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Impaired thyroid function making you fat? Find another excuse

A common contributor to weight gain is hypothyroidism (impaired thyroid function), which occurs when the thyroid gland fails to secrete sufficient thyroid hormones into the bloodstream.

The thyroid gland is a butterfly-shaped gland located on the front of your throat, just under your larynx (the Adam's apple) and extending over either side of your windpipe. It produces the thyroid hormones T3 (otherwise known as triiodothyronine or 3,3',5-triiodothyronine) and the less active hormone from which it is derived, T4 (otherwise known as thyroxine or 3,5,3',5'-tetraiodothyronine).

Thyroid hormones act on almost every cell in the body to regulate several functions, notably metabolic rate. In fact, if you didn't have any thyroid hormones in your system, your basal metabolic rate would drop by about thirty percent.

In about six to twenty five percent of adults, particularly older women, the thyroid gland ceases to produce sufficient thyroid hormones and the result is hypothyroidism. In developed countries, this is most commonly due to the autoimmune disease Hashimoto's Thyroiditis, where the body produces antibodies and white blood cells that attack and gradually destroy the thyroid gland. Other causes of hypothyroidism include iodine deficiency - now disturbingly common in Australia, the United States, Europe and other developed countries - as well as dysfunction in parts of the pituitary gland or hypothalamus that control the thyroid gland.

Symptoms of hypothyroidism may include fatigue, depression, cold intolerance, hair loss, constipation, difficulties with concentration and unexplained weight gain. Thankfully, doctors can easily treat hypothyroidism with thyroxine tablets, which are a form of hormone replacement, or iodine supplementation if the hypothyroidism is caused by iodine deficiency.

Many people assume that a drop in metabolic rate due to the onset of hypothyroidism and prior to the commencement of treatment will naturally result in large weight gains. That is not the case, however, because not everyone who's newly diagnosed with hypothyroidism has gained a lot of weight. Part of the reason for this may be that while low thyroid function is known to cause a drop in metabolic rate, research suggests that it also causes a drop in appetite.

Could it be that the people who don't gain excess weight as their thyroid gland expires are those that are so in tune with their bodies that they actually eat less when their appetite decreases? More research is needed, but I'm inclined to believe that this may be the case. I've personally seen the effects - or lack thereof - of a deteriorating thyroid gland on body weight in people who've used a Success Diary and learned how to eat only when hungry.

One such example is forty-four year old Raylene, who I introduced in July 2008 as the woman who started losing weight when she stopped eating six small meals or snacks per day as her local gym had recommended and instead started eating according to what her body told her. Raylene has since lost all the weight she wanted to lose and has kept it off for over a year...despite the fact that she was diagnosed with hypothyroidism in that time.

When I first met Raylene via e-mail she was so bright and bubbly. Every few weeks she'd write and tell me about her weight loss adventure, as well as certain aspects of her life. She was working full-time as a receptionist in a busy medical practice while training to qualify as a health councilor.

But after several months, the tone of Raylene's e-mails began to change. Things at work seemed to bother her more than before, so much so that her frustration made its way into her normally chipper e-mails. Raylene counted down the days until her holiday in a Fijian resort with her husband, but when she got back from the long-awaited trip she seemed even more worn down than ever.

"I am suffering badly from post holiday blues", she wrote. "I can not get going at all, it is terrible!!!!!! I am sooooo glad I booked the rest of the week off as there is no way I would have done anything at all productive. We are already looking at where we can go next year, terrible, huh??? We have to have something to look forward to or we will go mad".

As it turns out, the cause of Raylene's fatigue and disgruntlement had been hypothyroidism, which her doctor diagnosed with a blood test when she told him she'd been feeling unusually tired. Raylene's doctor told her that unexplained weight gain was another common symptom of hypothyroidism, but Raylene was unscathed by that one. Sure, during her holidays she'd gained a kilo, but this was readily explained by ten days of resort food.

"The food was just heaven, especially the breakfasts, so much fresh fruit and all sorts, and I ate heaps of lovely Indian food!!!" she told me in an e-mail. Moreover, within three weeks of returning from holidays the extra kilo was gone.

Of course, this didn't all just happen as if by magic. Raylene was scrupulous about making healthy food choices, about eating only when hungry, and about being active.

"I did eat a big breakfast every day at the resort, but then I rarely needed to eat anything until dinner time, so my intake was really not too bad overall, and we were active playing golf and walking all the time we were away. Now that we are back, my appetite is very low I must admit. I really don't feel like eating much, showing that my fat brake is working (it would have been working overtime on holiday!!). We have been eating a lot of salads and Greek salads since we have been back as that is what I have felt like eating", she wrote.

So, if you're not feeling a hundred percent and you've got symptoms of hypothyroidism as described above, you may like to ask your doctor to check your thyroid function.

If you do happen to have hypothyroidism, keeping a Success Diary until you feel confident about eating only when hungry could mean the difference between being one of the people who gain ten or more kilos when their thyroid gland gives up the ghost, and being one of the 'lucky' people like Raylene who successfully manage their weight.

Additionally, the sooner your hypothyroidism is diagnosed and the sooner you commence an appropriate, medically supervised treatment, the less likely you are to gain disturbing amounts of weight.

And once your condition is under treatment that's regularly monitored by your doctor, there's absolutely no reason why you can't manage your weight fruitfully.

Many of my clients have told me that they gained excess weight around the time leading up to the diagnosis of hypothyroidism, but that hasn't stopped them from losing the surplus once they started using a Success Diary and eating according to their physical needs.

One such example is Jocelyn, who lost 8 centimeters off her waist over the course of a year - including some ups and downs with several overseas trips - to reach her target size twelve. This is despite the fact that Hashimoto's Thyroiditis means she'll need to take thyroxine tablets for the rest of her life.

Over to you

Here's something you can do immediately to put these ideas into action.

If you struggle with excess weight and you're not entirely sure how it got there, it's worth talking with your doctor about whether any underlying medical conditions - such as hypothyroidism - could be contributing to the problem.

Remember, symptoms of hypothyroidism to look out for include fatigue, depression, cold intolerance, hair loss, constipation, difficulties with concentration and unexplained weight gain.

Many people - myself included - feel reluctant to go to the doctor unless there's something obviously wrong with them. However, regular medical check-ups are important because they enable you to uncover any medical conditions in their early stages when treatment is often more effective.

And if you do happen to have hypothyroidism, early diagnosis and treatment will make it easier for you to maintain your weight, or at least prevent depressingly large weight gains.

If you've already gained weight because of hypothyroidism, please don't buy into the myth that it will prevent you from losing it again because it won't. The trick is to get appropriate and medically supervised treatment, and to listen to your body and make sure you're eating only when you feel comfortably and physically hungry and only until you've had enough, no more and no less. Your Success Diary is the key to learning how to do this.

So, what are your experiences of managing your weight despite hypothyroidism? If you'd like to let me know, click 'reply' and send me a note. It always makes my day to hear from readers, and I look forward to hearing from you, too.

Sincerely,

Amanda

Dr Amanda
Connect with your body
www.DrAmandaOnline.com

What our readers say...

"Dear Amanda, Well my goodness! I came across your website somewhere in the vastness of the internet and instantly identified with the way you presented your message. The only place in NZ I could locate a copy of your book was Nelson, so I waited patiently (not my strongest skill!) until Christmas when I knew I'd be joining my family there, and the first opportunity I got I bolted for Blackmores bookstore and grabbed a copy. I didn't get a chance to read it over Christmas but as soon as I got home to Wellington I opened it up and just couldn't put it down. To give you a bit of background about me, I'm 172cm & 63 kg. Not overweight really, although definitely carrying too much for my very slender bones and carrying it on my tummy & hips at that. Two years ago I joined a gym and followed their weight-loss programme. Portion control. Carb restriction. Protein increase. No more than 2 serves of fruit per day. I white-knuckled my way through the 12 week programme, and while I had more muscle at the end, I had almost as much body fat & in exactly the same places as when I started. On the outside, I looked just the same & my clothes didn't fit any differently. Grr! I don't even like sweet things all that much, but I tell you, when I couldn't have them what do you think I craved every day? That's right. By this time I was pretty upset. I'd been raised to think of food as a blessing, and here it looked like I was going to have to battle with it every day for the rest of my life. That particularly sucked, because there is nothing I would rather do than spend an afternoon with dear friends, laughing & eating a leisurely lunch I've prepared with love for us all. It is one of the true joys of my life. I started to wonder what the hell to do. I felt stuck. It depressed me to think of it. Life without delicious food is not life, it is existence and a poor one at that. It would not be overstating the case to say your book has been the ray of light I need. Recently I started questioning the people I grew up with who still eat the way they did when I was a child. I don't know if you spent any time in NZ in the '70s or '80s but there were a LOT of hippies around & not a single fat one among them and those who still eat that way are all still slender. Anyway, I've been asking them what they eat & why, and their answers are identical to those given in your book. It is just the best feeling of relief to have my fledgling theories confirmed by your science. In all this rambling, I guess what I'm trying to say is thank you. Thank you very much. To be able to make these lunches for my friends & know that I'm doing a good thing, to be able to eat the food I enjoy in the quantities that feel right - well, it's freedom of the best kind. Bless you Amanda, I needed this. Warmest regards, L.B. P.S. I've recommended your book to the Oprah producers - probably should have asked you first so I hope that's OK with you! I don't know if they've covered it already but I suspect I would have heard if they had. If ever there was a country that needed your book it’s the USA! P.P.S. I have just experienced my first Famine Reaction, and it felt great! I could just feel my body saying wow, thanks! It lasted from Thursday morning until Saturday afternoon, when my body realised it didn't actually need any dinner because it was totally reassured that everything was fine. How utterly lovely to be giving myself what I need in such a satisfying and delicious way. I'll be back in Nelson in a fortnight and will be buying another copy of your book. I've been raving - evangelizing even - to my friends about it but I can't bear to lend it out because I'm using the recipes every day, as well as dipping into it for inspiration. But I do so want my friends to be able to read it that I've decided the best thing to do is have a 'me' copy and a 'friends' copy. "

- L.B., Wellington, New Zealand