Health Chats
Weight Gain and Diabetes: Is Your Thyroid To Blame?
Wednesday Jun 29, 2011, 01:00PM - 02:00PM (EST)
Medical Director and CEO
Holtorf Medical Group and National Academy of Hypothyroidism
, Torrance, CA
You have tried everything to lose weight. You’ve tried the latest and greatest diet or fat-melting workout. You may even have tried prescription medication but you are now heavier than ever. Have you thought your thyroid is to blame? Every test you take and every doctor you see says you are in the normal range. Is type 2 diabetes looming? Weight gain is just one of a long list of symptoms that can be attributed to an underactive thyroid. Have you had other problems such as fatigue, brain fog, difficulty concentrating, depressed moods, muscle pain, elevated cholesterol, cold sensitivity, hair loss, or chronic infections just to name a few?<br><br> Learn how you can get the diagnosis and treatment you need to get back to the way you used to look and feel. Dr. Holtorf will answer your questions and share valuable information concerning your health. Kent Holtorf, M.D. will answer your questions about Diabetes, Hypothyroid or other Endocrine questions, on June 29, 2011 from 10am – 11am (Pacific Time). <br><br> Kent Holtorf, M.D. is founder and medical director of the Holtorf Medical Group. For well over a decade he has specialized in innovative evidence-based therapies for hard-to-treat and poorly understood illnesses: hypothyroidism, complex endocrine dysfunction, chronic fatigue syndrome, fibromyalgia and chronic infectious diseases including Lyme disease and chronic viral illness. For years he has scoured the medical literature for innovative therapies to help patients and has passionately trained physicians across the country. Dr. Holtorf is dedicated to empowering patients with knowledge and encourages patients to take an active role in their health-care. He founded the non-profit National Academy of Hypothyroidism, which provides physicians and patients with the most up-to-date information on the diagnosis and treatment of hypothyroidism. His opinion is regularly sought after by major publications and networks. Dr. Holtorf is dedicated to empowering patients with knowledge and encourages patients to take an active role in their health-care. <br>
Hello everyone and welcome to today's health chat with Dr. Kent Holtorf. We will be starting in a few minutes, so please feel free to submit your questions now.
Kent Holtorf, MD:
Hello and thank you for joining me today.  I am eager to answer as many questions as we can get to today.  
Can you have both hypothyroidism and hyperthyroidism?
Kent Holtorf, MD:
You can have symptoms of both.  We see this when someone has high Free T3 and high reverse T3.
Kent Holtorf, MD:
Each tissue is different, which is also why there is such a high variability in hypothyroidism.
Kent Holtorf, MD:
Additionally if someone has Graves Disease they usually always have Hashimotos with it.
Have had low normal thyroid readings since birth of my 2nd child. Prior to this time (20yrs) my thyroid readings were in the high normal range. Physicians won't treat as these readings although not normal for me still fall in the normal range. I am 30 lbs overweight, am loosing my hair, and it's very dry.  Can I take anything nutritionally to help?
Kent Holtorf, MD:
This is a very good question.  This is the problem with population reference ranges.  
Kent Holtorf, MD:
95% of the people will be considered normal, but does not necessarily mean normal for you.
Kent Holtorf, MD:
Yes, bringing your levels to more optimal level may be very beneficial to you.
Kent Holtorf, MD:
You could check your iodine and iron levels to make sure they are optimal.
When is it necessary to add t3 meds to t4 meds for patient with Hashimoto's.
Kent Holtorf, MD:
Studies show almost always will be beneficial.  Only if someone has no stress or inflamation, chronic illness or weight problem, depressioin, fatigue, then you may not need it.  For the overwhelming majority of people it is usually helpful.
What is the optimum ratio of T3 to T4 for thyroid replacement in hypothyroidism?  Or is slow-release T3 the only way to go?
Kent Holtorf, MD:
It all depends if someone has none of the conditioins that we just discussed, then mostly T4 might be okay.  As the severity of the illness or weight gain, stress, etc.  the more T3 is needed.  Makaing straight T3 SR the most optimal for many.
Going to be going to a new Dr soon (with no insurance) to talk hypothyroid. What can I ask for specifically, so that time and resources are not wasted? I am exhibiting many signs, including my mom is hypothyroid. Thanks!
Kent Holtorf, MD:
I would check the TSH, Free T3, Free T4, SHBG, reverse T3, and leptin level.  The Free T3/Reverse T3 ratio should be greater than 2.  SHBG greater than 70 and leptin less than 10.
I hope I can ask a questioin about hyperthyroid. On june 3 I had a hida scan with radioactive dye, every since I have had problems I have lost weight, resting heart rate wont go below 90 my eyes have the surprised look, and I just dont feel well I also have a lump on my thyroid. I have read that the radioactive dye can sometimes cause thyroid problems and also thyroid problems run in my family my sister and my mom. Every night my face feels feverish but yet im cold and sometimes im very hot when sleeping I wake all sweaty. Please help I finally conviced my doc to run more blood work Testing tsh t3 t4 and other hormones along with cholesterol, cbc gluclose etc.. I feel like im going nuts.
Kent Holtorf, MD:
The scan can precipitate hyperthyroidism so further testing should be done.  
How is the function of the pituitary and hypothalamas improved?
Kent Holtorf, MD:
The problem is the pituitary and hypothalmus are highly affected by stress, illness, weight, chronic infections, inflammation, and evironmental toxiins.  So  many things negatively affect these tissues and no great way to improve their function other than removing the affecting condition.  
Hi! I am a patient of yours in Torrance. I have a severe reverse t3 problem but whenever I take t3, I get horrible hypoglycemia because it burns up my cortisol. What do you recommend?
Kent Holtorf, MD:
Yes, that is a classic sign of low adrenals.   You can support the adrenals with glandulars, etc. or take cortisol for a period of time.  I don't know what doctor you are seeing so please call the office so we can  help!  
Can hypothyroidism cause pre-diabetes? Or is it only due to our eating habits?
Kent Holtorf, MD:
Absolutely!  It is a viscious cycle becuase the insulin resistance with diabetes also lowers the T4 to T3 conversion so your thyroid is lower making the diabetes worse. It become the chicken or the egg. Go to  for more details.
Hi Dr. Holtorf, Are there any medicines or vitamins.. or foods best avoided with my morning synthroid medication?
Kent Holtorf, MD:
Foods are terrible and won't make much difference.  The problem is the minerals such as iron and magnesium, etc.
I have Hashimoto's which has resulted in a great deal of variability in my need for medication. I have been taking levothyroxin at escalating levels for about two years, but I still suffer nadir episodes where I feel extremely T3 depleted for 10 - 14 days, followed by relief when thyroid function recovers to it's prevailing, nominal level.The question is this: would I benefit from taking a base dose of Cytomel T3 and reducing my levothyroxine dosage? My life would be so much better if I could somewhat moderate the swings resulting from the larger dips in thyroid function.
Kent Holtorf, MD:
This is often a problem with Hashi.  The antibodies are attacking the thyroid which is slowly killing off the thyroid, but it also releases thyroid into the system and thus the variability.  The key is to reduce those antibodies. We have found a combination of low dose Naltrexone and a product called Thyroid RX can be very helpful.  
Is is possible for a person to be resistance to T3 medication?
Kent Holtorf, MD:
Yes you can.  You can have a genetic resistance, but more commonly is a acquired resistance from chronic infections, toxins, inflammation, etc.  This resistance is often variable in different tissues so it can have signs of high and low as different tissues require different amounts of T3 due to the resistance.
What specific tests should I request to have done if the medication, namely Levoxyl, is not addressing my symptoms