Gaining Weight/Blemia

[unsure613]

The surgeon I went to is recommending a total Thyroidectomy as I have multi-nodules on both lobes (largest 3.1cm, others are smaller).  I am hyperthyroid with multi-nodule goiters.  I am concerned when I become hypo-thyriod of the weight gain, which is why I keep procrastinating.  My endo said that we will monitor my levels and I will be on medication to control the hypo and there won't be any weight gain as long as I take the medication; however, there are so many posts where patients have gained weight no matter what they do.  My concern is I've never been heavy (size 2) and had a slight problem maybe 10 yeara ago with belemia?? (never diagnosed).....maybe 2-3 times a month...not like an everyday issue (now maybe 2-3 times a year).  I want to stay on the PTU medicine, but my Dr. is saying either surgery or RAI because they don't recommend being on the medication more than a year or 2 (been on about 2 years now.).  Can you share any of your own experieinces with patients, maybe statistics, and any insight?  I'm so worked up over this, it's causing me anxiety. Also, can my problem with belemia in the past be the reason I am now hyper with multi-nodules?  I can't seem to find anything concrete about it on the internet?

[unsure613]

My T3 and T4 have always been of normal range.  It the TSH that's been out of range .229 and the 3.1 cm nodule.  My symptoms are minimal...it's mainly the racing heart beat and nervousness...occasional hoarseness, but not so much when I'm on the meds.  The Dr. got me in to normal range...then eventually took me off to see how I would react, plus did another ultrasound.  The nodule sizes have not changed and the TSH went back down.  I currently take 2-3 pills a day.  He said it was not good to stay on the meds because it's a synthetic drug and can damage the liver.

[Smilerdeb]

My one question to your Doctor would be....

If I can stay on anti-thyroid meds for 2 years and not have thyroid storm, be able to continue keeping my levels stable...then why RAI or TT?

I have known people to be on a minimal dose of atds for at least 10 years as long as the levels are stable and it hasnt affected the liver.
Some are even put on B & B (block and replace) where you are given say....the smallest dose of PTU and the smallest dose of thyroxin (T4 med).

Get a 2nd opinion.

[gimel]

Read your post with interest and just wanted to pass on something that might be of interest to you after surgery or RAI.  If your doctor is one of those that base their treatment on TSH levels, there is a good possibility of ending up undertreated, and with hypothyroid symptoms.   So I thought I would re-post something I said to another member.  It's something to keep in mind for the future.


When a doctor treats a patient strictly by TSH level,  it frequently leaves the patient still suffering from hypo symptoms.  This is because TSH is a pituitary hormone that is affected by many variables, so that it has only a fair correlation with T4 and T3 levels in the blood, and  a very poor correlation with thyroid symptoms.  Much of the biological activity in the body is dependent on free T3 and free T4 (free meaning not bound up by protein).  Free T3 is the most important because it is four times as potent as free T4, and correlates best with hypo symptoms.

If I were in your shoes, I would try to get the doctor to treat you by testing and adjusting free T3 and free T4 levels as required to alleviate symptoms and get you into what I call the "sweet spot", by which I mean neither hypo nor hyper symptoms.  Sometimes, this will mean that the TSH is suppressed to the very low end of the reference range or even below, even though  free T3 and free T4 are still well within their ranges.  A TSH suppressed below the reference range doesn't automatically mean you are hyperthyroid. In my opinion, a patient's hyper or hypo status should only be defined by symptoms, not TSH level.

[BabyBlue139]

I don't know if it's too early to tell for me , but my TT was 10 weeks ago and my weight is the exact same as it was the day I went in for surgery.  I haven't chnaged my diet or exercise regimen at all.  Weight gain was my number one reason for not wanting the surgery, and believe me I'm definitely still concerned that it may happen.  The fact that I haven't gained any weight yet might have something to do with the way I take my Synthroid.  I take it two hours before I get up in the morning.  I put a glass of H2O and the pill right next to my bed and set my cellphone alarm.  This way, I am consistent with when I take it, I never miss a dose, and absolutely no food/drink interferes with the absorption of it.  That's my theory anyways.  Good luck to you and whatever you decide to do.