Family, Internal Medicine, General Medical Questions/Thyroid issue?

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Question
I'm 41 and was diagnosed with Hashimoto's Thyroiditis about 6 years ago.  I had been gaining weight and feeling fatigued and my thyroid was swollen.  Since then, I have been on thyroid replacement hormone, currently, 150 mcg a day of Synthroid and 20 mcg of Cytomel a week (recently upping the Cytomel in the hopes it would increase my metabolism).  I was told once I was on hormone replacement that I would see my metabolism start working again and I would lose the weight I gained.  I'm very active and work out 5 to 6 days a week: cardio, strength, and swimming.  I do not overeat nor do I snack except very periodically.  I don't drink.  I'm not on birth control.  Quite the contrary has happened since going on hormone replacement.  I have been steadily GAINING weight and it is becoming very frustrating.  My CBC is good.  Insulin and sugar are fine.  My doctor is also a family medicine doctor.  Should I request a specific test or tests from her to find out what the problem is?  If so, which ones?  Or should I request to see a specialist?  An endocrinologist?  I'm at my wit's end since I'm very active and I keep getting fatter and fatter.  Any suggestions you might have would be appreciated.  Thanks.

Answer
those sometimes can be tough problems.....   the key is to replace thyroid hormone with synthroid (or some of the others, like cytomel, armour thyroid) or a combination to suppress the TSH to a value of 0.5 to 1.0.  I try to keep it relatively low, even though normal may be as high as 4.5.

If you have done that, then the weight gain, etc is not from  thyroid, it is due to too many calories.....  I would then look at a diet.... I like the low carb diets.... effective, safe and easy.  

Family, Internal Medicine, General Medical Questions

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Robert Borucki

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