What Is Causing Weight Gain After Antithyroid Drug Therapy
Dr. Boelaert still cant say for sure why individuals who are treated with antithyroid drugs to reverse their hyperthyroidism show a tendency to gain back the lost weight plus more. “It appears something in the disease process or perhaps from the treatment makes them end up heavier.” Clearly, more research is needed for us to understand the specific mechanisms behind the shift upward in body weight as a result of non-surgical treatment for overactive thyroid, she says.
Also, we know that appetite signals get disturbed when the thyroid goes out of whack, she says. When patients come in for treatment, ”lots of patients say, ‘I am losing weight although I feel like am eating like a horse.'” After the antithyroid treatment begins, at least some people may continue to eat the same larger amounts that they have grown accustomed to, and this may contribute to the weight gain, she says.
Do appetite signals return to normal once treatment begin? “We don’t know, but we hope to study this,” Dr. Boelaert says.
She worries about the adverse effects that are associated with overweight. “People with an overactive thyroid already have an increased risk of cardiovascular disease,” she explains. “If they then become overweight or obese, that is a further ‘hit.”’ So recognizing your increased risk for heart disease, and concerns about weight gain should be discussed with your doctor, and incorporated into your treatment plan.;;
Address Weight Gain from Antithyroid Drug Therapy;;
Thyroid Function In Obese Subjects
TSH levels are at the upper limit of the normal range or slightly increased in obese children, adolescents, and adults and are positively correlated with BMI. Low fT4 with a moderate increase in T3 or free T3 levels has been reported in obese subjects. Progressive fat accumulation was associated with a parallel increase in TSH, and fT3 levels irrespective of insulin sensitivity and metabolic parameters and a positive association has been reported between the fT3 to fT4 ratio and both waist circumference and BMI in obese patients. Although the typical picture of high TSH, low fT4, and high fT3 is the most common, various studies on adult obese individuals report thyroid hormone and TSH concentrations as normal, elevated, or reduced.
In obese children, the most common abnormality clearly is hyperthyrotropinemia. Recently, it has also been shown that obese pediatric patients frequently have an ultrasound pattern of the thyroid which is highly suggestive of Hashimoto’s thyroiditis. These findings are not associated, however, with production of thyroid autoantibodies.
When To Contact Your Doctor
If youve checked off signs and are not feeling yourself, discuss this with your primary care doctor. These signs dont necessarily mean that you have thyroid disease. By asking you about your symptoms, your doctor can decide whether you need a blood test to check for thyroid disease.
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ImagesImage 1: Getty ImagesImages 2, 3, 4: Used with permission of the Journal of the American Academy of Dermatology: J Am Acad Dermatol. 2003 Jun;48:970-2.
ReferencesAi J, Leonhardt JM, et al. Autoimmune thyroid diseases: etiology, pathogenesis, and dermatologic manifestations. J Am Acad Dermatol. 2003;48:641-59.
Anderson CK, Miller OF. Triad of exophthalmos, pretibial myxedema, and acropachy in a patient with Graves’ disease. J Am Acad Dermatol. 2003;48:970-2.
Bae JM, Lee JH, et al. Vitiligo and overt thyroid diseases: A nationwide population-based study in Korea. J Am Acad Dermatol. 2017;76:871-8.
Callen JP. Dermatologic manifestations in patients with systemic disease. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008: 681-2.
Kalus AA, Chien AJ, et al. Diabetes mellitus and other endocrine diseases. In Wolff K et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill, China, 2008:1470-4.
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Losing Weight With Hypothyroidism
If you have hypothyroidism, losing weight can be very challenging. Many people think that once you start taking thyroid hormone replacement medications, the weight just falls off. While treatment can help you lose some of the weight you have gained, it takes planning, hard work, diet, exercise, and getting enough sleep to shed a number of pounds.
Determining how far off you are from your ideal weight and body fat can help you assess how much weight you need to lose. A body mass index calculator can help you get started.
Another step to weight loss is determining your own basal metabolic rate , which can help you gauge your metabolism and guide you in coming up with a target calorie intake per day.
Understanding Weight Gain Related To Hypothyroidism
Hypothyroidism occurs when your thyroid gland doesnt produce enough of certain hormones. Its estimated that nearly 5 percent of the U.S. population over the age of 12 may be living with hypothyroidism. Below, Dr. Harshit Shah, an endocrinologist with Dignity Health Medical Group – Bakersfield, explains how hypothyroidism can impact weight gain.;
“While the condition may not cause any noticeable symptoms at first, it can lead to other health problems if left untreated including weight gain,” says Dr. Shah. “In fact, the majority of patients I see in my practice who are diagnosed with hypothyroidism are experiencing unwanted weight gain.”
Hypothyroidism causes a decreased body metabolism or BMR , which is what leads to weight gain. The weight gain is often greater in those individuals with more severe hypothyroidism.
The cause of this weight is complex and not always related to excess fat accumulation. Most of the extra weight gained 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 thyroid, depending on the severity of the disease. Since much of the weight gain is from salt and water, one can expect a small weight loss once the hypothyroidism is addressed.
Dr. Shah also;recommends patients follow general weight loss and wellness guidelines:
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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?
Thyroid Hormone And Brown Adipose Tissue In Energy Homoeostasis
Thermogenically active brown adipose tissue is found in adults. Hence, the presence of thermogenically active D2 BAT in an adult is clinically important. In the recent years, the presence of BAT has been recognized as an important target for treating obesity. The energy homeostasis in the BAT has been found to be affected by a great extent by thyroid hormone signaling. Thyroid hormone signaling, particularly by inducing type II deiodinases, has a cardinal function in brown tissue adipogenesis. The BAT gets activated by local D2 mediated action. D2 increases expression of the gene Ppargc1a by enhancing thyroid hormone signaling, which coactivates thyroid hormone receptors, leading to increased expression of the gene Ucp1. Dio2 is also upregulated by increased T3 signaling. These D2-dependent pathways provide the mature brown adipocyte with its full thermogenic identity. D2 dependent T3 is necessary for BAT to be functional and also for brown adipogenesis as demonstrated by preclinical trials and cell line studies. Thereby, activation of BAT in adults, specifically through thyroid hormone-mediated pathways, has a potential role in treating obesity.
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Causes Of Endocrine Disorders
Endocrine disorders are typically grouped into two categories:
- Endocrine disease that results when a gland produces too much or too little of an endocrine hormone, called a hormone imbalance.
- Endocrine disease due to the development of lesions in the endocrine system, which may or may not affect hormone levels.
The endocrine’s feedback system helps control the balance of hormones in the bloodstream. If your body has too much or too little of a certain hormone, the feedback system signals the proper gland or glands to correct the problem. A hormone imbalance may occur if this feedback system has trouble keeping the right level of hormones in the bloodstream, or if your body doesn’t clear them out of the bloodstream properly.
Increased or decreased levels of endocrine hormone may be caused by:
- A problem with the endocrine feedback system
- Failure of a gland to stimulate another gland to release hormones
- A genetic disorder, such as multiple endocrine neoplasia or congenital hypothyroidism
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.
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How Much Weight Can I Expect To Lose Once The Hypothyroidism Is Treated
Since much of the weight gain in hypothyroidism is accumulation in salt and water, when the hypothyroidism is treated one can expect a small weight loss. As in the treatment with hyperthyroidism, treatment of the abnormal state of hypothyroidism with thyroid hormone results in a return of body weight to what it was before the hypothyroidism developed. Since weight gain may have many causes and develops over a long period of time, it is fairly common to find that there is not a large amount of weight loss after successful treatment of hypothyroidism. Again, if all of the symptoms of hypothyroidism other than weight gain resolve with thyroid hormone treatment, it is unlikely that the weight gain was solely due to the thyroid. Once hypothyroidism has been treated and thyroid hormone levels are in the normal range, the ability to gain or lose weight is the same as in individuals who do not have thyroid problems.
When Your Thyroid Underperforms And Can’t Produce Enough Of The Thyroid Hormone Needed To Regulate Many Bodily Functions It Can Cause Weight Gain But The Good News Is That The Condition Can Be Treated
But other times, you can blame your thyroid.
If you have hypothyroidism, it can slow your metabolism and make it harder for you to lose pounds and maintain a healthy body weight. That’s because the condition causes your thyroid to underperform and become underactive and unable to produce enough of the thyroid hormone necessary to allow your body to function properly.
Your metabolism, in addition to regulating your body temperature and your heartbeat, affects how efficiently and effectively your body burns calories.
What causes your thyroid to underperform? There are a number of conditions and circumstances that can cause hypothyroidism; the most common is Hashimoto’s thyroiditis, an autoimmune disorder that causes your body to produce antibodies that attack and destroy the thyroid gland, leading to chronic inflammation. Over time, your thyroid loses its ability to produce enough thyroid hormone. The condition tends to run in families and most commonly occurs in middle-aged women, though it can affect men, women and children of any age.
Learn more about 15 Things Your Thyroid Can Affect.
Other things, like pregnancy, can affect your thyroid. Known as postpartum thyroiditis, the condition causes the thyroid to become inflamed after pregnancy, making thyroid levels first increase, then sharply drop. This condition usually resolves itself. Sometimes a thyroid problem can be caused by issues with the pituitary gland or hypothalamus, as well.
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Cut Out Simple Carbs And Sugars
Kelly Austin, ND, a naturopathic doctor specializing in hormone disorders and the director of the Prime Wellness Clinic in San Diego, recommends a moderate- to low-carbohydrate diet that focuses on complex carbohydrates and avoids simple sugars . According to the Linus;Pauling Institute at Oregon State University, foods with a high a;glycemic load may increase inflammation in the body. But Dr. Austin stresses the importance of eating enough calories because “low calories can cause a stress response and result in decreased T3 production, she says.
About Dr Kent Holtorf
Kent Holtorf, M.D. is the medical director of the Holtorf Medical Group;with locations in Los Angeles, Foster City, Atlanta, and Philadelphia. He is also founder and director of the non-profit National Academy of Hypothyroidism , which is dedicated to dissemination of new information to doctors and patients on the diagnosis and treatment of hypothyroidism.
Dr. Holtorf has personally trained numerous physicians across the country in the use of bioidentical hormones, hypothyroidism, complex endocrine dysfunction, and innovative treatments of chronic fatigue syndrome, weight loss, fibromyalgia, and chronic infectious diseases, including Lyme disease.
He has been a featured guest on numerous TV shows including CNBC, ABC News, CNN, EXTRA TV, Discovery Health, The Learning Channel, The Today Show, The Doctors, Dr. Dean Edell, Glenn Beck, Nancy Grace, Fox Business, ESPN, Rush Limbaugh, CBS Sunday Morning, Sean Hannity, So Cal News, and quoted in numerous print media including the Wall Street Journal, Los Angeles Times, US New and World Report, San Francisco Chronicle, WebMD, Health, Elle, Better Homes and Garden, US Weekly, Forbes, Cosmopolitan, New York Daily News, Self magazine, among many others.
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Why Am I Gaining Weight While Taking Levothyroxine
Weight gain This is because the drug can increase your appetite, which may make you eat more food than usual. Its also possible for you to gain weight if your dose of Synthroid isnt high enough for your bodys needs. This is because if your thyroid hormone levels arent high enough, your metabolism* may be slowed.
Gastroesophageal Reflux Disease & Irritable Bowel Syndrome:
Gastroesophageal reflux disease causes the relaxation of the muscle between the esophagus and stomach, thus allowing the contents of the stomach to flow back in to your esophagus and this results in heartburn. While, this condition itself does not cause individuals to gain weight, common remedies to relieve the symptoms generally adds unnecessary pounds. Many people eat a lot to reduce the painful consequences of GERD temporarily. Eating to relieve the pain temporarily is pretty much guaranteed to make you gain extra pounds. So, it is good to talk to doctor, change to a healthy lifestyle and treat the condition without gaining unwanted weight.
Same is in case with Irritable Bowel syndrome, where during the days when you are experiencing less severe symptoms, you might eat more and that may make you gain weight. You must consult your doctor and take the necessary treatments for it.
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Signs And Symptoms Of Hypothyroidism
Symptoms of hypothyroidism are usually subtle and gradual, and may resemble those of other conditions or medical problems. Many symptoms are non-specific and may be ignored as normal parts of our everyday lives. Because of this, the condition may go undetected for years.
Symptoms may include:
- Slower reaction time
- Weight gain
- Sparse, coarse and dry hair
- Coarse, dry and thickened skin
- Slow pulse
- Sides of eyebrows thin or fall out
- Dull facial expression
- Enlarged thyroid, producing a goiter-like growth on the neck
- Increased menstrual flow and cramping in girls and young women
If you have concerns about your child’s health, talk to your childs physician.
How Is Hashimoto’s Disease Treated
Hashimotos disease is treated with a daily dose of . This is the same hormone that your thyroid gland makes. You will probably need to take thyroid hormone pills for the rest of your life. Talk to your doctor or nurse about any questions or concerns.
You may have to see your doctor or nurse a few times to test the level of thyroid stimulating hormone in your body. Thyroid hormone acts very slowly in the body, so it can take several months after the start of treatment for symptoms to go away. Once your TSH level is normal, your doctor or nurse will need to see you less often.
The same treatment dose usually works for many years. But your TSH levels may change sometimes, especially during pregnancy, if you have , or if you take . Your doctor or nurse may need to adjust your dose.
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Can You Have Gravess Disease And Gain Weight
Gravess disease is essentially a disorder affecting the immune system of the body, which ultimately leads to hyperthyroidism. The condition of hyperthyroidism is best explained by the overproduction of the thyroid gland. There may be various conditions which lead to hyperthyroidism, Graves disease is one of them.