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.