Thyroid Q & A
WebMD Live Events Transcript
Are you one of the more than 13 million Americans with thyroid problems? If you have questions about the diagnosis or treatment of thyroid problems and their affects on your weight, energy level, fertility, and more, check out our discussion with WebMD's in-house expert, Brunilda Nazario, MD. She joined us Sept. 1, 2004.
The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.MEMBER QUESTION:
I have Hashimoto's disease and I am on Synthroid. Any suggestions for losing weight? I have about 80 pounds I need to lose.
It's not uncommon to have weight gain attributed to thyroid problems. It's an unfortunate reality that for the most part, excess weight is not attributed to a detectable thyroid abnormality. Having said that, I would make sure that your lab results that checks for adequate replacement is on the mark, meaning your TSH should be at least less than 3. Secondly, you really want to make sure that you take your thyroid hormone without any other medications, and try and take it the first thing in the morning.
My best advice, having done lots of work with patients that are overweight and obese, is actually quite simple. The first step should be cutting back on the amount of calories we take in. This cutting back should not be a drastic amount where you're left with hunger throughout the day. Simply cutting back about 500 calories a day should lead to about 1 to 2 pounds weight loss per week.
Secondly, increasing physical activity is key to maintaining that weight loss. That doesn't mean joining a gym and drastically changing, such as joining the next marathon, it simply means taking a few more steps a day. Eighty pounds is a lot of weight to lose. Weight loss is a difficult challenge for anyone and there are no magic pills. I would start there.
What we need to look at when we talk about excess weight is excess weight as a chronic condition. What that means is we need to make lifelong changes. So the decrease in calories and increase in physical activity is something you need to commit to, lifelong. That alone is guaranteed to take your weight off and keep it off. Surgery doesn't promise this, and medications do not promise this.
I don't know if I have a thyroid problem, but I have been having lots of symptoms that make me think that I do have a problem. I am wondering what tests I should have done.
It sounds like this is a very simple issue that you're looking at. Simply stated, you need a blood test called a TSH, and another blood test called a T4, which is the actual level of thyroid hormone.
I would not be surprised if these blood tests come back normal, so prepare yourself. Unfortunately, many of the symptoms of a thyroid problem, especially hypothyroidism, are quite vague and shared by many other conditions.
These are a bit more specific. There are also many telltale signs on examination that help us pinpoint a thyroid problem with hyperthyroidism. But again, a blood test is needed.
I am a 56-year-old female. I have hypothyroidism diagnosed two years ago. I was prescribed 75 micrograms of Levoxyl. I would like to know if severe sweating and flushing of the face, chills, heart palps, fatigue, and anemia symptoms should be this persistent, to the point that the sweating is very embarrassing and annoying. It has me changing my lifestyle by not wanting to go anywhere because I am embarrassed. Every time my doctor runs labs he tells me they are good. This is so confusing to me. He seems to dismiss my complaints of sweating, etc. Also what is Armour thyroid, and is it safe to take?
The first thing I would do is I would check the thyroid panel, and again, specifically looking at what the level of your TSH level is. That level would determine whether you have sufficient replacement, and more importantly, whether you are taking excess amounts. Excess amounts of thyroid hormone could lead to symptoms of hyperthyroidism. You could get fatigue and flushing and excess sweating.
I'm not quite sure what it is when you say the doctor says your hormone levels are normal. You want a TSH level that's less than 3, but you certainly don't want a TSH level that is close to undetectable.
You're on Levoxyl, which should be an adequate medication. Armour is also a thyroid hormone, but it is a combination of two different thyroid hormones, one called T4, which the thyroid makes, and one called T3, which comes after breaking down T4. T3 is particularly potent; so many endocrinologists tend to shy away from prescribing Armour because it can lead to hyperthyroid symptoms.
The symptoms that you describe, the fact you're a female, and that they started around the age of 54, leads me to suspect a potential drop or deficiency of female hormones, or estrogen. Many of the symptoms that you describe sound like the perimenopausal flush. Again, this is something that can easily be detected by having your doctor measure FSH, and a level of estrogen would help determine that.
If this is related to menopause, the answer may lie in putting you on female hormone replacement, but many other options also exist. If the problem is more relating to the flushing episodes and the chills, there are indeed many options for women aside from estrogen. A few of the seizure medications and even antidepressants can be used to treat hot flashes.
I would suggest opening a discussion with your physician about the possibility that this may be flushing relating to menopause. Typically, if it is, women can have these symptoms for a period of five years on average, although many women have this for less time, and there are women who have this even for more extended periods. So it's worthwhile having this investigated in particular, because it seems it is affecting the quality of your life.
I have been on Synthroid for four years. This year I turned 60 and have been having some problems with losing my hair and dry skin dermatitis. I asked the doctor if this was from my hypothyroid and if I need to have an adjustment with my meds. She said no, but I have never gone to a specialist for this. Should I, because of these events?
This is a question I get asked commonly. Certainly hypo or hyperthyroidism affects hair loss, so it's always a good idea to get your thyroid checked and adjusted if there is a problem.
Hair, as an organ, is a very complex system. There are totally asynchronous phases in hair, so while some hair follicles are totally dormant, some are growing, some are shedding, and it's asynchronous for a reason. If we all shed our hair at the same time we'd all become bald. It's not uncommon that there are periods or seasons where the shedding seems to be more exaggerated. Some of that may be linked to a small degree of vitamin D deficiency, although that does not usually occur in the summer when we're bathing in the sun; it's in the winter season. It still would be a good idea to have your vitamin D levels checked. From a hormonal standpoint those are two things I would check.
The third thing from a hormonal standpoint, when we talk about hair loss, is male hormone. When women go through the changes of life we typically lose female hormones without a loss of male hormones that we make. Male hormones, although they cause an increase in body hair, cause a loss of scalp hair, especially frontal balding (I'm assuming you're not talking about male type baldness; I assume what you're talking about is shedding throughout your scalp). An assessment of what your male hormone levels are should be done now.
Aside from those things, let's look at the damage we do to our hair. If you use hair color, if you highlight, take a look at the quality of those substances. Most of those are acidic substances that take away the natural lubricant on the hair follicle. What I see in our society is as we age and we become gray, like myself, we tend to try to cover that up. We tend to put in more highlights so we have a younger appearance. So look for salon-quality products, and try and limit the amount of treatments you do to your hair.
As an endocrinologist, if you're looking at hair loss, it's important to look at your level of thyroid hormone, your level of vitamin D, and if the pattern is male hair loss, and then an evaluation for excess male hormones should be done.
Left alone, you could go into what's called a myxedema coma
Can Synthroid cause weight gain? I was told I would lose weight.
Synthroid is not a weight loss pill. The only way you'll lose weight is to change your diet and increase physical activity. Synthroid does not make people lose weight. Taken in excess, it can. But it can also lead to other negative effects, such as aging of the heart and osteoporosis and muscle paralysis.
I had a craniopharyngioma removed back in 1989. Without an active thyroid is there anyway to speed up my metabolism to help with the extra weight?
Again, this is another issue of weight loss relating to hypothyroidism. In your case, specifically, the fact you had the craniopharyngioma makes it a little more difficult. Typically the area of the brain and the area you find craniopharyngiomas affects appetite, how much food you take in, energy, and metabolism. So in your case, be aware that despite doing everything right, you may still have difficulty losing weight. It does not mean or translate into "give up." It means:
Unfortunately, in your case it is going to be difficult because of the location of where the craniopharangioma was.
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