November 29, 2022

Can levothyroxine really cause weight gain? Yes. But not for the reasons you’ve maybe heard before. I also discuss two options to stop the weight gain as well as 1 lab test you may want to ask your doctor to run.

Hey guys this is curtis alexander i’m a pharmacist in this video i want to tackle a subscriber question which is basically this she was taking lethal thyroxine she was diagnosed as having low thyroid taken levothyroxine started it 25 micrograms a day about a year ago over the course of the year the doctor’s been monitoring her tsh which is common practice and the

Tsh began to normalize as they increase the dose she’s now set at 100 micrograms a day the problem is over the course of the year she’s gained 10 pounds she still has brain fog still has some hair falling out sort of these low thyroid symptoms but she’s particularly worried about the weight gain because she said when i look online it says that levothyroxine can

Cause an increase in appetite and that’s where the weight gain is coming from which i disagree with and i’ll get into a moment why i don’t think that’s what’s going on but she kind of backed it up by saying you know i’m counting my calories i’m not eating more i don’t feel hungrier but i’m really struggling to lose any weight so what’s going on is it the leave of

That rock and there’s a good chance that it is and i’m going to explain that so what do we have going on in our bodies your body naturally produces a combination of t4 and t3 okay t4 is the inactive thyroid we’ll call it inactive it does bind to some receptors but for argument’s sake it’s inactive and about six of that so a hundred to six ratio about six of that

Is t3 which is the active component that’s what causes the metabolism boost to have more energy those sorts of things but there’s another thing that goes on in the body this is what the body dumps into your system but what also happens is your body will take this t4 and it will convert it on its own to more t3 and it does that with about 25 mic or excuse me 20

Micrograms so overall the ratio now becomes 100 and the 6 plus 20 gives us 26. so now it’s about a 4 to 1 ratio now this conversion part is really important and we’re going to talk about that in a second okay so now we know the end result is for about every four t4 we have one t3 so what we do with levothyroxine what the doctors done levothyroxine is only t4

It contains no t3 so what we’ve done is we’re dumping t4 into the system over time your body sees that t4 coming in and it starts lowering the thyroid stimulating hormone because it’s going i don’t need more t4 pushed out i need more t3 so it down regulates the tsh the tsh normalizes and makes it look if you’re only looking at the labs the tsh looks good so you

Should be like we’re good but what i would encourage her to do is ask the doctor to measure rt3 or reverse t3 reverse t3 is essentially blocks the actions of active t3 why is it doing that it’s doing that because it’s seeing how much it’s like having a fire you’re pouring more and more wood on it in the form of t4 but you’ve got no flame to put out any heat so

It’s not being converted so this is where dumping more t4 and if you’re not able to convert it then we’ve got problems and that’s what i would suggest is probably happening in this case so what do we have for solution so answering the first part of the question yes levothyroxine can cause weight gain not because of increased appetite in most cases it’s usually

Going to be a conversion problem now this conversion problem primarily occurs in the liver and we’ll get to that in a second the quickest fix is to change products we we can leave the levothyroxine on board so for example right now she’s taking 100 micrograms a day what i would encourage her to do is go back to the doctor and say let’s try to add in t3 and

T3 the t3 on the market that i’m familiar with the cytomel or leothyronine you can add in t3 and we already know our ratio is four to one so i would suggest trying 50 micrograms of t4 so i would drop this down and then i would add in 12 and a half micrograms t3 and just see how she feels continue to monitor the labs continue to monitor the reverse t3 not just

The tsh and then also look how is the how is the body temperatures in the morning how is the pulse in the morning and also how do you feel are you starting to lose weight is the brain fog lifting and you can adjust the dose based off symptoms instead of going completely based off labs so that’s the first thing we could do the second thing is we need to help this

Person improve their conversion of t4 to t3 so like we said it most of it occurs in the liver so we need to focus on the liver health so you know does a person drink a lot is a person diabetic these are some things that you’ll see that can contribute to the conversion process we already know that insulin resistance plays a role in some of these things so there’s

A broad range of things we can tackle but the first of which is we got to get our liver health in uh in alignment the other thing is we can’t have macro or micronutrient deficiencies and what i mean by that is one of the things that’s critical for t4 to t3 conversion is healthy glucose levels now i don’t want to get into a diet discussion to make this video too

Long but one of the worst things you can do if you have thyroid issues i don’t do fasting that’s not a good way to tackle it it’s probably going to make things worse and don’t go on low carb diets which are two things i did that made my thyroid health worse give your body the macronutrients it needs yes your body can convert glucose by not having carbohydrates i’m

Not saying that’s not the case it’s just not the best way to go about it if you have thyroid problems so eat a balanced diet protein carbs fats don’t eliminate carbohydrates and don’t fast the other thing is the micronutrients so we’re talking things like zinc uh selenium uh copper plays a role there’s there’s uh micronutrients that help this conversion process

As well as macronutrients so that’s a two-pronged plan yes levothyroxine can cause weight gain generally not due to increased appetite it’s generally due to trying to work against your body’s normal process and then we have to help our body along with this conversion process and that starts with our diet so i would love for you guys to post in the comments um

Have you seen this happen to you before your experience with it some people take t4 and they feel good because they still have conversion available so it works for them but any rate i appreciate you you dropping some comments and i learn a lot from the comments i read them all i may not be able to respond to him but i read them all so i hope this video was helpful

I hope it answered that question and made sense and until the next one this is curtis alexander thank you

Transcribed from video
Levothyroxine Causing Weight Gain? [Plus: 2 Things You Can Do About It] By Curtis Alexander Pharm.D.