Anyone here on Synthroid?

[skinimini]

Half my thyroid was removed when I was a teenager (1970's) for benign nodules. No Synthroid then. Since that time, my thyroid has been functioning just OK--thyroid hormone levels have always been just a little low. Now I have two more fairly large nodules on the remaining lobe. They were only found because my resting HR has been wacked out lately and made a visit to the cardiologist (I have some other arrythmia type issues). Biopsy was inconclusive and my internist, general surgeon, and physician husband are recommending surgery to remove the remaining lobe. I'm pretty much resigned to the fact that it'll have to come out--it's just not a good time (is it ever for surgery?)

What has been your experience on Synthroid? I've lost a lot of weight (intentionally) in the past year and I am so terrified of messing up my metabolism. Has it been difficult to regulate? Any side effects? I've read horror stories elsewhere on the internet. Internist and surgeon downplay the regulation issues, husband (gynecologist) says it can be difficult. I guess I'm just asking for your personal experience. Thanks for sharing.

[Zen]

I'm sure you'll find a lot of us are on Synthroid.

I can't imagine what the 'horror stories' might be :confused:
I don't think it's affected me negatively at all but I have so many other things wrong with me, who knows?

With a biopsy that's inconclusive I don't think I'd be so quick to start slicing. Perhaps another doctor or another biopsy?
I can't imagine that was much fun either:(

[maillotpois]

I can't imagine what the 'horror stories' might be :confused:


Me either. I've been on it for over 10 years with no problems at all. Any weight fluctuations have been entirely my own fault, not the fault of the drug or my thyroid problem.

[skinimini]

I guess I overstated the "horror" stories. I've just read that lots of people have had great difficulty in regulating the thyroid replacement hormone and have had other effects--huge weight gain, arrythmia issues.

Bx was not fun, only local anesthetic. All three docs, as well as the endocrinologist told me that a thyroid biopsy doesn't always give the answer--I don't even know why they do them. At any rate, it's not an emergency, so I'll take some time (and another opinion) to try to figure out the right thing to do.

[solobiker]

I have been on it since 1989. I did not have any troubles at all until some yahoo Dr adjusted my dosage and increased a lot. I didn't notice anything for a little while but slowly I was becoming anxious, nervous and soon was not able to sleep. I would be wide awake until 3-4am and would get up a 530. I was also feeling so out of control and it was making me feel depressed. I went to a different Dr who wanted to put me on meds for depression and I told her to please look at my thyroid levels first. She did not think my symptoms had anything to do with my thyroid but tested it any way. Well my results came back revealing I was taking way too much...I think I was at .2 and she has decreased it mulitlple times and now I am at .137 I feel far better, am happy again and actually sleep.

[tctrek]

I've been on Synthroid since 1997. Unfortunately, my TSH levels won't stay stabilized, so I have to be tested every 6 weeks and get a dosage change. I have prescription bottle in everything from 200 mcg to 88 mcg! I used to think it was the root cause of my weight issues, but I don't think that anymore. I also took Armour Thyroid for a couple of months a few years ago - I was convinced I would lose weight on it. Had to take it twice a day as it has a short shelf-life. My TSH jumped all over and I didn't lose weight, so I went back to Synthroid.

But I really don't have any bad stories. I'm sure it's not the meds fault that my levels go up and down all the time.

[Zen]

I used to think it was the root cause of my weight issues, but I don't think that anymore.

For me it was cake dosage causing that problem.

[tctrek]

For me it was cake dosage causing that problem.

For me it was pizza and beer. :p

[maillotpois]

Wine, pizza, chocolate and beer. :rolleyes:

[ehirsch83]

I have been on Synthroid since 2003, I had a total thyroidectamy(thyroid cancer). I have to say anytime I have gained weight on synthroid has been my own fault! Giving into sweets or that extra drink with dinner.
It didn't take long for them to regulate my dosage, they slowly increased it until we found the sweet spot. And then every 3-6 months for the first few years I had blood work done to make sure it was ok. I am now on blood work once a year and the dosage is pretty stabalized.

I will also say that I do now tend to put the weight on in my middle, as if I was older then I am. But... I am also still a size 2/4 so I can't complain to much! I just need to get motivated to do crunches on a regular basis!

So I am not sure why people say these "horror"stories. It is a synthetic hormone to replace what your body is not producing. Not sure how that could be any worse then what you have at the moment!!

[skinimini]

Thanks everyone for putting me at ease about the medications. I know thyroidectomy is a fairly common surgery and most everyone does just fine and adjusts easily to the medication. I tend to get a little overwrought with big changes. I'm still on the fence about the surgery (mainly because it's surgery). At least it's not an emergency which will give me time to really think.

[ZenSojourner]

There are a lot of horror stories regarding thyroid problems and mis-, under-, and over-medication. When un- or under-medicated, weight is a huge issue for a lot of us. My mother had a complete thyroidectomy when she was young and they put her on Armour because that's all there was. She maintained her weight just fine for many years. Then when $ynthroid the "wonder drug" came out they switched her onto it and from then on her weight spiraled out of control to the point where she was in the hospital on a measured and weighed 1000 calorie a day diet, was only eating about half of it, and was gaining a pound every single day. She had to have an intestinal bypass.

I went undiagnosed for 20 years because doctors misinterpreted blood test results. In the first place my TSH levels were moderately elevated, and in the second place, TSH levels are really a measure of pituitary function, not thyroid function, and when someone has multiple symptoms of thyroid disorder (as I did) with inconclusive or even nominally "normal" TSH levels (and a family history to boot), there are other tests that should have been run and were not. I have some form of weird tertiary (its not even secondary) hypothyroid disorder that was never going to show up as a strong positive on a TSH test (though I had several weak positives which doctors were ignoring because they thought it wasn't out of range ENOUGH).

I have been on Armour thyroid for about 10 years now and when I can get it (sometimes I can't because of my financial situation and lack of insurance and access to doctors) it regulates my condition very well, but it took almost a year for things to stabilize.

Even if you need Armour as opposed to Synthroid (I do because I need both T3 and T4 because of binding issues and failures in the conversion process) you will not lose weight on it by magic. Without the Armour I gain weight uncontrollably: unless I literally go on a starvation diet I WILL gain weight.

On the proper, stabilized dosage, the weight gain stops, but I have to work harder than "normal" people to lose the weight. Figure I was running (not jogging) 2.5 miles a day and eating 1200 calories a day just to maintain at 20 pounds overweight when I was younger (and unmedicated); now if I bike 250 to 300 miles per week I can maintain at "just" 60 lbs overweight on stabilized meds. Without the meds my weight will shoot up to 100 lbs overweight on the same diet and the same level of exercise. So being properly medicated doesn't mean you'll start losing weight spontaneously, but you should stop unwarranted weight gain (by that I mean you're not downing a gallon of Mountain Dew and a family size bag of chips just for a snack) and weight loss becomes at least possible, if still difficult.

There are some people that Synthroid just won't work for, and we usually have a devil of a time finding that out because doctors have been brainwashed into thinking man-made is better than natural. Well sometimes it is better for a few people, and it's "as good" or "good enough" for a bunch more, but it doesn't work for everybody. Same is true of Armour; it doesn't work for everybody. The original poster indicated some heart problems, and that's a prime reason NOT to give Armour because of the effect too much T3 can have on heart function (though too much T4 can do the same thing for people who's T4 to T3 conversion processes are working properly).

Sometimes the doctors will "trial" us on synthroid for 6 to 8 weeks, and if there isn't immediate improvement they don't consider that possibly it's the wrong medication, the wrong dosage, or both, they'll just tell you you're imagining things. It's backwards thinking: short term treatment with this med didn't work therefore you're not sick, as opposed to this med wasn't appropriate for you, let's try an alternative treatment. Also people who are long-term untreated as I was take a lot longer to stabilize because there is so much more wrong by that point than just your thyroid hormone levels (I flunked an adrenal stimulation test and had to take a small dose of cortisol, gradually tapered off over a 3 year period).

People with Hashimoto's syndrome (google it if you're curious) have a hard time stabilizing on ANY form of thyroid meds. And Hashi's is rarely tested for unless the patient finds out about it and asks for the proper tests (patient better know what the proper tests are too because most docs don't)

So yes, there are "horror stories" out there for people who are put on synthetic thyroid hormone when it isn't appropriate for them. If you can't metabolize the drug; if you have absorption issues related to fillers; if you have binding problems or conversion problems; or if you have any other problem specifically related to levels of T3, the synthetic version isn't going to help you, no matter how thoroughly convinced people are that it's the "same thing only better". It isn't the same thing, and it isn't "better". It's just different.

Can you guess that's a sore topic for me? LOL! I SUFFERED for over 20 years while doctors told me there was nothing wrong with me when there clearly was (I spent 12 years of that AVOIDING doctors because I was tired of being blamed for my health problems). Still tingles a bit. LOL!

[Triskeliongirl]

I have hashimotos and have been on thyroid replacement for many years. I could not lose weight until I found the correct dosage, and for me I needed combo therapy, I take both T4 and T3. But with a knowledgable endocrinologist monitoring you its not that hard. For me, I would only gain weight if I were being under-treated, which for me meant not getting enough T3. When my endo replaced some of my T4 with T3 everything fell into place.

I cannot imagine living without my medication so I don't think you need to be afraid. You will only feel better.

To clarify the previous post, I agree that many of us need combo therapy, and that while armour is one way to get both T4 and T3, you should know that you can also take synthetic versions of both T4 and T3 (the T4 I take is called synthroid and the T3 is called cytomel). What is nice about the synthetics, is that you can titrate the dosages of each hormone separately, and end up with very consistent dosing.

[tctrek]

I should mention that after 12 years of hypothyroidism and taking Synthroid, I started riding a bike and taking spinning classes to lose weight and gain fitness. I was 60 pounds overweight and miserable. My TSH was 43 :eek: and I was taking Synthroid!!! That was 2 years ago. Since then I have lost 40 pounds. My weight loss has slowed down, but my fitness level is going up and I am losing inches.

And.. here's the cool part.. my TSH levels are improving. My Synthroid dosage has reduced from 200 mcg, to 150 mch, to 137, 125, 100.. and now I am on 88 mcg! Although, the doctor can't explain it, I am convinced that my increased fitness levels are somehow responsible for this improvement.

I also had high cholesterol and triglycerides and now have perfectly normal levels without any medication. I also had high blood pressure requiring 3 different meds and am now down to one mild dosage of pb meds.

I'm a firm believer that eating fresh foods and getting lots of exercise can turn around health problems. Keep on riding!!

[Triskeliongirl]

FYI, you do expect your absolute snythyroid dosage to go down as you lose weight, not because of increased fitness, but becasue dosage is really per unit of body weight. My dosage also went down as I lost weight, but only proportional to my weight loss (although it sounds like yours went down more than that).

[maillotpois]

FYI, you do expect your absolute snythyroid dosage to go down as you lose weight, not because of increased fitness, but becasue dosage is really per unit of body weight. My dosage also went down as I lost weight, but only proportional to my weight loss (although it sounds like yours went down more than that).

Exactly - my weight fluctuates regularly depending on how much I ride and how much attention I pay to what I eat. My dosage goes up and down in kind.

[Triskeliongirl]

Yes. Its best to think about dosage as an amount of synthroid per unit of body weight. So, the absolute dosage stays the same, even if the amount of each daily pill varies with body weight.

This is true for all medications, but usually dosage isn't as sensitive so it doesn't get adjusted (there is just a child dose or adult dose). Sticking to the same brand of thryoid medication is also important, not because one brand is 'better' but because even the fillers that different manufacturers use can effect absorption rates, and because our bodies are so sensitive to fluctuations if you work out your dose with one brand and then change brands the dose may be off.

But none of this is meant to scare you. Thyroid meds work great, you just need to find the right dosage, and if just synthroid, or combo therapy is right for you. You need to be patient, because it takes about 3 months to really see the effects of a change. My best advice is to work with an endocrinologist with a good reputation in your area. I started with my internist, but needed an endo to get it right (because of my need for combo therapy).

[skinimini]

Thanks everyone for all the great information. It makes me feel a lot better getting first-hand info about your experiences with thyroid replacement hormone. I have an appointment next week with a different endocrinologist for a second opinion. I've done about every test possible, and the consensus so far, is that the thyroid needs to come out. Maybe I'll throw in a little neck lift while they're there!

[ZenSojourner]

To clarify the previous post, I agree that many of us need combo therapy, and that while armour is one way to get both T4 and T3, you should know that you can also take synthetic versions of both T4 and T3 (the T4 I take is called synthroid and the T3 is called cytomel). What is nice about the synthetics, is that you can titrate the dosages of each hormone separately, and end up with very consistent dosing.

Just a note, you get a very consistent dose of both the T3 and the T4 in the Armour, too, it's just not ADJUSTABLE, LOL! Some people find it's a tad bit too much T3. I tolerate it just fine, but if you take Armour and need to get less T3, you would reduce the Armour and add a little bit of synthetic T4.

Also, a few years ago $ynthroid was taken off the market for a time because of repeated problems with inconsistent dosage. They were warned several times over an 8 to 10 year period to improve dosage consistency and ignored the FDA, until finally the FDA pulled it from the market. So it's $ynthroid, not Armour, that has had problems with consistency.

My doctor wanted to put me on synthetics, but the cytomel is pretty expensive (or was back then). Armour is a much MUCH cheaper option for me.

[Triskeliongirl]

By consistency, I mean that armour is made from the dessicated thyroid glands of pigs, so the variablity from animal to animal is going to be greater than a preparation of purified chemicals produced in a laboratory.

And, as you said, the ability to titrate the dosages separately of the T4 and T3 is easier with synthetics. That doesn't mean that armour isn't a good option for some, but for me, I like my synthroid/cytomel combo. In terms of cost, for me my insurance has the same co-pay regardless of which drug I am on so its the same.

[tctrek]

FYI, you do expect your absolute snythyroid dosage to go down as you lose weight, not because of increased fitness, but becasue dosage is really per unit of body weight. My dosage also went down as I lost weight, but only proportional to my weight loss (although it sounds like yours went down more than that).

My dosage went down even though my weight stayed the same. I've been at a steady weight for about a year now, but dosage has continued to go down as I got more fit. Go figure....

[Dogmama]

Lupus messed with my thyroid. Synthroid has never been a problem. My doc checks my levels regularly & my dosage has never changed.

Glad you're getting second opinion. I don't see why the doc can't take a little extra skin for that neck lift. Heck, what the insurance company doesn't know won't hurt them!

[ZenSojourner]

By consistency, I mean that armour is made from the dessicated thyroid glands of pigs, so the variablity from animal to animal is going to be greater than a preparation of purified chemicals produced in a laboratory.

Whatever variation there may be from one animal to the next is handled by the processing of the raw substances into the final drug. That processing IS a process of titration and purification.

One batch of Armour has the exact same proportion of T3 and T4 as every other batch. That's what is meant by consistency.

And people should take what works for them. Unfortunately many many people are never given the option of natural thyroid hormone, or even a synthetic T4 with an additional dose of T3. Partly this is due to misconceptions on the part of doctors and pharmacists as to the consistency (or the alleged lack thereof) of the natural products, coupled with an additional misconception that T3 is not necessary.

Some people do fine without it. Some people get by, but could improve their situation even more with a bit of T3. And some people can't do without the additional T3. There's just no one solution for everyone.

[lisathew8lifter]

hello there,
i have been on thyroid meds since 2004. at first i lost weight and i was able to pretty much eat anything and keep it off. i admit, i took that for granted and when i started school as an adult learner working full time, i got lazy and the work outs took a back seat.

i continued to take generic synthroid for the four years i was going to school and the weight kept creeping up. i gained about 30 pounds over four years (luckily that was only one pants size, no joke) and after graduating last fall, i focused my efforts on resuming my active lifestyle and losing that weight.

after working out for three months sometimes three times per day (my work has a fitness center and i was taking classes at lunch and at night), i learned that i gained weight at my yearly exam. i about flipped!!!! i went back to my endocrinologist who gave me every test known to wo/man and we learned my TSH had crept up to where it was when i first started taking meds.

fast forward: i am now on a mild appetite suppressant and i am on 12 mcg higher dosage of non generic synthroid. since february, i have lost 11 pounds. while i'm happy with this loss, i have realized that this will be a struggle for the REST of my life and i always must WATCH everything i eat and everything i do. i require far fewer calories than the average person and the only way i see results is by increasing the exercise (sometimes two and one half hours per day) and decreasing the food intake.

so, my point is:
generic thyroid meds are frowned upon by my medical professional
you must always be on top of your TSH and make sure you monitor that
you likely will feel better by being on the meds but the price you will pay is that it may be harder for you to maintain your desired weight.

i hope this helps!??!

[surgtech1956]

what is the mild appetite suppressant? I'm just starting my Synthyroid.:mad:

[lisathew8lifter]

what is the mild appetite suppressant? I'm just starting my Synthyroid.:mad:

It is a prescription drug called phentermine

[maillotpois]

Wasn't that part of Phen - phen that was linked to heart wall degradation? :confused:

[snapdragen]

Wasn't that part of Phen - phen that was linked to heart wall degradation? :confused:

Yup, it was. It's considered a controlled substance.

[lisathew8lifter]

Yup, it was. It's considered a controlled substance.

WHAT?!? Can someone provide a link to this info? :eek:

[snapdragen]

WHAT?!? Can someone provide a link to this info? :eek:

http://www.deadiversion.usdoj.gov/schedules/schedules.htm

Schedule IV

[maillotpois]

What a drag it is getting old
"Kids are different today,"
I hear ev'ry mother say
Mother needs something today to calm her down
And though she's not really ill
There's a little yellow pill
She goes running for the shelter of a mother's little helper
And it helps her on her way, gets her through her busy day

ETA: Maybe that was about valium. I thought it was speed, but might have been valium. Nonetheless, it is an excellent song.

ETA: I guess I was thinking of this: http://snltranscripts.jt.org/75/75fspeed.phtml

[surgtech1956]

I just started on Synthyroid(generic) today, 50. I go back to the doctor in 3 months. How long was it before you started noticing any effects?

[Kano]

Wasn't that part of Phen - phen that was linked to heart wall degradation? :confused:


It was the other Fen -- Fenfluramine that was taken off the market in 1997because of the heart valve issue.

Karen in Boise

[Triskeliongirl]

you likely will feel better by being on the meds but the price you will pay is that it may be harder for you to maintain your desired weight.



Are you suggesting that is harder to maintain your weight on medication? Its harder to maintain your weight when your TSH is high! As long as you are being appropriately treated (depending the person, its the right does of synthroid, synthroid/cytomel, or armour) it should get easier, not harder, to lose or maintain weight, i.e. think of thyroid hormone as being important for your metabolism, if it is down, your metabolism is slow, so it will be harder to lose weight.

Even if you TSH is normal, if you still feel sluggish and/or your free T3 is low you may need some form of T4/T3 combo therapy. I would explore this before taking an apetite suppresant. Or, see if there isn't something else going on that interferes with weight loss. In my case it wasn't until I got on T4/T3 combo therapy AND found out I had impaired glucose tolerance so went on a low carb diet that I could lose weight.

[lisathew8lifter]

Are you suggesting that is harder to maintain your weight on medication? Its harder to maintain your weight when your TSH is high! As long as you are being appropriately treated (depending the person, its the right does of synthroid, synthroid/cytomel, or armour) it should get easier, not harder, to lose or maintain weight, i.e. think of thyroid hormone as being important for your metabolism, if it is down, your metabolism is slow, so it will be harder to lose weight.

Even if you TSH is normal, if you still feel sluggish and/or your free T3 is low you may need some form of T4/T3 combo therapy. I would explore this before taking an apetite suppresant. Or, see if there isn't something else going on that interferes with weight loss. In my case it wasn't until I got on T4/T3 combo therapy AND found out I had impaired glucose tolerance so went on a low carb diet that I could lose weight.

Sorry but in my case, i totally disagree with you. My TSH is 1.05 right now and I have worked my *** off to lose 9 pounds since February. I work out sometimes 3 hours per day and my TSH has not been this low EVER. My endo tested me for anything and everything with regard to my metabolism and everything was within the normal range if not low end of normal. The appetite suppressant was to jump start the weight loss because I had been gaining not losing despite the work outs.

I believe there is a fine line when playing around with your TSH and your metabolism. If you over medicate that poses other health issues and if you under medicate that causes a different set of concerns. This is just my personal experience, for what it is worth.

[lisathew8lifter]

It was the other Fen -- Fenfluramine that was taken off the market in 1997because of the heart valve issue.

Karen in Boise


thanks Karen! :) i had asked because my endo had assured me that these were not related. i am only on the phentermine temporarily until i lose the 30 pounds (now 21) that i have to lose. my mother has diabetes and since all of my excess is around my middle, it isn't just about looking good, its about my long term health. when my TSH is high, so are my triglycerides and my cholesterol and we want to be sure we keep all of that in check.

[tctrek]

Sorry but in my case, I work out sometimes 3 hours per day and my TSH has not been this low EVER. My endo tested me for anything and everything with regard to my metabolism and everything was within the normal range if not low end of normal. The appetite suppressant was to jump start the weight loss because I had been gaining not losing despite the work outs.

Lisa - I have the same problem, but I think it is a coincidence that you are hypothroid, on Synthroid and not able to lose weight. Working out 3 hours a day, depending on how many calories you are eating, can/will throw your body into a starvation mode. Your body could be storing as much as it can of what you eat as FAT! Because you are working it so hard and eating so little. Your net calories per day should not ever be less than 1,000 and better yet 1,200. That means if you can eat 1800 calories and burn 600 calories in exercise. If you workout 1 hour or less per day, you can get away with eating less calories, but never less than 1,000 per day no matter what.

I will wager that there are plenty of women on this forum who are NOT hypothyroid and who eat great and workout a lot and can't lose weight. Don't fool yourself into thinking it's your thyroid -- look at our other eating habits and make sure you are eating a fresh, balanced diet that wil support your body during hard exercise.

[snapdragen]

I find taking amphetamines to lose weight a really bad idea, but that's just me......hell, meth worked for a friend of mine.

[maillotpois]

I would consult with a nutritionist to ensure you are not pushing your body into starvation mode, as tctrek suggests, which will affect your metabolism in ways that don't show up ion a TSH test. It you are doing 3 hours a day of aerobic exercise, you need to fuel your body appropriately. Talk to your doctor about nutrition as an alternative to drugs. Mastering the nutrition piece is also something you can/should do your whole life - as opposed to amphetamines.

[Triskeliongirl]

You didn't understand what I said. Its not just about having a normal TSH. I too was being treated with synthroid, had a TSH of 1, was eating 1200 calories a day, biking 100 miles a week, and gaining weight.

But, it wasn't cuz I was taking synthroid as you conclude, its because my hypothyroidism wasn't being adequately treated by synthroid alone. In some cases, you will have a low free T3, which right away tells you there is a conversion problem. By that I mean that synthroid is T4, which is an inactive precurser to T3, the active form of thryoid hormone. In that case its obvious you need to be on T3 (cytomel). In my case my T3 and TSH were both normal, so at that point I was referred to an endo who put me on T4/T3 combo therapy. At the same time we discovered I was hypoinsulinemic, so I was put on a low carb diet. THEN, and only then, I finally was able to lose 35 lb and get to a healthy normal weight.

Now, I am not saying that you have exactly what I have, but it is definitely wrong to blame synthroid for your weight problem. If you are still having a weight problem on synthroid, it means something else is still not right and you and your endo. need to look for other reasons you are struggling so much with your weight.

I teach this stuff to medical students, and I am absolutely certain that having too much thyroid hormone as you suggest does not make you gain weight. THere are reasons you don't want to be overmedicated, but weight gain is not one of them (its quite the opposite, folks that are hyperthryoid will lose weight, but there are lots of good reasons not to overmedicate). You need to find the UNDERLYING REASON you struggle with your weight rather than using amphetamines as a quick fix. Here, I am speaking from a lifetime of experience that once we got to the route of my problem, a 50 year battle with weight control was stopped dead in its tracks. I felt as if my weight simply normalized, not like I was dieting anymore. I was satisified with reasonable amounts of food. If I cut back, I would lose, if I overate I would gain, but things started to work as they should, and I have maintained my loss for 2 years by simply eating healthy food in moderate portions (but low in carbs due to my impaired glucose tolerance/hypoinsulinemia) and leading a healthy lifestyle, something that never worked for me before I understood that I had a body that couldn't process carbs correctly.



Sorry but in my case, i totally disagree with you. My TSH is 1.05 right now and I have worked my *** off to lose 9 pounds since February. I work out sometimes 3 hours per day and my TSH has not been this low EVER. My endo tested me for anything and everything with regard to my metabolism and everything was within the normal range if not low end of normal. The appetite suppressant was to jump start the weight loss because I had been gaining not losing despite the work outs.

I believe there is a fine line when playing around with your TSH and your metabolism. If you over medicate that poses other health issues and if you under medicate that causes a different set of concerns. This is just my personal experience, for what it is worth.

[tctrek]

But, it wasn't cuz I was taking synthroid as you conclude, its because my hypothyroidism wasn't being adequately treated by synthroid alone. In some cases, you will have a low free T3, which right away tells you there is a conversion problem. By that I mean that synthroid is T4, which is an inactive precurser to T3, the active form of thryoid hormone. In that case its obvious you need to be on T3 (cytomel). In my case my T3 and TSH were both normal, so at that point I was referred to an endo who put me on T4/T3 combo therapy. At the same time we discovered I was hypoinsulinemic, so I was put on a low carb diet. THEN, and only then, I finally was able to lose 35 lb and get to a healthy normal weight.


Trisk -- I'm curious how you found a doctor that will work with you on T3/T4 strategies? I've had several endos over the years and they always look at only T4 and TSH, but not T3. Do you think that some doctors don't "believe" in T3 therapy?

Also, when you say "low carb" diet, how many grams of carbs do you eat and what kind of carbs? I tried low carb for a week - eating about 30 grams of carbs per day, but my only carbs were green vegetables. I really "felt" like crap and didn't have the energy to exercise or ride my bike. Does that level out? Or maybe I needed more than 30 grams of carbs?

I am so grouchy when I can't work out and found I was a real monster when I didn't have carbs + couldn't exercise.

[Triskeliongirl]

TC Trek, indeed many endos don't recognize combo therapy, but I think its a lack of current education. My internist had referred me to a 'group' and then when I looked on one of the thyroid lists, I found one member of this group on that list as being open to combo therapy, so I made my appointment with him. He was willing to try it, given that I was symptomatic despite normal TSH. But, he was also smart to look for other underlying reasons for my weight problem, and found the impaired glucose tolerance. I always had just borderline high fasting glucose, but when he ran an OGTT it really showed up. Then we had my insulin measured throughout an OGTT and found out that my problem is that I undersecrete insulin, not that I am insulin resistant. THis is a bit unusual, most adult onset diabetes is due to insulin resistance but I participated in a research study by one of my colleagues who found that in fact I am unusually insulin sensitive, but just undersecrete (so I am more like a type I than type II diabetic, accept I make enough insulin to maintain glucose homeostasis in the absence of a glucose challenge). On the low carb diet, coupled with exercise (which increases number of glucose transporters on the cell membrane) I can maintain glucose homeostatsis.

In terms of low carb diet and exercise, yes, I eat ~30g of CHO a day, mostly from non-starcyy veggies. The rule is that I don't eat anything that lets my blood sugar go above 120, 30 min. after meal, and not be back under 100 2 hours after meal. In the beginning I also felt bad when I exercised, until I started learning how to use alternative fuel sources on the bike: fat and amino acid metabolism. It takes a bit of time, there is a training effect. I also consume carb free protein shakes (made w Jay Robb's whey protein powder) on the bike. These contain a mix of pre-digested and undigested proteins.

The idea (and remember I am a biochemist) is that the amino acids get deaminated to carbon skeletons, which are then TCA cycle intermediates that can be burned for energy in the muscle. Plus, they can also SLOWLY get converted into glucose by gluconeogenesis, but at a slow enough rate that it never generates a high blood sugar spike, yet still gives me glycogen stores. As intensity on the bike goes up, the ratio of carbs to fat burned does too. SO, as long as I ride at moderate intensities I am fine. I just can't handle really fast accelerations or sprint finishes, that kind of thig (basically going anaerobic) but I can hold a respectable pace in a group ride, even do a century without consuming any carbs. In addition to these shakes, I also consume almonds on longer bike rides.

It is also important to not try to do both low carb and low fat. I eat plenty of fat, and it's critical to eat plenty of protein (at least 1g/lb of LBM). I choose mostly 'healthy' fats (that is I eat a lot of fish, olive oil, etc.), but I am not afraid of red meat either. I have low triglycerides, cholesterol, etc. The high protein is important to slowly replenish glycogen stores and give glucose to your brain, but its also important to preserve lean body mass when dieting. I lost 35 lbs, but mostly fat, so now even though I weigh what some may consider a lot (140 lb) I can wear size 4-6/Small clothing.

I also FEEL absolutely great. If I eat carbs, my brain would go into a hyperglycemic fog, so I am much more clear headed and have great energy eating this way.

[tctrek]

OK - so I have high "BUN" scores on blood tests and take Metformin - 1000 MG twice a day. My sugar levels are ok as is cholesterol, potassium, etc.
So, I'm thinking I *should* be able to adjust to the low carb diet and maybe I just need to give it more time. I was drinking EAS Carb Control protein drinks 2-3 times a day as my "snack". These have 5 grams of carb each, but only 1 g of sugar. I was

I got scared when I was going out to do a 45 mile ride yesterday without carbs and fell off the wagon and ate carbs all day. I just didn't see how I was going to make it through the day on Protein.

I guess I'll give it another shot next week.

[Triskeliongirl]

You didn't say you were on metformin. That is the problem. If you are on metformin, you need to do the low carb diet under a doctor's supervision. Probably your doctor will need to lower you medication. If you don't ingest any carbs, then the metformin will make your blood sugar fall too low since your dosage was prescribed assuming you would be consuming a certain amount of carbs, which may explain why you were feeling bad.

PLEASE, ONLY DO THIS UNDER A DOCTOR'S SUPERVISION. You might want to read the book Dr. Bernstein's Diabetes Solution, and then discuss this dietary appproach with your doctor if it appeals to you. Also, what I do won't work so well on metformin, since it will inhibit gluconeogenesis.

[tctrek]

Thanks! I will definitely talk to my doctor about it before I try anything.

[lisathew8lifter]

You didn't understand what I said. Its not just about having a normal TSH. I too was being treated with synthroid, had a TSH of 1, was eating 1200 calories a day, biking 100 miles a week, and gaining weight.

But, it wasn't cuz I was taking synthroid as you conclude, its because my hypothyroidism wasn't being adequately treated by synthroid alone. In some cases, you will have a low free T3, which right away tells you there is a conversion problem. By that I mean that synthroid is T4, which is an inactive precurser to T3, the active form of thryoid hormone. In that case its obvious you need to be on T3 (cytomel). In my case my T3 and TSH were both normal, so at that point I was referred to an endo who put me on T4/T3 combo therapy. At the same time we discovered I was hypoinsulinemic, so I was put on a low carb diet. THEN, and only then, I finally was able to lose 35 lb and get to a healthy normal weight.


You need to find the UNDERLYING REASON you struggle with your weight rather than using amphetamines as a quick fix. Here, I am speaking from a lifetime of experience that once we got to the route of my problem, a 50 year battle with weight control was stopped dead in its tracks. I felt as if my weight simply normalized, not like I was dieting anymore. I was satisified with reasonable amounts of food. If I cut back, I would lose, if I overate I would gain, but things started to work as they should, and I have maintained my loss for 2 years by simply eating healthy food in moderate portions (but low in carbs due to my impaired glucose tolerance/hypoinsulinemia) and leading a healthy lifestyle, something that never worked for me before I understood that I had a body that couldn't process carbs correctly.


Hi Trisk,
I am sorry if you thought i was implying that my inability to lose weight was because of synthroid. I did not mean to infer that.

Thank you for taking the time to respond with a very informative post. I need to go back and review your writings and check into the term hypoinsulinemic. I have not heard of that until your post. How did the doctor determine that was your situation?

I discussed combo therapy with my endo and although not nearly (not even close actually!) as knowledgable as you in the topic, i have done research.

First of all, I need to be diligently tracking what I eat. I have known that, but work and life have gotten in the way. I stick to a diet of foods that are in their natural state and try to eat very few processed foods. It may be that I'm not eating enough - but without tracking my caloric intake I will not know. Duh. :rolleyes: I will get better about doing this.

I also am interested to know how you are able to keep your energy levels up going low carb. I realize you touched on this before and forgive me if I read this wrong (it was in another post that I cannot see while I type) but did you say you stick to 30g carbs per day?!?!

I, too, have been looking to crack the code so to speak and figure out what makes my body work efficiently. Now that I have my thyroid under control, it is time to get a handle on the weight. I realize I am fortunate to "only" have 20 pounds to lose but I am trying to avoid the road to diabetes, and coronary artery disease like my mother.

[Triskeliongirl]

Just re-read post 42 in this thread. I think it answers all your questions, and good luck at sorting this out!

Hypoinsulinemic means I undersecrete insulin. You should start by asking for an oral glucose tolerance test (OGTT). If that doesn't look good, then you can get your insulin as well as glucose measured during an OGTT test (they may not be willing to do this right away since the insulin test is more expensive, or they may, you can always ask). A good endo should be able to do this for you.

[Dogmama]

During your weight loss journey, keep in mind that we're all very different. 30g carbs would have me on top of a tall building with an automatic weapon. The production of glucose from protein is a very slow process and works differently in all of us. That's why some people do very well on protein dominant type of diets and others fail.

[lisathew8lifter]

During your weight loss journey, keep in mind that we're all very different. 30g carbs would have me on top of a tall building with an automatic weapon. The production of glucose from protein is a very slow process and works differently in all of us. That's why some people do very well on protein dominant type of diets and others fail.


:D I think I'd be joining you at the top of a tall building for a fleeting moment ... right before I jumped off of it! i could get 30g carbs by 9 a.m. most days...and I would likely struggle to maintain the energy i need to do the work outs that I do. :eek:

[surgtech1956]

I finished my first week on Synthyroid. Don't notice anything.

[lisathew8lifter]

I finished my first week on Synthyroid. Don't notice anything.

I started to notice less fatigue after a few weeks of starting the med. I think with any drug it takes a few weeks to adjust.

[lisathew8lifter]

Hey Trisk,
I made my appt with my endo for Friday and am printing this out and bringing it with. Thank you again for the info!

I have two questions:

What does OGTT stand for? I am hoping my doctor will know (if not i think i might look into finding a new one!)

also

In post #42 you stated you have low triglycerides and cholesterol. Has that always been that way? When my TSH is high, so are the triglycerides and the cholesterol levels. I was just curious if these are low as a result of the way you are eating now or if they have always been low. I need to go back and look at my fasting glucose number to see if that has been borderline high.

Thanks again.

[Triskeliongirl]

1. OGTT means an Oral Glucose Tolerance Test.

2. My triglycerides and cholesterol both went down on the low carb diet.

[GreatPaws]

surgetech- one week isn't enough to "feel" anything. Synthyroid works when it builds up in your system. It's not immediate like aspirin or Tylenol. My doc says it's usually 4-6 weeks to feel ANYTHING. And it will depend upon what you TSH was at diagnosis. Since people are being put on Synthyroid for very low numbers now adays (it used to be your doc laughed at you and told you you were normal at 3) if you're much higher than 20 it might take awhile.

I was diagnosed at 14 when I failed to thrive. I stopped growing for 3 years and, even with a strong family history, my mother had to pull teeth to get them to run a simple TSH test. Gee, I was 412. No, that's not a typo.

When I was 28, I had a I-131 uptake scan test done to test the functioning level of thyroid tissue. After about 4 shots with the gamma camera, the doc called out to stop the test. I have no functioning thyroid. ( Nor pancreas, for that matter, but the OGTT found that later.) So I'm on complete t4 replacement and have been on the same dose since age 14 - 200. No matter what my weight. :) So dose is not always 100% proportional to weight.

If you want to investigate T3, all you have to do is ask for a Full thyroid panel. I've been on Cytomel since 1999 and wouldn't go a day without it. I haven't found it to be any more expensive than Synthyroid. I haven't tried the natural t3/t4 stuff but I've talked to people who love it. I think it's whatever works for your body.

I will tell you a strange story. When I was 19 and was sick of college, I went to massage therapy school for 6 months. They taught alot of healing methods and therapies and we had one person come in who claimed they could tell what medications you took just by touching your feet. We were all skeptical, but lined up. Darned if that woman didn't say "Synthroid! And lots of it!". She said people on Synthroid have "fake" feeling feet- like they're made of wax. To this day I"m still trying to feel it...

Nice to see such a great discussion and people sharing their experiences! The only time I have "horror" stories is when I forget to take my pills... :)