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Old 04-27-2006, 02:00 PM   #1
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Weight and Thyroid Need

I'm still trying to ponder why I feel fine and other people with scores much closer to "normal" feel miserable, and I was thinking about weight. I've read several places that thyroid replacement dosages are often linked to weight, with heavier people needing more. I'm not entirely sure how thyroid works in the body, but I suppose it makes sense that someone who is larger would need more of it, it's that way with many other medications.

So I was wondering if this could be a factor in why the normal ranges don't seem to work for people so well. Ignoring TSH since everyone around here is so utterly convinced that it means absolutely nothing, how about T4 (since I don't know my T3). I'm at .7, "normal" range is .8 - 1.7, but judging from reading back through posts, most people are already feeling bad at around .9 or so, and prefer to be close to the top of the t4 range. Why?

Just to play with numbers, say that the normal range is based on someone who weighs 180lbs. Assuming an arithmetic distribution, since I weigh 120, -my- normal range would be *breaks out the calculator* .53 - 1.1, meaning that my current .7, while looking quite low for the standard range, would be actually close to the middle of -my- range. Which could explain why I feel basically fine, just tire a little easier than I should and have a low body temperature.

People with hypo symptoms but "normal" thyroid levels tend to be overweight. Assuming again that 180 was the baseline, someone who weighs 230 might have a range of 1.0 - 2.2. At .7 they'd be quite definitely below range, and therefore, one would presume, more symptomatic.

Now these are just random, completely hypothetical numbers. But I was wondering if anyone had seen any research on whether thyroid need was related at all to weight, or even a lab that had different ranges based on whether you are male or female (since men tend to weigh more than women) or even ranges based on general weight?

Have any of you noticed a difference in how you feel, based on your weight in relation to your test levels? Have you lost weight and felt better at the same hormone levels, or vice versa? Or is there no relationship at all? If there's no relationship, what does the thyroid do for the body, that wouldn't create a greater need for a larger person?

 
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Old 04-27-2006, 03:23 PM   #2
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Re: Weight and Thyroid Need

Interesting. I have read that if you have no thyroid or a nonworking one, your dose might be around you weight, so 200mcg for a 200lbs person. So the more you weigh the more you do need. But as far as tsh, In a normal person, it seems it should be about the same. But your thyroid would need to make more if your bigger. But i see what your saying, I'm sure a heaver person would feel better with more t3 and t4 in them, to a point.

 
Old 04-27-2006, 05:24 PM   #3
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Re: Weight and Thyroid Need

You low body temperature should be a concern to everyone. It means you have lower metabolism, and doctors have concluded that this is a factor in heart disease, if not the reason for heart disease. The only thing that will raise your T3 is Armour. I don't understand why people ignore TSH. A better way to do it would be to ignore all the numbers and just treat the symptoms.. Again doctors treat numbers...not people.

 
Old 04-27-2006, 06:35 PM   #4
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Re: Weight and Thyroid Need

Actually, I just read a study that concluded thyroid replacement is not related to total weight. It found that heavier people do not need more, unless their extra weight is more muscular than fatty. Thus, a man might need more than a woman of similar weight, because his weight is more muscular. Or, a very athletic woman of a certain weight might need more than a sedentary woman of identical weight. But, in general, the average full replacement dose is between 150-200 mcgs of T4 no matter the size of the person.
You might think a 300-lb. person would need more than a 150-lb. person, but it simply isn't true that they do.

Your computation of your need for FT4 based on weight doesn't hold up, either. The lab range is set by running the test on a large segment of the population - all sizes and both sexes - who are presumably (but debatably) thyroid-healthy. It has nothing at all to do with weight, so you can't apply a weight standard to your result.

 
Old 04-27-2006, 07:10 PM   #5
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Re: Weight and Thyroid Need

Quote:
Originally Posted by midwest1
Actually, I just read a study that concluded thyroid replacement is not related to total weight. It found that heavier people do not need more, unless their extra weight is more muscular than fatty. Thus, a man might need more than a woman of similar weight, because his weight is more muscular. Or, a very athletic woman of a certain weight might need more than a sedentary woman of identical weight. But, in general, the average full replacement dose is between 150-200 mcgs of T4 no matter the size of the person.
You might think a 300-lb. person would need more than a 150-lb. person, but it simply isn't true that they do.

Your computation of your need for FT4 based on weight doesn't hold up, either. The lab range is set by running the test on a large segment of the population - all sizes and both sexes - who are presumably (but debatably) thyroid-healthy. It has nothing at all to do with weight, so you can't apply a weight standard to your result.
But they say "The T4, or rather the T3 derived from it, and the T3 secreted direct by the thyroid gland influence the metabolism of your body cells. So doesn't a larger person have more cells in there body? Would that make it so they would need more hormone to go around? A bigger person does usually have bigger muscles, most of us anyways, and bigger bones, more skin, bigger lungs, bigger everything, so wouldn't we have more cells to use up the t4 and t3?

 
Old 04-28-2006, 05:31 AM   #6
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Re: Weight and Thyroid Need

Here's the study...
http://jcem.endojournals.org/cgi/content/abstract/90/1/124

According to it, the highest dose a normal-weight person needed was about 150 mcgs. The highest dose an obese person needed was 180 mcgs. That isn't a lot of difference.
Of course, some of us could argue that all or some of the subjects could've been undertreated. We can't really judge that from here. My own MD, who is not stingy with Armour when a patient needs it, and who has been practicing since the 1980's, has told me that he never had anyone need more than 200 mcgs, and that was a very tall and brawny man. He said it would be rare for anyone to need more. I'm an unusual patient for him; I weight 165 and am 5'7"... not huge, but overweight, and certainly not petite. I need only 90 mgs of Armour to feel well. He said I have an unusually low need, which seems to be true from everything I've read.

I'm not a scientist... can't debate any of it... I'm only reporting what I ran across the other day while looking for something else.

 
Old 04-28-2006, 09:49 AM   #7
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Re: Weight and Thyroid Need

Quote:
Originally Posted by midwest1
Your computation of your need for FT4 based on weight doesn't hold up, either. The lab range is set by running the test on a large segment of the population - all sizes and both sexes - who are presumably (but debatably) thyroid-healthy. It has nothing at all to do with weight, so you can't apply a weight standard to your result.
That is not an assumption I would make at all. We know that medicines are more likely to be tested on men than women, for some complex reasons. So why assume that lab ranges are based on a broader population? And even if they are, a large segment of the population would look completely different depending on what part of the country the testing was done, and we don't have any idea what that population sample looked like, and how it might be weighted. Because there's no such thing as an unbiased sample. Even assuming that it all perfectly balances out, somehow, magically, this range reflects averages, and for people who don't bear any resemblance to the average, the results might not be very applicable. Weight is one factor that can't be ruled out. All of the people used to define the range weighed some amount, that was averaged in. Age too. All of the people had some age, and that data is also averaged.

What I'm saying is that the very averaging of the sample population has obscured information that could explain why people have different reactions to low thyroid. Now of course I just made a random weight number up, as a demonstration how weight -could- affect the range, not that it does. I could have picked age instead, and queried whether younger people seemed to handle a lower thyroid fewer symptoms than older people with the same numbers.

You've offered a study, which is what I asked for, and I'll read it. But I admit it sounds quite counter-intuitive. Indeed, all of the people I know who are obese have a great deal more muscle mass than me, at least in their lower body, even though I am quite active, and rather muscular for my size. The very factor of being overweight causes bones to become more dense, and muscles more strong, unless the person is completely immobile. If weight has no factor in thyroid need, that certainly raises a huge question in my mind as to what the heck the thyroid acts on then.

 
Old 04-28-2006, 09:59 AM   #8
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Re: Weight and Thyroid Need

You seem to want to debate, but I told you I can't. I'm not a scientist, but if I were, the first thing I'd exclude from the equation is fat. Fat doesn't use thyroid hormone for any reason, but well-toned muscle does.

Hard as you try, you aren't going to figure out a one-size-fits-all dose based on weight. There are too many differentials to do that... The way cells absorb T4, the amount that livers can convert, the type of symptoms, the amount of enzymes contributing to metabolic processes, etc. All of these differ from person to person, and all of that combined determines the need for T4.

That's all I know. Case closed on my end.

Last edited by midwest1; 04-28-2006 at 10:07 AM.

 
Old 04-28-2006, 11:30 AM   #9
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Re: Weight and Thyroid Need

Are you guys talking about a person that has an intact thyroid or one who has had their thyroid completely removed? I do know that a messed up thyroid gland will cause some people to not absorb their medication as they should - or as a "normal" person would.

Last edited by mollyann; 04-28-2006 at 11:31 AM. Reason: misword

 
Old 04-28-2006, 12:00 PM   #10
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Re: Weight and Thyroid Need

Quote:
Originally Posted by mollyann
Are you guys talking about a person that has an intact thyroid or one who has had their thyroid completely removed? I do know that a messed up thyroid gland will cause some people to not absorb their medication as they should - or as a "normal" person would.
I'm not talking about either instance in particular. I'm just trying to get a grasp of what this whole thyroid problem is, why people react the way they do, and what factors cause what. Midwest doesn't seem to understand my interest, which is not to find a correct dosage based on weight, but rather to simply understand why the normal ranges don't work, why some people with really out of range scores feel basically fine, and why other people don't, basically to get a better grasp on what this thing is that I have.

A lot of what I read is essentially useless to me. "Listen to the tests only if they agree with what you already feel is wrong with you, think tests and doctors are stupid if they don't agree with what you feel is wrong." There's no magic here. There's a reason why people react differently, feel different symptoms, need different dosages, and do or don't match up to test results. "I'm special, my needs are different," doesn't satisfy me. "The ranges are wrong," doesn't satisfy me. I want to know why, and if the doctors don't know, then I want to know why they don't know.

I'm sure the reasons people react to low thyroid differently are complex. The exact nature of the disease, the person's age, other health conditions, body composition and activity level, genetics, perhaps diet, gender, perhaps mental outlook, stress level, etc. etc. But just saying "it's complex, do what works for you" doesn't help me at all, because despite what my tests said, doing nothing was working for me just fine, but nevertheless everyone says I need to be on pills. If tests are unreliable, then I have no way to judge my condition, and I'm back to "no one knows what's going on," which doesn't help me. And I don't think it helps people who are actually suffering either. So I'm probing at what the different factors are, and how I can understand them, so that I can understand me, because no one else is helping me understand anything.

There are real, scientific, provable, specific answers out there for all the problems people have with their thyroid, it's just a matter of looking for them. If the science isn't there yet, it will be eventually, and I need to know what questions to ask, so I'll know when I've found the answer.

I'm not ready to give up on weight being one of the factors, and by asking the question I now can ask new questions, focus on how thyroid affects different cells, different body compositions. I also pretty curious about gender, and that's probably the next factor I'll look into. The whole genetics thing, family predispositions, will be next. And I'm going to keep going until I understand everything I can, and can make my own informed judgement about the factors that influence my condition, my treatment, my symptoms, and how to manage my medication.

 
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