Can I Blame my Weight on my Thyroid?

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Question:

I have heard that a low thyroid can make it hard to lose weight. How do I test for thyroid status and what are the treatments and natural options to make sure it’s functioning properly?

From Wendy Bazilian, DrPH, RD:
Approximately 27 million Americans have some form of thyroid disease and half of those don’t even know it. This has led some health experts to call it a hidden epidemic since it is so common and yet so under-diagnosed. There are a variety of disorders from overactive thyroid (hyperthyroidism) to growths (swollen nodules, goiters and cancer) to an under-functioning thyroid (hypothyroidism). This last, hypothyroidism, is what many women are quick to blame indiscriminately almost even hope for as their underlying cause when they struggle to lose weight.

But hold on: before you completely blame your thyroid for your sluggish metabolism, there are some important considerations so you can get the facts, have the tests, and maximize your health thyroid issue or not. Getting tested is important.

Testing for thyroid function. Melina Jampolis MD, a physician nutrition specialist and the diet and fitness expert for CNNHealth.com, explained that, “after getting a full medical, weight and family history and assessing symptoms, I do a careful diet analysis and order a full blood panel. I test all my patients for thyroid function including not only thyroid-stimulating hormone (TSH) but other more specific tests as well.”

But be aware that not all doctors do what Jampolis does. In fact, many doctors still just use the TSH test and rely on older ranges for healthy or abnormal. Those who are more current like Jampolis also look at free T4, free T3 and thyroid antibodies (thyroid peroxidase and antithyroglobulin) for a more comprehensive picture. Be sure to ask about these and other markers when you visit your doctor.

Basic symptoms of hypothyroid.

While the chief symptoms reported by patients include unexplained weight gain, fatigue, increased sensitivity to cold and dry skin, Jampolis is quick to point out that “constipation, heart function abnormalities like high cholesterol, heavier than normal menstrual cycles, and hair loss are also common.” Other symptoms can include muscle weakness, water retention and puffiness in the hands, feet and face, a hoarse voice, and mood swings and depression.

In or out of range.

TSH is still the first number of consideration and the one upon which hypothyroid function is first assessed for diagnosis. The American College of Endocrinology issued newer guidelines indicating that a TSH level over 3.0 indicated primary hypothyroidism.

The target (healthy) TSH level should be between 0.3 and 3.0.

Some doctors still use earlier, more outdated benchmarks and won’t treat for hypothyroid below 5.0 or even higher, so it’s important that you are informed and ask questions when you have your levels tested.

Treatment for hypothyroid.

While a more aggressive lifestyle approach and healthy habits are essential to help counter the symptoms and effects like weight gain and to feel your best, Jampolis noted, without pause, that medications are really the best and only route for dealing with a sluggish thyroid. She reported that there really isn’t a way beside medication to boost an under-functioning thyroid.

This said, there are options including a natural thyroid medication made from pig thyroids called Armour Thyroid (sorry vegetarians, there are no vegetarian natural forms available). “I actually use Armour Thyroid quite a bit as I find that my patients feel much better on it, although I haven’t necessarily seen it work any better for weight loss,” shares Jampolis.

The most common artificial thyroid hormone medications include Synthroid, Levoxyl, Levothyroid and Unithroid. Fortunately, the side effect profiles for these drugs are low.

Other issues to consider.

The function of your thyroid is tied to other factors including food allergies, vitamin and mineral deficiencies like vitamins A and D, as well as selenium, zinc, and also the omega-3 fats. And there’s an association between stress and thyroid function, as well, making this a particularly tricky issue in our often busy and stressful lives today. The higher or more regular the stress, the worse the thyroid tends to function.

And since hypothyroid has been linked to increased mental health issues, menstrual cycle abnormalities, liver cancer, kidney disease, among other issues, making sure to get screened and treated if necessary is essential. Hypothyroidism is also a significant risk factor for heart attacks, so knowing where you stand is clearly a bigger issue than the also real, but perhaps less life-threatening aggravation of weight gain where the concern usually starts.

So, can I blame my thyroid?

Jampolis shared that in her medical office many women do actually come in ‘hoping’ to find they have a sluggish thyroid as a way to “find an easy answer” and thus an easy solution to their weight struggles. And when true hypothyroidism is treated, many of her patients often describe the improvement like “waking from a fog.”

But sometimes the thyroid simply turns out to be healthy. (And this, of course, is really what we want). As much as we may want to blame our failed attempts at weight loss on this little butterfly shaped organ, at times we have to face the music and turn back to good old fashioned portion-control, exercise and hard work. One of my own clients in my nutrition clinic summed it up this way, “before I really gave myself a fair shot at losing weight through how I ate and moved, I would’ve bet my mortgage it was my thyroid.” Thirty-plus pounds later and pages and pages of food diaries accounting her diet and exercise to prove it, she was happy she discovered she didn’t have a health condition like hypothyroidism to manage, but instead a true picture of her personal health and what it takes.

So the lesson: Let the thyroid be a guide test it, don’t ignore it and let the results either way inform your personal goals to maximize your healthy lifestyle.

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Wendy Bazilian, DrPH, MA, RD

Wendy Bazilian is a doctor of public health, registered dietitian, American College of Sports Medicine certified Exercise Physiologist and freelance writer in San Diego. She is an expert advisor to the spa industry and co-owns Bazilian’s Health Clinic with her husband and business partner, Dr. Jason Bazilian. Dr. Wendy is co-author of Eat Clean, Stay Lean (Rodale, 2015) and author of The SuperFoodsRx Diet (Rodale). Find her onFacebook and Twitter

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