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Thyroid Diseases

Preventive Thyroid Treatment and Weight Loss

08/23/2006

Question:

My daughter 14, has Hashimoto`s thyroiditis, T3 30.28, T4 7.1, antithyroid peroxidase 90. Enlarged thyroid especially the right side. Extremely tired after exercise, dry skin, had shingles, pitoriasis, warts, nail fungus, 5th disease and low immunoglobulin G 446, Total IGE 275. We saw an endicrinologist and she suggested blood tests every 6 month.

My daughter gains weight very easily is shorter than anyone in the family and has always been in the 80th % in weight. In 1998 her thyroid tests were normal although she had an extremely large neck, voice nodules and reflux. She is now 5`3" and 135 pounds after exercising 2 hours a day 5 days a week at summer conditioning.

Should I suggest preventive thyroid treatment?

Answer:

No, I don't believe starting your daughter on thyroid hormone will change anything. Her T4 level is already normal (though a Thyroid Stimulating Hormone level would actually be a better test) so starting thyroid hormone pills will not help your daughter's problems - they are not related to the thyroid. I agree that checking the thyroid blood tests periodically is all that should be done for the thyroid problem right now.

If your daughter is shorter than the rest of the family you should discuss this with her pediatrician. If her growth curve has been normal then this is unlikely to be due to any disease.

There are only a small number of diseases, as such, that cause weight gain. I'm sure your endocrinologist has already determined whether or not it is likely that your daughter has one of them. In the vast majority of patients weight trouble is not being caused by any particular disease.

If you eat more calories than your body needs in order to survive, you store the extra calories as fat. If you are only eating a tiny amount of food and you are still gaining weight, then that tiny amount of food is more than your body needs. Exercise will help, but exercise alone will have a disappointing effect on weight loss. One pound of fat equals 3500 calories. Jogging without interruption for a solid hour only burns off about 675 calories. Thus, exercise is really best viewed as an aid to calorie restriction in keeping down one's weight - not the main treatment.

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Response by:

Thomas A Murphy, MD, FACP, FACE Thomas A Murphy, MD, FACP, FACE
Associate Professor of Medicine
School of Medicine
Case Western Reserve University