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There are four prominent endocrine and metabolic disorders that not only contribute to obesity, but also make weight loss difficult. These conditions – “bad metabolism,” hypothyroidism, an underactive thyroid, and “adrenal fatigue” – are frequently misdiagnosed by doctors, or incorrectly self-diagnosed by patients. As a result, healthy people may think that they have them, while truly affected – may miss them. Both groups suffer needlessly. Let’s review some of the long-held misconceptions about this paradox.
The first misconception is about “bad metabolism,” and it is the most common, approaching a near 100% popularity. Medically and nutritionally speaking, it is a complete opposite. What you may think is “bad” is, actually, “good,” and here is why.
Bad Metabolism
The truly “bad” metabolic disorders concern water balance and fluid volume; the balance of electrolytes (sodium, potassium, calcium, magnesium, and phosphate); acid-base regulation; disorders of carbohydrate metabolism, such as hypoglycemia, type 1 and type 2 diabetes, diabetic and alcoholic ketoacidosis; and lipid disorders, such as dyslipidemia and hypolipidemia [1].
These conditions affect people of all ages, genders, and body weights. Some of them are outright deadly, while others – such as diabetes or dyslipidemia – are chronic. Within the same group of conditions, some are associated with obesity, such as prediabetes and type 2 diabetes. Others, such as type 1 diabetes or diabetic ketoacidosis, result in profound and life-threatening weight loss.
Consequently, any time you mention “bad metabolism” in relationship to your weight, your doctor will know exactly what you mean, but may still chuckle at your misinterpretation. And if you continue insisting that you may have it, he or she may also tell you that when it comes to body weight, a true “bad metabolism” is a sign of impending death, and that a precipitous weight loss, not gain, is one of its primary symptoms.
The emaciated gentleman on the left is Steve Jobs of Apple fame, shortly before his premature and unfortunate death. Take a hard look at this heartbreaking picture. That is what an actual “bad metabolism” – meaning the body’s inability to properly metabolize nutrients essential for life – really looks like.
Not so long ago, the dominant thinking and attitudes toward metabolism was a complete opposite. When my mother met my dad, a tall and handsome man with manners to match, she was short and moderately overweight, with big hips and large breasts, an ideal body shape for the 1950s. Single men would look at her thinking: “Gosh, this lady is so attractive! I want her to become my wife and the mother of my children.”
Today’s young men, conditioned by the Victoria Secrets’ standards, are more likely to pass over someone like my mother in favor of a waifish girl like Calista Flockhart (32A-23-30), who just three generations ago would have had a hard time finding a marriage partner because of prejudices typical for that era:
- Her appearance would reflect probable malnutrition or chronic illness throughout early development. In that rough era of near-zero upward mobility, malnourished children came predominantly from impoverished households, and no man or woman wanted to marry into a poor family.
- Before the near universal availability of on-demand C-section, her narrow hips would be considered life-threatening during natural childbirth.
- Her small breasts would be assumed inadequate for motherhood because she might have difficulties breastfeeding her numerous offspring. This isn’t, really, entirely correct, but that’s, unfortunately, how it was and still is in undeveloped societies.
- Back then, her small body would be deemed too weak to chop wood, milk cows, carry buckets of water, and cook, clean, and wash from dawn to dusk for the entire family.
- Personality-wise, a person of her shape would be considered a “cold fish” because underweight women have lower levels of estrogen and are believed to be not as libidinous as normal weight or, even better, overweight women. I don’t know if that is true, but that’s how it was.
All of that primitive, misogynistic, and mostly unconscious thinking – to find a partner who will last you and your children through thick and thin – was, essentially, a basic “animal” instinct in action, honed over hundreds of thousands of years of pragmatic and merciless natural selection.
Naturally, that’s exactly what my father did without giving it a second thought – he married a woman with a good metabolism. He knew instinctively what my mom’s doctor told her after every check-up: “Polina, you have a fantastic metabolism!” For her generation it was an asset, not a curse. (The photographs of my parents on the right are from 1958, four years after my birth. They are, respectively, 43 and 37 years old).
True to form, my mother had an accidental pregnancy at the age of 45, while the usual rate of conception after age 40 is less than 5%. And that is after surviving the horrors of starvation and backbreaking labor during the four years of World War II as well as the devastation of postwar Russia.
Calista Flockhart, on the other hand, finally married actor Harrison Ford at the age of 46. In all probability, natural selection wasn’t on the mind of Mr. Ford, who at the time of their marriage in 2010 was already 68 years old. The couple is raising her adopted son Liam, who was born in 2001. Any way you look at it, the laws of evolution remain as tough today as they have ever been, even to someone as beautiful, talented, and famous as Ms. Flockhart.
So, if you too are endowed with a good metabolism just like my mother was, the problem isn’t with you, your genes, or your body, but with the times we are living – the sum of abundant food, minimal physical exertion, and all conceivable creature comforts is behind obesity epidemics on one hand, while the incorrect believe into “bad metabolism” causes many people to drop their weight loss diets too soon, or discourages them from considering one in the first place.
THE TAKEAWAY: Since it’s too late to get another set of genes, or become a lumberjack, or give up comforts, concentrate on the two factors that are still under your total control – what you eat and how your “burn” it! In fact, your “good metabolism” will work in your favor – the better it is, the faster you are going to lose weight.
Hypothyroidism and underactive thyroid
The situation with thyroid-related disorders is a lot more complicated than with bad metabolism. A true “underactive thyroid” – a vernacular for subclinical hypothyroidism – affects up to 10% of women and 6% of men, many of them over 65 years of age. The rate of clinical hypothyroidism is under 1.2% of women and 0.4% of men [2] predominantly among older adults, 33.3% of adult Americans are overweight and 35.9% are clinically obese, or 69.2% .
As you can see, the number of overweight people is significantly greater than the number of people affected by subclinical or clinical hypothyroidism [3], even though many people who are affected by adiposity – a shorthand for “overweight or obese” – believe they may have this condition because of weight loss resistance or weight gain on a moderate diet.
On the opposite side of the spectrum, there are people who are misdiagnosed and untreated because both conditions are challenging to manage even to specialists. According to The Merck Manual of Diagnosis and Therapy, the early stages of this condition are associated with the following symptoms:
“…cold intolerance, constipation, forgetfulness, and personality changes. Modest weight gain is largely the result of fluid retention and decreased metabolism. Paresthesias [tingling – KM] of the hands and feet are common, often due to carpal-tarsal tunnel syndrome…[4]”
Please also note one significant detail in the above quote: “Modest weight gain is largely the result of fluid retention…” This explains why some people who are affected by this condition can’t lose weight even on a very low calorie diet – most of that extra weight comes at the expense of water, not body fat.
Women with hypothyroidism may also be affected by menorrhagia – an abnormally heavy bleeding during menstruation, or amenorrhea – an abnormal absence of menstruation. If you are experiencing any of these symptoms, get evaluated by a board certified endocrinologist.
Because clinical hypothyroidism isn’t as common as some other disease, non-specialists may not be able to properly diagnose and treat you, especially during the earlier stages while the symptoms are still subtle, and the tests aren’t as definitive. If your diagnosis or treatment outcomes are not satisfactory, you may also consider working with alternative providers.
Things get even more complicated with Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis. It is an autoimmune inflammatory condition of the thyroid. In addition to the transient symptoms of hypothyroidism during early stages, it is distinguished by painless enlargement of the thyroid gland, and, in some cases, a feeling of fullness in the throat. It may or may not be associated with adiposity.
The prevalence of Hashimoto’s thyroiditis ranges from 0.1 to 0.15% of the population (1 to 1.5 cases per 1,000 people), and it affects women 10 to 20 times more often than men. It is most common between the ages of 45 to 65, and it often runs in families (i.e. it has a genetic component).
The same immune mechanisms which cause Hashimoto’s thyroiditis may also cause Graves’ disease (thyroid enlargement, goiter), Addison’s disease, type 1 diabetes, celiac disease (an autoimmune inflammation in the small intestine), vitiligo (skin depigmentation), premature graying of hair (same mechanism as in vitiligo), pernicious anemia, and connective tissue disorders.
If you suspect that you may have Hashimoto’s thyroiditis, GET TESTED. The level of thyroid hormones T4 and TSH may remain normal during early stages, making its diagnosis difficult in non-specialized clinical settings. Seek out a specialist trained in diagnosing and treating this relatively rare condition. 1 case in 1,000 is, indeed, rare for an internist who treats on average 2,000-3,000 patients a year, and may not encounter a single patient with Hashimoto’s in years.
I do not recommend commencing any type of weight loss diet until you are properly diagnosed and treated for hypothyroidism. A reduced calorie diet may deny your body from getting essential nutrients, and may exacerbate the progression of the disease. Besides, it isn’t likely to be effective anyway because of fluid retention.
As clinical hypothyroidism progresses, the symptoms become more severe and obvious, including precipitous weight loss. You can learn more about other manifestations of clinical hypothyroidism in countless online resources.
THE TAKEAWAY: Do not rely on outdated misconceptions about clinical and subclinical hypothyroidism. If you are experiencing any symptoms related to either condition, seek out the best treatment money can buy. Continuous weight gain in healthy people isn’t always a symptom of hypothyroidism. As epidemiological statistic – however flawed it may be – demonstrates, the majority of people with adiposity are not affected by hypothyroidism. If you are in this fortunate majority, you earlier failures to lose weight weren’t related to bad health, but to bad diets.
Adrenal fatigue
What you may think is “adrenal fatigue” endocrinologists call primary or secondary adrenal insufficiency. Both conditions are ascertained by a blood test, and treated, when necessary, with appropriate medication.
Primary adrenal insufficiency – also known as Addison’s disease – is a hard to miss condition because it is accompanied by severe skin pigmentation. Its prevalence – a medical term for the number of affected people – is less than 1 person in 14,000 (<0.007%) in population [5]. Just like truly “bad metabolism,” it causes weight loss, not gain:
“The slowly progressive loss of cortisol and aldosterone secretion usually produces a chronic, steadily worsening fatigue, a loss of appetite, and some weight loss. Blood pressure is low and falls further when a person is standing, producing lightheadedness. Nausea, sometimes with vomiting, and diarrhea are common. The muscles are weak and often go into spasm. [6]”
If you have any of the above symptoms, get tested immediately. This debilitating condition can be well controlled with medication.
The prevalence of secondary adrenal insufficiency is less than 1 person in 3,600, or 0.027% of the population. The symptoms of this condition are similar to Addison’s disease, but without pigmentation. Again, a blood test is required to screen it out and receive an appropriate and effective treatment.
A popular opinion exists that this condition may be substantially underdiagnosed. It may very well be correct, so let’s assume that there are 100 times more people affected by secondary adrenal insufficiency than what epidemiologists are telling us. Alas, it still comes to only 2.7%, a drop in the bucket next to 69.2% of the population with adiposity.
THE TAKEAWAY: Just as with “bad metabolism” and hypothyroidism, don’t rely on outdated misconceptions about “adrenal fatigue” and its relations to weight loss or gain. Seek out expert help to screen out primary and secondary adrenal insufficiency, and, if necessary, obtain adequate treatment.
References
[1] Endocrine and Metabolic Disorders; The Merck Manual of Diagnosis and Therapy, online edition; Last accessed March 30, 2013; [link]
[2] Vanderpump, Mark P.J., “The epidemiology of thyroid disease.” (2011) : 39-51. [link]
[3] This calculation is based on the following numbers: percent of adults age 20 years and over who are obese: 35.9% (2009-2010); percent of adults age 20 years and over who are overweight (and not obese): 33.3% (2009-2010). Source: Department of Health and Human Services, Health, United States, 2011, by Kathleen Sebelius, et. al., 2011, [link to PDF]
[4] Hypothyroidism; Symptoms and Signs; The Merck Manual of Diagnosis and Therapy, online edition; Last accessed March 30, 2013; [link]
[5] Division of Medical Sciences, University of Birmingham, and Department of Medicine, Endocrine and Diabetes University of Wurzburg, “Adrenal Insufficiency,” Lancet, 361 (2003): 1881-93; [link to PDF]
[6] Margulies, Paul, MD; National Adrenal Diseases Foundation; Addison’s Disease – The Facts You Need To Know; “What are the symptoms of Addison’s Disease?” Last accessed March 30, 2013; [link]
Previous posts from the “Why Diets Fail?” series:
1. The Real Reason Diets Fail and What You Can Do About It
2. How Long Will It Take Me to Lose the Weight?
3. Why One Calorie For Her Is Half a Calorie For Him
For your health and safety, please read these important Weight Loss Common Sense Warnings and Disclaimers before commencing a reduced calorie diet.
So Konstantin Monastyrsky since you think you know everything explain this to me..
how did I a woman of 5 feet 10 inches tall.. someone who ate healthy, ran 3 miles a day, avoided all types of fats in my diet at all costs all my life end up putting on 30 pounds? I mean clearly you being a thyroid expert must know what you are talking about right?
Oh wait no sorry you are not a thyroid expert. You are merely voicing an opinion about what you think is happening and clearly you have no clue what you are talking about.
Before you decide to answer me.. let me clear a few things up for you. No I did not change my lifestyle, no I did not get up and eat cake in the middle of the night and even if I did it would not be enough to gain 30 pounds. After essentially starving myself for 30 straight days and still not losing a pound I ended up passing out during my jogs and being brought to the hospital. Diagnosed with severe hypothyroidism I was put on synthroid where unfortunately nothing has changed for me.
You sir, have no idea what you are speaking about. You have issues with overweight people and you have thoughts and opinions on issues you know nothing about. Steve Jobs had cancer. It’s appalling you would even reference him in this article.
It’s narrow minded people like you who make this world unbearable. You write articles like this clearly to cover up your own personal insecurities.
Until you know what this disease entails. Why not stick to things your good at, because clearly this is not one of them.
Leela,
Sorry. I have no clue what’s going on with your health and weight, and I am not a clairvoyant to make guesses.
I don’t have any issues with overweight people. In fact, all of my closest friends happen to be overweight or obese, and so are their spouses and children. Also, all of them happen to be either medical professionals or medical entrepreneurs. And not so long I was pretty overweight myself.
My wife is the only exception — she is normal weight. We met back in 1976, when she was 21, and I had no way of knowing if she’ll be that way at 58. Her sister and her mother are both overweight. My dizygotic (fraternal) twin cats are normal weight too because I monitor their nutrition since we adopted them 14 years ago.
Steve Jobs didn’t die directly from pancreatic cancer, but from malnutrition related to either liver failure, or pancreatitis, or both. I believe it was liver failure because he was eating normally (per os) until at least few weeks before his death (according to what was written about it in the media). As any medical professional will tell you, people don’t die directly from cancer, but from multiple organ failure related, among other things, to “protein energy undernutrition” a.k.a. “bad metabolism.”
The liver, the blood, and our digestive organs govern energy and structural metabolism. Thyroid and parathyroid glands regulate the body’s thermogenesis, and play a secondary role in energy and structural metabolism.
Leela, your problem is, that you starved your body… your body NEEDS fat, especially saturated fat, to be healthy.
Cutting out all carbs and eating enough meat (organic) and saturated fats will help you lose weight in a healthy way.
Leela and Ursula,
I could not agree more about our need for saturated fats. Again, I recommend (cut and paste into) “youtube: Enjoy your saturated fats, they are good for you. Donald Miller ” (cardiac surgeon) After you view this important health doc, you will understand how much we have all been subjected to the low-fat scam along with the statin scam and been human guinea pigs for our goverment, the Ag industry and Big Pharma. We have all been fools! Best wishes, dear hearts!
The author of this article doesn’t know what he’s talking about. Hypothyroidism is much more prevalent than his 1.2% of OLDER adults. I myself went hypo at age 37…and I don’t consider that as an older adult. Once I was finally diagnosed my doctor did put me on synthetic thyroid hormones (T4 Synthroid and T3 Cytomel). I took these for 2 yrs and could never get myself regulated. Then I found a group of gals on a board that clued me into NDT (natural dessicated thyroid…made from porcine thyroid glands) and I got some and started taking it. I was over 40 lbs overweight (weight gain caused by my hypo condition)…but that was the only symptom I had. I had none of the other symptoms that the author describes as hypo symptoms. No hoarse voice, no drooping eyelids, etc….nothing. Once I started taking the NDT and was optimized (my Free T3 and Free T4 numbers were right where they should be) I lost all the extra weight that I had gained over the years of being hypo. Now…I keep myself fit and don’t have to worry about weight gain any longer because of my thyroid meds. Don’t let anyone tell you because your TSH (which is basically a worthless test for thyroid function because it is a pituitary hormone test) is “normal” that you don’t have thyroid disease. You very well could. My TSH when I was diagnosed was only 1.2 (well within the “normal” range of 0.3-3.0) but my Free T3 (which is the thyroid hormone that your body needs) wasn’t even registering on a blood test scale. And yes…many people are overweight because of having hypothyroidism. I belong to a group of people who are hypo (7,000 of us) and the big majority of them are overweight and trying to get their hypo condition under control.
So I say to you dear Mr. Konstantin Monastyrsky…you better take a good long look at the statistics again and know that hypothyroidism is far more widespread than anyone thinks. There are probably hundreds of thousands of people here in the US that are undiagnosed because of stupidity on the part of doctors who don’t know how to diagnose or treat thyroid conditions. It is people like you who keep all of us suffering from hypothyroidism sick!!!
Char,
Medical community in the United States has zero incentive to underreport and underdiagnose this condition because as more people get diagnosed, they stand to make more money. And since our medicine is money driven, the predominant thinking is that most of the diseases are overdiagnosed, a complete opposite of what you believe.
I am reporting on the best data that is available to me from “blue chip” sources. If you have better data from better sources, please show it to me, and I’ll be glad to update my article.
I’m sorry…but I don’t have to show you data from better sources. It is out there on the internet and you can find it as easy as I can. Your data is either outdated or just simply stupid and wrong. When the Endocrinology society updated their TSH levels about 10 yrs ago….they themselves stated that there were many hundreds of thousands of people who were either undiagnosed or undertreated. And I have absolutely no love for Endocrinologists…because it was 10 of them that kept me undiagnosed and all because my TSH (which is a worthless test because all it does is test a pituitary hormone) never went above the “normal” levels.
You don’t know what you are talking about and as I said…I have a group of 7,000 of us who will stand with me and say the very same thing. Our group is growing day by day with people who DO have thyroid disease and can’t get diagnosed because of idiots like you who don’t believe that 90% of the symptoms that we suffer with are real. So they give us anti-depressants, they give us pain pills, they give us every kind of drug except the one that we need to get us well.
And I would stand up anywhere and debate you because as I said…you are deaf, dumb and blind to the fact that thyroid disease IS REAL and it is becoming an epidemic disease.
Char,
You don’t need to debate anything with me because I don’t disagree with you on anything. Besides, how can we debate anything if I am “deaf, dumb, and blind?”
And if you believe that the Endocrinology Society is mistreating you and your fellow sufferers, let all of 7,000 of you to donate $100 each, and I’ll donate too. Hire the best attorney and expert witnesses these $700,100 will buy you, and “sue the bastards.” I am sure no jury will be able to resist your furry.
thanks for all your well said info. i love the straight talk. i have never said i have hypothyroid or adrenal fatigue. i don’t understand why i am 20 lbs overweight at 47. i was always thin regardless of what i ate and i ate very poorly till my thirties and my diet has only improved. i like to blame it on having two of my three children after age 40 but i know that really isn’t it either…though i don’t know what it is. i eat a traditional- more paleo for the past year- at least 95% of the time. i do drink wine each night but even when i didn’t for a 4 week trial the weight didn’t budge (maybe a pound?) i do cross fit three times a week and do an interval run for 20minutes two days a week. i’m reading your post for some insight. i feel like i am always going to look like this and i don’t like it yet i feel as though i need to accept it. HELP!
one other question- slightly off topic but perhaps you can address at some point- i don’t eat rice or oatmeal anymore but i do soak them in whey (that i make from raw milk). i also soak the beans (that i don’t eat anymore). is it ok to eat beans and grains if they are soaked? the paleo wold says no but the traditional world says yes. very confusing.
thanks for taking the time to answers all our questions.
I’m very happy the author is a pharmacist and not a clinician.
The whole tone of this article is negative and condescending.
Basic medicine is ignored by the author and he takes a very simplistic
view of complicated topics like obesity, thyroid dysfunction and it’s treatment, and
adrenal insufficiency and let’s not forget that he totally ignores topics such as
leptin resistance, inflammation, hormone imbalances.
This author has or at least writes with an arrogant, “know it all” attitude that would not go far to promote healthy choices in a patient.
I do agree with the author that most over weight patients aren’t hypothyroid and people should definitely get tested * correctly* (not as easy as the author makes it out to be) to find out if they have medical issues impacting their weight. I feel the author misses the boat on so many points I can’t take the time to correct them all but will comment on a few.
Obesity is a very complex issue.
thyroid issues, adrenal issues, inflammation, leptin resistance, hormonal disruptors… the issues go on and on.
Per the author:”The “underactive thyroid” is an equally minor factor in the obesity epidemic because this condition is rare among young and middle aged adults, while most affected seniors keep it in check by taking a daily dose of L-thyroxine, a synthetic hormone that brings the balance of T4 hormone back to normal range.”
I find that thyroid issues are relatively common in middle aged women.
T4 is an inactive hormone and correcting it doesn’t necessarily correct hypothyroidism. Many people are not good at converting T4 to T3 (the active hormone). T4 can also be converted to Reverse T3 which is also inactive.
Studies show that most patients feel better on T4/T3 preparations rather than T4 only meds like L thyroxine even though there is no difference in their lab values. *Feeling better* is more important than lab values. Correct evaluation and treatment of thyroid disorders is much more complicated than “get a TSH and prescribe synthroid” mentality that is so prevalent in today’s medical community.
The medical community admits obesity is multifactorial and we don’t know all we need to know about it.
I would recommend the readers here educate yourself and do not rely on the word of this author, me or any one medical provider. With topics like obesity and thyroid disease it is hard to stay on top of new information. If you are interested in obtaining more information about thyroid disease I would recommend thyroid.about.com
As for secondary adrenal insufficiency you might want to consider saliva testing over blood tests. In this day and age of ongoing high stress levels adrenal insufficiency is becoming
a more common problem.
The author states “The misconception about “bad metabolism” is just as irrational as the one about hypothyroidism. Just ask any doctor or nurse, and they will tell you right away that a true “bad metabolism” – not a make-believe one – is a sign of imminent death, and that a precipitous weight loss, not gain, is its number one symptom.”
I would disagree and state that most informed doctors and nurses wouldn’t say this and instead might actually measure the patients basal metabolic rate and then measure hormone levels including vit D 25 oh (which is actually a hormone not a vitamin), and optimize nutrition, supplements, and exercise and correct any underlying hormonal imbalances.
Optimizing hormone levels, nutrition, sleep, Vit D, exercise and supplements can go a long way to correcting obesity but ignoring the fact that we don’t know all that we need to know about obesity is foolish. So is equating Steve Jobs death from cancer as the only definition of bad metabolism.
So is thinking obesity is all about calories in equals calories out, humans are much more similar to a chemistry lab than a math equation.
So is blaming the patient which is what many in the medical community continue to do instead of looking at the real underlying factors.
Susan
Susan,
I am not a pharmacist, but a medical writer. I am not a part of any medical community. My article is based on academic data. All of your commentary is based on what you see around you. If you have better data, feel free to write your own article on this very page.
I completely agree with what you’re saying. I have severe Hashimotos that has caused my vitiligo but I know it has nothing to do with my current weight. I didn’t get diagnosed with Hashimotos until my early 20’s because of misdiagnoses when I was a teenager. I had tested positive for under active thyroid twice but the third test showed fine. I’ve heard it depends on the time of day and month that they test you. When I was a teenager I talked incredibly slow (got called “slow motion” which was very embarrassing) and my hair fell out constantly but I was a size 3-5. My friend Laura has Hashimotos as well but is usually around a size 6 I think (since I’ve known her). We’ve both been on GAPS because I have Aspergers and she has Bi Polar. She also has adrenal fatigue as confirmed by a test and I suspect I may but am not too concerned with it because I figure it’ll prolly work itself out through the way I eat. I’ve gained weight through the yrs (I’m 29 now) but its because of my former very crappy diet. I’m currently a 12/14 so not gigantic but I’m not comfortable with it and I’m continuing to change it by focusing on my gut health. I also haven’t taken thyroid medication since the end of December and have lost a couple pounds since then and I haven’t felt any different for prolonged periods of time (I get tired on occasion I’m human lol). If I do start to get overly sluggish and can’t get rid of it then I’ll go back to my dr but until then like I said I’m just focusing on my gut. Thanks so much for this series it’s very interesting:).
Natalia,
Thank you for sharing. Your story is very instructive. These disorders aren’t as black&white as they may at first appear. There are a lot of gray areas that befuddle doctors and patients alike. Glad to have you aboard, and am hoping these articles will help you focus on maintaining your optimal weight and health.
Thank you for your article. It’s very informative, looking forward to your future posts.
Olga, you are very welcome! Feel privileged to release future post!
Two years ago, when I told my former doctor that I wanted to be tested for hypothyroidism, he told me that I just needed to exercise and go on a diet. I told him what my symptoms were, and insisted on being tested. Very reluctantly, he agreed to do so. When the test came back showing that I was indeed hypothyroid, he put me on Synthroid and told me how fortunate I was, because if he could choose any lifelong disease to have, he would choose hypothyroidism because it was the easiest to deal with. Then he recommended that I take iodine supplements. When I left his office, I started doing some reading about hypothyroidism and found a new doctor. He had my blood tested for antibodies and found that I have Hashimotos. I believe the statistics you quoted are not accurate, and some people are not being correctly diagnosed and treated because doctors look at them and judge them based on their appearance and don’t want to run tests.
Peggy,
We have access to the same sources. If my sources aren’t accurate, please point out to other sources with more accurate statistic.
Hi Dr.
Is low body temp something that affects weight and overall health?
Virginia,
It does and it doesn’t. It all depends on the causes, circumstances, body morphology and weight, ambient temperature, time of day, nutrition, activities, the make-up of your central nervous system, dehydration, anemia, heart disease, atherosclerosis, medication, and a lot of other factors. At the most basic level, low temperature may suggest underactive thyroid, the very subject of this discussion. It is best to address this question to your doctor, and it definitely can’t be resolved via the Internet.
Actually, I think it CAN in some cases be resolved via the internet.
I was overweight and healthy…according to the tests. But at 45 I needed to have both my hips replaced. After the surgery, I was still testing healthy, if somewhat anaemic (due to surgical bloodloss). I hadn’t slept well in years, despite being healthy, according to tests. Did I mention I was overweight?
My visit to the specialist resulted in a recommendation to lose 40 lbs. I’d feel fantastic.
Well, suddenly for the first time in my life, I DID manage to lose that 40 lbs…then 50 lbs…and I felt utterly crappy. The weight loss was not in my control. Going for my sleep study, I had to use my health card to give my home address…as I couldn’t remember it (I’d had the address for 4 years). But the tests said I was healthy.
It was on the internet that I managed to start sifting through my horrible brain fog and start finding answers. I was healthy…according to tests…and hypothyroid. WHY I was hypo was really irrelevant at the time. Being treated for it (when I found a doc who saw what I saw) helped me get off the antidepressants, and get my brain functioning enough to be able to try to solve the problem. I now have the ‘luxury’ of being able to question why I am hypothyroid, although at this point I’m happy enough to have a reasonable body weight and some functioning brain cells. Funny thing is, my thyroid test, if it were only TSH would show me as hyperthyroid, which I am definitely not.
Mr Monastyrsky, I would respectfully suggest that a great many overweight people may actually have underlying issues which keep them that way. The tests show them as healthy. The tests are probably 100% accurate…in what they are testing…but are not being interpreted properly. TSH is a fine example of this problem. I believe ACTH testing (the adrenal test…had that one too) is also easily skewed. But that might just be me.
JP,
My post says word-by-word what you are suggesting:
“If you suspect that you may have Hashimoto’s thyroiditis, GET TESTED. The level of thyroid hormones T4 and TSH may remain normal during early stages, making its diagnosis difficult in non-specialized clinical settings. Seek out a specialist trained in diagnosing and treating this relatively rare condition. 1 case in 1,000 is, indeed, rare for an internist who treats on average 2,000-3,000 patients a year, and may not encounter a single patient with Hashimoto’s in years.”
Because clinical hypothyroidism isn’t as common as some other disease, non-specialists may not be able to properly diagnose and treat you, especially during the earlier stages while the symptoms are still subtle, and the tests aren’t as definitive. If your diagnosis or treatment outcomes are not satisfactory, you may also consider working with alternative providers.
Thank you!
I can understand why some people are angry. But if you think about it, it makes sense. I can blame sleepless nights and fatigue all I want…. but in the end the truth is I do find myself reaching for that second piece of cake.
Don’t get mad people. Yes, life is not fair, some people can have that extra piece and are fine. But every “body” is different. Either eat the cake and enjoy it or stop complaining.
If you guys remember Konstantin did say in a previous article 1 calorie might be 1/2 a calorie to another person. Something along those lines. Clearly he understands that some people have to work harder. He is also someone who has been there and struggled with a weight issue. He knows what we are going through.
Sofia,
Thank you! Couldn’t say it better:
“Don’t get mad people. Yes, life is not fair, some people can have that extra piece and are fine. But every “body” is different. Either eat the cake and enjoy it or stop complaining.”
are you freaking serious?? I have hashimotos, i am hypo thyroid, TSH will not help you! every doc has a different range, and it rages MASSIVELY what people feel best at. I am on Armor thyroid and finally feel like a human being. If i listened to what docs/endos have said, i would be SEVERELY hypo and near death. The thing is, FREE T3 & FREE T4 are very important in knowing what is really going on. TSH is a request from the pituitary and not a TRUE indication of what is going on. Sure, its elevation is something to help a doc start, but if all they ever test is the TSH, its not going to help anyone. EVER. I went 3 years with a “normal tsh” (which can range from .5, at the time, to 5.0) But was severely hypo. Does everyone wear a size 5 shoe? Does everyone wear the same size clothes? NO, everyone is individual and you can not go on an outdated range to diagnose someone with something important, especially the thyroid which DOES control a WHOLE lot of body functions. This article is HOOEY, written by a pharmacist, who did not and has not, and probably will not do any actual research on thyroid issues.
Postpartum thyroiditis is something that is real, that was how my hashis presented itself. Dry skin, dry hair, hair that falls out waaaay too much, painful joints, depression, and lots of other symptoms ARE symptoms of under-active *hypo* thyroidism. EVEN some psychiatrists will test thyroid function before giving anti depressants, they seem to be more informed than some docs, and especially this guy who thinks that some med I’ve never heard of is the only thing to give for thyroids… When you get tested, get tested for FREE T3, FREE T4, antibodies, VitD3, Ferritin, iron. D3 is important as well, not to just be “in range” but to be over mid range, it can also cause depression and it goes hand in hand with normal thyroid function.
Now that I’ve typed a book, cause i’m so SICK and tired of docs trying to say “your fat cause you’re lazy, the tsh test is all you need and i know it all” junk, I mean seriously, don’t you think if there was an easier way, we’d take it? do you know how much i hate being on a med for the rest of my life while my body continues to attack my thyroid killing it?? I’ve had 3 open heart surgeries, and take no meds for that, but, if i had to, i would. The heart needs your thyroid running efficiently so it can run efficiently, and if the thyroid is off YES it WILL mess with your heart eventually. Take this guy with a grain of salt and many other experts that tell you that you can “heal yourself” by taking “natural supplements” do your own research and know you don’t have to stay feeling awful when you know something is wrong.
Yes, I am “freaking” serious. That’s exactly what my article is saying: “If you suspect having “symptoms of under-active *hypo* thyroidism,” get tested, period.”
If these tests are bad, or doctors are wrong, what exactly this has to do with my article? Please reserve your outrage to someone who wronged you. I have nothing to do with your condition, diagnosis, or care, and your attack is uncalled for.
“:To hear these claims is quite amusing because a true underactive thyroid – a vernacular for subclinical hypothyroidism – affects less than 10% of women and 6% of men over 65 years of age, while the rate of real hypothyroidism is even less – under 1.2% of women and 0.4% of men [1] predominantly among older adults.
In other words, the number of overweight men and women is, respectively, a whopping 58 and 175 times greater than the number of people affected by hypothyroidism [2], even though practically all people who are affected by adiposity – a shorthand for “overweight or obese” – believe they may have this condition.” – quote from you, saying its uncommon, saying its rare, i call BS!
“The “underactive thyroid” is an equally minor factor in the obesity epidemic because this condition is rare among young and middle aged adults, while most affected seniors keep it in check by taking a daily dose of L-thyroxine, a synthetic hormone that brings the balance of T4 hormone back to normal range. Thus, whatever you may have that caused you to gain weight in your early thirties, forties, or fifties, it isn’t likely to be an underactive thyroid either, and that was the second lie!
If you still believe that it isn’t a lie in your case, just do a blood test. If it ends up positive, switch over to a traditional diet, take the supplements that may help to reverse this functional condition, or, as a last resort, get a prescription from your doctor for L-thyroxine, and be done with it.”
There is no misconception about what i’m saying is BS in your article, and what i’m saying. YES i’m outraged, because of “doctors” like you that just want to say that its easily diagnosed with a blood test and easily fixed with a synthetic pill. If its so “rare” why do the rates go up every year? why is it COMMONLY tested and treated? the fact is, you touched on a very very very very raw nerve for a lot of people. The fact is, one blood test is not enough for alot of thyroid patients, the TSH is not a true thyroid function test, and your l-thyroixine or whatever script you are talking about is not enough for most people. there is no supplement that can “fix” the condition of hypothyroidism. people that prey on people with problems, handing them an “easy fix” is just sad and it should be against the law as a malicious act against the person with the illness they did not ask for, nor create. What it has to do with your article is that your article is giving false information and basically lying to people that expect to come here for help.