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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.
I’m trying to understand how this post entitled “Ugly Lies Behind Obeisity Epidemic” is “geared towards healthy people”. Is it meant to make healthy people feel better that they are not obese by stating stats implying that there are a bunch of obese people out there hiding behind made-up diseases? How does one self-diagnose themself with hypo-thyroidism or adrenal fatigue? Doesn’t it take a doctor to diagnose these serious/real health issues? I don’t know, I think the points could have been made without throwing a whole bunch of people under the bus; especially those struggling with thyroid disease. One can find stats out there to write about many things; that doesn’t make it right.
Ella,
I am not a medical doctor, but a medical writer with medical education. For these reasons my work is addressed and geared toward relatively healthy people who also happens to be overweight. By “relatively healthy” I mean people who aren’t being treated for clinical conditions with prescription medicines. On this site, these people are in the majority, or so I hope.
I bet you wouldn’t bring your sparkling new Camry (a metaphor) to a rag tag mechanic for a check up. Why, then, you or anyone else would want to be “treated” for serious clinical disorders by a “rag tag” (a metaphor) medical writer.
So if you are seeking a proper diagnosis for thyroid or adrenal disorders, you need to go to a “proper” doctor. And if you find her diagnosis lacking, seek out a second opinion for your utmost safety and peace of mind.
And, incidentally, I don’t throw anyone “under the bus.” Nobody can through you under anything until you do it to yourself.
Thank you for responding. I must say, it is nice of you to take the time to address all of our concerns. I think you may have misunderstood; I was not seeking medical advice. My point was that I’m not sure how people would self-diagnose thyroid disease or adrenal fatigue without seeing a doctor. I think the main reason people are tested for these things is because of unexpected weight gain, fatigue, or depression. Most-often, I believe, from my experience, doctors do not test for thyroid or adrenal function first–they prescribe anti-depressants (which often causes more weight gain–oops!) So, I think the reason people may “feel” offended is that it is a real struggle to even get doctors to pay attention to thyroid disease, or to manage it properly. And if you are tired, depressed and, in a fog, it is unfortunately difficult to get up te energy to do the research on your own. In my opinion, it is depression that is over-diagnosed, not thyroid disease. And I worry that people may be discouraged from getting tested for thyroid disease if they read this article and “feel” someone is implying that their weight gain probably has nothing to do with their thyroid. P.S. I feel like I’m a pretty “healthy” person, even though I’m on thyroid meds (Armour). I definitley DID NOT feel healthy when I was on Synthroid. So I guess I have a different outlook on what makes a person unhealthy. But, again, thank you for taking the time to respond and spark the discussion.
Ella,
You are very welcome. As I said before, it is my pleasure and privilege (courtesy of Sarah, The Healthy Home Economist) to participate in this forum and answer questions from you and other readers.
Back to your comment: I don’t recall suggesting even once that people should self-diagnose themselves. To the contrary, I urge people to seek out specialists and get properly tested (and retested) if they suspect that they may have any of the conditions discussed in my article.
As far as all other issues in your comment — depression vs. hypothyroidism, best medication, etc. — sorry, I have zero expertise in this subject. That’s why I encourage readers to describe their own experiences, and help others by sharing.
Somehow, this good intent turned into flagellation and name calling. This not only doesn’t help anybody, but also turns away people who may actually benefit from this kind of constructive help.
Thank you, Ella, for being civil!
Thank you. I don’t mean to talk in circles, but I did not mean to imply that you were suggesting to self-diagnose. My takeaway from the post is an implication that people are somehow self-diagnosing thyroid disease or adrenal disease as an excuse for weight gain–and I just don’t believe that is the case. So we can agree to disagree. Unfortunately, I think it takes women (and men) a lot to even go to a doctor and describe their problems with weight gain, depression, etc. I think most people just suffer on their own without medical care. The same I would assume is true with adrenal fatigue. I just don’t believe this is on many doctors’ radars. And I have heard that testing your adrenals is kind of involved (I have not done it because no endocrinologist has mentioned it). I would bet that most people do not take the steps to complete the testing, so accurate statistics would seem pretty difficult to come by.
Ella,
You are very welcome. It isn’t my intent to imply anything. I am simply recounting my professional experience. If it isn’t pleasant to hear or read, sorry, but I don’t have another experience, and I am not a fiction writer. If anyone needs a good feel read, there is an app for that…
I don’t know anything about the epidemiology of “adrenal fatigue” outside of what’s published in medical references. Judging by the amount of hatred toward me on this forum, no one who accused me of all mortal sins has it.
I would also point out a wide variety of people view this web page, many of whom are trying to find their way to better health. It is not only HEALTHY people who are reading these posts. Many are trying to find out what to avoid (GMOs, fluoride, pesticides, processed foods, etc.) and what to consume to find better health. Many people are just now becoming more aware of all of the endocrine disrupters luriking in our food and water. My takeaway from that article is that you believe people are self-diagnosing hypothyroidism and adrenal fatigue as an excuse for weight gain. I just cannot get on board with anyone implying that we are overdiagnosing these these serious health conditions that are so often ignored and mis-managed by otherwise qualified doctors. The good news is that this post is bringing out lots of good information in the comments section — information that will hopefully be beneficial to those suffering from mis-managed thyroid health. Sadly, this affects mostly women, often new mothers, and can disrupt life in horrible ways.
Marcy, I agree with most of your points, but you are also misreading my article. I simply cite available stats, and also add that some experts doubt these stats. If doing that is, somehow, wrong, offensive, insensitive, uncaring, ignorant, stupid, or arrogant, very sorry to all who feel offended, but I work with what I have, not with what I wish I could have.
Thank you. I don’t recall using any of those words, but I understand your frustration. I think the problem is that many of us with thyroid issues believe the stats are so far off and the disease is so mis-understood and under-reported; it’s also very frustrating. I think it’s easy to get offended by feeling like someone is implying that we are somehow making up our condition. I understand when you say this was not your intent. The problem is so many doctors out there are very quick to discount women’s health struggles and it takes a great deal of energy to manage thyroid disease. We have probably all encountered doctors who roll their eyes and discount our struggles with weight loss, fatigue, etc. Whether or not the statistics show the high prevelance of hypothyroidism seems beside the point when so many of us are surrounded by others who are also struggling with this disease.
It is also my understanding that there are no national statistics kept on autoimmune disease (hashimotos thyroiditis, celiac, diabetes, etc.) There is a cancer database, but not an autoimmune database. Someone should start one — I think we would all be shocked by the numbers.
Marcy, your point is well made. I hope the information in this and future post will help you and others in your situation. Thank you for commenting.
There is no way hypothyroidism is being over-diagnosed. Doctors are more likely to prescribe antidepressants for thyroid symptoms than to test thyroid function and try to get to the bottom of the cause of the symptoms… extreme fatigue, etc. Even WHEN thyroid tests are run, many doctors ignore the importance of keeping track of T3 levels, etc.
After 13 years of thyroid mis-management by many doctors, I have seen it all. The most recent was being prescribed too much thyroid medication for at least two years… raised to a level that put me into a hyperthyroid state (doctor raised Synthroid meds instead of lowering…oops). Oh yes, and before doctors realized what was causing heart palpitations and extreme fatigue (also found in hyperthyroidism, btw) and realized that my dose was too high, they just wanted to prescribe me Xanax and move on, even though I kept insisting something was up with my thyroid.
I suggest people do their own research, talk to other patients. Check out websites like thyroidchange.org and stopthethyroidmadness.com. Ask your doctor about Armour and other natural thyroid meds. Find foods that help with thyroid function (coconut oil, etc.), many of which are often dicussed on this facebook page. Avoid Fluoride. Switch doctors if you need to.
I don’t know, it may be possible to avoid thyroid meds if the disease is caught early enough, but I’m pretty sure the synthetic meds have taken away that chance for me. Take charge of your own health be your own best advocate. IMO, don’t accept prescriptions for antidepressants, etc, until they test all of your Thyroid levels, B12, Vitamin D, Adrenals, etc, and what Lisa mentioned above.
By the way, I don’t think adrenal fatigue is being over-diagnosed either. I have been to many doctors for my thyroid problems and not once has anyone suggested testing my adrenals. I only learned about adrenals through research and talking to other hypothyroid sufferers.
Adrenal insufficiency is seen as rare in the medical world, yes. However, that is because it is under diagnosed. I am not even talking about diagnosing it beyond the conventional criteria. According to the leading Addison’s disease expert in the world (Professor Wiebke Arlt), adrenal insufficiency should be dx when a person has a morning cortisol of <5, yet most doctors do not know this, and hence do not diagnose based on this criteria. Professor Wiebke Arlt also states that the patient should reach a certain point during a stimulation test. Again the vast majority of enods do not know about these guidelines and continue to tell patients they are fine even when they do not fulfil the criteria of the leading global expert on the subject.
As for pigmentation, it used to be seen as the classic sign. However many patients with nocfirmed AI do not have this symptom.
Lynn,
Please bring this issue with medical doctors in that particular field. I work with what I have, and urge people to be aware that what they are getting may not be best or optimal. My field of expertise is “Why Diets Fail?”, not “Why Doctors Fail” This particular subject is a domain of other doctors, the FDA, and tort lawyers.
Yes, but you asserted that adrenal insufficiency is rare and that it always presents with hyperpigmentation. It is nowhere near as rare as doctors think, and it does not always present with hyperpigmentation. Hence why I wrote that comment.
Lynn,
I did not assert anything, but cited the stats from some of the top flight academic sources.
Even if the prevalence of adrenal insufficiency is 100 times higher than what these sources claim, it still makes only 0.7% (0.007% * 100) of the population, not exactly an earth shuttering number as you believe it is.
And if you don’t like these sources, bring your argument to them, not to me. There is no point in beating the messenger because you don’t like/agree with the message.
You SOUND like you know what you’re talking about, but perhaps you’re a bit under-educated on how thyroid testing works. Did you know that the TSH normal range was set by one single study of 90 nurses, none of them were excluded for thyroid disease. All they did was knock off the outliers and go with the median clump…and that’s pretty much the last word on what the AACE (American Association of Clinical Endocrinologists) have officially stated.
So best not to say what’s sub-clinical and what’s REALLY hypothyroidism if you’re not aware of that simple fact.
If you’re at all curious, perhaps you should go to Medline or Google Scholar and learn a little bit about T3 (tested by the free T3 test) and find out what the last 20 years of research is telling us; that the lack of availability of T3 to cells causes a huge range of neurological and metabolic problems. Obstetricians have been on board with a much narrower range of normal and test both Free T3 and Free T4 because of how devestating low thyoid is to the developing fetus. Guess what, it’s not so great for healthy women, either.
As far as your assertion that every fat person blames their thyroid; unfortunately, in my work as a thyroid advocate, I’ve found that people (and most of their doctors) are woefully in the dark about thyroid disease. I’ve talked to scores of people claiming to have no thyroid problem who, once they learned how to look at their tests, found that they could indeed benefit from thyroid meds (and not just T4/levothyroxine, newer studies show that often that’s inadequate.
I’d have been more gentle with you if I had any inkling that you were capable of evolving on this issue, but it’s obvious you have no interest in educating yourself on this issue since you’ve spouted off without doing even a modicum of research; you’re just parroting the entrenched old guard at the AACE.
By the way, I’m 5′ 5″ and 130 lbs; I don’t have a dog in this “fat excuse.”
Kit,
Thank you for your feedback. I didn’t make the assertion that every overweight person blames their thyroid. Please don’t confuse what I hear from a limited number of people that I encounter during my weight loss seminars and radio talk-shows, and the community at large.
Also, I don’t imply that the linking of obesity to medical conditions is, somehow, a blame game, or a denial of personal responsibility. Not at all. As you and I know, a lot of overweight people indeed consume moderate diets without much success of containing/reducing their weight. I addressed this very problem in the previous post: https://www.thehealthyhomeeconomist.com/why-one-calorie-for-her-is-half-a-calorie-for-him/
“As a weight loss counselor, I’ve yet to encounter an overweight person who wouldn’t tell me upfront: ‘I am overweight because I have a bad metabolism,’ or ‘I am overweight because I have an underactive thyroid,’ or ‘I am overweight because I have hypothyroidism.'”
So, what you meant here when you said that you haven’t yet met any overweight person that didn’t blame their extra weight on a medical condition is really just “a limited number of people”?
That is correct. Just a limited number of people that I had a chance to discuss this condition with. Well, it is no longer true because a very nice lady introduced herself on this forum, and she said something along these lines: “I am perfectly healthy but overweight because I am a compulsive eater.”
Dr. Monastyrsky:
Please review this evidence of our cause:
Oh & that Scotland is currently investigating this as well: http://www.scottish.parliament.uk/GettingInvolved/Petitions/PE01463
Michelle,
Please note that (a) I am not a medical doctor, and (b) I don’t dispute with anyone that the testing and diagnostic of thyroid and adrenal disorders may be completely, utterly wrong. I simply report on what information is available to me, and urge people who believe otherwise to seek better information, better doctors, and better labs.
Thank you for sharing your information. I am sure it will be interesting and helpful to many people, particularly in the United States because most of its regions are known as “endemic zones” for thyroid disorders.
if the u.s. is “endemic” for thyroid disorders…how can you claim, in your article, that thyroid disorders are rare…
you failed to provide ALL of the relevant information from merck by leaving out the paragraph previous to the one you quoted:
“Symptoms and signs of primary hypothyroidism are often subtle and insidious. Symptoms may include cold intolerance, constipation, forgetfulness, and personality changes. Modest weight gain is largely the result of fluid retention and decreased metabolism. Paresthesias of the hands and feet are common, often due to carpal-tarsal tunnel syndrome caused by deposition of proteinaceous ground substance in the ligaments around the wrist and ankle. Women with hypothyroidism may develop menorrhagia or secondary amenorrhea.” (from the same source as stated above)
the mayo clinic web site states:
********** Copyrighted content removed by the moderator *********
seems to me you need to do more research before you write…
Undrgrndgirl,
“Endemic” doesn’t mean “more frequent” but means that the prevalence of hypothyroidism related to iodine deficiency in the US may be slightly higher than in other locales.
Regarding “you failed to provide ALL of the relevant information…” As you may know, it is against the law to liberally quote from copyrighted materials. I quoted a relevant snippet under the “fair use” doctrine, and provided the link to the source, so people can read the rest.
What you call “research” is actually called plagiarism. That I don’t do, and suggest that you don’t do it too.
I am enjoying this series. I am a mom of 5 and have about 10 lbs that I would like to lose. This is going to be a challenge since I spend some days entirely in the kitchen. I look forward to reading more about mineral deficiency and how you can identify which minerals you may be lacking or just not absorbing.
I enjoy your voice. My parents are from Eastern Europe (my father is from Kiev) and we lived in NYC. I have many fond memories of family gatherings with heaps of food and disbelieving looks if anyone said they were full.
I had thought low thyroid was a root cause of certain problems but you mention there are factors that can cause low thyroid function and I look forward to reading more about this too.
Thank you, Irena. Same was in our family — heaps of foods and lots of vodka on holidays and weekends, fairly moderate diet during the week. Lo and behold, all of my relatives (except some men with demanding physical jobs) were overweight or obese. And so were their friends. That said, I had a blast growing up and managed to stay normal weight until my second dog passed away in 1989. But what really did me in was a switch to vegetarian diet in 1991. By 1996 I had BMI two points shy of obesity (28) and type 2 diabetes so severe that I could barely walk or drive.
So, as you can see, this subject is “near and dear” to me much more than I would like it. I normalized my weight around 2000-2002, and has been stable plus/minus few seasonal kg in both direction since then. With 17 years of experience (1996-2013) behind my belt researching this subject, discussing it with thousands of overweight people, performing in close to 1,000 live radio talk shows (Russian-language), writing hundreds of newspaper articles, publishing four books, and producing one massive web site, I am finally ready to tackle this subject.
Being 58 — that’s close to 60 — also a great help. I see a lot of younger authors — 35-45 — working with this subject with too much self-confidence and too little compassion. Alas, as we get older, the body’s response is drastically different, so what worked great at 40 is near useless at 60.
Thank you again for your comments, and welcome aboard!
By linking being overweight with thyroid disease this article has conflated body size with health. Rapid fluctuations in body weight are frequently indicative of health issues. However, body size is indicative of nothing more than the size of the body. I understand that the overall point of the article is that the perception that larger bodies are bad may simply be function of social perspective. What the author fails to ask is why larger people feel the need to justify their size irrespective of having a medically diagnosed reason. Could it be due to the fact that many medical professionals, despite the evidence, insist on weight-loss being a magic bullet for everything from sprained ankles to heart disease mortality?
My main problem with this article, however, is the misguided assertion that thyroid disease is so rare and anyone who suspects their thyroid is a contributor to their weight should “… 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 …” It’s that simple, huh? Why then does the accepted “normal range” vary between countries? My doctor initially tested me for hypothyroidism in the late 90’s as he, not I, suspected there might be a problem. According to the accepted “normal range”, at that time, my thyroid was fine.
Fast forward 13 years. My ‘thyroid symptoms’ had become so much worse that I was no longer functional. However, I put the my symptoms down a to combination of fibromyalgia (medically diagnosed) and perimenopause. In discussion with my dr, he suggested retesting my thyroid. This time, I was considered to be clearly hypothyroid despite the fact that my test came back with only marginally higher numbers than the previous one. The range considered to be “normal” had changed. If the current “normal range” had been applied when I was originally tested my hypothyroidism would not have been unrecognised and untreated for over a decade.
It is definitely not a case of get a blood test and then you’ll know. The Australian “normal range” for TSH is lower than that generally accepted in the USA. Many Americans with underfunctioning thyroids are not receiving appropriate treatment because they have the misfortune to be subject to the American “normal range” for thyroid hormones.
Simply eating a traditional diet and taking supplements may help but cannot either prevent nor cure thyroid disease. Even by the standards of this blog, I have eaten well, used appropriate supplements and exercised ‘right’ for more than 3 decades. Yet I unaccountably gained weight and had my thyroid deteriorate. Even once diagnosed, it was not as simple as getting a prescription for L-thyroxine and being “done with it”. With everything else already being ‘right’ my dr did prescribed L-thyroxine. As a result my TSH increased at an alarming rate and I rapidly became more unwell. Increasing the dosage made thing worse. My body was not able to convert the synthetic T4 to T3. Even though I had numerous blood tests, it was not until my thyroid was scanned that became obvious I had Hashimoto’s Thyroiditis.
There is nothing simple about thyroid dysfunction. The flippancy with which which it is assumed, in this article, that a blood test result is the final arbiter of diagnosis irrespective of symptoms does a huge disservice to everyone who is trying to find out why they are feeling unwell. As is the implication that most doctors are more interested in writing prescriptions than finding the underlying cause of the problem. If it is simply a case of blood test results and prescription writing the job could be done by a computer. Maybe medicine is simply practiced differently in the USA.
You know your body better than anyone else. No numbers on a report can define your quality of life. If you are not feeling well and your doctor dismisses your symptoms on the basis of blood tests find another doctor.
Excellent resources for anyone who has reason to suspect their thyroid is dysfuntional are:
http://thyroid.about.com/bio/Mary-Shomon-350.htm
https://www.facebook.com/thyroidsexy
Cheryl,
This article does a complete opposite of “conflating body size with weight.” It is actually conflating body size with diet and a host of other primarily socioeconomic factors, and making a bold statement: “healthy body — lots of weight.” Unfortunately, the theme and core message of this article has been detoured by people affected with various severe clinical pathologies who were neither the “target audience” of this article or my future book, and I regret allowing this discussion to turn away from the core message:
“Healthy people with genetic predisposition (80% of the population) and financial means to eat as much as their hearts desire gain weight. For about 70% of these people, weight gain isn’t a sign of a disease, but a sign of eating too much, moving too little, and living in the wrong era.”
In any event, thank you for your feedback.
thank you cheryl. i was goint to say essentially the same thing, but i see you already did. no sense beating the same horse.
It would be impossible for me to over-emphasize HOW STRONGLY I DISAGREE with this writer. U-N-B-E-L-I-E-V-A-B-L-E! Pease readers, DO NOT believe or take as fact what has been written here by the author concerning thyroid issues.
I highly, highly, highly recommend Dr. Starr’s book instead, get the edition that was updated in 2011 if Hashimoto’s or Graves is (or might be) a concern; the 2005 edition is fine for everyone else. There is also a kindle edition. I have read 2005, and am getting the 2013 edition ASAP.
By the way, the word “Epidemic” in his book title, is in regard to the clinical definition of the word epidemic.
The entire book is written with great medical depth, extensively footnoted, etc.
Hypothyroidism Type 2: The Epidemic, 2011 Edition
Mark Starr, MD
http://www.amazon.com/Hypothyroidism-Type-Epidemic-Updated-Hashimotos/dp/B006S2OW30/ref=sr_1_4?s=books&ie=UTF8&qid=1365226580&sr=1-4&keywords=Hypothyroidism+type+2+the+epidemic
Publication Date: March 4, 2005 | ISBN-10: 0975262408 | ISBN-13: 978-0975262405 | Edition: Revised 2013
Book Description:
An astonishing book revealing the cause and successful treatment for the plague of illnesses affecting western civilization; including obesity, heart attacks, depression, diabetes, strokes, headaches, chronic fatigue, and many more.
In Dr. Starr’s description of Type 2 Hypothyroidism, he presents overwhelming evidence showing a majority of Americans suffer this illness, which is due to environmental and hereditary factors. Laboratory testing used to diagnose hypothyroidism is completely inadequate, and current treatment for hypothyroidism is ineffective. Groundbreaking research shows how persistent environmental toxins prevent thyroid and other hormones from working properly. This book will lead you to understanding more about your health than anything you have ever read.
Many of the more recent patients who have sought help from Dr. Starr have come to him with Hashimoto’s and Graves’ diseases. As a result, the updated 2011 version added a chapter on Hashimoto’s and Graves’ disease.
Revised for 2013 with a contribution by Jerry Tennant, M.D.
I stand behind Carol’s recommendation: If you or anyone in your family is affected by thyroid-related disorders, consider reading Dr. Starr and Dr. Tennant book.
I personally have not read it yet (already on order, there is no Kindle version), but since it has been written by two practicing physicians with expertise in this subject, and referred by several people on this forum, you may find it helpful.
This is for Been there done that:
I beg to differ with you on a few points. The ranges for thyroid testing here in the US are fairly broad too. They are supposed to be 0.3-3.0 as set my the Endocrinolgoy society…but my last tests came back with a range of 0.35-5.5. So don’t say that the US has narrower ranges. Also you say that just because someone doesn’t have a TSH that falls out of those ranges that they can’t possibly be hypo. Well my TSH was only 1.2 when I was first diagnosed (well within “normal” ranges)…but my Free T3 wasn’t even registering on the blood test range. And everyone I know personally who is Hypo needs their T3 because they don’t convert T4 to T3 properly. Myself is case in point. I was 40 lbs overweight…but after finding NDT (natural dessicated thyroid) and getting my Free T3 and Free T4 numbers optimized (and may I add that since starting to take NDT my TSH hasn’t been above 0.009 and I am in no way hyper)…I lost those 40 lbs without dieting or even watching what I was eating. In fact I was laid up in bed with a broken ankle for 3 of those months and wasn’t even allowed to walk. So your idea that the TSH tells all about if you are hypo or not and your idea that most do not need T3 is pure BUNK!!!