Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

136 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What causes inabiity to lose weight?

Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1414 Questions

default
Posted on Thu, 28 Aug 2014 in Thyroid Problem and Hormonal Problems
Question: Hi Dr. XXXXXXX I know it's been a while, but I finally have my blood test results, from 2 weeks ago, to go over with you. The date of the test was 7/24/14. My Thyroxine (T4) was 4.6; my Thyroxine (T4) Free, Direct, S was 0.99; my Triodothyronine (T3) was 114; and my TSH was 0.047. As you can see everything was OK except my TSH, much too low. I'm currently taking 120 mg of Armour Thyroid, which I feel is the right dose for me.

I am still having the water weight problem. My Saliva test showed my Cortisol is very low in the early morning, and very late evening. It is very high, in the late morning, and and early evening I have XXXXXXX long list of supplements I am taking, but nothing seems to be making a difference. I am seeing a very good Endocrinologist, but not until October. My Cardilogist/Internist does not think this is a thyroid problem. I am still not losing weight, inspite of exercising, and eating less and less all the time. I still think this problem is related somehow to my thyroid, I was wondering what you think.
doctor
Answered by Dr. Binu Parameswaran Pillai 15 hours later
Brief Answer:
Hello

Detailed Answer:
Hello,

Good day.

Welcome back.
Noted your points.
I would appreciate if you could attach the salivary cortisol and Thyroid function test report.

If the TSH is so low, we may have to modify the dose of Armour thyroid.
Noted the cortisol results. But to diagnose excess cortisol, we prefer to do a midnight salivary cortisol or a dexamethasone supression test. I hope in October, your endocrinologist wil be able to arrange that.

I am sorry to say that, i do not think thyroid is reponsible for your inabiity to lose weight. YourTSH is low. With this level of TSH, i expect your weight to go down. Since you have been gaining weight, i would certainly like to rule out excess cortisol production in body.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai 2 hours later
Hello, Dr. XXXXXXX

I have both test results here with me, but I do not know how to send it to you.
doctor
Answered by Dr. Binu Parameswaran Pillai 6 hours later
Brief Answer:
Hi

Detailed Answer:
Hi,
Good day
You may attach the reports to this question. There is an option for that. Or you may email the customer care the reports and they will attach. You can type in here too. All i wanted was the units and the ranges. ( these varies from lab to lab and with out this, i will not be able to guide you properly)

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai 6 minutes later
OK, Dr. XXXXXXX Thank you you very much. I will work on getting these reports to you tomorrow.

Regards to you,
XXXX
doctor
Answered by Dr. Binu Parameswaran Pillai 12 minutes later
Brief Answer:
Hi

Detailed Answer:
Great. If you have difficulty attaching the reports, please type in here . The ranges in each lab and the unts used ( pmol, mmol, microgram ) etc are extremely importnat in hormonal assay interpretation.

for example: TSH: 0.04 uIU ( range: 0.3- 4.5)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai 12 hours later
Sorry Dr. XXXXXXX

I just saw where they did respond back to me, that they have no alternate ways for me to send the reports.

I guess I will have to type everything in, but it will take some time, because I want you to see all the results of my saliva test, as well. I'm not sure when I will have time to give you all the information, but it will definitely be in the next day or 2.

doctor
Answered by Dr. Binu Parameswaran Pillai 2 hours later
Brief Answer:
Hi

Detailed Answer:
No worries. Take you time. if you are not able to attach all reports doesnt matter. atleast the Free T4, Free t3 and TSH would do

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai 19 hours later
Hello, Dr. XXXXXXX

Luckily I was able to send the test results, via e-mail to customer care, right now. Please let me know if you don't receive them, or you can't read them.

Thank you so much,
XXXXXXX
doctor
Answered by Dr. Binu Parameswaran Pillai 5 hours later
Brief Answer:
Hello

Detailed Answer:
hi,
Thank you very much. I got 2 attachments, but both of them are the same ( saliva report). I haven't got the Thyroid report yet. I have asked customer care to check again if your Thyroid report is with them. ( did you send the thyroid report as well ?).
Noted the report of cortisol. It is low in the morning.Feel the sample collection was inadequate. Besides, to find out hypercortisolism, we need a mid night saliva cortisol ( 12 night. We need a dexamethasone supression test as well. However, do not worry. Please wait till you see the endocrinologist in October. I am keen to see the thyroid function test reports.

Regards

Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai 43 minutes later
Hi Dr. XXXXXXX

I just sent my thyroid test results again. I am getting extremely frustrated with my body. I am still filled up with so much water. Please let me know what you think after you receive my test results. I may have to go to New York to see a doctor there, because I don't know if I can wait until October. It is so difficult living like this!I have an Endocrinolist in New York, but he is ridiculously expensive. He is excellent, but the problem is he is not in network, with my insurance, and every time I go it costs me $1000 or more. I think he can find my problem, and I can probably get an appointment pretty quick. I believe the doctor I have an appointment with in October, is probably even better, but I just don't know if I can wait another 2 full months to see him.

Sorry to keep bothering you, Dr. XXXXXXX I know you must be busy, otherwise I know you wold have responded to me. Now my husband thinks I should hold off going to New York, because I already waited 2 months to see this Dr. in October, so I might as well wait 2 more months.
doctor
Answered by Dr. Binu Parameswaran Pillai 22 hours later
Brief Answer:
Hi

Detailed Answer:
Hello,
Extremely sorry. My outpatient clinic was quite busy for the last two days. Besides, i was waiting for your reports too. I got them. Your Free T4 and Free T3 are normal. I wouldnt really worry about that low TSH too much. No need to change the dose right now.
Good that you are meeting an endocrinologist in next 2 months. I do not personally think that thyroid alone is responsible for your symptoms.
It is a shame that i am not able to examine you. That would have surely given additional clues and directions how to proceed.

I feel, you should do a mid night salivary cortisol and a dexamethasone suprression test. These tests are not at all expensive.

However, since you are going to meet an endocrinologist fairly soon, i would say that you should leave the decision to him. In the interim, you may take a low salt diet and use lasix to flush out the extra fluid. But be aware that, lasix can cause low sodium and potassium. So it is important to check them after you increase your lasix dose.

Please do not worry. Once we find out the exact problem, correct treatment can be given. Worrying will only make things worse.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai 18 minutes later
We'll thank you Dr XXXXXXX at least I know I am on the right dose of medication, for now. I'm afraid lowering it would bring my T4 and T3 below normal. Now I know I must be patient and wait until October when hopefully I will find out what my problem is once and for all. I was just wondering where your clinic is. I'm sure you are not close to me otherwise you would tell me to come see you. I live 10 miles from New York City.
doctor
Answered by Dr. Binu Parameswaran Pillai 12 minutes later
Brief Answer:
Hi

Detailed Answer:
Oh i am too far. I am from XXXXXXX worked in Australia and then XXXXXXX and currently working in Muscat, Oman.

At this stage, i would not advice you to reduce the dose of thyroid medications. However, if you have peristently low TSH values, then we have to do something about it. When you meet the endocrinologist in October, i am sure that, he would do another thyroid function test.

Did you have these symptoms whilst on Synthroid ??

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai 11 minutes later
Yes, you are way too far. One of my best friends is from Calcutta, in XXXXXXX

When I was on Synthroid, my TSH was coming up a little, but I refused to stay on it, because I gained even more weight while taking Synthroid, and my eyes were always swollen.

At least now on Armour Thyroid, my weight may not have really gone down, but at least it stabilized. I don't have the problem with swelling in my eyes.

I will write back to you after I see the Endocrinolgist in October, but I guess that's all for now, unless I can think of any other questions.

Thank you so much for trying to help me, I really appreciate it.

If you think of anything else, that might help me, please let me know, because I plan on staying with this website.
doctor
Answered by Dr. Binu Parameswaran Pillai 13 hours later
Brief Answer:
Hi

Detailed Answer:
Thank you again.
Yes, I think, you should continue the same dose for now and we may need to evaluate further after you have seen the endocrinologist there. Clinical examination is very important and he may pick up some clues of your weight gain after examination. In the interim, I would advice you to keep a food diary and write down the quantity of each food you take including the amount of fluids. That might help us to calculate the calories in food and the amount of fluid intake.
Wish you good health
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Drug/Medication ,   ,   ,   ,  
Medical Topics ,  

Recent questions on  Armour thyroid

doctor1 MD

I really need help with my hashimotos and my reg doc just looks at the TSH and proclaims I m fine. Recently I have had terrible side effects from my Armor Thyroid. I ended up in the ER with anaphylatic shock two weeks ago. I could barely breathe....

doctor1 MD

I want to buy natural thyroid for a low thyroid. Where do I buy it? Where? What is the name of it?

doctor1 MD

I am currently taking 90 mg of Armour Thyroid daily for the past 4 years. Every 6 months I have blood work done and I consisitently score either .01 or .02m IU/L on the TSH test which ranges from .4 - 4.5. This is quite low. Why does my MD want to...