanks to both of you for your patience!! :)

[Mark Lupo, M.D.]

The low TSH suggests you are on too much thyroid hormone -- would talk to your doctor about changing the dose.  Would not change to armour (or other thyroid med) until this  issue is addressed and the TSH is stable.  It looks like the weight is not likely related to thyroid.

[graywings]

First of all I would get switched to Armour.  Levo is too full of synthetics.  Armour has more of what our own thyroid produces.  Gaining weight is part of being hypo, but you are also starving yourself, so your body is going to hold onto the weight.  You are going to have to get optimized first with thyroid meds.  With your diet make sure you eat every 2 to 3 hours and have a protein with each meal and unfortuantely up your calories.  Add the good fats like Omega 3's (fish oil), olive oil, avocados, walnuts, almonds etc.  The body needs fat to burn fat.  Over doing it in the gym is hard on the adrenals, so it wouldn't surprise me that you have adrenal issues also.  Get your ferritn check, B12 and adrenals if you can.  Hairloss is a hypo symtom.  If is is an adrenal issue you can at least start with taking lots of Vitamin C 3000 to 5000 mg grams split throughout day, to bowel tolerance and also add 1/4 to 1/2 tsp daily of Celtic Sea Salt.  Adrenals live on the salt and Vit C.

Hope this helps.

graywings