What causes weight gain and tiredness in a person with thyroid disorder?
I am sorry to learn about your medical problem.
As long as the TSH is at goal, the thyroid can be considered well regulated and under control.
The TSH target is generally around 0.5 to 2, with high-normal Free T4 levels. So whatever dose of synthroid is required to keep the TSH stable in this range, is the right dose for your body.
That being said, sometimes the TSH target can be made more lenient ie greater than 2 , such closer to 3 or 4 if there are certain medical situations such as:
Severe, untreated osteoporosis
Heart rhythm problems
Heart related chest pain from coronary disease
When I see someone like you in my practice I make sure their TSH is around 1 most of the time, unless one or more of the above conditions are present.
Then if despite that and a healthy lifestyle, the individual keeps gaining weight then I consider other rare causes of weight gain such as Cushings syndrome and Acromegaly.
There are different ways to check for these. For example a midnight salivary cortisol test can help screen for Cushings syndrome and blood test called IGF1 helps rule out Acromegaly
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