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Weight Loss Resistance
I am a 28-year-old with Thyroid and a BMI of 32.0. I have been taking 50mcg of Thyroxine for one month, and my TSH is shigh at 10.5 mIU/L, and my HbA1c is 6.0%. Despite being physically active with swimming and recently started gyming, I am experiencing complete weight loss resistance and a high Visceral Fat level of 18. My biggest struggle right now is that I feel I have absolutely no control over my hunger; I experience intense 'food noise' and the urge to binge even immediately after eating full meals. I recently completed my Vitamin D treatment, but my metabolism feels completely stalled. I would like to know if my thyroid dose needs to be increased and if I am a candidate for Mounjaro (Tirzepatide) to help manage this uncontrollable hunger ?? I really want to lose weight as I'm out of energy and all day I feel inactive and sleepy
Answers (15)
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Your thyroid needs treating first as it is a common reason for weight gain.
Increase your thyronorm to 75mcg daily and have repeat TSH check after 6 weeks. Your goal is to bring the TSH to less than 4 with treatment.
All the best.
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Your frustration with "weight loss resistance" is clinically understandable given your current lab results. You are dealing with three interconnected factors: uncontrolled hypothyroidism, prediabetes, and significant metabolic adaptation.
Clinical Assessment:
Thyroid Status: A TSH of 10.5 mIU/L indicates that your current dose of 50\text{ mcg} Thyroxine is insufficient. In Hypothyroidism, the basal metabolic rate (BMR) drops significantly, making it almost impossible to lose weight regardless of exercise.
Prediabetes & "Food Noise": Your HbA1c of 6.0% falls in the prediabetic range. This often leads to insulin resistance, which triggers intense "food noise" and cravings because your cells aren't effectively using the energy from your meals.
Metabolic Stall: Between the thyroid deficiency and insulin resistance, your body is in "energy conservation mode," leading to the fatigue and sleepiness you feel.
Recommendations:
Dose Adjustment: You likely need a thyroid dose escalation. However, this must be done by your physician after checking your Free T4 and Free T3 levels to ensure a complete picture.
Mounjaro (Tirzepatide) Evaluation: You are a potential candidate for GLP-1/GIP receptor agonists like Tirzepatide, as they are specifically indicated for chronic weight management in patients with weight-related comorbidities (like prediabetes). They are highly effective at silencing "food noise."
Nutritional Strategy: Focus on a Low-Glycemic Index (GI) diet to stabilize insulin levels. Increasing protein intake can also help manage satiety while your thyroid levels are being corrected.
Immediate Next Steps:
Consult your Endocrinologist to review your TSH and discuss a dose increase for Thyroxine.
Check your Vitamin B12 and Ferritin levels; deficiencies here are common in thyroid patients and contribute heavily to "all-day" exhaustion.
Discuss the suitability of Tirzepatide or similar metabolic medications once your thyroid levels begin to stabilize.
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Change life style n diet plan drastically first.
Add exercise as walk, yoga.
Least use of carbohydrates add maximum protein.
In hypothyroidism its very difficult to loose weight.
Assessment of vitamin d3 b12 t3t4tsh mg crp cbc esr advisable
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-Your weight loss resistance is likely due to uncontrolled hypothyroidism as TSH is still high
-Inadequate thyroxine dose can slow metabolism and cause fatigue, weight gain and increased appetite
-HbA1c of 6.0 suggests insulin resistance which also contributes to hunger and fat gain
-Visceral fat and binge urges are commonly linked with hormonal imbalance and insulin resistance
Next Steps
Take
-Tab Thyroxine increase to 75 mcg once daily empty stomach morning (review after 6 weeks)
-Tab Metformin 500 mg once daily after dinner for 2 weeks then twice daily for 3 months
Health Tips
-Do not skip meals to avoid binge episodes
-Focus on high protein diet and fibre
-Avoid sugar and refined carbs
-Ensure proper sleep
-Continue regular exercise but avoid overexertion
contact me anytime on practo for further consultation
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If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a detailed discussion
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I can understand how frustrating and exhausting this must feel, especially when you’re putting in effort and still struggling with constant hunger, low energy, and sleepiness.
The intense ‘food noise’ and urge to binge even after full meals suggest that along with the thyroid issue, there may also be an element of binge eating / emotional eating that needs to be addressed separately.
At this age, eating disorders and disordered eating patterns are very much possible, and body image concerns often coexist with them, sometimes making the distress feel even more overwhelming.
Since your TSH is still high, your thyroxine dose may need reassessment, as this itself can contribute to fatigue, slowed metabolism, and difficulty with weight loss.
Regarding Mounjaro / tirzepatide, it may be considered in some cases for weight management, but before that it is important to first evaluate the eating pattern, triggers for binge urges, body image concerns, sleep, and thyroid control.
With the right combination of medical management and therapy for food cravings / binge eating, this can improve significantly. I also provide online consultation and therapy support, and you may consult me directly on nine eight two six five four five six six zero for a structured plan.
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Decrease the quantity of food intake and take snacks in between meals
Exercise should be mandatory but in moderation
Take water in plenty between meals
Next Steps
No junk no sugars no fat in ur diet
Health Tips
Feel free to contact in practo for any assistance
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One month is too early for seeing a significant response to thyroxine. You have prediabetes as well, that can also cause increased appetite. Cut down on fatty food, heavy meals, avoid sugar, snacking in between meals. Continue regular physical exercise.
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Consult soon
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Kindly consult
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Never change your dose yourself.
Next Steps
Let a endocrinologist decide the next step based on your weight and symptoms.
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Bukya Pushpanjali
Internal Medicine
7 yrs exp
Nizamabad
For how long your hypothyroid
What about fT4
Weight management is 80% controlled by food intake and 20% by physical activity
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