Interesting article about hypothyroidism and weight loss difficulty [View All]

Mary Shomon is a goddess as far as I'm concerned--she brings great things to light with her advocacy for thyroid sufferers. Long article, but the gist is "Eat less and exercise more is great IF you don't have a metabolism problem caused by thyroid issues." Worth the time to read it.

Long Term Weight Loss for Thyroid Patients: Hormonal Factors That Affect Diets

http://thyroid.about.com/od/loseweightsuccessfully/a/weight-loss-diet.htm

Mary Shomon: You have said that you feel that two key hormones -- leptin and reverse T3 -- are playing a key role in regulating weight and metabolism. Can you tell us a bit about leptin, first, and what it has to do with weight loss challenges?

Kent Holtorf, MD: The hormone leptin has been found to be a major regulator of body weight and metabolism. Leptin is secreted by fat cells and the levels of leptin increase with the accumulation of fat. The increased leptin secretion that occurs with increased weight normally feeds-back to the hypothalamus as a signal that there are adequate energy (fat) stores. This stimulates the body to burn fat rather than continue to store excess fat, and stimulates thyroid releasing hormone (TRH) to increase thyroid stimulating hormone (TSH) and thyroid production.

Studies are finding, however, that the majority of overweight individuals who are having difficulty losing weight have varying degrees of leptin resistance, where leptin has a diminished ability to affect the hypothalamus and regulate metabolism. This leptin resistance results in the hypothalamus sensing starvation, so multiple mechanisms are activated to increase fat stores, as the body tries to reverse the perceived state of starvation.

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Mary Shomon: How do you treat leptin resistance in your practice?

Kent Holtorf, MD: Treatment can be focus on treating the elevated leptin -- leptin resistance. An elevated leptin also indicates, however, that the TSH is an unreliable marker for tissue thyroid levels, as the TSH is often suppressed, along with significantly reduced T4-to-T3 conversion. In short, if your leptin is elevated, you have reduced tissue thyroid levels. Also, almost all diabetics are leptin resistant, which has been shown to reduce T4-to-T3 conversion in diabetics by as much as 50% without an increase in TSH, making it very difficult for type II diabetics to lose weight.

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My favorite part (ital added):

All those trainers and health gurus that never had a weight problem who tell you to do just as they do don’t realize what a disadvantage it is for people who have had a long-term weight problem. Of course, even these trainers would not even be able to maintain their weight with a metabolism that is 20 to 40% below normal.

We test the resting metabolic rate in our thyroid patients and find it inversely correlates with the reverse T3. The higher the reverse T3, the lower the metabolism, with many such individuals having a metabolism that is 20 to 40% lower than expected for their body mass index (BMI). Nobody believes how little they eat, and they are made to feel like failures -- despite doing everything right. Until their metabolic abnormalities are addressed, diet and exercise will certainly fail to achieve long-term success.