How to manage weight gain in hypothyroidism?

Q: I am suffering from hypothyroidism. My age is 38 now. Early last year my TSH was 12.0 by radioimmuno assay (RIA) when I started Eltroxin 100mcg per day. After six months my TSH was (0.3) and the dose of Eltroxin was reduced to 50mcg per day for 4-5 months and then withdrawn. Early this year, I again felt fatigue, weight gain, pain in hands & feet, lethargy etc. My blood pressure is always 130/86 mm Hg after taking drug Amlodipine 5 mg and Atenolol 0.25 mg per day since the beginning of this year. My Triglyceride and Cholesterol levels are high. Presently, my reports are as follows: TSH 29.5 (RIA) T4 65 - do - BS(F) 119 mg/dl In the year 1994 my weight was 56 kgs. In the year 2002 (early) my weight was 65 kgs. In the year 2002 (mid) my weight was 63 kgs. Now my weight is 68 kg. My height is 5ft 4in. What should I do now, please advise?

A:The first thing you need to do is restart the thyroxin and get the TSH test repeated after 6-8 weeks to make sure the dose is adequate. Subsequently get the TSH done 1-2 a year: make sure the TSH is maintained in the normal range. Most hypothyroid persons need 50-125 mcg/day. Weight gain due to hypothyroidism is usually 1-4 kg, and to the extent your weight gain is because of the hypothyroidism, you will lose that amount quite quickly after starting thyroxin. The rest of your weight gain is fat gain, and losing that requires long term commitment on your part, of:- eating regularly: missed meals, especially breakfast, make one gainweight,- eating sensibly by taking enough fruits and salads, making sure you are taking sufficient amounts of LOW FAT milk, and reducing excess fat intake in your diet, if any, and- exercising regularly, eg walking/swimming etc.This will also help you control the high BP, cholesterol and triglycerides.