I can’t lose weight – is it my thyroid?
Ok, ladies, I’m going to tell you a secret. Your Doctor can see it coming from a mile away. We know what you are hinting at when you start mentioning difficulty losing weight and being tired all of the time. You google searched thyroid disease and are just sure this is the answer to all of your problems. Especially the problem of, “I can’t lose weight – it is my thyroid?”
We also know what will happen next: you are politely going to ask for thyroid testing. It’s ok – you are not alone. It literally happens daily in my office. Equally interesting is the fact that men almost never ask for thyroid testing – of course, they have their testosterone levels to blame. I digress, more on that later.
I’m going to let you in on another secret – it’s probably not your thyroid. The vast majority of patients tested will have NORMAL thyroid levels (only 4-10% of patients have subclinical thyroid disease at the highest estimate) despite having gained weight. And, if it is your thyroid, you are not likely to get the 30-pound weight loss and massive adrenaline rush that you are looking for by starting medication. Ouch. I’m sorry, I promised to be honest.
The Sad Truth About Thyroid Replacement and Weight Loss
According to studies by the American Thyroid Association, only 50% of patients who are actually found to have low thyroid levels AND start treatment with thyroid replacement medication will lose any weight at all. Of those that did lose weight, the average was 8-9 pounds.
Allow me to illustrate:
Hmm… The truth is that my thyroid just started to burn out with time. My weight had little to do with it. I promised my Doctor to consistently take my thyroid replacement and, sadly, no weight loss. I did notice an improvement in energy, though. Of course, that could have been the baby getting closer to sleeping through the night.
So, should you check your thyroid levels anyway?
The effects of thyroid hormone can be so confusing for patients. I like to keep it simple – I tell my patients to think of their thyroid as their metabolism regulator. Low thyroid levels will show up like a slow metabolism – tiredness, weight gain, constipation, hair loss. Thyroid levels are checked by simple blood tests (TSH, free T4, and possibly free T3). If you are having symptoms, they are easy to check. Your Doctor will likely agree to testing as long as you are symptomatic.
I am not opposed to checking those tests by any means – just be reasonable about the outcomes of treatment if indicated. If your thyroid levels are low and you start replacement, you WILL likely notice an improvement in energy, hair loss, constipation, and dry skin and you just might get a LITTLE weight loss with it. Yes, I know about that mysterious “extra testing” your sister told you about as well. More on that below.
If you have gained a few pounds, feel more tired all of the time, are constipated, or have noticed hair loss, it may be that your thyroid levels are low. Get the blood test. If you have gained half a person in pounds, cheeseburgers, fries, and a coke are more likely to be the culprit.
For more information on thyroid, check out: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/thyroid-dysfunction-screening
For more Blog Posts on Thyroid: