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Hormone & Thyroid Replacement Weight Gain...

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  • Hormone & Thyroid Replacement Weight Gain...

    I have been living "primally" for several months now and LOVING all the information and encouraging advice I have read through Mark and the many very knowledgeable folks who write in this forum. I am a 41-year-old female who was attracted to this lifestyle after years of being a vegetarian/vegan, extreme exhaustion and digestion problems, and years of amenorrhea after the birth of my one and only child.

    I lost a great deal of weight since living this way and cannot EVER see myself going back to a SAD diet (despite the resistance I receive from family and friends). The problem was: I looked better, but was still dragging energy-wise and still sans-periods. After numerous doctor visits, I have been put on Estradiol 2mg, Prometrium 200mg, and Synthroid 50mcg.

    I feel a slight increase in energy and (I know, TMI) finally had a my female "visitor." I also have been steadily gaining weight to the tune of 10 pounds now (in less than two months). I want to cry.

    If anyone has any advice as to how I can halt this--and get back to my maintenance weight--I would be forever grateful. I am not sure if it's the hormone replacement, the thyroid med, or both. Because I have two different docs, it's been a nightmare to discuss as one med change seems to effect the other med. My gyno said with the straightest of face and so matter-of-factly when I mentioned how unhappy I was with the weight gain, "Well, it's your body trying to stabilize where it needs to be. Who could gain another 10-15 pounds by our next visit. We shall see..." I so badly wanted to reply, "And if I told you that your malehood would permanently shrink by an inch or two by our next visit," how would you feel? Ugh.

    I guess I will give up dairy again, reduce or cut out nuts, and reduce or cut out my daily handful of berries. Until then, I'm wingin' it.

    Sorry this is long. I do appreciate any insight one of you may have! Have a great day and enjoy this year's challenge!

  • #2
    I bet it's the hormones. It's really hard to micromanage hormone doses. It would be nice if you could work with a functional medicine practitioner who understands the interrelationships between hormones.
    Brady Hurst works long distance (he even does Skype appointments) and he works with both thyroid and hormone issues. He does functional health diagnostics, so he'd be able to figure out the big picture of what's going on in your body and get you the right meds/doses/supplements:
    TRUE HEALTH Center for Functional Medicine


    • #3
      Treating thyroid and sex hormones at the same time can be tricky. estrogen binds thyroid hormone making some of it unavaulable for the body to actually use. In order to see how much "free" thyroid hormones are really available you need to make sure Free T4 and Free T3 are tested.

      My experience-- estradiol bound a lot of my thyroid hormones/meds. It left me with very low TSH, high Total Ts and low frees. It was the low frees that left me feeling terrible and gaining weight.

      Do you have test results you could share?


      • #4
        THANK YOU, hazyjane and marcadav! I so appreciate your responses--more than you know. I will definitely look up the website you listed, hazyjane. And, marcadav, I am so ridiculously new and naive on hormones and thyroid, it's silly. I really need to begin to educate myself, pronto.

        My last hormone work-up was in May. The results look something like this:

        Testosterone: 3 ng/dL (8-48)
        Estradiol: 7.3 pg/mL (adult female: > 6.0 - 27.0 postmenopausal; 12.5 - 166.0 follicular phase; 85.8 - 498.0 ovulation phase; 43.8 - 211.0 luteal phase)
        FSH: 5.0 mIU/mL (3.5 - 12.5 follicular phase; 4.7 - 21.5 ovulation phase; 1.7 - 7.7 luteal phase; 25.8 - 134.8 postmenopausal)
        Luteinizing Hormone: 0.1 mIU/mL (2.4 - 12.6 follicular phase; 14.0 - 95.6 ovulation phase; 1.0 - 11.4 luteal phase; 7.7 - 58.5 postmenopausal)
        DHEA: 282 ng/dL (31 - 701)

        My labs from March were:

        Vitamin D, 25-Hydroxy: 49.7 ng/mL (32.0 - 100.0)
        TSH 0.720 uIU/mL (0.450 - 4.500)
        T4, Free (Direct): 0.87 ng/dL (0.87 - 1.77)
        Triiodothyronine, Free, Serum: 2.3 pg/mL (2.0 - 4.4) (I think this was after taking a month or so of Cytomel...)

        My full work-up was so long ago, that I only included this recent work-up. This recent thyroid work-up in July looked something like this (doesn't seem like everything was tested):

        Free Thyroxine: 0.73 ng/dL (0.53 - 1.43)
        TSH: 2.180 uIU/mL (0.350 - 5.500)
        Cortisol: 19.7 ug/dL (0.0 - 23.0)
        Thyroid Perox Ab TPO (??): 5.6 IU/mL (0.0 - 9.0)
        Insulin Fasting: 2 uIU/mL (3 - 19)
        T3: 1.7 pg/mL (2.4 - 4.2)
        C-Peptide: 0.9 ng/mL (0.8 - 3.5)

        So, not sure what to make of these results. I will be having more blood work in a week or so to see where I'm at. Perhaps now that I have actually had a few months of estrogen and progesterone under my belt, I should discontinue them and stick with the thyroid only? Thoughts?

        Thank you both for your help. Nice to know others have had similar experiences.

        Last edited by Laural; 09-13-2011, 08:42 PM.


        • #5
          Laurel, thanks for the results. Could you go back and edit your reslults to include reference ranges. They are usually found next to your results on parenthesis. For example:

          TSH: 2.18 (.35-3,3)

          I ask because each lab can have their own reference (normal) range.


          • #6
            What? You don't know these value ranges by heart? I'm kidding. I edited my post and perhaps that helps. I'm an absolute moron when it comes to "free" this and "direct" that. I have so much to learn...

            Thanks again for relaying your experiences--everything helps as I'm very lost and very defeated. It's funny (not really) that I finally felt in charge of my health and body by going primal. Then, WHAM. I feel like a victim to my hormones. It will all get straightened out--I believe that. It's just a challenge at the moment.

            Thanks again!


            • #7
              Bumping this because I, too, am desperate. Started Prometrium three months ago and have gained four pounds- this despite being at Atkins induction level-carbs for two of those months and Primal for one month (basically adding in berries, some Greek yogurt, dark chocolate, and nuts to bring my carbs to about 75). Prior to starting Prometrium I had lost 22 pounds over five weeks on Atkins induction.

              I'm about to lose my mind.

              50 year old female, menopause, 210 pounds at 5'9", 1800-2000 calories a day, 70% fat. HbA1C: 5.3. FSH: 6.1. T4 Free: 0.9. TSH: 1.22. These results were from the week I started Atkins (about four months ago) and right before I started Prometrium.

              I have hot flashes and got one TOM since I started. I can live with the hot flashes but I can't live with the fat any more. And no, I haven't just replaced it with muscle and bone density.

              Please, oh please, somebody out there help me. I'm about to take a spear and chuck it through my bloody head. My OBGYN is of no use. The Prometrium is routine- nothing special about my case. Should I stay on it?


              • #8
                CarlaC: Laural here. I saw you wrote and really hope someone can help you with your (our) issue. Sadly, I have gotten only worse and am now at shy of 50 lbs gained since beginning HRT and thyroid treatment last year. 50 lbs!! I am actually as heavy as I was midway through my pregnancy. My issue, it seems, is difficult to figure out as I have been diagnosed with central or secondary hypothyroidism. My meds keep raising and so does my weight.

                As an aside, I have begun to actually eat more carbs a la the Jaminet's Perfect Health Diet. No weight loss, but the inclusion of a daily sweet potato has definitely lifted my mood and digestion. I only mention this because some folks don't do super well with really low carb (and from what you wrote above, you don't seem SUPER low), but maybe your body is adjusting to your new way of eating AND the stupid Prometrium. Frankly, I don't care what any physician says to me: I began my escalation of weight when I began HRT and thyroid meds. As a matter of fact, I literally just came back from my doctor's office and he's punting...Says I should investigate the Mayo Clinic.

                Carla, maybe you should start a new thread so that it's front and center (and so more educated people than myself will comment)! I feel your pain. MORE than you know. I donated all my "big" and maternity clothes, then the weight came back and THEN some. I'm now in a world of hurt and so depressed. If you have an extra spear for my head, I'll take it...

                Take care and I pray you get some answers.


                • #9
                  THIS is likely the cause of your weight gain!

                  T3: 1.7 pg/mL (2.4 - 4.2)

                  Your T3 is below the lab range. You mention "Cytomel" which indicates you're supplementing T3--but you need an increased dose.

                  When my T3 goes below the lab range, I will gain weight quickly--even when eating at a level at which I lose. I take Cytomel, and have had to have my dosage increased several times.

                  Note: Becuse of pressure from my insurance company, a couple of months ago I tried 'generic' T3. After 2 months, I found myself having to eat only 500 cal a day to keep my weight stable. I called my endo, went in for blood tests, and, sure enough, my T3 was below the lab range. I'm back on Cytomel, and all is well.


                  • #10
                    Thanks, Emmie! Yeah, those results were from a long time ago when I was on Cytomel temporarily. My new Endo has me on 90mg of Armour and is afraid to raise my dose. My fT3 is finally in the low range now--as is my fT4 (which suggests I need to raise my dosage), but my TSH is 0.030 uIU/mL (range 0.300 - 3.700) which suggests I'm being overmedicated. (However, it also isn't a reliable test with my pituitary or hypothalamic disorder.) So, here I sit... Maybe I should also supplement with Cytomel again--who knows. Good to know about your reaction to the generic form!

                    CarlaC: emmie brought up a very good point. You may want to test your free T3 as well. (Chris Kresser has excellent posts on thyroid and low T3 syndrome, fyi. Check out his website: Chris Kresser)

                    Thanks for your response, emmie! And best of luck to you, Carla!


                    • #11
                      Ray Peat has a lot of good information about hormones & thyroid.