The Thyroid - Weight Loss Connection:
Is a diagnosed – or undiagnosed – thyroid condition the real reason
behind your weight problem?
By Mary J. Shomon
Totie Fields once said, “I've been on a diet for two weeks and all I've lost is two weeks.” When you have a thyroid problem and are trying to lose weight, you may feel like Totie was talking about you. I know that I have. I tried fad diets, herbal diet pills, low-carb, etc. -- I even gained weight on Weight Watchers. And that was after my thyroid condition was diagnosed and treated. I know I'm not alone. In 2002, I conducted a patient survey of nearly 1000 people with thyroid conditions, and after fatigue and exhaustion, weight gain and difficulty losing weight were considered the next worst side effects.
I also feel for the estimated half of the estimated 20-30 million thyroid patients who don't even know they have a thyroid problem. Members of this group may find themselves defying the laws of physics, gaining weight on less and less calories, or unable to lose a pound despite the most rigorous diet and exercise program. Many of these people will be told they are stressed, depressed, or simply lazy -- one 2003 study showed that general practitioners and even health professionals who specialize in treating obesity typically associate being overweight with the stereotypes “lazy, stupid, and worthless.” But the weight problems may in fact be due to the undiagnosed thyroid condition, which, if not treated, can condemn them to a life of obesity, not to mention life-threatening heart disease, depression, and other conditions. One study actually found that as many as 40% of overweight people had evidence of a dysfunctional thyroid.
The assumption among the medical world is that hypothyroidism treatment solves the weight problem. But unfortunately, that is not the case for most patients. as we tweaked my medicine and dosages, I definitely felt better in some ways – less exhausted, not so moody and achy – but except for several pounds, the weight didn’t budge. Despite treatment, nothing I was doing in the beginning moved the scale an ounce. And I’m not alone. Many thyroid patients are extremely discouraged after treatment to discover that weight loss is impossible. So I set out on a mission. I needed to discover how best to optimize my thyroid treatment. I had to learn what -- and how much -- I can and can’t eat in order to lose weight. I found out whether I needed to exercise, what type of exercise, and how much. And I learned how to get back on track when my weight loss efforts get stalled or even derailed. It’s taken me almost ten years to figure out what I needed to know. I’ve outlined that approach in detail in my new book, The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss, and some of the key points are summarized here.
WEIGHT GAIN AND HYPOTHYROIDISM
When you’re hypothyroid – even with treatment, your body isn’t always functioning optimally. That is the most difficult point to get past -- to accept that fundamentally, your thyroid condition may, especially in the beginning, and perhaps forever, make weight loss an unfair fight. What you suspect is true. You very well may gain weight more easily than others, and you probably won’t lose weight as easily or quickly as others. In fact, when hypothyroid, your metabolism may become so efficient at storing every calorie that even the most rigorous diet and exercise programs may not work. Your friend or spouse could go on the same diet as you, lose a pound or two – or even more -- a week, and you might stay the same, or even gain weight. It's NOT FAIR!!
It doesn't matter how you become hypothyroid -- whether autoimmune Hashimoto's hypothyroidism, or even Radioactive Iodine (RAI) as a treatment for Graves’ disease and hyperthyroidism. One study found that more than 85% of patients receiving RAI became hypothyroid, and despite levothyroxine treatment, their median weight gain after 6 months was 11 pounds, 20 pounds at 12 months, and 25 pounds after 2 years.
When you’re hypothyroid, you can eat less than others, and still gain weight. How can we thyroid patients seemingly defying all the laws of physics? If it takes 3500 excess calories to gain a pound, how could you possibly gain 10 or 20 pounds in one month? And yet, when hypothyroid – even when treated -- you can. Some is water retention, but some is body weight. In The Thyroid Diet, I discuss in depth the various reasons why thyroid problems make it harder to lose weight.
WEIGHT LOSS CHALLENGES AND SOLUTIONS
There are a number of challenges inherent to hypothyroidism that may make weight loss difficult, but here’s a quick recap of things to do:
Optimize Your Thyroid Treatment: The most essential step for anyone who is hypothyroid and can’t lose weight is to make sure thyroid treatment is optimized. This means you need to be at the optimal TSH, T4, T3, and Free T4/Free T3 levels for you. You also need to be taking the best drug for you, which may mean a switch in brand, the addition of T3, or a switch to a drug that contains T3.
Evaluate Other Drugs: Determine whether you are taking any other drugs that promote weight gain (i.e., beta-blockers, steroids), and discuss any concerns with your physician.
Know Whether You are Calorie-Sensitive, Carbohydrate-Sensitive, or Both: Many thyroid patients are unable to lose weight on diets like "Atkins" because the "all the protein you can eat" approach results in too high a calorie intake for a lowered metabolism. At the same time, the low-cal, low-fat approaches that result in eating lots of bread, pasta, potatoes and rice may also prove ineffective for thyroid patients, who are more likely to exhibit signs of insulin resistance and carbohydrate intolerance. The Thyroid Diet helps you determine your particular type, and provides a detailed eating plan to follow that will help you lose weight.
Check Your Blood Sugar: Does your blood sugar indicate that your pre-diabetic or insulin resistant? If so, you may need an antidiabetic medication such as metformin, known by its brand name, Glucophage.
Consider Antidepressants or Supplements That Balance Brain Chemistry: Even if you do not suffer from depression, you might find that you have greater success fighting a stubborn weight problem if your doctor tries you on a course of antidepressants. You may also want to consider supplements that help your brain chemistry.
Eat Enough Protein and Good Fats: Protein is needed to build muscle, and to maintain energy, and so your diet should include sufficient levels of protein. Essential fatty acids (EFAs) cannot be produced in the body, and so you must get them through diet or supplements, as they help burn the body's bad fats, and increase metabolism.
Drink Enough Water: Hypothyroidism can cause water retention and bloating. So, because you feel or look bloated or swollen, you may not drink enough water. But the body will hold onto even more water more fiercely when you cut back on your water intake. Not drinking at least 64 ounces – or more – of water a day is counterproductive, as it will worsen bloating, and cause dehydration, which slows metabolism.
Get Enough Fiber: Fiber is another essential to digestion, and optimizing your weight loss efforts. Fiber has minimal calories but can fill you up by adding bulk, and when consumed with carbohydrates, it helps modulate the insulin response and normalize blood sugar.
Get the Right Supplements: You may need multivitamins to help address nutritional deficiencies. But you may want to also consider some of the various vitamins, herbs, minerals, enzymes, essential fatty acids, and combination formula supplements that can help increase metabolism, aid in fat-burning; slow fat-storage, balance blood sugar and reduce appetite. In The Thyroid Diet, I assess dozens of the supplements, providing a detailed review that separates the infomercial hype from the products that have actually helped me as well as other thyroid patients. The most promising include: Alpha lipoic acid; Acetyl-l-carnitine; Calcium; Capsaicin/cayenne pepper; Chromium picolinate; Conjugated linoleic acid/CLA; Glucosol; Glutamine/ L-glutamine; Hoodia gordonii; Pantethine; Pyruvate; Taurine; Vitamin C; and Zinc.
Build Muscle: Exercise is very important, but if there's any particular type of exercise I feel can't be left out from your life, it's muscle building. Muscle burns calories and raises metabolism, and even lifting simple hand weights, or doing weight-bearing yoga/Pilates, can help in your weight loss efforts by building fat-burning muscle.
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The Thyroid Diet discusses at these various dietary and lifestyle approaches at length, along with the rationales behind them. You'll get information on how to implement them, along with many other diet and exercise recommendations. Various food plans and menus help you customize the diet to fit your particular needs, your style, and your metabolism. And terrific, custom-developed recipes make it easy to incorporate delicious, healthy foods into diet.
Mary Shomon is a patient advocate and author of a number of best-selling books about health, including Living Well With Hypothyroidism, Living Well With Autoimmune Disease, and her newest book, The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss. Mary also publishes newsletters on thyroid disease, metabolism and autoimmune conditions. For more information, see
http://www.thyroid-info.com ,
http://www.goodmetabolism.com , and
http://thyroid.about.com . BUY Mary’s book @
www.thyroidfoundation.org http://thyroidfoundation.org/thyroidusajanfebmar.html 
The Thyroid - Weight Loss Connection 
