October 4, 2004

Question: I'm a 32-year-old female who is 5 feet 2 inches tall. I weigh 180 pounds. I had my thyroid removed eight years ago. At that time, I weighed only 140 pounds. For the whole eight years, I've had aches and pains, fatigue, air-headedness, and weight gain. My doctor diagnosed my condition as "depression" and prescribed antidepressants and painkillers. I’ve been lectured by everyone, my doctor included, that all of my symptoms would be controlled if I’d just lose weight. His diagnosis of depression and all the lecturing has gotten me into the mind set that I'm just fat and lazy.

The doctor has tested my TSH annually and adjusted my Synthroid dose up and down, and even when the dose is up, I still don’t lose weight. I've tried every way to lose the weight. I’ve done the starvation diet and even diet pills. My weight went up and down a little but has never stayed down. I even tried the "no carb" diet for eight weeks with my Mother. She lost 30 pounds and I lost nothing! I take nutritional supplements, am on the Zone diet, and joined a gym and work out four times a week, but I’m still not losing weight. Although I work out, I have trouble not feeling that I’m just fat and lazy. I’m now taking 200 mcg of Synthroid. My doctor says that’s such a large dose that it rules out hypothyroidism as the cause of my weight problem. Should I consider some other hormone problem?

Dr. Lowe: The "hormone problem" you need to consider is the T4-replacement you’re on. A study published in 2000 showed that weight gain is the usual result of being on T4-replacement therapy.[1] This confirms what hundreds of patients on T4-replacement have told us: they gained weight on T4-replacement and couldn’t lose it, even if they dieted and exercised, and they lost the weight shortly after switching to a slightly TSH-suppressive dose of a T4/T3 product, such as Armour or Thyrolar. These patients weren’t fat and lazy when they were on T4-replacement. Instead, they weren’t breaking down fats fast enough because T4-replacement was ineffective for them. And most likely, that’s exactly why you’ve gained and retained weight.

I strongly recommend that you read the section titled "Weight Gain" in my recent critique of Dr. Richard Guttler's false beliefs about hypothyroidism. I think you'll benefit by reading the whole section, but pay particular attention to the passages about the "Beckett and Toft" study.

I hope you completely clear your head of the idea that you’re just fat and lazy, and I hope you soon lose your excess weight. You can easily do that by finding a doctor who’ll switch you from T4-replacement to a safer and more effective approach to thyroid hormone therapy. With your wholesome diet, nutritional supplements, exercise, and more effective hormone therapy, you should in short order lose the weight T4-replacement caused you to gain and retain.

Reference

[1] Tigas, S., Idiculla, J., Beckett, G., and Toft, A.: Is excessive weight gain after ablative treatment of hyperthyroidism due to inadequate thyroid hormone therapy? Thyroid, 10(12):1107-1111, 2000.