What if you are not losing weight in hypothyroidism .
Common causes of hypothyroidism:-

1. Hashimoto’s
2. Radioactive Iodine ablation
3. Surgical removal of thyroid gland

How to lose weight if you have hypothyroidism due to any cause I mentioned above:

1. Start with a fresh set of thyroid lab tests:
T3 T4 TSH FT3 FT4 TPO Ab Thyroglobulin Ab
All these tests will serve as a baseline and you can keep an eye on all of them as you lose weight/weight changes.
Many patients are being undertreated for their thyroid problem, it could be the cause if you are unable to lose weight.

2. Focus on how your thyroid is functioning and on thyroid medication .
As thyroid hormones are the primary regulator of Metabolism. Even if your thyroid functioning is 10% less of what is ideal, adjusting the dose is far more effective and easier then cutting 10% of your calories or doing more exercise .

3. Be more strict about your diet
Stop processed food , grains , refined oil
Instead of counting your calories, focus on whole food, right quantity of high biological value proteins and healthy fats.
Keep your insulin levels in check
Any calorie which raise your insulin level is bad

4. Take care of your Gut and Liver
As most of the T4>T3 conversion takes place there.

5 . Manage your stress
Yoga and meditation 🧘‍♀ can help you fight stress and helps you in losing weight.
6. Execise regularly and stay active throughout the day.
7. Good sleep.

5 Thyroid time wasting things…Stop wasting your time and take action.

1. Checking your labs levels too frequently is a big mistake ( less than than 2 months and less than 1 month in a pregnant lady)

2. If you are staying with a doctor for thyroid treatment for more than 10 years, and still you feel there is no improvement
Things are same as they used to be, then do not stay with your doctor for too long

3. Another big mistake is checking what Google doctor is saying or copying what other thyroid patients are doing. Every person is different and every person needs special care.
There could be difference of severity of disease.

4. Calculating or guessing the thyroxine dose on your own. There are many factors which we need to consider upon while deciding the dose. Each thyroid patient is unique and they require personalised treatment.

5. There are some supplements which really work. They reduce inflammation, they reduce antibodies levels.
Don’t stay on supplement which doesn’t work, which is not helping you feel better. Checking Lab tests timely, right thyroxine dose, right supplement and stopping all triggers is the right treatment.

Hashimoto’s & Hypothyroidism

Hypothyroidism is a problem with your thyroid gland ; Hashimoto’s is a problem with your immune function towards your thyroid gland revealed by one or both antibodies –anti TPO and / or anti Tg

What is unusual about THYROID GLAND
The thyroid gland is unusual among the other endocrine glands in its ability to store large amount of hormone. After synthesis of the thyroid hormones has run its course, each Thyroglobulin molecule contains up to 30 thyroxine(T4) molecules and few Triiodothyronine (T3) molecules.

In this form, the thyroid hormones are stored in the thyroid gland in an amount sufficient to supply the body with its normal requirements of thyroid hormones for 2-3 months.
Therefore when synthesis of thyroid hormones stops as in Hashimoto’s thyroiditis, the physiological effects of deficiency are not observed for several months.

At a minimum it is important to at least ask your doctor to run TPO and TG antibodies to see if your thyroid condition is auto-immune in nature. Most medical doctors resist running these antibodies because it doesn’t change conventional protocol. From a functional medicine paradigm it’s important to know if you are auto-immune because it changes the overall approach to how the thyroid is treated. Any time any auto-immune condition is present the focus needs to more on the immune system and the gut and less on the thyroid or injured gland.

Subclinical Hypothyroidism

More of Biochemical diagnosis rather than clinical diagnosis.
Serum TSH is raised
Where as T3 T4 FT3 FT4 are all normal
These people are Usually asymptomatic.
There are 3 main issues that we should be worried about if we see TSH levels high(5-10)

1. How many of these cases will progress to Overt Hypothyroidism (where we need to give thyroxine )
Chances are high if:
* Those with TPO antibodies +ve
*Older age with high TSH
*Family History of thyroid disease

2. Is there anything we can do to prevent its progression to Overt Hypothyroidism.
Can progression to be prevented by thyroxine)
Few studies, but results are conflicting.
Some supplements can help at this stage.
Close follow up may be an alternative. (checking thyroid every 3-6 months)

3. Is this reading(TSH 5-10), was found out due to routine test or
3(a) There were symptoms related to subclinical hypothyroidism like fatigue, cold intolerance, hair loss, dry skin, constipation or memory issues.
Some studies show, treating with Thyroxine may or may not help in relieving symptoms. We can give it a try for 3 months thyroxine treatment at this stage,if it doesn’t help, we stop giving thyroxine further.
Studies show that in patients with
TSH > 10 there could be possible benefits in relieving symptoms .
TSH < 10 less benefit

3(b) some more specific health issues like high cholesterol and triglycerides, cardiovascular dysfunction, infertility and pregnancy
Should we treat such individuals with Thyroxine?
Few studies
In cardiovascular disease and high lipid levels
TSH>10 Good to start thyroxine (low dose in the start)
Younger patients can benefit more.
If TSH < 10 then less benefits in starting treatment

Infertility , pregnancy and Radioactive Iodine treated patients
It could be an indication for starting treatment early even if there are slight elevation in TSH values.

We selectively treat patients with TSH<10
Overtreatment could be more dangerous.

 Hypothyroidism and Hair Loss

4 most common conditions that can lead to hair loss in hypothyroidism

1. Thyroid medication
Thyroid medication itself can lead to hair loss. Sometimes switching to different medicine in the same class may help.
Low dose or undertreatment could be the cause for hair loss.
High dose or Overtreatment could lead to hair loss also.

60% of patients with hair loss, they fall in this category, either the dose is low or the dose is high

2. Iron and ferritin levels
Ferritin … measures the iron store in our body. Hair follicles need iron for hair growth. 50% of the patients with hypothyroidism have low iron and ferritin levels. This is because ,thyroid hormones affect iron absorption .

3. Vit B12 , Zinc and selenium…all are required to grow ur hair sufficiently.
If you are deficient in any of these nutrients then you are not able to grow your hair.

4. Autoimmune Disease can also contribute to hair loss …if you have one autoimmune disease then you are at risk of developing another autoimmune disease.
Alopecia areata occurs when the immune system attacks hair follicles and may be further triggered by severe stress. If you focus on your immune system, you can improve Hashimoto’s thyroiditis as well as the underlying cause of alopecia areata.