I have Graves and am coming up in 4 years with it. I feel good and did throughout the bulk of my illness, except for some depression last year. I was given some Levoxyl and that instantly made me feel better.
I post now because I have been on Cytomel(5mcgs) for 3 months and the weight has continued to come on. 18 pounds in the time that I have been sick. I ow carb and am extremely active. I run 15-20 miles a week. Yet I gain weight.
My newest labs were TSH: .001(reference .3-3.5) and FT4 was 1.2(.8-2.0). TT3 was 178. Not the best test but the only one that she uses.
I was ready for RAI but the endo is sort of steering me away from that.
She wants to check into insulin resistance. She states that maybe the exercising and eating well hs headed off an even bigger gain, from possible IR.

I have checked my insulin and I do not believe that that is at issue. I have a monitor and a 92 fasting is not diabetic.

But I have had crazy menstrual cycles too. Breakthrough bleeding and HEAVY. No GYN issues.
So, I'll take the test, but I doubt that that is at issue. She is also testing BMP and cortisol. She did mention the possibility of perimenopause. I am 34.

I am thinking of backing off the Cytomel dose in an effort to get my FT4 back up there. Thoughts?

Anything else that you can think of that could be causing this weight gain? I can't handle it and I fear the worst.

Well... doesn't really look like thyroid to me. Yeah, getting a little more T4 might make you feel less hyper if you've got that issue, but it probably won't make the weight issue go away.

I think for me, my issue was my food intolerances. Once I stopped eating foods that I can't digest, I started to see my weight drift down again, without even trying.

Nancy, I have been owcarbing on and off for years. I am doing so hard right now. SDo, that in effect will remove gluten from my diet. I am just baffled. I am also going off of caffeine and a ton of artificial sweeteners. I will use some sparingly, but I was using just way too much.
No hyper issues, but I know that too much T3 can lower T4.

I don't know what to do next. The endo explained in simple terms that I have a heightened metabolism because of the Graves at this pint. That is why she thinks maybe IR. The quitting caffeine will help stabilize my insulin, but I doubt hughly that I have IR.

I am just so lost and scared.

Have you looked at dairy as being a potential issue? With me it is as bad as gluten.

Yes, hyperthyroidism can make you IR, very important to stay low carb.

I find it odd your doctor isn't testing Free T3.

Are you being suppressed at all or just on thyroid replacement?

Are you eating lots of extra calories? Or starving yourself?

I think the best, healthiest diet a human being can eat is one that is meat, fish, veggies, fruits (not too much though) and possibly nuts if you can digest them. Avoid all grains and dairy too.

If your issue is diet related, getting on a simple and clean diet might help out.

www.enterolab.com has a lot of good advice.

Yeah, my diary consumption has naturally fallen since nixing coffee. Half and half was my only dairy, with a bit of yogurt here or there.

I did actually go off of dairy completely once before, with no weightloss and/or noticable benefits.

I hope you mind a dumb question here? If you have Graves and are hypermetabolic why do you have to take thyroid replacement?

Do you know how many calories you eat on average?

My friend who was never particularly overweight gained a ton right before she started menopause at 39, so maybe your hormones are causing some of this too. She gained about 3 years before her cycles went crazy and has the unstable cycle and is a heavy bleeder (we talk about everything)!

When you get your insulin level and other hormones it will give you a little more information to go on.

Do you feel okay otherwise, hyper or hypo?

I am on the cytomel in the hope of losing weight and my other hypo symptoms -depression and lethargy and brain fog. I am thinking of going off of it as it did nothing for the weight and may have contributed to some of the gain?

I feel fine now. No issues. No palps, no nothing. Just a perpetual gaining machine. I am petrified that I will never be able to lose this weight. If I can't lose now, how will I ever be able to? Am I destined to keep gaining??
*cries*

I went through a similar phase when I was hypo. The thought that there was nothing I could do to stop gaining weight back then made my head spin. Do the best you can and be aggressive about those test. Eventually you'll figure it out.