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What should I do? (hypothyroid)

I was recently diagnosed with a hypothyroid.  Here are my test results:

TSH: 4.31  (range: 0.23 - 3.07)
Free T4: 0.81 (range 0.58-1.64)

I am:
Male
26
height 5'7''
Weight:185

I am not sure if I should go on the Levothyroxine Sodium 50 MCG my doctor recommended to me.  I was wondering if you guys could give me some guidance.  I am clearly not an extreme case but I don't want to take a pill for the rest of my life.  

Also I fear that if I start taking the pill I will lose my resolve to eat heather and exercise.  I have been doing really well and working VERY hard to keep my weight down.  Most of the research I have read seems to say the diet and exercise can help but not change things drastically.  

What do you guys think?  Should I go on the medication?  Should I wait and get retested in a few weeks?  Should I go on, then see how things go and maybe go off in a year?

Thanks for your help,
~Pearce
4 Responses
Avatar universal
It's really mostly a matter of how you are feeling.  Do you have many hypo symptoms?  Weight loss/maintenance is often easier when thyroid hormones are optimized.

Also, have you had any antibody testing to determine if you have autoimmune thyroid disease (Hashimoto's thyroiditis), the most prevalent cause of hypo in the developed world?  Determining you have Hashi's might influence your decision.  With Hashi's, the antibodies keep destroying thyroid function.  So, function becomes less and less.  If you have Hashi's it's most likely not IF you should start meds, but WHEN.  
Avatar universal
Thanks so much for the reply.

The only thing I have trouble with right now is weight loss. I feel like it takes a month worth of work to lose 5 pounds then 3 days of weakness to gain it all back.  One of the other fears I have is that if I start taking the medication I will know it should be easier to lose weight.  So I will put less effort into it, and my mental resolve to lose weight will weaken and gain more weight in the long run.  I know this is a personal mental battle but any advice is helpful.

I have not been tested for Hashimoto's thyroiditis, I will have to request that I am when I go back in 6 weeks.
Avatar universal
Also get tested for Free T3 in addition to the TSH and Free T4.  Free T3 is the ONLY hormone your body actually uses.  T4 is a storage hormone and is converted to T3 (mostly in the liver) when your body needs more Hormone.

Testing FT3 is important in that some people have difficulty in converting the T4 into T3.  Without testing for this it is almost impossible to determine.

Have you gone to a list of Low Thyroid symptoms to determine if in fact you have more symptoms other than difficulty losing weight.

Thyroid is absolutely necessary for your body to remain healthy.  There is really no way known to get Thyroid other than through medication if your Thyroid gland is not supplying an ample amount.

Even if your Thyroid is functioning properly or you are getting enough through medication it doesn't mean weight loss will be easy.

Many people however stated that it was nearly impossible to lose weight without having the proper amount of Thyroid.  My wife is one of these persons.  So don't fool yourself into thinking that Thyroid medication is some sort of wonder weight loss pill.  It really isn't. At least not for most people. They have to really work hard even with taking Thyroid meds.

One thought about the 50 mcg dosage is that some people can not tolerate going from zero to 50.  Others can.  One way to avoid this is to start out with 25 mcg for a couple weeks and then go up to 50 mcg.

T4 medication is a slow acting drug.  It will take 6 weeks or so to stabilize in the bloodstream. So prepare to be tested every 6 weeks or so with dosage changes in between.

BEWARE of the Dr's who believe solely in TSH.  And will attempt to adjust your dosage based solely on TSH which is just about impossible.

THis is the importance of getting the Free T4 AND free T3 tested.  Most people tend to find that symptom relief occurs when:

1) FT4 is in the MIDDLE of the range.

   AND

2) FT3 is in the UPPER 1/3 of the range

Simply being somewhere within range is NOT good enough for most people.
Avatar universal
Ask your doctor to test both TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies).  Some of us with Hashi's are TPOab positive, some TGab positive and some both.

As you indicated, your numbers are by no means drastically off, so it's highly unlikely that waiting a few weeks and getting retested will be a problem.  If you can determine whether or not you have autoimmune thyroid disease at that point as well, you'l have more information on which to make an informed decision.

Best of luck...
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