General Medicine

» sararose27 - Methamazole and Weight Loss

I was recently diagnosed with Grave's disease. Initially I took 30mg of Methamzole. I gained back a couple of the pounds that I lost. My dose has just been doubled to 60mg. I work out regularly and eat relatively healthy. I am concerned that my weight is just going to continue to go up. It's becoming very demotivating and depressing to continue to work out and eat healthy to get the opposite of desired results. Also, I need to lose weight. I'm about 10 pounds over the normal range. I used to be 40 pounds over and really do not what to end up there again. Any suggestions/advice would be greatly appreciative.

-- posted by sararose27

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» Elaine Moore - Methamazole and Weight Loss

In response to Methamazole and Weight Loss posted by sararose27:
Hi SaraRose,
The initial starting dose for methimazole is 10-30 mg with most of the newer studies suggesting that 10 mg daily is effective for most people.
A dose of 60 mg daily is very high and suggests that your doctor is interpreting your test results incorrectly. If he or she is looking at your level of TSH, which is a pituitary hormone this can happen. Some doctors don't understand that TSH stays low, usually to levels as low as .01 for a very long time in Graves' disease. For this reason, you are considered euthyroid (normal thyroid function either naturally or from meds) as soon as your FT4 level falls into the normal range. This typically takes 6-8 weeks.

And as soon as FT4 falls within the reference range, which is usually 0.8-1.8 ng/dl, the metimazole dose is lowered to prevent your becoming hypothyroid. Hypothyroidism needs to be avoided for many reasons. Anyway, the dose is reduced to between 2.5-10.0 mg daily, and over time the dose is reduced. Ideally, you'd be on the lowest dose needed to keep your FT4 near the high end of the reference range, like 1.5 or 1.6 or so with the range I listed.

The fact that you've gained weight suggests that you're responding to the methimazole. And it's not unusual for inexperienced doctors to prescribe inappropriately high doses of anti-thyroid drugs because of confusion regarding thyroid test results.

Ask for a copy of your last lab results and if FT4 is ok you can question your new dose or find a more experienced doctor, not necessarily an endocrinologist. Best to you, Elaine

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» sararose27 - Methamazole and Weight Loss

In response to Methamazole and Weight Loss posted by daisyelaine:

Thanks for the quick response Elaine. I think that my FTF level was still pretty high when I went on Thursday. So it's likely if I drop to normal by the time I go back in six weeks he might lower the dose. That's good to know. Hopefully the weight gain will not be too much. I've been as much as 35 overweight in the past and it's not a road I want to go down again.

-- posted by sararose27

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» Elaine Moore - Methamazole and Weight Loss

In response to Methamazole and Weight Loss posted by sararose27:
Hi Sara,
If you can eliminate environmental triggers that'll help lower your thyroid hormone levels. And you can always add foods known as goitrogens that work much like ATDs, blocking the amount of iodine that you absorb. These include raw broccoli, cabbage, cauliflower, peaches, plums, almonds, peanuts, grapes, grapefruit, squash, etc. If you stay on top of things you should be able to avoid weight gain. Best to you, Elaine

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