Hashimoto's and Smoking Cessation

[gailwind]

I have been enjoying reading the posts out here but haven't found one that addresses my concerns exactly.  I smoked over a pack a day for 33 years (am 53 now) and quit for the first time on my 40th birthday.   I lasted a few months but unfortunately started up again.  Fast forward a year and I am increasingly fatigued as would come home from work, cook dinner for the kids and fall asleep on the couch at least 3 nights a week!  Gained 50 pounds and finally......the PA noticed by thyroid felt enlarged.  Off to an endocrinologist, ultrasounds, blood work etc.  There are goiters, he diagnosed Hashimotos but felt it was OK to leave as is.  On Levythyroxine and after a year or two of playing with the dose I have landed on 175mg a day. I skip about one a week in the summer as don't seem to need as much then.  So, doing OK with this for years as no longer so fatigued and no longer constipated.  Who would have thought daily, easy bowel movements could be such a pleasure :)   Anyway...what didn't improve is my hair still falls out and while it used to be very thick is now extremely thin on top...can see my scalp with a direct look.  I hate it!  And no magic weight loss.  If I work hard at it and nearly starve at 1300 calories a day and sustain that for 6 months, I can lose 25 pounds.  I've done so but it comes back on over the next year.   My point with this back story is I found sites that suggest a link between smoking cessation and Thyroid troubles.  In hind sight, maybe I was a victim of that.

So...to the point of my post today.  I quit smoking again 7 weeks ago.  Cold turkey, no Nicotine Replacement, no Chantrix...just powered through and while very difficult I feel I have tamed the beast.  I will never go back to smoking. Not one puff, not ever.   My blood pressure was creeping up to pre-hypertension and I knew I was running out of time.  How many healthy, smoking, retirees do you see?   But NOW....I wonder about my thyroid.  I am more fatigued than I would expect as need to nap again.  I gave myself a buy on dieting the first 6 weeks and unfortunately between the holidays and this 6 week cold turkey quit I put on 25 pounds.  So..turning my attention to that.  Last week I journaled everything that went into my mouth and I held it to 1450 calories a day, yet I GAINED a pound.  I am 240 pounds, 5'8", at 1450 calories in week I should have lost 5 pounds at least.  

Does the thyroid need to be retested after smoking cessation?  My blood work was just done 3 months ago so would be an out of cycle visit to ask them to test it again.   I have never had my Free T3 or T4 tested...they number they always give me in the TSH.  When diagnosed it was 7.9 and I now hover about 1.3.

Welcome input from any and all.  Thank you for listening!

[Red_Star]

Smoking is associated with a low prevalence of thyroid antibodies. Withdrawal enhances thyroid antibody levels and may be a risk factor for the development of hypothyroidism. The risk of an overt autoimmune hypothyroidism diagnosis is more than a 6 fold increase in the first 2 years after cessation of smoking.

[Barb135]

I think smoking cessation and weight gain sort of "automatically" go together, just like hypothyroidism and weight gain go together.  I quit smoking about 6 years ago and was diagnosed with hypo a year later, though I'm pretty sure I was hypo for a good while before being diagnosed.

You may be cutting your calories by too much.  You need a certain amount of calories, just to live - to maintain bodily functions: heart, lung, brain, liver, kidney function, etc.  If you don't take in enough calories, your metabolism will slow down even more to conserve fat stores. You need to figure out how many calories you need for basic functions, then drop approximately 500 calories/day from that.  You can also expend some of those calories via exercise.

If the only test your doctor is doing is TSH, he's doing you a great disservice.  Without the FT3 and FT4 tests, you have no idea whether your levels are actually "right" for you or not.  TSH does not correlate with symptoms; FT3 does.

You should also ask to get tested for thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab) to determine whether or not you have Hashimoto's Thyroiditis.  With Hashimoto's, the body sees the thyroid as foreign and produces antibodies to destroy it.  The destruction process usually lasts for several years, but doesn't have to.  As the antibodies destroy more and more thyroid tissue, the thyroid produces less and less hormones.  This causes a need for periodic adjustments of medication. Once there is no more healthy thyroid tissue, levels often stabilize and the need for adjustment declines.

Try to get the FT3, FT4 and antibody tests.  If you doctor refuses, you should start looking for another, because this one will keep you ill.