Aa
Aa
A
A
A
Close
Avatar universal

weight gain & hair loss

my numbers are:
TSH 2.3 (.40-4.00); Free T4 .73 (.70-1.8); Free T3 3.1 (2.3-5.0)
My doses:  Tirosint 50 mcg.; Cytomel 12 mcg/day  My thyroid was destroyed roughly 8 years ago; the only problems I have is hair loss and weight gain - I don't overeat, I exercise - I don't eat processed foods - I could eat 1200 calories a day - good calories and put on weight.  I grow most of what I eat.  Help! I am 65.   Can you help with making sure my doses are correct and not causing this problem - I am not cyclic.  If I eat any carb or root vegetable i.e. potato, carrots, anything that grows below the ground I will have instant weight on in one day (and its not water weight) and takes a week of severe dieting to lose it.  Any help would be greatly be appreciated.
5 Responses
Sort by: Helpful Oldest Newest
Avatar universal
Good info from flyingfool.  It is difficult to suggest a specific dosage increment.  You really have to just gradually increase until symptoms are relieved, and monitor FT4 and FT3 along the way to help decide what the med and dosage increases should be.  

I have sent you a PM with some info that might be useful for you to review with your doctor.  To access, just click on your name and then from your personal page, click on messages.
Helpful - 0
Avatar universal
Your body cells use Free T3.  It is also available literally withing hours of taking the medication.  As it peaks about 4 hours after taking the T3 med (Cytomel)  

On the other hand, T4 Medication like Triosint takes up to 6 WEEKS to stabilize in your blood.  T4 is a storage hormone and remains in your blood until your body calls for more thyroid, which then must convert the T4 into T3 before being used by the cells.

This is why you nearly felt immediate relief of symptoms by starting the T3 because it was a "short cut" directly to the end result.

I agree with Gimel. You are under-medicated.

My recommendation is the slow and safe approach.  It is not what you probably want to hear but I think it may prove in the end to be the best route.

The process I recommend would be to increase your Tirosint (T4).  The Dr will decide what dose to up you to. But typically it is in jumps of 12.5 to 25 mcg of T4.  Then re-test in about 6 weeks.  This process should repeat itself until one of two things happen.  Either you feel well, OR your FT4 level rises to the MIDDLE of the range. That is 50% of the range as in RIGHT in the middle. Not simply somewhere in-between the bottom and top of the range.  For you that would be FT4 value of 1.25.

IF.  that is only IF, you achieve an FT4 of 1.25 and you STILL do NOT feel well. THEN it is time to slowly increase your T3 (Cytomel) dosage until you get to no higher than about 67% of the range.

If things are working and your body is converting properly or at all. each increase in T4 should result in an increase in FT3 levels.  Initially your FT4 value may not even move all that much as your body may use all the additional T4 from the dose increase to convert into T3. But at some point you should see a rise in both the FT4 and FT3 levels.

I would not recommend increasing both of the doses at the same time. Because if you feel worse, or better, you really won't know which change was effective.

Going at this methodologically in a slow planned manner will be frustrating and take many weeks perhaps, but it is probably the most effective way to attack the problem.

Also if you take the Cytomel only in the morning and you "drag" in the afternoon. You may try splitting the pill in half and take only half in the morning and half in the afternoon say between 1PM and 3PM.  Since it peaks about 4 hours after you take it,  that may give you a little bit of energy later into the evening!

Finally do NOT.  Do NOT take your Cytomel prior to the blood test.  Since it is so fast acting, if you take it prior to the blood draw, it will give you a result that is NOT representative of what you generally are living with.  In fact I would recommend you not take any thyroid medication prior to the blood draw.  Also try to test about the same time of the day each time. In that way, you are best comparing apples to apples for each test.

I will also assume you are aware to take your T4 med on an empty stomach.  By at least an hour of eating.  Also be sure to stay away from Calcium supplements (including milk etc) for about 4 hours of taking your T4 as the calcium binds to the thyroid and makes it impossible/difficult for your body to absorb the thyroid.

You may also want to test for Selenium.  Selenium is a mineral that helps with the conversion of  T4 to T3.  This is not a panacea, but if your body is a slow converter, added Selenium may help if you are deficient.  Brazil nuts by the way, have a lot of Selenium in them!
Helpful - 0
Avatar universal
Thank you very much can you give me the specific doses I should take, my dr. says to stay were I am but I agree with you - and then I can just go to him with the doses I feel I should take for the T3 & T4 - he is open if I can prove to him.  I do take Vitamin D but not B12 and ferritin - any recommended doses?  Have not been tested for B12 or ferritin since 2012 - at which time the ferritin was 246 yeah!! 246  so I will get retested for those three.  But if you could give me what you would recommend for the tirosint and cytomel I would greatly appreciate it.  I have read where other people were asking about cytomel - well my short story was when i first went on tirosint (they killed my thyroid) I was dead tired and saw a specialist that put me on the cytomel and within 1 week I was back to my normal self - no longer dead tired - made a huge difference!  Look forward to hearing from you!    
Helpful - 0
Avatar universal
I agree!  I had similar ranges on Nature-throid but instead of gaining, I felt hyper yet with a low FT4 like that, I did not feel well at all!  I think an increase may not be a bad idea to discuss with your doctor.  Still, I, too, have hair loss...
Helpful - 0
Avatar universal
I'd say that your basic problem is that you are still hypothyroid.  Your Free T4 is at rock bottom when mid-range should be the minimum target.  Your Free T3 is only at 29% of the range, when it should be high enough in the upper half of the range to relieve hypo symptoms.  Optimizing your levels will help to get your metabolism to where it should be and also help with the hair loss.  Just for info, TSH frequently becomes suppressed when taking adequate thyroid meds so as you increase your FT4 and FT3 levels, don't let the doctor become alarmed with a  low TSH and try to reduce your meds.  TSH is a useless test when already taking thyroid meds.


In addition hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  You need to know those test results and then supplement as needed to optimize.  D should be targeted for 55, B12 in the upper end of the range and ferritin should be about 70.  Ferritin is very important to having good  hair.
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.