HYPOTHYROIDISM

Hypothyroidism, also called underactive thyroid disease, is a common disorder. It is found in about 2% of the UK population and in more than 5% of those over 60. Women are 5 to 10 times more likely to be affected than men.

With hypothyroidism, your thyroid gland does not make enough thyroid hormone.

What are the symptoms of hypothyroidism?

The main symptoms of hypothyroidism are:

• Tiredness
• Weight gain
• Dry skin
• Lethargy and feeling low

Hypothyroidism and weight gain

The effects of the thyroid on the body’s metabolism and body weight are complex. When the thyroid gland is underactive and there is a deficiency of thyroid hormones, the body’s rate of metabolism becomes slower. Slowing of the metabolic rate, in turn, results in changes in energy balance causing weight gain. In simple terms the slowing of the metabolic rate results in an imbalance between the energy or calories consumed and the energy or calories utilised.

Weight gain is often greater in those with more severe hypothyroidism but also in those whose hypothyroidism is not recognised, diagnosed, or treated in a timely manner. Delays occur as the symptoms of hypothyroidism are sometimes non-specific and attributed to the day to day stresses and pressures of modern-day life and because the biochemical changes often become obvious only after a period of time. The weight gain is also slower and insidious and therefore not recognised as being down to an underactive thyroid.

Hypothyroidism and weight loss

The weight gain is a combination of fat accumulation as well as an excess accumulation of salt and water. Studies suggest that the weight gain due purely to the underactive thyroid is predominantly the salt and water retention and therefore treatment of the underactive thyroid only results in a moderate amount of weight loss.

In some individuals the weight gain is more marked and treating the underactive thyroid to achieve normalisation of the thyroid blood tests is not always accompanied by the weight loss the individual hopes to achieve. Once the blood tests are in the normal range and other symptoms, other than weight gain, resolve, other strategies to achieve the weight loss will be required.

The expenditure of energy, food intake, and body weight are controlled by an interplay of several hormones (including thyroid hormone), proteins, and other chemicals. These regulators interact at the brain centres that regulate energy expenditure and appetite as well as in the tissues throughout the body. It is difficult to predict the effect of altering only one of these factors (such as thyroid hormone) on body weight as a whole. It is important to recognise the limitation of treatment with thyroid hormone to achieve any further weight loss after normalisation of thyroid blood results.

Weight loss treatment for hypothyroidism

Thyroid hormones have been used as a weight loss tool in the past in patients without any prior thyroid dysfunction. This is no longer considered safe as the weight loss can result from loss of muscle mass in addition to any loss of body fat, there can be abnormal heart rhythm changes and untoward symptoms of anxiety, sweating and tremors. Longer-term use can also result in bone thinning.  

Some patients with an underactive thyroid derive better symptomatic improvement with energy levels, concentration and mood when the replacement is at the top end of the normal range and some do with combination treatment with T4 and T3 hormone. Pushing the thyroid hormone dose to cause thyroid hormone levels to be elevated and the use of combination T4 and T3 hormone treatment does not tend to have a similar benefit when it comes to weight loss.

At the Liverpool Weight Loss clinic, we help patients with hypothyroidism to explore all the options available (including clinically proven weight loss medication) to achieve not just their weight loss goals but any persistent hypothyroid symptoms despite what is considered standard therapy.

If you are suffering from hypothyroidism and would like some help with managing the symptoms, please get in touch.