[its_alwaiz_bor1n]

#1058873

Hi, I’m fairly new to this board. I’ve been newly diagnosed with hyperthyroidism and have been prescribed with methimazole 5mg, 3 times a day.

Prior to being diagnosed, I had no symptoms of hyperthyroidism besides a fast heartbeat (about 120/min) and slight fatigue. My doctor said my hyperthyroidism is still in its “mild” stages, with TSH/T3/T4 levels as such:

TSH, <0.01L mIU/L
T3 Uptake, 44H
T4 Thyroxine Total, 19.4H
Free T4 Index, 8.5H

I am 5’4″ and have maintained a very stable weight of 103 for the past four+ years. I exercised regularly to maintain this weight, and I also eat very healthily and have not experienced any weight loss prior to being diagnosed with hyperthyroidism. I know that usually people gain weight after undergoing treatment for hyperthyroidism because their muscle mass has declines, causing weight loss; thus the body needs to compensate by gaining weight with the help of anti-thyroid meds. However, if no sudden weight loss was present, does this mean that the methimazole will still make me gain weight?

Basically, my main concern is that by taking this medicine, will it cause me to gain weight even though I had not lost weight because of hyperthyroidism? I’ve worked very hard to get to the weight I am and maintain this level; however I am very worried that taking methimazole will cause me to gain weight drastically. Any help will be most appreciated. Thank you

[Bobbi]

#1170553

Hi, and welcome to our board.

It doesn’t matter that you have not lost weight — some folks actually gain weight while hyperthyroid. What matters is your blood levels of thyroid hormone…and yours are off/hyper. Basically, the body weight goes back to normal — or near normal — once our thyroid levels are put back into the normal zone and controlled there. If you are eating properly, in the proper portions, you should be just fine. There may be “some” fluctuation, but it should not be anything extreme if you are watching what you eat, and getting appropriate exercise once your doctor clears you for it. But while you are hyper, and your heart rate is elevated, exercise can be dangerous. So, wait for your doctor to give you permission to go back any strenuous exercise.

[Kimberly]

#1170551

Hello and welcome – I have a little different perspective on this from Bobbi, as I *have* struggled with weight issues post-treatment (methimazole), despite leading an active lifestyle and carefully tracking my food intake. In fact, I used to lead meetings for Weight Watchers prior to diagnosis, and had to quit last year, because I had such a hard time maintaining my goal weight…which I had previously maintained for 3 years with no problems.

There haven’t been many good studies on this in adults, but one presenter at our 2011 Boston conference looked at children who were treated for Graves’…many of them *did* have issues with weight gain. I wish that researchers would take a closer look at this in adults.

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing. As an alternative, you can right-click the link and open it in a new tab or new window).

http://www.endocrinetoday.com/view.aspx?rid=87077

With that said, though, your priority right now is to treat your hyperthyroidism…you definitely don’t want to deal with complications down the road such as heart issues and bone/muscle wasting. Untreated hyperthyroidism can also lead to thyroid storm, a potentially life-threatening condition.

Take care — and keep us posted on how you are doing!

[Bobbi]

#1170554

While I understand that some folks deal with weight issues after treatment, it is not a given. I lose weight when I increase exercise and decrease calorie intake. That happened to me right after RAI when I eliminated empty calories from my diet. And it happened to me again last year, when I did the same. I know of others who have had treatment for either hyperthyroidism or thyroid cancer, and some are heavier than they would like to be, and others of us are not. I don’t know that there is enough research out there to be able to attribute lingering weight problems to our thyroid issues.

So, to repeat Kimberly’s advice — it is important to forget the weight issues and get your hyperthyroidism treated. Deal with whatever weight issues might crop up once you are well again. Right now, concentrate on eating properly — good nutrition. And concentrate on eliminating your hyperthyroid state.

[lammie]

#1170555

Hi there

Just wanted to add a little bit of info on my weight since I was in a similar situation as you with no weight loss being hyper and kind of stable weight (size 10 AUS). When I was taking 2 pills a day, I didn’t really gain but when I took 3 later on I gained a small amount which I could see in my face in some photos I took. As 2 years went by, I went with RAI and hit hypo stage and I think I gained about 3-4kgs but then a few months later I was back to being hyper. However, I never really lost that extra kilos I gained (since I never did lose while being hyper) and now I’m a size 12. I was a bridesmaid in a wedding and so I was trying to look my best and prob reached 58kgs and after 1 year of RAI I think I went to 63kgs but it’s not that noticeable because I somehow feel like it’s more muscle gaining but yes some clothes did get tighter so I knew I had gained as well.

It’s strange because I thought I could lose weight if I was still a bit hyper but it’s quite hard. Anyways, I’m back on carbimazole for 1 month now and I’m 65kgs so trying to work out now. Even when I was 58kgs I wanted to lose more but now that I’m here now I just want to be 60 again! It’s so frustrating but oh wells. However, because it sounds like you have the eating habits and fitness right, I think you will do better as I kind of gave up exercising last year after another wedding where I was a bridesmaid and I didn’t reach my goal for that so it made me feel a bit down.

Good luck with everything!

[Kimberly]

#1170556

Hi Bobbi – I absolutely agree that the absolute #1 priority for newly diagnosed patients is to get their levels stabilized first.

However, I do think it’s important to recognize the prevalence of issues with weight gain…and also the impact that this can have on an individual’s self-esteem and overall quality of life.

We did a poll a while back on the Foundation’s Facebook page about weight issues. Out of about 70 responses, 60% said that losing weight post-treatment was “extremely difficult”. 16% said that losing weight post-treatment was “challenging, but manageable”. 14% said they had noticed no impact on their weight. The remainder said that they had simply regained the weight they lost, with a very small percentage having difficulty re-gaining the weight they lost.

I asked a question about weight issues at the Foundation’s 2008 conference, and one presenter theorized that there might be a “resetting” of one’s metabolism following thyroid issues. There was another small study done a couple of years ago that noted that patients can gain weight when their TSH is on the upswing — even if it remains within the “normal” range.

http://www.ncbi.nlm.nih.gov/pubmed/18362250

(Note on links: if you click directly on the above link, you will need to use your browser’s “back” button to return to the boards after viewing. As an alternative, you can right-click the link and open it in a new tab or new window).

I sure wish I had the answers to this — if I did, I would certainly fix myself first! But I do think it’s important to acknowledge that weight gain above and beyond what was lost when hypER *is* an issue that many patients do struggle with.

[trlrunner]

#1170557

This subject is near and dear to my heart! I am an endurance athlete – cycling and trail running and was diagnosed with Graves in Feb 2011. Long story short, I opted to try the methimazole before considering one of the other options (RAI or surgery). I am 5-6 and pre-Graves, hovered around 117 – 119 lbs. I lost a total of 11 lbs with the Graves. I looked like a skeleton. I also lost much of my muscle mass/definition. I have been on the methimazole for one year. I am currently hovering around the 118 -119 mark. A very important thing to remember here – everyone responds differently to the medication. For me, it did what it was intended to do – the methimazole brought me down out of the dangerous hyper state and allowed my to feel overall better. The problem, for me, which became apparent as the year progressed, is that I was not able to rebuild my strength, endurance, and muscle tone and in fact, saw an incremental deterioration in my training capacity as the year progressed. I improved somewhat but then started a slow backward slide. Part of my problem is that we were never able to keep me in a constant, steady range for extended periods of time. My thyroid levels were in a constant state of flux – always a little high then heading a little low and then heading a little high again – my dosage was adjusted according to my levels. Because of the fact that we weren’t able to achieve steady, consistent hormone levels combined with my slowly declining training capacity despite being on the methimazole, I opted to have RAI 12 days ago (I will post on that in a separate post – so far nothing unusual or odd has happened – my doc educated me about the various stages my body will go through). I would say that in the past month or two prior to the RAI, I was just beginning to see even more of a difference in my body composition (fluffier, not necessarily heavier) but that is due to continued diminished muscle tone – possibly heading in the direction of some weight management difficulties. The fine moderators here have done a great job in pointing this aspect out in many other posts. Graves causes muscle wasting. Less muscle results in less shapeliness and less fat burning energy. Again, everyone responds differently to medication so don’t base your decisions solely on what you read. Base your decisions on a good doctor’s opinion, educating yourself, real-life/ in-person testimony, and reputable websites such as this one. It can all seem completely overwhelming and discouraging at the beginning but you will make it through, really!!!

[Bobbi]

#1170558

Hi, trlrunner:

I do hope the treatment works out to put you back on track (ooh, bad pun!) soon. I know how hard it is to have to give up doing something you love.

[TraceyAnne]

#1170559

After reading this thread, I feel a little discouraged and still quite unsure… I was diagnosed GD a couple years ago but did not begin treatment until Feb 2011. I was dealing with a Nurse Practitioner rather than the Endocrinologist, because I did not like him at all and he is the only one in my town. Being that thyroid was not her specialty, she was treating me strictly by the book starting with 10mg Methimazole 3x day. Well it turns out that I respond to treatment extremely quickly and within six months (August 2011) and 3 med adjustments I was so severely hypO that I had gained 25 pounds over my normal weight and had undetectable levels of hormones and my TSH was through the roof. I was so upset, discouraged and a little depressed when I saw those lab results and the 165 pounds, that I immediately dropped that NP and the office and called my PCP. She took me off the meds completely and put me on ant-depressants and we discussed a new Endo. I found a great one a half hour away and she kept me off the meds so she could figure out exactly what was going on. By December I had lost 15 of those extra pounds and in January it was time for treatment again. I have been working my rear off trying to lose that last 10 pounds and I am soooo frustrated. My entire diet has been modified over the last 6 months. I have cut my overall food intake in half (I have always been able to eat like a horse so I am still within a healthy caloric intake), we have cut carbs and fat dramatically and I exercise about 5 days a week. I usually do either some Wii Fit for 30-45 minutes or, in the last month, 20 minutes of power walking on the treadmill. UGH! I have not lost a pound since December! My problem is it’s all sitting in the mid section and I don’t know what, if anything, I can do about it. I started back on Methimazole 10mg 3x day in January. One month later I was down to 2x and at my appointment later today, I expect to be down to 1x. My labs this time around show my T3 and T4 within the normal range, although my TSH is still quite low. I also show the Graves Antibodies to still be running rampant with a very small decline since last month. All in all, I feel so excellent, better than I have for 2 years. If only I could shed this last 10 pounds. Do you think there is any hope of that??? As the medication decreases will that effect my weight? If I continue to level out and stay that way for a while, will that effect my weight? I will be posing these questions to my endo today but am interested in hearing others’ experiences. So sorry for the lengthy post but, I know I am not alone in this battle and appreciate being able to express these concerns to others who know exactly what I am going through. As wonderful and understanding as my husband is and has been, I was still beautiful to him 25 pounds heavier, so he doesn’t quite understand how weight effects a woman’s psyche. Thanks for listening!!!

[Kimberly]

#1170560

Hi TraceyAnne – I wish I could predict the course of your weight loss as your dose decreases, but all I can do is say that I “feel your pain”.

Some patients (like me) seem to really struggle with weight issues post-treatment, despite being active and eating right. Others don’t have a problem.

I absolutely agree that weight issues have a definite impact on a woman’s psyche…but unfortunately, there aren’t any easy answers.

Definitely check back and let us know what your endo says!

[curmudgeoness]

#1170561

Hi, new poster here:

I’m a distance runner. By the time I was diagnosed and had commenced treatment, I had lost about fifteen pounds of muscle mass, along with all of my fitness. I had trouble climbing stairs or carrying anything that weighed more than my purse. I looked terrible, too.

I got up to 40mg/day of methimazole. The endo I was seeing overmedicated me and misread my bloodwork, and actually tried to up my dose to 50mg when I already had gone hypo. The result was like being fired out of a cannon into a brick wall. I gained weight as rapidly as I had lost it (2-3 lb./week), despite consuming at most 800 calories/day.

I would say that once I had stabilized it took me a year of hard work (strength training, running 40-50 miles/week) to get back to where I was, rebuilding lost muscle mass and losing the fat I acquired when I went hypo. I’ve never lost weight easily — I’m terrible at dieting. So, we’re talking about 10-12 pounds of added fat, and it took me a year to lose most of it.

I think that, in general, if you go hypo your metabolism will slow, so if you do not adjust your habits you can expect to see weight gain. But like others already have noted, some people gain weight when hyper, and some do everything they’re supposed to do but the weight will not come off. I agree that at any rate your first goal should be to stabilize

[TraceyAnne]

#1170562

Well, my endo, as wonderful and knowledgeable as she is, does tend to be a little quirky and recommends an alkaline diet… which is really unreasonable for me and my family. It is a true vegetarian diet which I don’t really think I need or want. I know it would probably work, but, do not want to make a complete lifestyle change. The last time I mentioned weight, she recommended some other diet which was also unrealistic. She did however discuss with me the mind-body-spirit-disease connection and we talked about the interconnectedness of it all and stress and hormones, etc., etc. So, I don’t think she has a good answer either. I guess I will just keep doing what I am doing and see if the summer weather and being outside helps. FYI, I didn’t mention that I am 42 and I know that in middle age this type of thing can happen, but I also know it doesn’t have to happen… so I will just keep exploring and trying things within my abilities. Thanks for the support!

[Author]

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