Layla hits a plateau in her treatment of hypothyroidism


Layla inquires about how to approach this common situation in the treatment of hypothyroidism:

Hello, I am a 23-year-old girl, and at the beginning of 2013 I started rapidly putting on weight, where I ballooned from 128 lbs to 155 within a few months, despite extremely healthy eating and exercise. I had my TSH tested and it was 4.71. I was put on 25 mcg of levothyroxine, which was eventually increased to 50 mcg (I am still currently taking this). It decreased my TSH to 0.69 and increased my free T4 t0 1.2, but recently my weight loss has slowed and I put on a little fat despite an extremely low carb diet. I retested and it showed that my TSH had gone up to 2.1, and my free T4 had gone down to 1.0. My endo was not tested T3, but she finally gave in when I asked, though she refused to test free T3. My total T3 came in at 40 (range 50 – 180, though I’ve seen 80 as the lowest amount for health), which is extremely low. I have always had incredibly slow metabolism, and even when I was at 128 lbs, I had a lot of body fat. I keep asking for Cytomel, and the endo is almost there in giving it to me, but she insists that my low T3 is due to some mystery illness that she thinks is temporary, and wants me to retest. My question is this: how much T3 should I end up taking, to get rid of my excess weight and body/belly fat, and improve my symptoms (dizziness, extreme fatigue, depression, PCOS)? I want to be around 115 – 120 lbs. I figure the starting dose will be around 5 mcg, but do I need more than this for optimal functioning and metabolism? Should I split the dose? Any advice is appreciated.

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