Thyroid and weight loss?

Type 1 and LADA
1

Hi All,

My partner is a type one diabetic and has hypothyroidism which is treated daily with levothyroxine. She's currently taking an average of 35 units of insulin a day and is very insulin sensitive. Average daily carb intake is about 150 grams. We are vegetarian (3 years)and gluten free (2 years). I'm vegan, she is not, but I'd say about 52% of her meals are vegan. Average daily calorie intake is 2000-2200. She does intensive cycling 3 times a week which is around 1000 to 1100 calorie burn and walks an hour 2 times a week.

My lifestyle is roughly the same. I cycle less then she does and eat more calories. I weigh 137 pounds. She weighs 280 pounds.

Ok,thank you for hanging in with me to this point :).

The reason I'm posting here is because she is struggling to find a doctor that will address her concerns about the continued hypothyroid symptoms she's having even though she's been successfully medicating it for 17 years and all test return borderline to good results.

Here current dr. insists that she needs to take symlin and that will help her loose weight but that doesn't address the other symptoms and she has tried symlin. It makes her sick and doesn't work(it's also a type 2 med). The doctor refuses to evaluate her lifestyle and just assumes that because my partner appears overweight that she is eating terribly but the problem is that my partner isn't. As you can see above we lead a relatively healthy lifestyle and it seems really odd that she would just be maintain her current weight considering all of her numbers.

My partner insisted that her dr. refer her to an endo to evaluate her hypothryoidism and the dr. coded the referral as an obesity evaluation, even though that is not what my partner asked for. Where the endo insisted yet again my partner take symlin and there's nothing else the endo can do if she doesn't take symlin.

Bottom line nobody is addressing the real problem here! Just because my partner is a larger lady doesn't mean she's lazy and eats terribly. There is something wrong with her thyroid or something else.

Is anybody experiencing a similar situation? Healthy lifestyle, good numbers but still present hypothyroid symptoms and have you found a doctor that will work with you and is willing to explore?

We've seen a naturopath and where we ended was that she needs to reset her metabolism by just not eating non starchy veggies, avocados, olive oil, nuts, seeds, some seasonings,fruit, grains, peas, beans, sweeteners, alcohol for 6 months. For a veg this would be extremely difficult and seen as a last ditch effort.

Thanks,
Tinks

2

There are a few things that strike me as a little strange in this post.

Your partner has T1 but had to ask for a referral to see an endocrinologist? Who's treating her diabetes? Her PCP? Endocrinologists are definitely better choices for treating both T1 and T2 diabetes. If anything, she should see an endo for her diabetes.

Borderline thyroid tests don't usually cause obesity. That being said, everyone is different--we're all individuals here!

Symlin isn't really a T2 drug. When your body releases insulin, it also releases amylin, which basically makes the food digest more slowly. People with T1 don't release much, if any, insulin, so they don't release adequate amylin for their needs. People with T2, on the other hand, usually produce lots of insulin, so there's lots of amylin around.

Lastly, of course the diet that the naturopath recommended would make her lose weight--your partner would starve! Doesn't that kind of diet mean no food except non-starchy veggies and protein and dairy? That's very, very little.

I think the reevaluation for hypothyroidism by an endocrinologist is your partner's best bet.

3

Guitarnut,

My partner sees a nurse practitioner at the University of Washington's(UW) Diabetes Center for diabetes needs and has a separate PCP that deals with none DB related needs.

For Symlin It was initially marketed as a type 2 medication that could possibly help type ones when she initially tried it.

I've done research in our area(seattle) and it seems there's an endo within the top 1% of all endos in the nation at UW(for what it's worth:)) so I think we will try that. It's just is disheartening to have some much resistance from the med professionals she's working with.

We are willing to travel so if anybody has had an endocrinologist that has helped you figure out edge case situations. Please let me know.

Thanks,
Tinks

5

A moderately active 20-25 yr old women needs about 2200 calories a day sedentary women should be eating about 2000 calories a day. She's also tried lowering her caloric intake to around 1800 for several months while keeping the same amount of activity with no movement in here weight. She's seen multiple nutritionists. They all say she's within guidelines and are so impressed with her diet they have no suggestions other then continue to lower carbs but she's already consuming under the lowest average for the amount of carbs a women should consume in a day.

She's type 1 and she doesn't want more medication she wants them to consider that there may be something else going on instead of prescribing another medication that doesn't work and not put her in a box just because she's over weight. She's aiming to solve problem not mask it with another medication.

I did research on dr. Hirsch and I think she's going to try him to see how it goes.

6

Thank you! We'll take a look.

7

From personal experience: 1984 had thyroid cancer, surgery to remove thyroid (all but 5%), refused any radiation or chemo. Put on thyroid medication. A few years later was trying to save some money and tried generic thyroid. I started to gain weight and things just weren't the same. After 3 months I had a blood test to check my levels. They were way out of whack. Generic thyroid DOES NOT WORK! I went back to the name brand and it took awhile but my levels went back to normal. Would highly recommend going and getting the name brand Synthroid. It can make a differnce.

8

Hi Tinks. I have type 1 diabetes and I consume a low fat (~10% of total calories), whole foods, vegan diet. I've eaten about 300g of carbohydrate today. I do not have any issues with my thyroid, so I'm sorry I have no input to offer about it. But I have been able to keep my blood glucose under better control eating this way and I happened to also lose about 25 pounds in the last 7-8 months. I'm still losing weight. Perhaps she could give it a try to see if it helps her.

I'm sorry to hear you two are having a hard time finding good medical care. I wish more doctors focused on lifestyle issues rather than prescriptions. I just visited with a physician's assistant that wanted to prescribe a statin to me just because I have type 1 diabetes. I have zero issues with my blood pressure or cholesterol and my BMI is good and he wanted me to take a statin. Blows my mind. I hope you find a medical care team that will work with your partner.

9

Hi Tinks, I am a T1 with hashimotos disease. My thyroid issues are often more difficult to address than my diabetes and I also struggle with weight. I have also used Symlin. First, she absolutly should be working with an endocrinologist. I try to keep my daily carb intake under 90 grams. I find that I have far better control of both my weight and my blood glucose when I do this. 90-100g is really plenty of carbs for a woman. I have never really liked using Symlin either. While some people swear by it - the nausea and unexpected low bgs that come with the use make it pretty undersirable. You might want to ask the doctor to try a different thyroid medication. Unlike other drugs, there is some thought that the generic forms of Synthroid may simply not be as effective as the branded version. I'm not sure why this is - -but I just have heard it said. I take Synthroid. Another observation from my own experience -- for about 10 years I was a vegetarian (although I ate dairy and eggs). I never had more difficulty controlling my weight than during that time. I have actually found that by adding lean meat back into my diet (primarily fish and some poultry) I have far greater success managing my weight. Of course, everyone is different, but I thought you might glean something from me sharing this info from my own experience.

10

I find your last comment interesting, Donna. I've been a vegetarian since before I was diagnosed with D, and considering that I don't have IR I have a hell of a time controlling my weight as well. I've always ate under 100 carbs and now am trying to keep it closer to 50...and still I can't lose weight! I was wondering if in your case it could be simply that as a vegetarian you naturally ate more carbs such as beans, rice, pasta, bread and cereal? Or did you eat under 90 grams then as well? (I'm also on Synthroid btw. I was actually hyperthyroid (Graves) but they couldn't control it with thyroid suppression so they nuked it and now I take replacement.