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Monday, June 29, 2009
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Ask the doctor Dear Dr. Eneas, Is there anything I can take to help me lose weight and not interfere with my thyroid medication. I am on Armor Thyroid and take 90 mgs. — one a day and 120 the next day. I took the radioactive iodine in 2001 to kill my thyroid. I was 120 pounds and am now 185 pounds and only five feet tall. I would really like some help with this. Thank you so much for any help you may be able to give.
Dear Thyroid patient, You had an overactive thyroid when you were diagnosed and that overactive thyroid probably caused you to lose weight down to 120 pounds. I agree 185 pounds is too much weight for your frame. The treatment of an overactive thyroid or Hyperthyroidism with radioactive iodine is designed to obliterate the thyroid gland — sort of a medical thyroidectomy. Your thyroid status must now be maintained with thyroid medication given orally. If your thyroid continues to be underactive you will gain weight. The symptoms of an underactive thyroid are cold intolerance, a slow heart rate, swelling in the legs, a sluggish feeling, a change in your menstrual periods and a change in hair texture. Weight gain could also be a symptom of an underactive thyroid (Hypothyroidism). First, we have to make sure you are on the right dose of thyroid medication to see if you are adequately medicated. A blood test will help with that. We could check your thyroid levels and TSH (Thyroid Stimulating Hormone level). If you are adequately medicated, your TSH level should be almost 0, as it would be suppressed by your medication, indicating that you were on the correct dose. Assuming you are on the correct dose, I am reluctant to prescribe medications to suppress your appetite as they are usually stimulants and can have major side effects, including heart disturbances, high blood pressure and even sudden death. There is one medication that is considered safe to take and that is Raductil, which can be prescribed and paid for by health insurance. Using medication to lose weight, however, is usually not effective in the long run. You will still need a program of nutrition counseling and exercise. Before prescribing a diet plan, you will need a complete a battery of tests to check your cholesterol and blood sugar among other things. An exercise program including aerobic exercise three to four times a week for at least 30 minutes is essential. Avoiding foods that are high in carbohydrates and watching your portions also becomes important. I would strongly suggest that after a thorough medical evaluation to assess your thyroid status that you seek the counsel of a nutritionist.
Judson Eneas, MD Internal Medicine Specialist
Do you have a medical question that needs answering? We would love to hear from you. Send us your question and look out for the next "Ask the Doctor" column. You can send your question via email to askthedoctor@doctorshosp.com, or to Doctors Hospital P.O. Box N 3018, Nassau, Bahamas or The Nassau Guardian.
This informative column is intended to educate the community about important issues regarding their health and is not intended as a substitute for consultation with a primary physician. For more information or for a physician referral, please call 302-4707.
Monday, June 29, 2009 |
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