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Weight loss with elevated TSH levels, HYPOTHYROIDISM.

Resolved Question:

I have hypothyrodism. I am 32 years old, Female and weigh 95 kilograms. I am battling wih my weight loss.
Here are my TSH values. I have had 3 tests done so far.
May 2014: 6.5
July 2014: 1.9
Jan 2015: 9.14

I started with 50 mcg, then was asked to take 25 mcg, now after the third tsh value, I am asked to get back to 50 mcg.

I am taking Thyroxine Sodium Tablets. I.P under the name Thyronorm


There is a huge fluctuation in the TSH values in the past 9 months.
Please advice on the dosage.

Thanks, Sahana


Category: Endocrinologist

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Category: Diabetologist
Dr. J Muthukrishnan is online now

Expert:  Dr. J Muthukrishnan replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
Yes, you need to take 50 mcg and retest TSH after two months. Do not reduce the dose if TSH levels r in the normal range, like u did last time. Continue same dose. Weight is not due to thyroid alone and you need to concentrate on diet and exercise as well.
Feel free to discuss further,
Regards.


Patient replied :

Dr Muthukrishnan,
Thank you for the response. I will do as advised by you. I have more questions:
1. There has been a whole lot of discussions on what is the right time to take the thyroid medication. Some doctors say night as you have more time for the harmones to be ingested to the blood stream and some say early morning. What is the right time to take it?
2. How many hours of gap is required after taking the medicine before I take any food?
3. What is the dangerous thyroid level? For example, my present TSH value is 9.14. Is is towards high risk?
4. What are the foods I must completely avoid? I have been advised to not have spinach, cauliflower, cabbage etc. I love all these vegetables. I have heard I cannot eat them raw but I can eat them when well cooked. Can I consume them like once a month in moderate quantities?Are there any fruits I should not be eating? I am accustomed to eating an apple every day and I take orange juice after breakfast.
5. I am married and I want to start a family. I am having issues with my weight which I mentioned. I am obese. I have started a workout program at the gym and trying to reduce as much as possible this year. I am already 32 and I know time is running out. What are the risks of getting pregnant with a thyroid problem?

Thanks in advance...
Sahana.


Expert:  Dr. J Muthukrishnan replied 3 Days.

You shud take the med in morning empty stomach and eat or drink after 1hr.
Avoid calcium and iron tablets with this, you can take it after an hour.
No need to restrict any vegetable or fruits, only excessive cabbage or broccoli should be avoided.
Pregnancy is better avoided till ur TSH is wthn normal range. There's no dangerous TSH level. All can be treated.
Your level can actually be controlled very easily with medication, so please do not worry.
Regards.


Patient replied :

Thank you doctor for taking the time to answer my questions. Will do as advised.
My parents do not have Thyroid problems. So I am assuming it may not be heridetary or is it?
Here is some medical histrory about me;
I had a miscarriage in July 2010. I did not have thyroid issues when I got pregnant. I was three months pregnant at that time. I was very depressed with the trauma and then was okay after a couple of months. I got into a job after that and I got busy every since.
In 2012 I started having irregular periods and went to my gyno. She ran some tests and she said I had PCOS and fibroids in my uterus. My skin started having pimples and I started noticing hair growth on my chin. I knew I had harmonal imbalance. I started some medicines to regularize my periods then started taking homeopathic medication when friends and family advised.
I started keeping a track of my periods since a few months. It gets delayed sometimes and it is on time sometimes. The file is attached. You can see the average duration.
Please advise on how I can get back to my normal healthy self with regularized periods. I am definately trying to lose weight this year. I also need to get my thyroid levels to normal. I hope I can have a healthy pregnancy one day and have a healthy baby. Please let me know where to get started and what I need to follow.

Many thanks,
Sahana.


Expert:  Dr. J Muthukrishnan replied 2 Days.

Your cycles are alright. A delay or early periods by upto 7 days are fine. Also, miscarriages are known to occur without any reasons, but in your case, since thyroid is abnormal, it definitely will help once its treated adequately. Weight reduction will also help. Target your TSH levels between 0.3-2.5mIU/l with dose adjustments. That will definitely help. I am sure you will have a successful pregnancy with a healthy baby.
Regards.


Patient replied :

Dear doctor,
I got my TSH test done today and it is 5.42. I am presently taking 50 mcg of Thyronorm tablets.
please advice if dosage needs to be changed.
The previous TSH readings are mentioned below.
May 2014: 6.5 July 2014: 1.9 Jan 2015: 9.14
Regards,
Sahana.


Expert:  Dr. J Muthukrishnan replied 1 Day.

Admin Message -
Hello,
Your consult has been closed. Either you have utilized more than 3 follow-up queries or your consult is now older than 1 month. If you have further queries, I request you to initiate a new consult. You could consult the same Doctor as well, please mention the same in the new consult.
Hope this communication was fruitful. Wish you good health.
Thank you
In-house Physician
DoctorSpring.com


Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
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