My weight just prior to surgery had climbed to an astounding 195 pounds, fully 30 pounds more than I weighed for the majority of my life. Erich was a cross-country runner, 5'10", who kept himself at a trim 145 pounds for most of his life, until he developed hyperthyroidism, went on antithyroid drugs, then had a thyroidectomy. But after your diagnosis and after your metabolism adjusts to antithyroid medication and beta-blockers, you may find yourself gaining weight if you don't cut calories and/or increase physical activity. Even if you did not increase your food intake, you may have been eating at a level that maintained your weight. The double whammy comes when you find yourself feeling tired, so you cut back on activity and burn even less. You're going to be burning up less calories, and you can start gaining weight quickly on your former calorie level. If you were eating at higher-calorie levels and all of a sudden you go on antithyroid drugs to slow down your thyroid and beta-blockers to slow down your heart rate, it's like taking your metabolism from 60 to 0. The problem is that you may continue to eat as you did before.

Or you may get RAI treatment that permanently makes you hypothyroid. So at minimum, your doctor will give you antithyroid drugs and perhaps beta-blockers, to help slow things down temporarily and see if you respond. It can cause rapid pulse and high blood pressure, and untreated hyperthyroidism puts you at risk for thyroid storm, an episode of uncontrollably high blood pressure and heart rate that can result in heart attack or stroke.

The problem is that hyperthyroidism needs to be treated. Unfortunately, the higher dosage failed to alleviate many of the symptoms of hypothyroidism such as cold hands, lethargy, weight gain, etc. Gradually, the dosage was increased (sometimes by my taking two pills on my own) until the point where I was taking 500 meg per day. Following surgery, I was placed on a minimal dosage of Levothroid, which failed to provide me with the necessary supplement for my removed thyroid gland. Or, if appetite remains the same, some people enjoy desirable weight loss that occurs as they eat normal amounts but lose weight because of improved metabolic efficiency. So during this period, there's an increase in resting metabolism and often an increase in activity level that often outweighs increased appetite.