Dieting? Exercising? Still can’t reduce ? Dr. Kent Holtorf shares 10 surprising factors likely contributing to your weight loss challenges with hypothyroidism that you simply probably haven’t considered (and your doctor probably hasn’t considered).
Written by Kent Holtorf, MD
Obesity has become a serious health epidemic and has dramatically increased over the last decade. Studies show that approximately one-third of the U.S. population is assessed as obese and over two-thirds are significantly overweight. While the cause is multifactorial, studies are clear that nearly all overweight individuals have metabolic and endocrinological dysfunction that's causing or contributing to their inability to reduce .
Losing weight with hypothyroidism are often a difficult task. Therefore, thyroid patients got to know more about factors that are likely at work contributing to weight loss challenges.
To properly treat hypothyroidism, you want to first know your Ts. Thyroxine, or T4, is that the thyroid “storage hormone.” Triodothyronine, or T3, is that the “energy hormone.” For the body to use T4, it must first convert it to the active hormone T3, giving energy to each cell within the body.
Another critical hormone is reverse T3 (RT3). Reverse T3 is that the body’s “emergency brake.” Many endocrinologists believe that Reverse T3 is just an inactive metabolite with no physiologic effect on the body. They couldn’t be more wrong.
In some patients, rather than properly converting T4 to T3, the body converts an excessive amount of T4 to reverse T3, effectively shutting down the body. These patients often experience debilitating fatigue and weight gain, and still worsen in spite of taking T4 hormone medication.
Thyroid hormone conversion problems are often caused by variety of common issues including significant stress, depression, a history of dieting, insulin resistance, obesity, diabetes, chronic fatigue syndrome, fibromyalgia, autoimmune diseases, chronic inflammation, chronic infections, PMS, iron deficiency, and lots of more. anybody of those issues could cause a patient to possess an excessive amount of RT3 or an improper T3/RT3 ratio.
Now imagine that a patient with a hormone conversion problem – i.e., an excessive amount of RT3 – is seeing a doctor who “doesn’t believe RT3.” It’s a recipe for disaster. The more T4 the doctor gives the patient to enhance hypothyroid symptoms, the more severe the patient will feel, because an excessive amount of of that T4 is being converted into more RT3. and every one the while, the patient’s TSH test appears to be “normal.” Although the patient isn’t recuperating , the doctor refuses to order lab tests to see for RT3, and tells the patient that she’s fine, that her labs are in range, that she must exercise more and eat less, or that it’s beat her head.
Regardless of whether or not your TSH is “in range,” if you've got an excessive amount of RT3, you're hypothyroid. Treating a patient with RT3 issues requires a deep understanding of the subtle nuances and complexities of thyroid disorders, also as a willingness to treat supported a mixture of things , including patient symptoms, instead of simply counting on standard thyroid tests like TSH and T4. it's critical to try to to comprehensive testing, including a full thyroid panel for TSH, free T4, free T3, RT3 and thyroid antibodies. additionally , a steroid hormone binding globulin (SHBG) test can help determine the cellular level of T3. A goal of proper thyroid replacement is to possess an optimal metabolism, so this could be checked before and through treatment. Reflex response tests should even be done, because studies show that the speed of the relief phase of a reflex may be a better test for hypothyroidism than the TSH. Thorough testing and examination to work out what's causing the conversion issues are key, and steps should be taken to correct any related problems.
It’s also important to seem beyond the quality T4 treatment. Patients with RT3 issues often see improvement with preparations containing combinations of T4 and T3, and particularly with straight time-released T3. By providing the body with some or all of the T3 that it needs, the thyroid will produce less T4. With less T4 to convert to RT3, the patient’s system can slowly regain proper hormone balance. Conversely, continuing to offer T4 preparations or refusing to treat RT3 issues means the patient will become increasingly hypothyroid.
The “set point” is that the brain’s target weight for a person’s body. even as the body works to take care of a reasonably degree Centigrade of 98.6 degrees Fahrenheit, it also works to take care of a weight that's physiologically comfortable. The point is maintained by the hypothalamus, and is usually genetically influenced. However, variety of things can cause the point to vary , moving a person’s normal weight to a better number on the size , and sabotaging weight loss efforts.
One of the more common causes of point malfunction is aggressive or yo-yo dieting. Calorie restrictive diets can actually slow thyroid function, leading to a slower metabolism. Illnesses like chronic fatigue or fibromyalgia also can cause the point to malfunction. Some medications can cause the point to extend , including common antidepressants like Paxil, Celexa, Zoloft and Lexapro, anti-convulsant medications, vital sign medications, anti-seizure or pain medications like Neurontin or Lyrica, contraception pills, synthetic hormone replacement, and diabetic medications that stimulate insulin secretion, like glyburide and Amaryll.
The point also can increase as a natural effect of aging. However, this cause is usually associated with hormone decline, which may be successfully treated.
Fortunately, there are solutions which will help to lower the body’s point to a more acceptable number. These include hormone optimization, consistency in diet and exercise levels, and aggressive management of conditions like chronic fatigue, fibromyalgia, chronic infections, and chronic inflammation.
If added support is required , there are now medications which will be wont to lower the point and increase weight loss success. Naltrexone, a drug typically utilized in high doses as a treatment for narcotic opioid overdose and to assist patients detox from narcotic addiction, is showing success in decreasing the body’s point when used the maximum amount lower doses. mentioned as low-dose naltrexone, this drug is now widely used as an efficient immune modulator, and is useful for managing autoimmune conditions like Hashimoto’s disease, Grave’s disease, and Lupus. At a dose slightly above “low-dose,” Naltrexone has been shown to scale back the body’s point , performing at the extent of the hypothalamus, bringing about significant weight loss.
The success of naltrexone for weight loss is greatly enhanced when combined with the common antidepressant, Wellbutrin. Patients lose a mean of a half pound per week, and knowledge reduced appetite and cravings. In one clinical study, the LDN plus Wellbutrin combination protocol was shown to end in significant weight loss at quite twice the speed of placebo, with a mean weight loss of quite 17 pounds.
The body secretes leptin as weight is gained to signal the brain (specifically the hypothalamus) that there's adequate energy (fat) storage. New research has found that this leptin signaling is dysfunctional within the majority of individuals who have difficultly losing weight. Studies show that the bulk of overweight individuals who are having difficulty losing weight have a leptin resistance, where the brain receptors become desensitized or immune to leptin when a surge of leptin is prolonged and are not any longer ready to answer the signal. Despite the surplus of leptin the person with leptin resistance actually suffers from symptoms of low levels of the hormone. The overweight person could also be feeling hungry more often and store fat too readily. rather than feeling satisfied, his/her brain instructs the body that it needs more food. It’s a vicious circle .
There are many factors which will negatively impact leptin levels including: fructose and straightforward carbs consumption, overeating, lack of sleep and high stress, high insulin levels, exercising an excessive amount of or insufficient , grain and lectin consumption.
Medications like Byetta and Symlin can contribute to a decrease in leptin resistance. These can have good results if given in conjunction with other metabolic treatments and following a healthy diet and lifestyle. during a randomized, double-blind placebo controlled, cross-over trial, it had been found that short-term use (less than 4 months) of the leptin sensitizing medication, resulted in significant weight loss in 65% of people .
The brain, organs and muscles escape of glucose, the body’s preferred source of fuel. If your cells don't get the adequate amounts of glucose into them, you can’t produce energy to assist run your body. Hormones aren't produced optimally, brain function doesn't work properly and each system of your body suffers, including the power to sleep, lose weight, immune and stress response, etc.
When cells become insulin resistant and therefore the glucose can’t get in, it circulates round and around the bloodstream, damaging arterial walls and therefore the brain. Because the body wants to normalize blood glucose levels as soon as possible, it converts the surplus glucose into triglycerides to be stored as fat. This process demands such a lot energy that you simply become sleepy. Furthermore, insulin resistance decreases the body’s ability to use stored fat for energy.
The liver mediates between the activities of the insulin-releasing pancreas and therefore the adrenal and thyroid glands, which are alleged to “tell” the liver to release glucose. If the adrenals and thyroid aren’t working properly on the “telling” end, or if the liver is sluggish, stressed , or toxic, and not performing on the “receiving” end, the system goes out of balance. Either way, the result's elevated excess insulin.
Any illness — including thyroid problems — also creates physical stress. And stress raises cortisol levels. Increased cortisol increases insulin levels. More insulin means increased chance of insulin resistance. Cortisol also can mobilize triglycerides from storage and relocate them to visceral fat cells (around the belly). Thus, getting obviate that belly isn't easy for several people that don’t address all the underlying causes.
Written by Kent Holtorf, MD
Obesity has become a serious health epidemic and has dramatically increased over the last decade. Studies show that approximately one-third of the U.S. population is assessed as obese and over two-thirds are significantly overweight. While the cause is multifactorial, studies are clear that nearly all overweight individuals have metabolic and endocrinological dysfunction that's causing or contributing to their inability to reduce .
Losing weight with hypothyroidism are often a difficult task. Therefore, thyroid patients got to know more about factors that are likely at work contributing to weight loss challenges.
1. Get Reverse T3 Checked For Low Thyroid Problem
Some physicians believe treatment of hypothyroidism is straightforward . Give the patient a prescription for T4, within the sort of Synthroid or generic Levothyroxine, and everything are going to be fine. But sometimes, what could be the right treatment for one patient will actually make another patient much sicker. For patients with hormone conversion problems, treatment with T3 are often very beneficial.To properly treat hypothyroidism, you want to first know your Ts. Thyroxine, or T4, is that the thyroid “storage hormone.” Triodothyronine, or T3, is that the “energy hormone.” For the body to use T4, it must first convert it to the active hormone T3, giving energy to each cell within the body.
Another critical hormone is reverse T3 (RT3). Reverse T3 is that the body’s “emergency brake.” Many endocrinologists believe that Reverse T3 is just an inactive metabolite with no physiologic effect on the body. They couldn’t be more wrong.
In some patients, rather than properly converting T4 to T3, the body converts an excessive amount of T4 to reverse T3, effectively shutting down the body. These patients often experience debilitating fatigue and weight gain, and still worsen in spite of taking T4 hormone medication.
Thyroid hormone conversion problems are often caused by variety of common issues including significant stress, depression, a history of dieting, insulin resistance, obesity, diabetes, chronic fatigue syndrome, fibromyalgia, autoimmune diseases, chronic inflammation, chronic infections, PMS, iron deficiency, and lots of more. anybody of those issues could cause a patient to possess an excessive amount of RT3 or an improper T3/RT3 ratio.
Now imagine that a patient with a hormone conversion problem – i.e., an excessive amount of RT3 – is seeing a doctor who “doesn’t believe RT3.” It’s a recipe for disaster. The more T4 the doctor gives the patient to enhance hypothyroid symptoms, the more severe the patient will feel, because an excessive amount of of that T4 is being converted into more RT3. and every one the while, the patient’s TSH test appears to be “normal.” Although the patient isn’t recuperating , the doctor refuses to order lab tests to see for RT3, and tells the patient that she’s fine, that her labs are in range, that she must exercise more and eat less, or that it’s beat her head.
Regardless of whether or not your TSH is “in range,” if you've got an excessive amount of RT3, you're hypothyroid. Treating a patient with RT3 issues requires a deep understanding of the subtle nuances and complexities of thyroid disorders, also as a willingness to treat supported a mixture of things , including patient symptoms, instead of simply counting on standard thyroid tests like TSH and T4. it's critical to try to to comprehensive testing, including a full thyroid panel for TSH, free T4, free T3, RT3 and thyroid antibodies. additionally , a steroid hormone binding globulin (SHBG) test can help determine the cellular level of T3. A goal of proper thyroid replacement is to possess an optimal metabolism, so this could be checked before and through treatment. Reflex response tests should even be done, because studies show that the speed of the relief phase of a reflex may be a better test for hypothyroidism than the TSH. Thorough testing and examination to work out what's causing the conversion issues are key, and steps should be taken to correct any related problems.
It’s also important to seem beyond the quality T4 treatment. Patients with RT3 issues often see improvement with preparations containing combinations of T4 and T3, and particularly with straight time-released T3. By providing the body with some or all of the T3 that it needs, the thyroid will produce less T4. With less T4 to convert to RT3, the patient’s system can slowly regain proper hormone balance. Conversely, continuing to offer T4 preparations or refusing to treat RT3 issues means the patient will become increasingly hypothyroid.
2. Manage Your Metabolic point
Does it seem that your scale always seems to land on an equivalent number, regardless of how hard you diet, what proportion you narrow calories, or how hard you exercise? If so, you'll be battling a malfunctioning “set point.”The “set point” is that the brain’s target weight for a person’s body. even as the body works to take care of a reasonably degree Centigrade of 98.6 degrees Fahrenheit, it also works to take care of a weight that's physiologically comfortable. The point is maintained by the hypothalamus, and is usually genetically influenced. However, variety of things can cause the point to vary , moving a person’s normal weight to a better number on the size , and sabotaging weight loss efforts.
One of the more common causes of point malfunction is aggressive or yo-yo dieting. Calorie restrictive diets can actually slow thyroid function, leading to a slower metabolism. Illnesses like chronic fatigue or fibromyalgia also can cause the point to malfunction. Some medications can cause the point to extend , including common antidepressants like Paxil, Celexa, Zoloft and Lexapro, anti-convulsant medications, vital sign medications, anti-seizure or pain medications like Neurontin or Lyrica, contraception pills, synthetic hormone replacement, and diabetic medications that stimulate insulin secretion, like glyburide and Amaryll.
The point also can increase as a natural effect of aging. However, this cause is usually associated with hormone decline, which may be successfully treated.
Fortunately, there are solutions which will help to lower the body’s point to a more acceptable number. These include hormone optimization, consistency in diet and exercise levels, and aggressive management of conditions like chronic fatigue, fibromyalgia, chronic infections, and chronic inflammation.
If added support is required , there are now medications which will be wont to lower the point and increase weight loss success. Naltrexone, a drug typically utilized in high doses as a treatment for narcotic opioid overdose and to assist patients detox from narcotic addiction, is showing success in decreasing the body’s point when used the maximum amount lower doses. mentioned as low-dose naltrexone, this drug is now widely used as an efficient immune modulator, and is useful for managing autoimmune conditions like Hashimoto’s disease, Grave’s disease, and Lupus. At a dose slightly above “low-dose,” Naltrexone has been shown to scale back the body’s point , performing at the extent of the hypothalamus, bringing about significant weight loss.
The success of naltrexone for weight loss is greatly enhanced when combined with the common antidepressant, Wellbutrin. Patients lose a mean of a half pound per week, and knowledge reduced appetite and cravings. In one clinical study, the LDN plus Wellbutrin combination protocol was shown to end in significant weight loss at quite twice the speed of placebo, with a mean weight loss of quite 17 pounds.
3. Decrease Leptin Resistance
Leptin is a crucial hormone, which stimulates metabolism, reduces appetite, and signals the body to burn fat. It’s referred to as the “starvation hormone” because it notifies your brain once you have enough food in your stomach and your energy levels are sufficient. Leptin is secreted primarily from fat cells. it always correlates to fat mass – the more fat you've got , the more leptin you produce. Women tend to possess higher leptin levels than men because of their higher body fat percentage. Studies suggest leptin increases during the secretory phase of the cycle thanks to the consequences of estradiol and progesterone.The body secretes leptin as weight is gained to signal the brain (specifically the hypothalamus) that there's adequate energy (fat) storage. New research has found that this leptin signaling is dysfunctional within the majority of individuals who have difficultly losing weight. Studies show that the bulk of overweight individuals who are having difficulty losing weight have a leptin resistance, where the brain receptors become desensitized or immune to leptin when a surge of leptin is prolonged and are not any longer ready to answer the signal. Despite the surplus of leptin the person with leptin resistance actually suffers from symptoms of low levels of the hormone. The overweight person could also be feeling hungry more often and store fat too readily. rather than feeling satisfied, his/her brain instructs the body that it needs more food. It’s a vicious circle .
There are many factors which will negatively impact leptin levels including: fructose and straightforward carbs consumption, overeating, lack of sleep and high stress, high insulin levels, exercising an excessive amount of or insufficient , grain and lectin consumption.
Medications like Byetta and Symlin can contribute to a decrease in leptin resistance. These can have good results if given in conjunction with other metabolic treatments and following a healthy diet and lifestyle. during a randomized, double-blind placebo controlled, cross-over trial, it had been found that short-term use (less than 4 months) of the leptin sensitizing medication, resulted in significant weight loss in 65% of people .
4. Resolve Insulin Resistance
When affected by hypothyroidism, everything in your system slows down right right down to your cells. The body’s ability to process carbohydrates slows down too, as does your cell’s ability to soak up blood glucose .The brain, organs and muscles escape of glucose, the body’s preferred source of fuel. If your cells don't get the adequate amounts of glucose into them, you can’t produce energy to assist run your body. Hormones aren't produced optimally, brain function doesn't work properly and each system of your body suffers, including the power to sleep, lose weight, immune and stress response, etc.
When cells become insulin resistant and therefore the glucose can’t get in, it circulates round and around the bloodstream, damaging arterial walls and therefore the brain. Because the body wants to normalize blood glucose levels as soon as possible, it converts the surplus glucose into triglycerides to be stored as fat. This process demands such a lot energy that you simply become sleepy. Furthermore, insulin resistance decreases the body’s ability to use stored fat for energy.
The liver mediates between the activities of the insulin-releasing pancreas and therefore the adrenal and thyroid glands, which are alleged to “tell” the liver to release glucose. If the adrenals and thyroid aren’t working properly on the “telling” end, or if the liver is sluggish, stressed , or toxic, and not performing on the “receiving” end, the system goes out of balance. Either way, the result's elevated excess insulin.
Any illness — including thyroid problems — also creates physical stress. And stress raises cortisol levels. Increased cortisol increases insulin levels. More insulin means increased chance of insulin resistance. Cortisol also can mobilize triglycerides from storage and relocate them to visceral fat cells (around the belly). Thus, getting obviate that belly isn't easy for several people that don’t address all the underlying causes.
All these factors mean that insulin resistance is perhaps even more of an element for overweight people with hypothyroidism than for the overall population.
Today’s low-fat diets emphasize more and more high-glycemic carbohydrates like white flour food , pasta, pizza, rice, potatoes, cereals, corn, desserts and sugary fat-free products, which may also trigger insulin resistance and obesity. Avoiding these sorts of carbohydrates is important to an extended term recovery.
People with insulin resistance feel tired most of the day and particularly after meals, they're hungry all the time, have sweet cravings, which usually aren't relieved after eating sweets, and might feel continuously thirsty.
Resolving insulin resistance needs a customized program. This involves the proper diet, the proper sort of exercise and specific nutrients like berberine, chromium, magnesium et al. .
5. Change Your Brain Chemistry
Hunger is intricately tied to your brain chemistry. When the hypothalamus senses you would like energy, it issues the brain neurotransmitter neuropeptide Y (NPY) with the message “eat carbohydrates.” The surge of NPY is what you experience as “hunger.” this technique are often dramatically altered by several factors, all of which may be present in chronic thyroid disease:
* Your metabolism is just too slow for the appetite level set by your brain. What your brain perceives as appropriate food intake levels can then exceed your body’s metabolism, creating weight gain.
* Your body is under stress, which interferes with the neurotransmitter functions, and is understood to scale back the discharge of serotonin.
Natural alternatives to boosting serotonin include aerobics and therefore the herbal treatment called St. John’s Wort (Hypericum perforatum).
6. Rule Out Hypothalamic Obesity Disorder
When the hypothalamus doesn't function properly it can affect your thyroid’s ability to require up T4 and convert it to T3. during this situation, hypothalamic obesity disorder can develop. With this condition, your systema nervosum continues to react as if you're starving, and you still gain weight.
Even with severe caloric restriction and high exercise, if you've got hypothalamic obesity disorder, your metabolism is so impaired that it focuses on storing calories, instead of burning them, causing continued weight gain. In hypothalamic obesity disorder, there also can be an overproduction of insulin, which may further contribute to obesity.
7. Stay Hydrated
A surprisingly high number of individuals are dehydrated lately , without even knowing it. Consumption of coffee and alcohol dehydrate the body even more, as do processed foods which usually contain high amounts of salt. Insufficient electrolytes within the diet also affect hydration.
When your body becomes dehydrated cellular functions begin to hamper and proper hydration is important to keeping your metabolism going. additionally to helping the metabolism, proper water intake helps the body get obviate toxins. Drink half your weight in ounces per day to make sure proper hydration, and a glass more if you drink coffee or alcohol.
8. pack up Your Diet
Acute or chronic dieting may result during a significant decrease in intracellular and circulating T3 levels by up to 50%, which significantly reduces basal rate (number of calories burned per day) by 15-40%. With chronic dieting, the thyroid levels and metabolism often don't return to normal levels; the body stays in starvation mode for years with significantly reduced metabolism despite the resumption of normal food intake, making it very difficult to lose or maintain lost weight.
Cleaning up your diet in an intelligent way is crucial. meaning to avoid inflammatory foods from processed foods and make sure you are becoming the proper nutrients in to support your thyroid. light bread , pastries, pasta, packaged meals, artificial sweeteners, processed dairy and desserts all got to be avoided. Choose top quality , organic protein, fat and vegetables and limit your fruit intake to stay a healthy blood glucose level.
When you can’t keep your regular meals and/or need a snack, eat alittle amount of protein every two to 3 hours. Going for long stretches without eating once you have dysglycemia, an abnormality in blood sugar levels, exacerbates your blood glucose issues, affecting other multiple metabolic processes in your body. Nuts, seeds, a coddled egg , cheese or meat are some samples of protein snacks.
9. Exercise, But Don’t Overdo It
Weight loss is extremely important to eliminate insulin resistance. The less you weigh, the less insulin resistant you'll be. Even a daily brisk walk of 45 minutes to an hour can substantially reduce insulin levels. you'll schedule this activity round the hours once you feel most rested. Exercising will help boost your metabolism, raise your resting metabolism, and burn calories.
But because it is with food, there's nobody size fits all sort of exercise for everybody . it's crucial to possess your stress level assessed before you begin doing more vigorous exercise. once we are exposed to any combination of stressors that elevate our stress hormone beyond the optimal, our repair hormones are suppressed.
It has been shown that ladies or men who perform quite moderate exercise, especially when related to dieting, have reduced T4 to T3 conversion and increase reverse T3, counteracting many of the positive effects of exercise in women including weight loss. Consequently, T3 and reverse T3 levels should be evaluated in individuals who exercise and/or diet to raised determine cellular thyroid levels, as TSH and T4 wouldn't necessarily reflect tissue levels in such patients.
10. Get Enough Sleep
Lack of sleep, and particularly chronic sleep deficit can have many negative reactions by affecting your hormones. It affects your ability to manufacture hormone properly and should impair T4 to T3 conversion, an important process for thyroid function. It lowers your production of somatotropin , which may help with weight loss and metabolism and interferes with the assembly and cycle of adrenal hormones. this will also cause increased belly fat.
Sleep deprivation affects hormones that control appetite and especially , cravings for easy carbohydrates and food . It also reduces levels of the hormone glucagon, which helps release fat from your cells. Less sleep means less fat is released. So these are many good reasons to aim for the much-needed 8 hours of sleep, and an early enough bedtime.
About Dr. Kent Holtorf
Kent Holtorf, M.D. is that the medical director of the Holtorf Medical Group with locations in l. a. , Foster City, Atlanta, and Philadelphia. he's also founder and director of the non-profit National Academy of Hypothyroidism (NAH), which is devoted to dissemination of latest information to doctors and patients on the diagnosis and treatment of hypothyroidism.
Dr. Holtorf has personally trained numerous physicians across the country within the use of bioidentical hormones, hypothyroidism, complex endocrine dysfunction, and innovative treatments of chronic fatigue syndrome, weight loss, fibromyalgia, and chronic infectious diseases, including Lyme disease .
He has been a featured guest on numerous TV shows including CNBC, ABC News, CNN, EXTRA TV, Discovery Health, the training Channel, The Today Show, The Doctors, Dr. Dean Edell, Glenn Beck, Nancy Grace, Fox Business, ESPN, Rush Limbaugh, CBS Sunday Morning, Sean Hannity, So Cal News, and quoted in numerous medium including the Wall Street Journal, l. a. Times, US New and World Report, San Francisco Chronicle, WebMD, Health, Elle, Better Homes and Garden, US Weekly, Forbes, Cosmopolitan, ny Daily News, Self magazine, among many others.
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