Being on a bunch of thyroid hormones myself this is something I wondered about when I started losing weigh. It is hard to Google thyroid hormones and weight loss because most of the hits are about losing weight because you are taking them, or (really not recommended) taking thyroid hormones
to lose weight.
What I have found is mainly doctors disagreeing and anecdotal evidence.
www.medhelp.org/posts/Thyroid-Disorders/Increased-dosage-for-weight-loss/show/1259725
Nelly57: I have been losing weight and as a result my dosages of Levo have gotten too strong and had to be lowered. I have now lost 44 pounds. The times that my medication was too strong and I became Hyper instead of Hypo were absolute misery!
www.lowcarbfriends.com/bbs/thyroid/743673-would-you-need-less-medication-after-losing-weigh.html
luvmybabyhead: My endo says no, weight has nothing to do with how much thyroid medicine you need. ... I know people who are much thinner than me and are on a lot more and a lot less medicine than I am so that is confirmed in real life to me.
cocoanut: ... I disagree. My needs are unique to me but my weight does have an impact on my needs. I need a higher dose to maintain the metabolism for my fatter body than I do on my thinner body.
inatic: i havent needed less meds even though im leaner.. I've actually needed more because of my training.
Leo41: I have an excellent endo, and he mentioned once that he 'expected' to lower my dosage because of my weight loss (almost 200 lbs). However, that hasn't happened... I seem to need to same dosage to maintain barely satisfactory T4 and T3 levels.
qbert: My doctor told me I would need to lower the dose if I lost weight - it needs to be monitored...
Speaking as a enthusiastic amateur, I suspect there are a couple of factors involved. One is the equilibrium between the hormones you take and the rate your body is metabolising them. As you weight is going down especially in the early stage of rapid weight loss, there is less you for incoming hormones to spread around, meanwhile stores of hormone bound to plasma proteins in your lost volume ends up more concentrated back in the rest of you, so your hormone levels will go up. But this is only a temporary effect and the excess will decrease as the extra thyroid hormones are metabolised.
The bigger question is what type of tissue that uses thyroid hormones the most. I can't imagine fat tissue has much use for it. Muscle obviously does. If you lose fat, gain muscle and are more active, does that mean your need to thyroid hormones goes up? Or if your diet is one of those damaging ones where you lose muscle instead, does your need for thyroid hormone go down? Then again metabolising thyroid hormones by the liver and kidneys is a different process to their use as hormones by muscle tissue and weight loss has nothing to do with dosage once equilibrium has been re-established.
There may be a clue in the half lives of thyroid hormones which vary depending on whether the person is hypothyroid euthyroid (just right) or hyperthyroid.
From
Gibaldi's Drug Delivery Systems in Pharmaceutical CareHalf Life of Levothyroxine (T4) Liothyronine (T3)
hypothyroid__9-10 days__________1.4 days
euthyroid____6-7 days___________1 day
hyperthyroid_3-4 days___________0.6 days
Now the terms hypothyroid euthyroid and hyperthyroid can have two distinct meanings as experienced by anyone still suffering the effects of hypothyroidism while their doctor says their blood test fine. The term euthyroid can be mean your blood levels are in the right range, below that range and you are hypothyroid, too high and you are hyperthyroid. But before the blood tests hypothyroidism used to mean your metabolism was too slow because of an under active thyroid, hyperthyroid was when you metabolism was racing because of an over active thyroid, euthyroid and you were just right.
Could losing weight, especially accompanied by an increase in metabolism change the half life you metabolise thyroid hormones at? So for a tired overweight person treated for hypothyroidism with blood levels in the euthyroid range, when they lose weight and speed up their metabolism, could their blood level drop because they are metabolising their hormones faster? Or could the increase in metabolism balance effects of weight loss that might otherwise raise your blood levels?
D_C