Weight Loss and Muscle Wasting: Exploring Thyroid Issues and Traditional Remedies

Cachexia and Sarcopenia

I weigh only 47.8 kg and am 171 cm tall.
My weight has gradually decreased from 53-54 kg a few years ago to 52 kg at the end of last year, and now it is below 48 kg.
I pay attention to appropriate calorie intake, sufficient protein, and consumption of fruits and vegetables, and I even have snacks like milk and toast between meals.
I do not have diabetes (pre-meal blood sugar is 96, post-meal is 106).
Could this be caused by hyperthyroidism? My thyroid-stimulating hormone (TSH) level is 0.4494, with a reference range of 0.35 to 4.94.
Is this indicative of hyperthyroidism? I had coronary artery bypass surgery on April 11, and I felt a bit weak afterward, but I am undergoing cardiac rehabilitation.
However, my appetite is unaffected; in fact, I enjoy eating more.
I am increasingly losing weight, and I am unsure of the reason.
If it is hyperthyroidism, what dietary recommendations should I follow? Are there any traditional Chinese medicine prescriptions for weight gain and muscle building to enhance nutrient absorption? Thank you.

Peng Ren, 60~69 year old female. Ask Date: 2019/08/04

Dr. Zhang Weidong reply Traditional Chinese Medicine

Hello, your TSH levels are within the normal range (it is best to interpret this alongside thyroid hormone levels).
Your blood sugar is normal, you have regular meals, and your nutrition is balanced; however, you are experiencing gradual weight loss.
First, we need to rule out the impact of emotional stress, as emotions can affect the absorption of nutrients in the gastrointestinal tract.
If you are feeling happy and living normally, I recommend undergoing a comprehensive full-body health check-up, as unexplained weight loss can indicate underlying issues.
Based on your description, I do not see any apparent problems, so it is essential to check for any hidden issues before proceeding with targeted treatment.
Wishing you good health.
Dr.
Chang Wei-Dong, Department of Traditional Chinese Medicine, Changhua Hospital.

Reply Date: 2019/08/04

More Info

Understanding weight loss and muscle wasting can be complex, especially when thyroid issues are involved. Based on your description, it appears that you have experienced a significant decrease in weight over the past few years, dropping from around 53-54 kg to your current weight of 47.8 kg, despite maintaining a balanced diet with adequate protein and caloric intake. Your concern about potential hyperthyroidism (overactive thyroid) is valid, especially given your TSH level of 0.4494, which is on the lower end of the normal range (0.35 to 4.94).
Hyperthyroidism can lead to weight loss, increased appetite, and muscle wasting due to the accelerated metabolism it causes. Symptoms may also include anxiety, tremors, heat intolerance, and increased sweating. However, your TSH level alone does not definitively indicate hyperthyroidism; it is essential to consider other thyroid hormones, such as Free T4 and Free T3, to get a complete picture of thyroid function. If these levels are elevated, it would support the diagnosis of hyperthyroidism.

Given your history of heart surgery and subsequent rehabilitation, it is also important to consider how your body is responding to these changes. Post-surgical recovery can lead to muscle wasting due to decreased physical activity and metabolic changes. Even if your appetite has increased, your body may not be absorbing nutrients effectively, or you may not be consuming enough calories to offset the increased metabolic demands.

To address your concerns about weight loss and potential thyroid issues, here are some recommendations:
1. Consult a Healthcare Provider: It is crucial to follow up with an endocrinologist who can evaluate your thyroid function comprehensively. They may recommend additional tests, including Free T4 and Free T3 levels, to determine if you have hyperthyroidism.

2. Dietary Adjustments: If hyperthyroidism is confirmed, dietary modifications may be necessary. Generally, a diet rich in calories and protein is recommended to help counteract weight loss. Focus on nutrient-dense foods such as nuts, seeds, avocados, whole grains, lean meats, and dairy products. Incorporating healthy fats can also help increase caloric intake.

3. Strength Training: Engaging in resistance training can help build muscle mass and counteract muscle wasting. Even light weights or bodyweight exercises can be beneficial. It is essential to work with a physical therapist or a trainer who understands your post-surgical condition to ensure safety and effectiveness.

4. Traditional Remedies: In traditional Chinese medicine (TCM), there are various herbal remedies that may support appetite and digestion. Herbs such as ginseng, astragalus, and certain tonics can be used to enhance energy and improve nutrient absorption. However, it is crucial to consult with a qualified TCM practitioner to tailor a regimen that suits your specific needs and to ensure that it does not interfere with any medications you may be taking.

5. Monitor Your Progress: Keep track of your weight, dietary intake, and any symptoms you experience. Regular follow-ups with your healthcare provider will help assess your progress and make necessary adjustments to your treatment plan.

6. Mental Health Support: Given the stress of your medical history and weight changes, consider seeking support from a mental health professional. Emotional well-being is closely linked to physical health, and addressing any anxiety or depression can positively impact your overall recovery.

In summary, while your weight loss may be related to thyroid issues, it is essential to conduct a thorough evaluation to determine the underlying cause. By working closely with healthcare professionals and making appropriate lifestyle adjustments, you can address your concerns about weight loss and muscle wasting effectively.

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