Why You Can't Lose Weight with Hashimoto's with Dr. Deb Matthew MD
In this episode, Dr. Deb Matthew discusses the reasons for not being able to lose weight with Hashimoto’s and how to correct it.
Dr. Deb Matthew MD is America's Happy Hormones Doctor, best-selling author, international speaker, educator, wife, and mom of four boys. After suffering for years with fatigue and irritability due to hormonal imbalances, her quest to resolve her personal health led her to change everything about her practice of medicine.
Watch the full episode here...
Below are the conversation between Dr. Anshul Gupta and Dr. Deb Matthew where they discuss in detail about Hashimoto's, Weight loss and much more.
Hi Deb, we would like to hear your story and your personal experience with Hashimoto’s. Can you share it with us here?
Back in high school, I was somebody who needed like 10 hours of sleep just to function like a normal human being. Then while at medical school, some of the doctors looked at my neck and said my thyroid seemed enlarged and I must check it. I did blood tests which came out normal and I just carried on. It wasn't until after I finished my residency I used to be tired and cold all the time. I used to carry sweaters everywhere - theatres, grocery stores, restaurants, almost all places.
Later, after I finished my residency and started my family, I wasn't able to get pregnant and I went back in for tests. This time they did a thyroid panel again and I found out that, in fact, I was hypothyroid. Luckily, I have a forward-thinking doctor who also tested me for Hashimoto’s for which I was positive.
Then, I went on the thyroid pills and had four babies too. So, obviously, it did something but all those years I still was exhausted and cold all the time. I had dry skin, and dull hair and couldn't lose weight no matter how hard I tried
The worst part is I didn’t even realize there could be more because my TSH was normal as it was taught at medical school.
In my late 30s, I started to get really anxious - I would wake up in the middle of the night with panic attacks for no reason, and I would fly off the handle of my kids way too often and would then feel like the worst mom ever.
I felt something is not normal in me and none of my medical studies helped me understand why. Then, when I read a book about women's hormones written by Suzanne Summers, it changed my perspective completely. As a medical professional, I know we don’t get medical information from celebrities but the book had stories about women who were just like me and how much better they felt once they got their hormones in balance.
There I learned there are other things that we can do for the thyroid besides just taking a pill so once my mind was opened I came to know about different medical approaches where we can take care of the root cause instead of putting a band-aid over symptoms.
And with this alternative approach, I got my energy back, my kids got their mom back, my husband got his wife back and I got my life back.
Then, I retired from my old practice and now, for the last 15 years I've been helping men and women get their hormones back in balance so they can get their life back
I'm sure a lot of the people who are listening over here can relate to your story. The good part about telling our stories is that now people can relate that they are not the only ones who are suffering.
A lot of thyroid patients, especially, Hashimoto’s patients struggle with losing weight, no matter how hard they try. Can you share what may be the underlying reason for this resistant weight in Hashimoto’s patients?
The thyroid hormone is so important for weight loss. It sets our metabolic rate and tells our body how many calories to burn - like a thermostat. So, if your internal thermostat is set too low then your metabolism slows down and every cell in your body will generate less energy.
Hence, if thyroid hormone is not optimal, you're just not burning as many calories as you normally would. So, sometimes, even if you try various weight loss methods, it would be in vain.
In such cases, it is not just TSH that will determine the proper functioning of your thyroid, but also the thyroid hormones that must do their job properly. The thyroid hormone is really important for telling your body to burn fat for fuel. If this does not happen properly, your body will store this as carbohydrates in your muscles, as glycogen in your liver. Eventually, if you go out and start walking or whatever you do, your body will start to use up the stored glycogen as it is the earliest source of energy.
Again, once it's used up your body will switch over and start to burn fat for fuel. But sometimes, you can't burn fat for fuel effectively because you don't have enough functional thyroid hormones in your system. You burn off the glycogen, get tired, stop, then again you eat something, and store more glycogen to replace your stores. When this happens in a loop, you end up never touching that roll on your belly which may be the reason for your excess weight.
We see in most patients that even after taking external thyroid medications or hormones, they are not able to lose weight. Why is it so?
In such cases, even external thyroid hormones, mostly synthetic forms of T4, alone won’t work.
T4 is one main hormone that gets converted to T3 in your cells which actually activates your cells and tells your body to generate more energy and burn more calories and burn fat for fuel.
So, conventional doctors mostly assume when the right amount of T4 is given other steps will become normal.
However, a lot of women are not able to activate this T4 to T3. So, the pills just make their TSH and T4 level look normal but your symptoms may not go away.
So, instead of just changing your thyroid medication dosage, it is important to figure out the root cause.
Getting deeper into it, can you talk about why T4 to T3 conversion might not be happening in Hashimoto's?
The main reason for most is estrogen dominance. Progesterone (the calming hormone that regulates period, and helps prevent PMS symptoms) and estrogen are the two that go up and down over the menstrual cycle. So, in women over 35, the female hormones are shifting as they move towards menopause. While, at this stage, estrogen level may be mostly normal, the progesterone level goes down causing more anxiousness and irritable behavior.
This can cause heavier periods, and more PMS, and eventually a lot of women in their 40s end up having things like hysterectomies.
This estrogen dominance, by itself, may cause weight gain issues, especially in the hips, thighs, and butt. This also interferes with the proper functioning of thyroid hormones, be they natural or external ones.
Another common reason for the dysfunctioning thyroid is cortisol problems. Cortisol is your main stress hormone that goes up when we are stressed and helps us cope with it. However, when the stress is always high, then cortisol levels become chronically elevated. It, eventually, shuts down that conversion of t4 to active t3.
So, stress is a really big cause for thyroid hormones in your system to not work well even if you're already taking a thyroid pill.
Another reason is our gut microbiome like the probiotics that is really important for processing our thyroid hormones. So if you don't have the healthy probiotics living in your digestive tract you may not be converting your t4 into t3 and activating it the way that you should. and a clue is
Vitamin and mineral deficiencies are also important to activate that thyroid hormone. Zinc and selenium are the most important of these.
Wonderful, most people don’t know the various connections between these things and thyroid problems. So, now what is the stepwise process that you go through while evaluating your patients?
I, usually, give them a few options where we can go by symptom or get full testing before that. We usually do tests like:
- Full thyroid panel
- T4 to t3 conversion
- Antibody levels
- Reverse t3 levels
- Female hormone levels
- Cortisol levels
We go step by step where we will address other things like
- Gut health
- Hormone balance
- Lifestyle habits
Once lab work is done, we take a comprehensive look at all these factors and analyze the root cause. Then, we start with a lifestyle program, diet plans, and other personalized treatment plans.
Great, now can you share what people can do to improve the t4 to t3 conversion?
One thing is to reduce stress because stress is a huge cause of hormone imbalances for women. While the cortisol level rise blocks t4 to t3 conversion, it is also crucial to regulate your immune system. Since Hashimoto's disease is an autoimmune condition, your immune system and inflammation are part of the problem here. So balancing out cortisol by reducing stress can be helpful on all of those fronts.
Some simple tips to reduce stress include:
- Deep breathing
- Proper sleeping
Another thing is to improve gut health. Most of our immune system lives right along the lining of our digestive tract. So, gut health is so important to immune system health and autoimmunity. For a healthy gut, you may need to
- Take whole foods
- Avoid packaged foods with chemicals, preservatives, artificial sweeteners, etc…
- Reduce starchy carbohydrates which may increase inflammation
- Take lots of fruits and vegetables as they provide vitamins and minerals
- Include nuts
- Focus on eating the foods the right way. Slow down and chew our food properly for proper digestion.
- Try intermittent fasting as it can give your metabolism a little boost
- Do regular exercises mainly resistance exercises
- Include cruciferous vegetables
Please share some things about the supplements that can boost the metabolism and improve the conversion
There is no magic pill to boost metabolism overnight, but when taken with proper lifestyle changes certain supplements can aid your body get better. They include:
- Omega-3 as a fish oil supplement
- Vitamin D
Now that we have covered things that could affect weight loss, can we touch briefly on the toxins that affect hormonal balance?
We are regularly exposed to a lot of toxins in the environment and most of them are hormone disruptors so they muck up how our hormones work. The two of the first hormones that get into trouble are thyroid and cortisol.
Eventually, cortisol makes us gain belly fat and the thyroid makes us gain weight everywhere. So, most of these chemicals are what we call obesogens which means they make us gain weight. Another problem is when you get more chemicals that are fat soluble in your body they get stored in your fat cells which may build up and mess up your thyroid function further.
Flushing toxins out of your system can help your hormones work better so that you can successfully lose weight.
There are many toxins including heavy metals, molds, plastics, etc…
Here are a few simple tips to minimize our exposure to toxins.
- Swap the plastic in their kitchen for a glass
- Don't ever microwave in plastic because that pulls the toxins from the plastic into your food so there are some simple things that we
With all these said, it is important that you understand the root cause of your problem and then get treated for your problem. A functional medicine doctor can help you on this front by diagnosing your problems properly, identifying exactly where your problem is, and treating it accordingly.
Great to have learned so much from you today. Do you have any other tips or things that you have for people to share over here?
It is you who need to take responsibility for your own health. You can't wait for your doctor to fix you or to give you the magic pill. So all of us can take some small steps and start living a healthier lifestyle
About Dr. Deb Matthew MD
Dr. Deb Matthew MD, America's Happy Hormones Doctor, is a best-selling author, international speaker, educator, wife, and mom of four boys. After suffering for years with fatigue and irritability due to hormone imbalances, her quest to resolve her personal health led her to change everything about her practice of medicine. She has been featured on national podcasts, radio, and broadcast shows, including NBC, ABC, CBS, and FOX.
Website - https://drdeborahmatthew.com/
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