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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Histroy Of Hypothyroidism. TSH 2.5, No Weight Loss. On Thyronorm. Dosage?

I had been diagnosed with Hypothyroidism in 1996 and since then have ben taking 100 mcg of Thyronorm everyday. Recently my TSH went up to 12 so the doc asked me to take 125 mcg for the weekdays and 100 mcg on the weekends.My TSH has gone down to 2.5 but my weight gain jsut doesnt reduce. even though I do brisk walking for half hr everyday i still dotn lose weight n feel tired easily. could you please guide me as to the correct dosage ?
Mon, 22 Apr 2013
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Orthopaedic Surgeon 's  Response
your maintenance dose is that which keeps your TSh level below 3.0
As for weight reduction, you must seek helpof a dietician. However,cutting on fats,calories and exercises are a must.Get your Lipid profile done also, along with blood sugar.if total cholesterol and triglycerides are raised for which suitable medicines shall be prescribed,,sometimes altered metabolism of cholesterol also makes one obese.
Body metabolism converts sugar and proteins also to fats and vice-versa so a balanced diet is recommended. If you cut on fats but don't curtail on carbohydrates, proteins , these may inter-convert to fats if there is a tendency or defective metabolism.Small meals at a time and more frequent @ hourly,coupled with some form of exercise every 4 hours shall help you burn calories faster rather than exercise or walking once a day. Don't let calories accumulate burn every 4 hours what you eat, small frequent meals will keep you satiated also and exercise will burn cals taken. Craving for food will gradually stabilize
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General & Family Physician Dr. S. Jegadeesan's  Response
Hi,
TSH is secreted by pituitary gland in the brain. TSH acts as a moderator to act on the Thyroid gland to increase or decrease its secretion of T3 in turn to active form T4.
Normal value of TSH is approximately 0.5 to 5.0. When TSH is more it indicates that Thyroid is not performing its function correctly leading to T3 & T4 reduction in blood (hypothyroidism) which makes the pituitary gland to secrete more TSH - to stimulate the thyroid to secrete more.(understand vice versa mechanism)
When TSH is more assuming that your blood level of thyroid is low thyroid tabs are given to make up the deficiency. So once thyroid tabs are indicated for you you have take those tabs life long. Alteration of doses are possible. you have take thyroid scan and other investigations to find out why thyroid is secreting less.
So the dr treating you has done the correct thing. As your TSH level has come to normal you can continue the same increased dosage with periodical monitoring - means you have to maintain your TSH within normal limits. A free T3 & free T4 evaluation may help you to increase the dosage of thyroid tab even though your TSH is within range - This point you have to discuss with your endocrinologist.
Regarding wt reduction, along with exercise, proper dieting, tabs to prevent lipid absorption, statin group of drugs, regular BP and ECG check up and tension free life is important.
Best wishes

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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Hi,
Welcome to HCM,
You are know case of Hypothyroidism and taking treatment in the form of Thyronorm 100 micro gram, if your TSH is high it is correct increase the dose as per advice of Physician.
It is true that hypothyroid state can cause some gain in weight as there is edema all over but no way it is the only cause of weight gain, in fact that is related to your caloric intake and physical activity, it is good that you are going for brisk walk please continue that and try to increase duration and take care of diet low in calories and fats more of fibres and fruits.
If you continue to take low calories in diet and continue exercise you will certainly lose weight.
Please do not lose heart.
Please discuss with your Physician if there is any need to add medicine like Orlistat.
You can take up Yoga, meditation and Pranayam.
Take care
Good Luck
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Histroy Of Hypothyroidism. TSH 2.5, No Weight Loss. On Thyronorm. Dosage?

your maintenance dose is that which keeps your TSh level below 3.0 As for weight reduction, you must seek helpof a dietician. However,cutting on fats,calories and exercises are a must.Get your Lipid profile done also, along with blood sugar.if total cholesterol and triglycerides are raised for which suitable medicines shall be prescribed,,sometimes altered metabolism of cholesterol also makes one obese. Body metabolism converts sugar and proteins also to fats and vice-versa so a balanced diet is recommended. If you cut on fats but don t curtail on carbohydrates, proteins , these may inter-convert to fats if there is a tendency or defective metabolism.Small meals at a time and more frequent @ hourly,coupled with some form of exercise every 4 hours shall help you burn calories faster rather than exercise or walking once a day. Don t let calories accumulate burn every 4 hours what you eat, small frequent meals will keep you satiated also and exercise will burn cals taken. Craving for food will gradually stabilize