Weight Gain After Thyroidectomy And Radioactive Iodine Ablation & Taking Medications
Let’s take a minute to talk about the various therapies and treatments for hyperthyroid patients so we know what they are doing and how we might be able to intervene.
In most cases, patients with hyperthyroidism eventually undergo either a thyroidectomy or radioactive iodine ablation therapy.
What’s unfortunate is that studies have shown that regardless of what treatment you use for hyperthyroidism you will gain weight after.
Researchers have found that patients who undergo radioactive iodine ablation, thyroidectomy or take hyperthyroid medication will gain on average anywhere from 10-25 pounds within the first 3 months of therapy.
This occurs regardless of whether or not the patient gets thyroid hormone replacement after these therapies .
Much of this is due to a lack of understanding of thyroid hormone function in the body, and I have written many articles that you can learn from.
Let’s talk about these various therapies and how they work.
Now, this is obviously necessary if you have high circulating levels of thyroid hormone, to begin with, but this medication is difficult to fine tune.
That means it’s easy to either over treat or undertreat .
Because of these issues, methimazole generally isn’t used long term which leads to thyroidectomy or RAI .
Radioactive iodine ablation:
The Link Between Thyroid And Your Weight
The thyroid gland is a butterfly-shaped gland located in the front of your neck. This gland is responsible for producing, storing and secreting thyroid hormone, an essential hormone for the function of virtually all parts of your body. Reduced production of thyroid hormone can be temporary, but when it is permanent, the result is called hypothyroidism.
Approximately 4.6 percent of people in the U.S. ages 12 and older have some degree of hypothyroidism, the vast majority falling into what is known as subclinical or mild hypothyroidism. Mild hypothyroidism is typically asymptomatic but can progress to overt hypothyroidism. Hypothyroidism from any cause results in a decrease in energy metabolism, or the basal metabolic rate. Patients often experience a modest amount of weight gain prior to diagnosis because of this metabolic slowing, explains Northwestern Medicine Endocrinologist Eve D. Bloomgarden, MD. Other symptoms depend on the severity of hypothyroidism but commonly include fatigue, constipation, muscle aches and feeling cold. And while this can lead to weight gain for some that is only a small part of the big picture.
What Is The Relationship Between Thyroid And Weight
It has been appreciated for a very long time that there is a complex relationship between thyroid disease, body weight and metabolism. Thyroid hormone regulates metabolism in both animals and humans. Metabolism is determined by measuring the amount of oxygen used by the body over a specific amount of time. If the measurement is made at rest, it is known as the basal metabolic rate . Indeed, measurement of the BMR was one of the earliest tests used to assess a patients thyroid status. Patients whose thyroid glands were not working were found to have low BMRs, and those with overactive thyroid glands had high BMRs. Later studies linked these observations with measurements of thyroid hormone levels and showed that low thyroid hormone levels were associated with low BMRs and high thyroid hormone levels were associated with BMRs. Most physicians no longer use BMR due to the complexity in doing the test and because the BMR is subject to many influences other than the thyroid state.
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Are There Any Foods I Can Eat To Help My Hypothyroidism
Most foods in western diets contain iodine, so you do not have to worry about your diet. Iodine is a mineral that helps your thyroid produce hormones. One idea is that if you have low levels of thyroid hormone, eating foods rich in iodine could help increase your hormone levels. The most reliable way to increase your hormone levels is with a prescription medication from your healthcare provider. Do not try any new diets without talking to your provider first. Its important to always have a conversation before starting a new diet, especially if you have a medical condition like hypothyroidism.
Foods that are high in iodine include:
- Edible seaweed.
- Iodized salt.
Work with your healthcare provider or a nutritionist to craft a meal plan. Your food is your fuel. Making sure you are eating foods that will help your body, along with taking your medications as instructed by your healthcare provider, can keep you healthy over time. People with thyroid condition should not consume large amounts of iodine because the effect may be paradoxical .
Surgery For Thyroid Disorders
Removing the thyroid gland can cure hyperthyroidism, but the procedure is only recommended if antithyroid drugs don’t work, or if there is a large goiter. Surgery may also be recommended for patients with thyroid nodules. Once the thyroid is removed, most patients require daily supplements of thyroid hormones to avoid developing hypothyroidism.
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What Prompts Hyperthyroid Related Weight Gain
“This woman had developed thyroid storm,” says Kristien Boelaert, MD, PhD, associate professor of endocrinology at the University of Birmingham in the United Kingdom, and senior author of a new study focusing on weight gain after treatment for hyperthyroidism. Thyroid storm is a life-threatening condition in which body temperature, heart rate, and blood pressure often rise to dangerous levels.
These symptoms arose in June, landing her in the intensive care unit, Dr. Boelaert says, and required urgent medical attention. Just like this patient, many people are tempted to stop taking their antithyroid therapy with of the hope of lessening the weight gain, she says, and for those who do, the result is even worse medical complications.
In recognizing this common scenario, Dr. Boelaert and her colleagues were compelled to study the issueexactly how much weight people typicaly gain while being treated for hyperthyroidismand report their findings in the journal Thyroid.1
Dr. Boelaerts team found that many people do indeed gain weight, with some developing obesity. The data gathered from this study puts concrete numbers to this adverse effect of hyperthyroid treatment. Simple awareness of how common excess weight gain may be can be a big relief for patients, Dr. Boelaert tells EndocrineWeb knowing that weight gain can occur means patients can take proactive steps to anticipate the problem and lessen the result.
You’re Constantly Wearing 5 Layers
If you are still wearing your winter coat when it’s 60 degrees and sunny, you might be suffering from hypothyroidism. It might be easy to adjust the temperature in your house or car, but patients who have hypothyroidism struggle to regulate the temperature in their bodies. Because the thyroid gland controls your body temperature, when hypothyroidism patients’ bodies make too little thyroid hormone, body temperature tends to decrease because less energy is being burned by downstream cell targets. Less energy compounded with slow metabolism equals less heat.
So, to conclude Julys blog, dont go through life feeling that something is not right with your body. Make an appointmentand come in to see us so that we can help.
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Levothyroxine And Synthroid Are Both T4 Only Medications
So here is the primary problem:
Levothyroxine and Synthroid are both T4 only medications.
Most Doctors will prescribe T4 medication under the assumption that your body will have no problem converting T4 into T3.
And in a perfect world, a world without stress, inflammation or other hormonal imbalances – it would.
But that’s not the world we live in…
Nowadays it’s VERY uncommon if someone has their stress managed, has no issues with blood sugar/insulin/leptin, has a normal menstrual cycle, is not overweight, has never done yo-yo diets, or has normal adrenal function.
Do any of these symptoms or situations sound familiar?
Chances are high that you are dealing with 1 or more of them.
And in states such as these, your body will turn T4 into reverse T3 as a way to “put on the brakes” and slow down your metabolism and cause symptoms of hypothyroidism.
How Are Weight Changes Associated With Thyroid Hormone Replacement
To assess the weight changes associated with thyroid hormone replacement or suppressive therapy after thyroidectomy, we measured the weights of patients before and after thyroidectomy and compared them to the weights of euthyroid patients with thyroid nodules who were being followed for many years.
An impaired metabolism, however, can also cause weight gain, even if the patient hasnt changed their diet or the amount of food that they eat. Whether the patient loses or gains weight will depend on the part of the thyroid affected by cancer.
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Hypothyroidism Weight Gain And Mitochondria
The real cause of hypothyroidism weight gain is this weight gain is because of small organelle in your body called mitochondria.
This mitochondrion is responsible for producing energy in your body and also regulates several metabolic processes.
It was initially thought that the thyroid hormone affects the functioning of mitochondria and this affects the metabolic rate and thus causing weight gain.
But in reality, the mitochondrial dysfunction in people with thyroid problems happens earlier than the hypothyroidism.
What this means is that first, mitochondrial destruction happens and then later on thyroid gland destruction happens.
When To See A Doctor
In most cases, weight gain with hyperthyroidism is probably nothing to worry about, especially if you previously lost a lot of weight due to your initially untreated condition. However, if youre gaining a lot of weight or have other uncomfortable symptoms, it might indicate a new problem. Talk to your doctor about finding the right course of treatment for you.
Weight gain alone is generally not a sign of a thyroid problem. But weight gain alongside the following symptoms can indicate hypothyroidism:
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Signs Your Weight Loss Problem Is Really A Thyroid Problem
You did your homework and tried every weight loss program you could find.
And nothing worked for your weight loss, or didnt work for long.
You lost weight only to regain it. Or you sacrificed for months without shedding a pound.
They told you that you didnt have will power, and you started to believe them.
You questioned yourself. Is this weight loss problem in my head or is it in my hormones?
Would you be surprised to learn that an estimated 30 million Americans are unsuccessful at weight loss because it is caused by a thyroid problem, and not to a lack of will power or discipline?
The Thyroid/weight Gain Connection
Hypothyroidism has long been associated with weight gain , but the exact biochemical cause of this link is not completely clear. That said, there are several mechanisms that may explain the connection in cases of low thyroid function.
The two most active thyroid hormones, thyroxine and triiodothyronine , circulate in the body, and they affect your metabolism through their interaction with your:
- Fat cells
Thyroid hormones normally help the body break down fat, and they help the liver and pancreas function to metabolize stored calories to be used for energy. These hormones also help the muscles throughout the body as they use energy. And when there is an adequate amount of thyroid hormones circulating in the body, the hypothalamus, which is a regulator of thyroid hormone in the brain, decreases the amount of thyrotropin regulating hormone secretion.
Treatment with thyroid replacement medications does not necessarily induce weight loss, even when optimal thyroid hormone levels are measured on blood tests.
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You Have High Cholesterol Levels
Even though your doctor doesn’t typically look for thyroid problems during your check-ups, he or she will often measure your cholesterol levels. High blood cholesterol levels can put you at risk of getting heart disease, but they also might be indicative of a thyroid problem.
According to Dr. Srinath, “Hypothyroidism causes reduced clearance of cholesterol particles, so LDL and triglycerides may be elevated in a hypothyroid patient.” Looking to lower LDL levels? Try eating overnight oats. The fiber called beta-glucan in this cereal grain has been shown to reduce LDL cholesterol levels by 5 to 10 percent.
See your doctor to get checked for high cholesterol levels, and when you’re looking to change your diet to lower these levels, consider these 17 Foods That Lower Cholesterol.
What Is The Thyroid Gland
The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroids job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormones help the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.
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How Low Thyroid Changes The Way Your Body Manages Weight
Thyroid-related weight gain affects millions of women but it has very specific causes. Low thyroid, also known as subclinical hypothyroidism, can make it much harder to lose weight at the same time it is turning on mechanisms that make it easier to pile on new weight.
The thyroid can affect your weight so easily because one of its main jobs is to regulate metabolism. If thyroid hormones are low, your heart rate slows and so does your digestive system, often leading to constipation, which is linked to weight gain. And in a vicious-circle effect, these small shifts in weight can change thyroid hormone levels.
When thyroid hormones are low even just a little bit it causes physical changes in your body and brain that can stimulate weight gain. Lowered thyroid hormones alter the brain centers that control appetite.
This small shift is enough to confuse your brains chemical messengers, serotonin, beta endorphin, and gamma-aminobutyric acid . These neurotransmitters regulate how and when you eat, and are also tightly connected to moods.
Weight Gain After Hyperthyroidism Treatment Is Common: What To Know
With Kristien Boelaert, MD, PhD, and Reshmi Srinath, MD
After successful treatment for her overactive thyroid , the patient , not only gained all excess the weight she had lost while her thyroid gland was in overdrive, but the weight continued to creep up.
This is common complaint repeated by many people who visit the discussion board on EndocrineWeb. Understandably, June was so distraught with the undesirable weight gain, so she stopped taking the medication meant to normalize her thyroid levels.
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Signs Of Thyroid Cancer That Most People Miss
The thyroid is a butterfly-shaped endocrine gland in the neck. It produces two hormones, triiodothyronine and thyroxine , that regulate the bodys metabolism. Often, people attribute the first signs of thyroid cancer to other conditions.
Further, its essential to understand that the thyroid carries responsibility for hormone regulation. If the thyroid produces too much hormone, the patients metabolism is too fast, and they become hyperthyroid. If the thyroid produces too little hormone, the patients metabolism is sluggish, and they become hypothyroid.
Thus any thyroid disease can cause severe illnesses.
S You Can Take Today To Lose Weight And Boost Thyroid Function
There are several things YOU can do to optimize your thyroid function.
These steps should be taken in addition to the steps outlined above for best results.
Whenever I treat patients I often employ multiple therapies at once for the multiplicative effect that it provides on metabolism and thyroid function.
Follow these steps below to naturally boost your thyroid function and reset the metabolic conditions that favor T4 to reverse T3 conversion:
1. Optimize T4 to T3 Conversion
One of the easiest things you can start with right away is making sure that you have all of the right nutrients for proper thyroid conversion.
You can read more in this post about the 13+ nutrients required for proper thyroid creation, metabolism and conversion but I will go over the most important below.
The two primary nutrients involved in the conversion pathway are zinc and selenium.
It also happens that MANY patients are deficient in both of these nutrients due to a variety of reasons, which creates a great opportunity for most patients.
Let me go over the benefits of each of these…
Benefits of Zinc Supplementation on thyroid function:
- Acts as an anti-inflammatory agent
- Acts as an anti-oxidant in the body
How to supplement with Zinc and Selenium:
- Zinc: Take up to 60mg per day
- Selenium: Take up to 50mcg to 200mcg per day
- Look for supplements which contain both Zinc and Selenium such as this one.
2. Optimize your Adrenal Function and Cortisol Levels
Cortisol and thyroid function are linked.
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Who Is More Likely To Develop Hypothyroidism
Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1
You are more likely to have hypothyroidism if you
- had a thyroid problem before, such as a goiter
- had surgery or radioactive iodine to correct a thyroid problem
- received radiation treatment to the thyroid, neck, or chest
- have a family history of thyroid disease
- were pregnant in the past 6 months
- have Turner syndrome, a genetic disorder that affects women
Your thyroid is also more likely to be underactive if you have other health problems, including
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