Head, Meet Desk

July 18, 2011

Head, Meet Desk

A friend tells me that he’s been diagnosed with hypothyroidism (TSH 7.5) and he’s starting on Synthroid (Levothyroxine). Google takes me to the NIH page on Levothyroxine. Right at the top is the following offset warning:

Thyroid hormone should not be used to treat obesity in patients with normal thyroid function. Levothyroxine is ineffective for weight reduction in normal thyroid patients and may cause serious or life-threatening toxicity, especially when taken with amphetamines. Talk to your doctor about the potential risks associated with this medication.

I know there are people who do risky things to lose weight. (Less than 600 calories a day, anyone? I’ve done it.) But … hello?

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Living 400lbs

I blog about what it’s like to be live life at about 400lbs. :)

15 responses to “Head, Meet Desk”

Erin Smith

July 18, 2011 at 11:04 pm

Never heard of anyone doing that to lose weight, but honestly it would not surprise me at all. Just look at how willing doctors have been to prescribe other weight loss products that turned out to ultimately be deadly. Phen fen or whatever it was called.

Don’t even need to go that far back… look how many are willing to cut apart a healthy functional organ just to induce anorexia in fat people. Because I’m sorry but in an underweight person, we would call eating under 1000 calories a day anorexia, but in a fat person it’s “a positive lifestyle change”.

And who knows. Maybe this side effect of death is less a bug and more a feature… you’ll either get thin, or I’ll kill you by trying sort of thing. Mercy killing for fatties, because killing them is better than being forced to look at them. Yes, that’s mostly snark, but given some of the things people feel comfortable saying about fat people it would only surprise me in that nobody has been caught at it before.

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Gorse

July 19, 2011 at 1:47 am

Hey there, I paused on your post as a sufferer of hypothyroidism, on a fairly hefty dosage of armor thyroid, as I suffer from unwanted side effects from Synthroid.

I don’t know if things are different from the UK but I have _never_ heard of a doctor prescribing synthroid to a patient for mere weight loss. In fact, it’s difficult to persuade doctors to put you on it in the first place (my TSH was 12, and they still wouldn’t do it until I came in with a 1″ stack of studies and papers about the normal TSH level.)

I don’t know if it’s because of my early-morning brain or if I’m just interpreting it wrong but your friend is taking it for TSH, and not because his doctor wants him to lose weight.

Of course I could be completely misinterpreting your words, and I’m really sorry if I have!

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1. Living 400lbs
  
  July 19, 2011 at 9:49 am
  
  I don’t know if it’s because of my early-morning brain or if I’m just interpreting it wrong but your friend is taking it for TSH, and not because his doctor wants him to lose weight.
  
  You are correct, my friend is diagnosed as hypothyroid and is prescribed Synthroid for that reason.
  
  My surprise was that the National Institutes of Health and/or FDA here in the US feels the need to put that kind of warning on the drug. I may be wrong, but I associate “too much thyroid” with “hyperthyroid”, which is ALSO not anything to mess with….
  
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2. Emily
  
  July 19, 2011 at 12:32 pm
  
  @Gorse- re: Synthroid… what were the negative side effects? I also take Armour. Thanks.
  
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  1. Gorse
    
    July 20, 2011 at 12:22 am
    
    I was tried on Synthroid a few years back after a stint on Armour and found my throat swelled up painfully, to the point where I spent most of my time eating ice cubes and popsicles. It also failed to counteract a few of the symptoms of my hypothyroidism such as the intense lethargy, so I was put back on Armour ASAP.
    
    I hope this helps shed some light on it, though obviously it would not be the same experience for another person.
    
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Faycin A Croud

July 19, 2011 at 5:54 am

It’s actually fairly common for levothyroxine to be prescribed for weight loss. 7.5 is slightly hypothyroid. I have mild hypothyroidism (7) and learned that I cannot take thyroxine. It put me into an artificially induced state of hyperthyroidism. Believe me, I’d rather be a quart low than the least bit high. I had such a horrific panic attack that I thought I was having a heart attack. My blood pressure skyrocketed. My doctor is usually pretty good about not bringing weight into the picture, but on this occasion he blamed the problem on the fact that I’d gained weight and put me on a beta blocker and clonazepam. The beta blocker exacerbated my mild asthma, and I felt like I was breathing under water and could hardly move. The clonazepam gave me such a bad rebound panic attack that I thought I was going to die. Fortunately I talked to my mother, who told me that thyroxine had driven her blood pressure way up when she was on it.
I went back to the doctor. Luckily he didn’t tell me something stupid like that I should stay on these medications. He marked on my chart that I should never take any of them again.
It took me three months for the artificial thyroid hormone to fully clear my system.
Three years later I did develop mild hypertension. I was 46 years old, in nursing school, and my father had recently passed away after a long, awful period of decline in his health. As well, this is hereditary in my family. Although I am overweight, I developed it ten years later than my younger brother. I now take amlodipine besylate, which has had far fewer side effects than propranolol. At least I don’t feel like I’m breathing underwater when I take it.

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1. Living 400lbs
  
  July 19, 2011 at 9:51 am
  
  I have mild hypothyroidism (7) and learned that I cannot take thyroxine. It put me into an artificially induced state of hyperthyroidism. Believe me, I’d rather be a quart low than the least bit high.
  
  See, that’s what surprised me with the warning. Hypothyroidism AND hyperthroidism are both serious conditions.
  
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Heather

July 19, 2011 at 6:12 am

Risking one’s life to be thin? Honestly that doesn’t seem unusual to me, unfortunately. I was in high school when ephedra was recalled because of heart damage.. I was devastated that it was recalled. I was only a teenager, but I certainly daydreamed about going to canada (where I assumed it was legal) to hoard diet pills and smuggle them back to the US. That’s just how powerful the fantasy of being thin is.

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1. Living 400lbs
  
  July 19, 2011 at 9:52 am
  
  I remember the old Metabolife too…..
  
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vesta44

July 19, 2011 at 9:16 am

I don’t remember what my TSH levels were the last time they were checked, but the doctor said they were in the normal range, whatever that is. However, my thyroid is enlarged. I had an ultrasound done in December, and another one done this month, and it’s even larger now. So I’ve made an appt with a surgeon for a consult about having it removed – my grandfather had a very enlarged thyroid that was cancerous, when they removed his, they couldn’t take it all. If they had, he wouldn’t have been able to speak or swallow. So not something I want to let go. I haven’t talked to the endo about what med I’ll be on after they remove my thyroid, I’m assuming she’ll talk to me about that afterward, while I’m in the hospital (I don’t think the surgeon would have anything to do with that).
My mother did take thyroid medication to lose weight, but it wasn’t something her regular doctor would prescribe for her, she went to other doctors, and she had to shop around for them, they kept losing their licenses to practice medicine. When I was younger, and still lived in the same state as my parents, my dad offered to pay for me to do the same thing so I could lose weight too, but I just didn’t think it was worth having to change doctors every time the state decided the doctor was illegally prescribing medicine (went through that once when I went to a doctor who prescribed amphetamines for weight loss, never again). To me, the side effects of taking a medication I don’t need aren’t worth the weight I might lose, especially if the state medical board may decide that the doctor is wrong in prescribing those drugs and I won’t be able to take them anyway, if that makes sense.

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1. Living 400lbs
  
  July 19, 2011 at 9:53 am
  
  Amphetamines were legal for weight loss in the 60s. My mother was on them (and a size 16) when she got pregnant with me. She had to stop them cold turkey, and her descriptions of withdrawal didn’t exactly encourage me to want to try amphetamines.
  
  So, yeah….withdrawal = not fun.
  
  Reply
Emily

July 19, 2011 at 12:30 pm

hmm, I have hypothyroidism and take Armour Thyroid. I was hoping when I started it that it would help me lose weight, because when I was diagnosed I had gained a lot of weight for no apparent reason. But the thyorid medication has not helped my weight at all, although my thyroid numbers now come up normal.

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JupiterPluvius

July 20, 2011 at 3:25 pm

You would be surprised how many doctors prescribe/recommend thyroid meds for weight loss. Or maybe you wouldn’t. Remember, duly board-licensed doctors advertise all kinds of “medical services” like cosmetic labiaplasty…

Trigger warning: eating disorder, self-injurious behavior:

I also knew someone in my ED treatment circle who had stolen a family member’s Metformin as a weightloss aid.

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The Well-Rounded Mama

July 20, 2011 at 4:58 pm

When I asked to be tested for hypothyroidism years and years ago, I remember the endocrinologist assuming I wanted it in order to lose weight. No, I wanted it so I could feel better, thanks. However, I think there was a time when some docs did prescribe it for weight loss and it was abused for that reason.

It took 5 more years to get someone to take my concerns seriously but when we started a trial of meds, I did find I lost about 20 lbs or so without effort. However in time, the weight normalized back to my setpoint, as these things tend to do, despite no change in habits. So I think it can be used for wt loss but it’s a very temporary thing and it’s risky because hyperthyroidism has risks too. Definitely not a good idea to use it for wt loss purposes–but docs should NOT assume that all fat people want it for that reason.

What TSH levels should be the cutoffs for diagnosing hypothyroidism is very controversial within the medical community. Each lab has its own version, but basically the most common cutoffs are ~0.5-5.5 TSH. So your friend definitely exceeds that and should be treated, providing he tolerates the meds well.

However, many people have subclinical hypothyroidism, with a TSH in the 3 and 4 range, and can’t get diagnosed or treated by traditional guidelines, but can with the newer AACE guidelines (~0.3 – 3.0 TSH). But a lot of doctors won’t honor those guidelines, even if you are totally symptomatic.

Personally, I start feeling crappy and gaining weight if my TSH goes above a 2. Keeping it to around 1 is where I feel best…….but too low (less than 0.5) is risky for your heart and can cause panic attacks and all kinds of issues too.

I think each person has to find the right “sweet spot” where they feel best It’s just hard sometimes to find a doctor who will treat to that. But responses to thyroid issues vary so much that I think it’s really important that docs individualize our care on these things.

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notlessthan

July 28, 2011 at 1:15 am

I used to have abnormal TSH levels, likely damage from being fed an absurd amount of anti-depressants and anti-psychotics as a young child. My levels were abnormal for 11 years and when I went into the hospital recently, they drew my levels and surprise! They were normal. Without having been on medication for 6+ months (because I was lazy and didn’t want to take it). I was told that my levels would never normalize because of the damage done prior to puberty. I am quite glad to have one less med to take. I’ve got plenty of meds already. Not that I’m great about taking those either…

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