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Difficulty in gaining weight. Low TSH count, inflammation in colon. Is low TSH or colon inflammation the cause of low weight?

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General & Family Physician
Practicing since : 1980
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Hi again Dr. S,
Got thyroid tests back last week and even after 4 weeks totally off all thryoid meds, TSH still less than 0. 01.Wondering if I just need more time for TSH to go back up and if there's any correlation between strength of overdose adn length of tiem taken and how long it takes for TSH to return to normal. Can't get in to endo until July 15; am hoping by then my thyroid will have normalized but meanwhile can't seem to get an answer as to whether i should continue to stay off all thyroid meds (will i regain weight faster if i do??) or get back on prior dose. A CT scan last week found inflammation/fluid in colon and possible contraction or mass but CEA and C125 negative, Blood tests found. no anemia or occult blood but liver enzymes slightly up. Cholesterol and blood pressure low. My medical team is City of Hope in Pasadena; awaiting appointment with gastro for evaluation and colonoscopy but fear this could take awhile...lab report said to check for possible colitis (which travels with interstitial cystitis), I'm having trouble gaining weight and wondering if TSH and colon inflammation are both conspiring against me. I'm very petite and not a huge eater; sticking to nutritous mini-meals but so far scale hasn't budged from 78 in three weeks. I'm 5 feet,small boned and normally weigh between 93-97 pounds. In great physical shape/exercise daily/eat a healthy lowish-carb Mediterranean diet.
Thanks again for all your help!
XXXXXX
Posted Sat, 27 Apr 2013 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Rahul Tawde 9 hours later
Dear XXXXXX,
Thanks again. Thyroxine has a half life of 7 days and atleast 3-4 half lives are required to re-equilibriate again. Only after this TSH can be expected to return to its original value. Sometimes if patients have been hyperthyroid for a long period of time, TSH can get suppressed and remain suppressed for few weeks to months even after thyroid hormones are normal. This is because of reset of TSH set point. The most important thing then is to consider the levels of thyroid hormone levels along with TSH value for interpretation and decision making. So its obvious that TSH is taking longer to return to original value because of protracted over treatment. We need to get serial thyroid function tests every 2-3 weeks to see the course of thyroid hormones and TSH. It may not be too long before we see the rise in TSH. So just be patient for some more time. One important thing to remember is that thyroid hormones T3 & T4 and not TSH dictate the thyroid status. So TSH value is of secondary importance. Colon inflammation may not directly be related to thyroid status. It has to be dealt with as an independent problem. So repeat thyroid function test after a couple of weeks.
Don't worry too much. Things are returning towards normalcy albeit slowly.
Shivaprasad
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