Weight Gain/Bloating with Increase of T & Cytomel (Thyroid Med T3)

Pharma / TRT Testosterone Replacement
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Hi all!
I joined this forum because as a woman, there seems to be very little information that is not clinical or from body builder level women available to us. I’m hoping to glean a little advice from anyone who is more experienced in women’s hormones than I currently am.

My background:
I am a life long fitness/wellness/nutritional enthusiast so working out, eating well, & supplementation do not come new to me. In my mid-20s I felt something was different in the way I felt. In my early 30s I knew something was off & consulted my family doctor. Through internet research (if it’s here, it must be true, right? JOKING!) I deduced I may have a hormonal imbalance as well as a possible problem with hypothyroidism. My doctor sent me in for a basic hormone panel & thyroid test. He said the test results yielded “within range” results, which I now know I should have pushed more persistently in learning to understand what that meant. Moving forward. I am 37 years old in May. About 2 years ago I started tracking exactly what I was eating because my weight increased about 8lbs in 1 year which was abnormal for me. Last year, my weight increased an additional 8lbs. I currently weight 130 which is not normal for me & I physically feel the effects of the unnecessary, additional weight. Desperate for a solution, I contacted Defy Medical.

Defy sent me in for a more comprehensive hormone panel to which very low T was discovered. My estrodiol is noted as being in the “high end” of the range. My DHEA was low & my insulin levels were noted per the lab as very high. Defy opted (intelligently IMO) to treat one thing at a time and started me on T therapy @ .05mg/ml for 2 weeks then increase to 1mg/ml thereafter, which is where I currently am in the regimen. While I’ve only been on T therapy for 2 weeks, most of my symptoms remain.

Symptoms which brought me to Defy are: Unexplained weight gain, sleeplessness @ night, tired during the day/low energy, less than normal libido, dry skin, always feeling cold, inability to gain muscle, & feeling overly emotional were the main concerns. My weight has increased 7lbs since starting tx, which I’ve gleaned is considered normal during the initial phase. Until by body accepts the T, water retention should be managed by taking dandelion capsules which work as a diuretic. While my emotions are less pronounced (less crying at sad movies), I feel “flat lined”, for lack of a better term. I don’t feel like my previous, more peppy self who laughed a lot. Maybe this comes in time? I am “slightly” impatient & a very poor patient.

My feeling of cold persists. At the advice of my husband who follows a few members here, he recommended I request my thyroids levels be tested. I will be tested Monday. It will be interesting to see what the results are.

Side effects of T therapy have only included water weight gain, which I’m told will subside & sore & itchy nipples which is inconvenient & uncomfortable to say the least. I’d love input as to an estimated time frame the latter should subside or if it ever does.

In re-reviewing my current labs, noting I was in the follicular phase, my progesterone levels are incredibly high which I feel may be the untreated, missing link which may, once addressed, bring my overall well being together. I am still unsure as to why Defy didn’t address this during my initial consultation. I will email & ask that to be addressed.

I’ve attached my labs for the seasoned helpers in the groups if viewing them is helpful in creating a remark & thanks to all who can help guide me.



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I would go through some of the Stickies in this forum and put up the data that applies to females as well.

A lot of the symptoms you describe are outlined in this sticky relating to low iodine. Thyroid Basics Explained

“Case in point; someone has “mid-range” TSH and thinks that things must be OK and so does the doctor. TSH should be near 1.0, mid-range means misery, low energy, low libido, lack of clarity of thought, low body temperatures, feeling cold, sparse outer eye brows, dry skin, mood/depression issues, lethargy and more - but you are “normal”. And if a doctor treated such cases aggressively insurance companies and State medical boards would put a stop to this unnecessary medical treatment. If you get TSH>4.5 and can barely function, then you are “treatable”.”

What is your history using iodized salt? Any iodine supplementation?

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Welcome to the forums. It is good to see a woman post here as I am sure there are many gals out there who are looking for information and/or are in the same boat as you.

Hopefully more folks will chime in with helpful feedback.

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You’re on the right track, definitely need testosterone. I think you need DHEA too and a more comprehensive thyroid work-up. My wife (she’s 60) has been doing BHRT for four years, estradiol, progesterone, test and DHEA. It’s been great for her.

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Thanks for the suggestion to look at stickys. I’ve been skimming through them, finding very little info pertaining specifically to women but also finding some info really helpful including links to research articles.
With regard to low iodine, I have not had that test specifically done beyond the TSH test which was included in my initial blood panel. My results from that are 2.6 ulU/ml. Defy noted that as being elevated & they’d like to see my numbers closer to the 1.0-1.4 range. Iodized salt affects me in that it creates ringing in my ears & severe bloat. No one looks forward to that.

I don’t add any type of salt to my diet which is pretty clean; No coffee, alcohol, sugar, low carb (50mg per day to prevent additional weight gain), low amount of grains, 1oz of almonds & an avocado daily & dark leafy greens with 1 pepper, 1 cucumber, & 1 cup snap peas, & 4oz either tuna or salmon. Typical daily caloric intake does not often exceed 650 calories (on the high side) ONLY because this is the only thing I’ve found that keeps my weight where it is. I will note that I definitely do splurge (I just took my son to a Roadhouse restaurant for lunch & had chicken tenders & a wedge salad, peanuts, & 3 of those delicious rolls w/butter) 650 cals is not sustainable.

I am well aware of that which is why I allow myself the occasional splurge but right now, I am also aware that my weight threatens to increase if I don’t keep my caloric/macro intake under control more often than not. Seaweed containing ingredients have never agreed with me either (headache & digestion issues), so there is certainly a chance I could be deficient in iodine. I am scheduled to have blood drawn to address T3, T4, fT3, fT4, & rT3. Will those tests be of some help in pin pointing a more precise root cause?

In reading the link you posted, I feel I should note I do not have the possible learning disability (Hahahha!) noted due to hypothyroidism. My temp never sees higher than 97.3 (at best) & is typically closer to 97.1-.2 Also noted in the link, I read that some people note always having low body temps (ME!) Grandma always said “cold hands, warm heart”. Based on this as well as other independent readings, I’ve ordered (directly from Optimox) Iodoral 12.5mg.

After reading possible side effects on their site, I see they note “headaches” as being a side effect, one which I’ve experienced in iodine containing foods such as seaweed (I LOVE seaweed salad at our local sushi restaurant but largely avoid it due to a headache after consumption). Not wanting to continue with my current symptoms, I’m willing to give this a try & thank you for your guidance. I have Selenium 200mg (Nature’s Way brand). Is this a good brand or do you suggest another?
Thanks again for helping.

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You really want to check free thyroid hormones, fT3 is the only active thyroid hormone which acts upon your T3 receptors much in the same way free testosterone acts on T receptors and drives fat burning and speeds up every cell in your body, it also sets your body temperatures (thermostat).

If body temperatures a low, fT3 is either low or is being opposed by rT3 which prevents fT3 from entering your cells making you hypothyroid. I would check fT3, rT3, fT4 and antibodies. Most doctors have no idea what rT3 represents or what to do about it, so they will say you’re fine.

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I am scheduled to have those levels checked Monday. Antibodies was not included in the test. Based on your information (and thank you very much, btw for chiming in), you note most doctors don’t know what to do about rT3. What are your thoughts as far as what to do? I will post lab results once I get them back.

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While it’s true most doctors are clueless about matters related to thyroid, you will not have that problem since you’re working with Defy Medical. Most outside the USA aren’t so lucky.

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I think you will be served well with the iodine supp. Based on what you’ve said you’re almost guaranteed deficient. Natures Way is probably fine.

How long have you been so low calorie? Has it been 2 years from when you started tracking all macros after the 8lb weight gain?

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I’ve been this low cal for about 3 months. I put on 8lbs last year & the year prior. My weight started creeping up again this year soI looked into keto & HGC diets. Knowing diets are used short term to lose a small amount of weight, I thought if I could get it off I could keep it off. But we all know the low cals are not sustainable. What I think is I’m not really gaining fat but instead it’s water retention from (my educated guess) elevated progesterone & estradiol. I’m not sure how to reduce those levels. Naturally is nonsense at this point & not working for me. Clearly, this is an issue that needs medical attention from professionals. My family doctor is nice enough but has made it clear this is not his specialty. Would I trust him to do surgery on me? Of course not! He asked why then would I trust him with this? Point taken!

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Your labs are missing the range for estradiol. The bloating could def be caused by high estradiol.

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The ranges are on the following page @ the top. I contacted Defy inquiring as to why my estradiol level was not addressed at the time I was prescribed T therapy. They said 1) give the T TIME to work (not to self), 2) in raising T, other levels needing to come up should & others needing to drop also should. There was mention of taking the supplement (diindolylmethane) DIM to modulate estrogen metabolism. After researching, I see it has been effecting for use in both men & women for uses other than just estrogen. This linkmay be helpful to others: Healthybynaturehwc.com is for sale | HugeDomains

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DIM has been a mixed bag with folks here. Some get no bene and others swear by it. Please report protocol and findings along with labs as you progress. I have ulterior motivation here as my wife approaches 44 and is pre-menopausal. Trying to educate myself.

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I do not know where you are located. Iodine supply varies by country. In any case, if you are not using salt you are not getting iodine from iodized salt. TSH=2.0 and low body temperatures are evidence of the problem and its depth. Your metabolic rate is low and you are limiting food to avoid some of the fat gain typical of low thyroid function and are thus also reducing intake of important nutrients - aka malnourished to some extent.

If you do not consume dairy, you are missing the Vit-D and iodine from that source.

Your iodine intake may have been adequate in your formative years and IQ was determined then.

Vit-D is very important as well and unless you get a lot of sun exposure year round you are deficient unless supplementing. The 400 and 800iu amounts in most vitamins is very much suboptimal but will prevent crooked legs in young children.

Find a good B-complex multi-vit that has 150-180mcg iodine and 200mcg selenium. Purchasing single mineral supplements is not very cost effective. The multi-vit should also contain several trace elements. Most enzymes in your body have metal atoms as part of the catalytic reaction sites.

If you get leg or food cramps or can tense a muscle and make it lock up you are magnesium deficient. See “ZMA” in this site’s Biotest store. The amounts of magnesium in a vitamin pill is inadequate as the amount of magnesium needed often exceeds the size of a multi-vit.

Introducing iodine in your condition without selenium creates some real risks. Understand this from the sticky.

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People with high blood pressure are often told to avoid salt. Less salt means less blood volume and general water content in tissues. Salt is not the cause of high blood pressure and the root cause of arterial damage. Less blood volume also means less blood circulation which is a problem in itself. In your case, consuming a normal amount of salt may simply be exposing something that your reduce salt intake has been masking.

With your low T and normal E levels, your tendency to bloat may be influenced or driven by estrogen dominance. Adding T will help. Note that progesterone is very important to balance estrogens.

Your estradiol cannot be evaluated without day of cycle. Ditto FSH.

Take 12.5mg DHEA per day, easy to find in USA with other supplements. This may support adrenal DHEA–>T. Get DHEA-S mid-range with higher dose if needed. Do not take more than needed as some women feel that is promotes facial-lip hair and note that T can do the same.

More iodine: You recall that your problems seem to have started in your mid-20’s. Is that when you reduced salt intake? Is your family getting iodine? Check body temperatures. Iodine deficiency is often a family affair.

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As I suggested the root problem may be estrogen dominance that you have been masking with low salt intake. You need to consider estrogen dominance as the cause instead of blaming the salt. I am not suggesting that you consume salt without first dealing with the hormone side of the equation. You can address iodine issues with supplements and iodized salt does not need to be part of your diet at this time. Your family does also need a source of iodine and iodized salt should be available to them if possible. Whole societies used to be wrecked with goiters and other problems and the lessons of iodized salt, that was a miracle at the time, have become largely forgotten.

Find out how you can utilize some of this information to improve things for you/family.

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In further research on Peak Testosterone’s web page, it is noted that DIM seems to be causing liver cancer which sounds like a negative side effect to me. I do not have plans to use DIM.

I am also pre (peri) menopausal. My recommendation is to have labs done regularly to get a better base line as to when she felt good (unless you’ve already have that) & start treatment as soon as possible to mitigate negative effects of the uncomfortable change.

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Thanks very much for taking time to weigh in on things for me. I think I did start cutting salt from my diet in my 20s because hearing “salt is bad” growing up, I had a newborn & husband & wanted to have a healthy family. I know understand that was poor knowledge. I ordered 12.5g iodine from Optimox & selenium. I will begin that Thursday after my thyroid blood test is complete.

I will increase my food intake slightly to allow for more nutrients. I have a sensitivity to dairy so I largely avoid that & though I do tan all year long, I would imagine you’re right in thinking I’m vit-D deficient as well. I used to take a multi vitamin but have been told by professionals that they don’t completely break down in the system so they are virtually pointless. Hearing from you leads me to believe that was not true just like salt is bad is not true. I’ve since bought a multi from New Chapter. Would it be beneficial to take a separate B-complex in addition to the multi?

My current form of exercise is running/walking 4-5 miles per day. My legs don’t often cramp but my feet do. I contemplated skipping my activity today because of foot cramps yesterday that left my foot sore this morning. I’ll get a magnesium supplement as well. Thank you for the pointer. It sounds like I’m deficient in a several areas which isn’t terrible because it sounds like the situation is repairable.

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Should all be in one product.

Using a B-complex multi-vit is good. And women who are cycling will need one that lists iron if their periods are more than light. Lab results for CBC, complete blood count can help identify iron status to look at RBC, hematocrit [HTC] and hemoglobin. If there are concerns one can test ferritin. Serum iron can be misleading at it can be swung by recent meals. If not eating red meat or eggs iron intake might be low. Some leafy green veges are a good source.

I think that you will find that magnesium makes a big difference. Might also have a calming effect and can lower BP if elevated. BP is affected by arterial muscle tone. If it works for you, you can be on the look out to help others. 2 ZMA caps seems to work. Try taking at bed time as part of your routine getting to bed.

Vit-D3 will absorb better with meals that have more fats/oils as that helps transfer Vit-D3 through the gut walls. High fiber meals are the opposite. Taking with a bowl of oatmeal would be the worst. Same for fish oil, Vit-E and any oral hormones. Oral hormones can also be DHEA or pregnenolone. Estrogens and progesterone as part of HRT should be taken at bed time so absorption factors are not so changeable. Then lab results can be relied on as a good guide for dose changes. [a bit off topic]

In case you are wondering … I am an old retired Engineer.

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WOW!! Thank you for more helpful information KSman! Now that I’ve got supplement levels & will get to looking into a high quality muti-vitamin. I wasn’t looking forward to taking a zillion separate pills so thanks for mentioning they should all be contained within one. I will take the DHEA & iodine separately as the levels included in a multi aren’t adequate. Got it!

Taking supplements with a high fat meal will prove to be a challenge that I’m wiling to take on as I don’t eat high fat & I do eat high fiber. I’ll research some meals I can accept and eek in a little more fat. DHEA should be delivered by Friday. I’ll take @ night. Thank you for noting when it should be taken. There is a lot of research available that points to men working out & using the supplement so I would have taken it during the day.

Maybe off topic here but I have noticed a common theme in the last 3 weeks of my T tx: I take the product Mon am. By Tuesday afternoon, I am bloated & don’t feel well, probably because of the the water retention. By Weds I feel better then I inject again Thursday. I’ve read a bit about side effects & as most of the data available tends to be for men, by men & or about men, that’s largely where I’ve gleaned insight from. From what I gather, water retention could be an effect of too high of a dose. What are your thoughts about that? Will/could the edema subside with time or should I decrease my dose to .05, which is what I was initially prescribed to take then “increase to .1 after 2 weeks.” Tomorrow is medication day & I am torn as to what dose I should take & very frustrated with feeling like a blow fish.

Engineer! I would have never guessed that but it certainly makes sense! I wish I had your brain. The numbers may make better sense to me. I have always struggled with them but English came naturally to me. I really appreciate you making time to explain things to me. Some of it makes perfect sense once I’m given a reason (I NEED to know the “why” of things before it clicks), while other parts simply overwhelm me & I close the page to reading for a bit to give my brain a break.