Are Weight Gain And Hair Loss After Decreasing Dose Of Levothyroxine Normal?

Posted on Tue, 22 Nov 2016

Question: Hello there. I am a 22-year-old female. Two years ago I was diagnosed with hypothyroidism after experiencing symptoms for about 8 years. I was initially prescribed 100mcg of Levothyroxine. I lost about 25 lbs., my hair stopped falling out, my periods were normal again, I wasn't feeling so depressed, and I felt all-around fantastic. I went for blood work three months later, and during my follow-up appointment, my doctor decided to drop my dose to 88mcg. Ever since, I've gained 20 lbs. back (even though I've made dietary changes for the better - more fruits and veggies, less sweets and salty foods, and I stopped eating fast food altogether!), my exercise routine is the same, and I've been losing hair again. My period also only comes every 45-50 days (I should add that I do not use hormonal birth control), and I feel exhausted all the time, even though I regularly get 8 hours of sleep a night. I went for blood work last week, but I was told everything came back normal. I really felt great on 100mcg. Should I request an increase? Should I ask for a different medication? I am aware that Synthroid/Levothyroxine only includes t4. Is it possible my t3 levels are not being tested or just not being treated? How would I go about explaining this to my doctor?

Answered by Dr. Shehzad Topiwala (1 hour later)

Brief Answer:
Thyroid

Detailed Answer:
Sorry to note your symptoms.

Generally, T3 is not recommended to be tested by thyroid experts worldwide in the diagnosis and treatment of Primary hypothyroidism. Treatment with T3 containing medications is also typically not recommended by thyroid experts as it is deemed unsafe

TSH and Free T4 are usually sufficient to make dose adjustments.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
Anti Thyroid Peroxidase (TPO) antibodies
Anti Thyroglobulin antibodies
25 hydroxy Vitamin D

None of these tests require any fasting and can be done at any time of the day

You will be best served by seeing an endocrinologist in person who will have the opportunity to examine you, and manage the complexities of hypothyroidism

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar