What Are Clinical Trials For Prescription Medications To Treat Overweight And Obesity
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help health care professionals and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of prescription medications to treat overweight or obesity, such as
- the effect of the FDA-approved medication liraglutide on weight loss and gastric functions in people who are overweight or have obesity
- adolescents and young adults who dont achieve expected weight loss or who still have severe obesity after undergoing weight-loss surgery
- patients who have obesity and binge-eating disorder
- women who are overweight or have obesity and polycystic ovary syndrome
What Is The Relationship Between Hyperthyroidism And Weight
Since the BMR in patients with hyperthyroidism is elevated, many patients with an overactive thyroid do, indeed, have some weight loss. Furthermore, weight loss is related to the severity of the overactive thyroid. For example, if the thyroid is extremely overactive, the individuals BMR increases which leads to increased calories needed to maintain the body weight. If the person does not increase the amount of calories eaten to match the excess calories burned, then there will be weight loss. As indicated earlier, the factors that control our appetite, metabolism, and activity are very complex and thyroid hormone is only one factor in this complex system. Nevertheless, on average the more severe the hyperthyroidism, the greater the weight loss observed. Weight loss is also observed in other conditions where thyroid hormones are elevated, such as in the toxic phase of thyroiditis or if the dose of thyroid hormone pills is too high for a patient. Since hyperthyroidism also increases appetite, some patients may not lose weight, and some may actually gain weight, depending on how much they increase their caloric intake.
How Does Hypothyroidism Affect Your Metabolism
The thyroid hormone helps control the speed of your metabolism. The faster your metabolism, the more calories your body burns at rest.
People with hypothyroidism make less thyroid hormone. This means they have a slower metabolism and burn fewer calories at rest.
Having a slow metabolism comes with several health risks. It may leave you tired, increase your blood cholesterol levels, and make it harder for you to lose weight .
If you find it difficult to maintain your weight with hypothyroidism, try doing moderate or high intensity cardio. This includes exercises like fast-paced walking, running, hiking, and rowing.
Research shows that moderate to high intensity aerobic exercise may help boost your thyroid hormone levels. In turn, this may help speed up your metabolism (
People with hypothyroidism usually have a slower metabolism. Research shows that aerobic exercise can help boost your thyroid hormone levels. Additionally, eating more protein may help boost your metabolism.
Several nutrients are important for optimal thyroid health.
Consider The Type Of Medication You Are Taking
Synthroid, a medication that contains the T4 hormone, is the most commonly prescribed medication for an underactive thyroid. However, the T3 thyroid hormone is more effective for maintaining our metabolism. In theory and on paper, T4 gets converted into T3 however, there are many potential factors that can prevent this conversion from happening in the human body!
Factors that Inhibit T4 to T3 Conversion
|Alcohol||Kidney and Liver Disease|
Furthermore, under stressful situations, T4 gets converted to Reverse T3 instead of T3. Reverse T3 is an inactive molecule related to T3, but without any physiological activity, it is a dud that just takes up space and blocks the active T3 from activating the receptors.
So what can one do to boost their T3 levels? Taking thyroid medications that contain T3 will help ensure that the right hormone is getting to the right receptors.
Some report more weight loss with T4/T3 combinations versus T4 medications alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.
In addition to losing weight, many patients that start taking a combination T4/T3 product often report that they feel better as well! For more information, be sure to read my article on which thyroid medications are best and mytop 11 thyroid medication tips.
Weight Loss Tips For Hypothyroidism
Maintaining a healthy weight can be a struggle when youre living with hypothyroidism. These tips can help you shed unwanted pounds and keep them off.
If hypothyroidism is inadequately treated it can be harder to lose weight, since the thyroid is a large regulator of metabolic function. The most important thing you can do for weight loss and for your overall health is to get proper treatment for your hypothyroidism. However, making a few dietary changes may help boost weight loss success. Losing weight is never easy, but people who have well-controlled hypothyroidism shouldnt struggle to lose weight more than anyone else, says Leonor Corsino, MD, an endocrinologist at the Duke Center for Metabolic and Weight Loss Surgery in Durham, North Carolina.
Use these six strategies to jump-start weight loss with hypothyroidism.
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Consider Medication Side Effects
As a consultant pharmacist, I have witnessed numerous people having major changes in weight gain with the use of certain medications.
Birth control, in particular, can be associated with significant weight gain, and 45 percent of my readers with Hashimotos reported that stopping birth control helped them normalize their weight. Ive written about the impact of birth control on our health in this article.
As people with Hashimotos are often misdiagnosed with anxiety, depression, bipolar disorder, etc. I would be remiss to report the important impact of psychotropic medications on weight gain.
The biggest culprits associated with weight gain include antipsychotic medications which were traditionally developed for schizophrenia but are used on and off label for conditions like bipolar disorder, depression, anxiety, irritability and even insomnia! In my experience, Zyprexa was the worst offender. I have seen people gain 100+ pounds on this medication. Other antipsychotics include Seroquel, Risperdal, and Abilify.
Antidepressants such as Prozac, Zoloft and Lexapro can also contribute to weight gain. The antidepressant Wellbutrin, however, is less likely to cause weight gain.
I recommend speaking with your doctor or pharmacist about your current medications to see if they could be potential culprits for causing weight gain, and if weight neutral alternatives exist.
What Are The Symptoms
You may have no symptoms at all. Or:
- You may feel nervous, moody, weak, or tired.
- Your hands may shake, your heart may beat fast, or you may have problems breathing.
- You may be hot and sweaty or have warm, red, itchy skin.
- You may have more bowel movements than usual.
- You may have fine, soft hair that is falling out.
- You may lose weight even though you eat the same or more than usual.
If you have any of these symptoms, call your doctor. Without treatment, hyperthyroidism can lead to heart problems, bone problems, and a dangerous condition called thyroid storm.
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What Medications Are Available To Treat Overweight And Obesity
The table below lists prescription drugs approved by the FDA for weight loss. The FDA has approved five of these drugsorlistat , phentermine-topiramate , naltrexone-bupropion , liraglutide , and semaglutide for long-term use. A sixth approved drug, setmelanotide , is limited to people who have been diagnosed with one of three specific rare genetic disorders, which must be confirmed by genetic testing. You can keep taking these medications as long as you are benefiting from treatment and not experiencing serious side effects.
Some weight management medications that curb appetite are approved by the FDA for short-term use only, for up to 12 weeks. Although some health care professionals prescribe them for longer periods, not many research studies have looked at how safe and effective they are for long-term use.
Never take weight management medications if you are pregnant. If you are planning to get pregnant, you should also avoid these medications, as some of them may harm the fetus.
Withdrawal And Overdose From Levothyroxine
Withdrawing from levothyroxine is not dangerous. In fact, if the drug is abused, quitting is safer than continuing, but it may include a resurgence of symptoms associated with the underlying thyroid problem. Symptoms include rapid weight gain, depression, low energy, and dry skin. People who abuse levothyroxine may develop insulin resistance during withdrawal, which can trigger diabetes.
When taken as prescribed, levothyroxine is a safe medication to treat thyroid-related disorders. However, when this drug is abused, or mixed with substances that increase the drugs potency, there is a risk of overdose. Call 911 immediately if someone displays the following signs of a levothyroxine overdose:
- Intense headache
- Physical tremors that are not controllable
- Extreme nervousness
- Shortness of breath
- Very high fever, leading to hyperthermia
Other signs that too much levothyroxine has been taken include warm or feverish skin due to blood flow changes and increased metabolism gastrointestinal discomfort anxiety or restlessness trouble concentrating and memory loss.
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They Can Contain Iodine
We need only 150 mcg of iodine per day in our diet, according to the Institute of Medicine. That tiny amount of iodine enables the thyroid to manufacture just the right amount of the thyroid hormone thyroxine, Lipman says.
But ingesting excess iodine can cause health problems. It is particularly worrisome for people with thyroid nodulesbumps on the thyroid glands that can be very small and often go unnoticed. If you have a nodular thyroidand chances are that 50 percent of us will develop one or more nodules by the time were 60even a slight excess of iodine can cause your thyroid to go into overdrive and produce excess thyroxine, Lipman says. An overactive thyroid can cause sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness or irritability.
Conversely, studies also show that too much iodine can cause the thyroid to slow down or even stop producing hormones in certain peoplethe opposite effect of what many people hope these supplements will do for them. That can result in weight gain and fatigue, and can increase your risk of cardiovascular disease, Lipman says.
Yet many supplements contain more than 150 mcg of iodine. For example, both Enzymatic Therapys Metabolic Advantage and Whole Foods Thyroid Complete contain 200 mcg per two-capsule serving. Follow the recommendation on the labels and swallow two capsules three times a day and youve ingested 600 mcg of iodineenough to cause health problems in certain people if taken long term.
How Is Hyperthyroidism Diagnosed
Your doctor will ask you about your symptoms and do a physical examination. Then he or she will order blood tests to see how much thyroid hormone your body is making.
Sometimes hyperthyroidism is found while you are having a test for another reason. You may be surprised to find out that you have this problem.
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Make Sure Your Treatment Is Tuned To Your Needs
Just starting thyroid medication will not necessarily help you lose the weight you have gained from having an underactive thyroid gland. Patients who do not change their diets or lifestyles after getting medication will often continue to gain weight. However, optimising your thyroid treatment can help kick start the process of getting healthy and losing weight.
Talk to your doctor about making sure that you are getting the proper levels of TSH, T3, and T4 in your medication. Scheduling follow-up appointments and keeping in close contact with your doctor will help them set the right level of treatment for your needs. Thats just the start, though. Read on to learn about the other steps you should take to get where you want to be.
What Is The Relationship Between Hypothyroidism And Weight Gain
Since the BMR in the patient with hypothyroidism is decreased, an underactive thyroid is generally associated with some weight gain. The weight gain is often greater in those individuals with more severe hypothyroidism. However, the decrease in BMR due to hypothyroidism is usually much less dramatic than the marked increase seen in hyperthyroidism, leading to more modest alterations in weight due to the underactive thyroid. The cause of the weight gain in hypothyroid individuals is also complex, and may not be related to excess fat accumulation. Most of the extra weight gained in hypothyroid individuals is due to excess accumulation of salt and water. Massive weight gain is rarely associated with hypothyroidism. In general, 5-10 pounds of body weight may be attributable to the thyroid, depending on the severity of the hypothyroidism. Finally, if weight gain is the only symptom of hypothyroidism that is present, it is less likely that the weight gain is solely due to the thyroid.
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Who Should Buy Thyroid Supplements
Thyroid supplements might be worth a shot if you want a supplement that provides the vitamins and minerals you need to support thyroid health. Thyroid function is delicate, though, so thyroid supplements should not be thought of as a replacement or substitute for prescription thyroid medication if you have diagnosed or suspected hypothyroidism or hyperthyroidism.
Some thyroid supplements contain herbal ingredients which could boost thyroid hormone activity, which is an undesirable side effect if you are already taking a thyroid medication. Thyroid supplements are better approached as tools to ensure that your thyroid has all of the building blocks it needs to function at full capacity.
That includes B vitamins, iodine, and other nutrients to produce thyroid hormones and keep your mood, energy levels, and weight stable. An ideal thyroid supplement should be something that allows you to maintain healthy thyroid function by providing your body with all of the ingredients it needs to both produce and regulate your thyroid hormone levels.
Too often, people think of thyroid supplements as an over the counter method to try to address hypothyroidism, but that should stay in the domain of prescription thyroid medication, because once you have thyroid problems, it can be very difficult to get your thyroid hormone concentrations to stay within the narrow window of normal levels.
Familiarize Yourself With Your Medications
Some of the drugs doctors prescribe for your thyroid-related symptoms or other conditions you might have can cause weight gain. For example, the following medications are associated with weight gain:
- Antithyroid drugs such as Tapazole and PTU , used to treat Graves disease and hyperthyroidism
- Beta-blockers, like Sectral , Tenormin , and Corgard , which are often used to treat hyperthyroidism
- Steroid anti-inflammatories such as prednisone
- Estrogen and progesterone, either alone or together in hormonal birth control or in hormone replacement therapy
- Certain antidepressants, especially Prozac , Paxil , and Zoloft
- Mood-stabilizing and anticonvulsant drugs such as those given for bipolar disorder, including lithium, Depakote and Tegretol
If you’re on any of these medications and you’re gaining weight, talk to your doctor about your concerns. Never stop taking a medication without your doctor’s input.
Thyroid Disease Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
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Prescription Medications Approved To Treat Overweight And Obesity
|Weight Management Medication|
|Available in lower dose without prescription||Adults and children ages 12 and older||Works in your gut to reduce the amount of fat your body absorbs from the food you eat|
Optimise Your Thyroid Medication
I wanted to begin with a nutrition recommendation, but correcting your thyroid medication first priority.
Work with your health care provider to determine what type of medication is better for you, and also to find the optimal dose required. While Levothyroxine is on average more effective, Armour is reportedly much better tolerated.
There is no difference between taking your thyroid hormone meds in the morning vs evening. Choose whatever is easier for you to have it on a fasting stomach .
Summary: It is fundamental to work with your doctor to explore what type and dose of thyroid medication is best for you. Until your thyroid hormone levels are corrected, weight loss is much more difficult.
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First Things First: You’ve Gotta Get It Diagnosed
If youre experiencing symptoms of hypothyroidismfatigue, unexplained weight gain, increased sensitivity to cold, constipation, and dry skinit’s time to see your doctor, who will do a blood test to determine your TSH levels.
After a diagnosis, you’ll likely start treatment for hypothyroidismand it’s a pretty straightforward approach: Youll be prescribed a cheap, safe, and effective synthetic hormone that replaces the one your body should be making on its own. The medication will restore normal levels of TSH.
Something to be wary of, though: at-home thyroid testing. Even if the results are reliable, it will likely be difficult for you to understand how to interpret the lab, or what action should be taken if you see an abnormal result, Dr. Isaacs adds.