HORMONES: THE MISSING LINK TO WEIGHT MANAGEMENT

We all know that an appropriate weight is critical for overall health. Despite that, achieving a healthy weight can be extremely difficult (having successfully worked with the HCG diet for a number of years), secondary to various eating disorders, some genetics, lifestyle and hormonal imbalance. What most folks don't know is that an undetected hormone imbalance (I test for this with a Saliva Test with results back in a week) can be a deterrent and a contributor to unhealthy weight. Women with a hidden (sex) hormone imbalance frequently find that they can't lose weight as easily as they used to or they now have immovable belly fat they never had before. This can occur at any age although primarily during perimenopause and menopause when the progesterone to estrogen ratio gets out of balance resulting in "estrogen dominance." In men, as testosterone and dhea levels go down, it is not unusual to see men with belly fat and "breasts" due to the conversion of testosterone to estrogen. Related imbalances of cortisol (adrenals) and insulin in both sexes can impair thyroid function and raise risks for metabolic syndrome and diabetes. The following are endocrine/hormone imbalances that impact weight:

Estrogen (estrogen dominance)/progesterone: Weight gain in hips and thighs, water retention, low thyroid, sluggish metabolism

Testosterone/DHEA: decreased lean muscle with increased body fat, decreased metabolic rate and abdominal obesity.

Cortisol (adrenals and sensitive to physical and emotional stress also tested through saliva along with the sex hormones). belly fat, increased appetite, sugar cravings, impaired thyroid metabolism.

Vitamin D3 deficiency (extremely common and one of the things I test for via blood work): Hyper insulinemia, belly (visceral-around organs) fat storage.

TSH elevated (suggests hypothyroidism-see thyroid blog): hypothyroidism, low metabolic rate, difficulty losing weight, obesity

Fasting insulin elevated: insulin resistance, abdominal obesity

The Saliva Test is easy and results are quick - call me to order kit

Your Thyroid

The thyroid gland plays a major role in the metabolism (converting food to energy), growth and development of the human body and is part of the endocrine system that includes sex hormones, growth hormone and the adrenals (ACTH). Many books, articles, etc have been written about the thyroid and can be very confusing and intimidating in its complexity however, let me see if I can simplify it a bit. 2 structures in the brain, the hypothalamus, determine if you need more thyroid hormone, (T4 and T3) and sends a message to the pituitary to release TSH (thyroid stimulating hormone) which tells the thyroid to make more T4 and T3, the 2 primary thyroid hormones. For the thyroid to make the hormones the body needs Iodine (T4 has 4 iodines etc.) and historically we would get the iodine from our diet however, if you think about it where do we get iodine from? Unless we eat a lot of kelp and iodized salt or take a supplement we all tend to be iodine deficient. Before I even consider putting a client on thyroid hormones I always try a thyroid supplement that includes iodine, zinc and selenium all critical for adequate thyroid function (ThyroMedica Plus is the supplement I use).. The thyroid makes a lot more T4 than T3 as T4 is much weaker than T3 but ultimately T4 is converted to T3. Important to note here, that T3 is what actually gets into the cells and impacts metabolism, etc, however theres is some evidence that T4 may also stimulate receptors making it a hormone versus a prohormone and there may be some value in adding T4 to a T3 protocol. T4 also converts to reverse T3. Reverse T3 has a very interesting role. When within normal limits, it stays behind the scenes, but when the body has been exposed to extreme physical or emotional stress T4 makes a lot of reverse T3 which then competes with T3 at the cellular level thus minimizing the metabolic effects of T3 giving the body an opportunity to slow down.

There are a number of common problems associated with a thyroid that is not functioning properly and include, hyperthyroidism (too much thyroid and may present as anxiety, irritability, hyperactivity and hand trembling), hypothyroidism (too little and may present as insomnia, hair loss, fatigue and tiredness, depression, difficulty concentrating, muscle pain, dry skin, cracking nails etc.) and Hashimoto's and Graves disease. These are autoimmune diseases where antibodies attack the thyroid. Hashimoto's, in particular, has become very common, as I see it in a lot of my clients. It can be easily detected by testing for thyroid peroxidase antibodies and anti-thyroglobulin antibodies (must test for both as one may be normal and the other positive). So what causes this autoimmunity. For the most part, in my experience, there appears to be 2 main causes. The primary cause is associated with gluten (the gut) and going gluten free ( has a number of other benefits as well, but another story) for a period of at least 3 months seems to decrease the number of antibodies. I have also found that viruses, in particular, Epstein Barr (EBV) has been shown to be a cause of autoimmune disease in general and associated with Hashimoto's. So how do we treat these various thyroid related problems?

As I mentioned, with the exception of Hashimoto's and Graves, I prefer to start with the above mentioned supplement that frequently will normalize thyroid markers. If I am treating Hashimoto's (Graves/hyperthyroidism is another story) I use something called low dose naltrexone (LDN) which addresses the EBV as well as the autoimmunity. There are a number of ways to treat hypothyroidism (here again can get pretty complex/confusing). Endocrinologists and other primary care clinicians tend to use just T4. More commonly, a glandular is used. A glandular is extracted from animals (porcine in most cases) and contains everything found in a thyroid gland, i.e. T4, T3, T2, reverse T3, etc. The clinician usually starts out with somewhat of an arbitrary dose to see how the patient responds. I prefer to start out with a low dose and allow the patient/client to titrate (slowly go up in dose) until they feel the benefit). If there is an elevated reverse T3, I will just use T3 and titreat in the same manner however some folks "seem to feel better" with some T4 thus supporting the idea of a T4 receptor.. When monitoring, there are certain labs that I focus on using "functional medicine" ranges but more importantly, labs are secondary to how you feel. Unfortunately, folks are dosed based on labs not symptoms, or lack of.

Your Genetics

Functional medicine, as you have seen or heard, encompasses pretty much everything pertaining to a person's physical and emotional wellbeing. We do a lot of testing (blood, urine, stool, hair etc.) and interviewing, focusing on time lines and cause and effect. The one area that is frequently overlooked, and an area that I feel is imperative, is a person's genetics. Our genetic profile is literally an umbrella that helps to define what may be going on with us both physically and emotionally. The recent interest in genetics has resulted in new genetic terminology. So, we have pharmacogenetics which is looking at how our genetics determines how we metabolize drugs, metabolic genomics which looks how our metabolism works, genetics specific to our ability to handle toxins etc. and of course genealogy. The one term that mandates a more comprehensive explanation is the term epigenetics. Epigenetics has been around for as long as we have. It has played a very crucial role in our evolution (or our need to balance, also known as homeostasis) as a species, and all species for that matter. In the grand scheme of things it has allowed us to adapt to environmental extremes, i.e. temperate weather to ice ages. We have assumed that we are born with a phenotype (how we look) understanding that does not change much, and a genotype which really does not change much. Turns out that epigenetics is a contributor to many of our modern day emotional and physical pathologies. Here is how it works: When we are exposed to processed food, Round Up, organic solvents, pesticides, gluten GMO foods, phytoestrogens (list goes on and on and on) epigenetics changes how our genes present/express themselves (does not change the structure of the chromosomes (23). Unfortunately, for the most part, this becomes permanent and our kids (just like the couple of generations prior to us), get to inherit the "mutations" (if only one from a parent-heterozygous) or both (homozygous: thanks mom and dad!). I do a lot of genetics testing using "23 and me" and another website called methylsupport.com, getting back about 60 pages of potential homozygous mutations, addressing numerous areas including our ability to detox, methylation, neurotransmitters, cognitive function, eye health, immunology, thyroid and others. What is appalling, is the trends. Everyone has an impaired ability to detox, our immune systems are compromised, our neurotransmitters are a disaster, etc. I found a website that gives me population percentages for a particular mutation (SNP). One of them (cyp1b1) is present in 100% of the population and sets us up for breast cancer (men and women). Recently, I read that by the year 2050 around 60% of the kids born are going to have some form of autism (supported by the genetics I am seeing). If you are interested in finding out about your genetics, I have you send off for the "23 and me" kit with health. When it comes back, I send you the instructions for getting into mthfrsupport. It comes back as a pdf which you then forward to me. Both websites cost around 230.00 and my fee is 150.00 to review and put together a report that we go over.