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Thyroid and weight struggles. For so many women, these issues are two sides of the same coin.
Even in our niche, specialized natural fertility practice, we hear about this concern on a daily basis.
It is wonderful to see women becoming self-educated and being empowered to ask for comprehensive thyroid testing as a part of their fertility evaluation. We have women coming into our office reporting common thyroid symptom patterns and saying they just want to know for sure whether their thyroid function is healthy. Often, after discussing their fertility issues, the next major concern is their weight.
One of our patients, Ellen*, came in explaining that she was really on top of her nutrition, eating 5-6 servings of fruits and veggies every day and cutting out almost all sugar from her diet. Even though she was exhausted, she was still making it to the gym at least four times a week, but her weight had not budged at all. She was so frustrated. Her struggles with her weight felt like the last straw given that she was already coping with infertility. Her OBGYN had tested her TSH and told her it was normal. When we looked at Ellen’s test results, we saw the TSH was a 3.6 and her free T4 was at 0.8. We didn’t have a free T3 level or Thyroglobulin or Thyroid Peroxidase levels to review, but we could tell based just on her TSH that her thyroid wasn’t optimized. So, for us as her Naturopathic Physicians, it wasn’t at all surprising that she was struggling with her weight (and her fertility).
When your body doesn’t make enough thyroid hormone (and “enough” is different from person to person), your cells don’t get clear signals on how much energy to make. Your cells don’t use their nutrients efficiently, increasing metabolic waste products. Basically, your cells go into low power mode. When you restrict calories and increase physical activity while your cells are in low power mode, your body reduces T3 production even more. That common refrain of “calories in vs calories out” just doesn’t work for women with thyroid problems. No wonder Ellen was so frustrated!
A quick PubMed search found 3 interesting studies discussing the relationship between thyroid and body weight.
Study #1 from 2017 showed that people with higher baseline levels of free T3 and free T4 (when TSH was between 0.1-4.5) would have more weight loss in 6 months with just nutritional changes.1
Study #2 proposes that using thyroid replacement medication for patients who are getting bariatric surgery might help them lose even more weight.2
Study #3 from 2014 “showed that no significant weight change occurs after initiation of LT4 treatment.”3
When we look at these studies together, we see a pattern that shows how important it is to look at the whole thyroid picture, thyroid issues absolutely can affect weight loss and that the cookie cutter approach for prescribing T4-only testing may not be comprehensive enough to help women who have weight problems due to hypothyroidism.
Do you think you might have a thyroid problem causing your weight issues?
Step 1: Stop beating yourself up about your challenges with weight loss.
Step 2: Ask your doctor for a full thyroid panel and if necessary, get your thyroid treated
Step 3: Once your thyroid panel is optimized, expect to see some weight loss occur within a few weeks
Step 4: Change your diet by increasing your veggies and fiber intake
Step 5: Have your thyroid checked again 6-8 weeks later to be sure it has stayed in the optimal range
It’s so important to work with a doctor who listens to you when you tell your story. A doctor who believes you when you say you’ve been eating well and exercising regularly but your weight still isn’t responding. Critically, a doctor who will do all the appropriate testing so you can know if your thyroid is the culprit with your weight issues.
If you are looking for a collaborative, caring relationship with your doctor, schedule a call with us so we can discuss how to get you all the information you need to understand your body and optimize your weight.
Are you ready to kickoff your fertility journey?
Liu G, Liang L, Bray GA, et al. Thyroid hormones and changes in body weight and metabolic parameters in response to weight loss diets: the POUNDS LOST trial. Int J Obes 2005. 2017;41(6):878-886. doi:10.1038/ijo.2017.28
Preoperative thyroid function and weight loss after bariatric surgery. - PubMed - NCBI. https://www.ncbi.nlm.nih.gov/pubmed/29769703. Accessed April 16, 2019.
Lee SY, Braverman LE, Pearce EN. Changes in body weight after treatment of primary hypothyroidism with levothyroxine. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol. 2014;20(11):1122-1128. doi:10.4158/EP14072.OR