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Question of the Month – Mar 2013
This question is going to have multiple parts. Did you have a weight issue in relation to your thyroid condition? Did you lose weight, once you started medication? What things have you tried to help with weight loss? What worked and what didn’t? Do you have other conditions that may exacerbate the problem? Those could include insulin resistance, PCOS, or others.
You've both added so much to this conversation. Less than hour ago I was reading an article on thyroid/weight/bmr. Loved coming here and seeing dialogue on this. I actually feel more optimistic about my ability to lose just a little bit of weight. Thank you!
I think you two have interpreted what I said as simplifying the weight issue as being only thyroid related. I did not. I know better, that's why at the very beginning, I stated, "Ignoring other possible contributors for a moment, obviously if your caloric input ( calories eaten minus calories burned with extra exercise) exceeds your BMR, then you gain weight." Thus, "when overweight due to low metabolism due to low thyroid, when thyroid levels are corrected, there should be a weight reduction to account for that." That clearly assumed that no other conditions existed that would interfere with the thyroid effect.
Obviously some hypo patients like yourselves do not find thyroid to be a big factor. Others, like myself, found it to be the whole answer for my weight gain and subsequent loss. So then, what is there to discuss, other than the percentage of patients that fall into each group, for which none of us have any facts to present, only anecdotal info.
My point from the beginning was to bring out that thyroid is potentially a significant factor in weight issues. Also, since BMR is also one of only two objective (downstream) measures of tissue thyroid levels which we all need to know about (basal body temperature is the second), I think members should be aware of its potential diagnostic value. Otherwise, we are left with subjective measures like symptoms, and upstream tests of serum thyroid levels, which are several levels of inference removed from the variable we really would like to know (actual tissue thyroid levels).
Obviously some hypo patients like yourselves do not find thyroid to be a big factor. Others, like myself, found it to be the whole answer for my weight gain and subsequent loss. So then, what is there to discuss, other than the percentage of patients that fall into each group, for which none of us have any facts to present, only anecdotal info.
My point from the beginning was to bring out that thyroid is potentially a significant factor in weight issues. Also, since BMR is also one of only two objective (downstream) measures of tissue thyroid levels which we all need to know about (basal body temperature is the second), I think members should be aware of its potential diagnostic value. Otherwise, we are left with subjective measures like symptoms, and upstream tests of serum thyroid levels, which are several levels of inference removed from the variable we really would like to know (actual tissue thyroid levels).
COMMUNITY LEADER
"If you are hypo and take thyroid meds and raise your metabolism, you will lose weight. Simple as that."
No, in my experience it's not as simple as that. I was really hypo, am now on med, with good levels, my metabolism is spot on. I had a BMR test, at my doctor's office, which put me within 1.5 calories of what my expected BMR (per the above formula) would be. My metabolism is just fine and I still don't lose weight.
I have lost up to 35 lbs a couple of times in my life. Once when I was in my late 30's and again, mid 40's.... none of my doctors tested thyroid function during these "gains/losses" so I don't know if they were caused by Hashi swings; I suspect they might have been.
For many, the concept of getting on adequate thyroid hormones, will do the trick; for many others, myself included, you can't discount other contributors. In my case, I have to take insulin resistance into account, along with low protein levels that cause fluid retention. My weight can fluctuate anywhere from 3-7 pounds in a 24 hr period. Of course we know that's not all "fat" weight, but where do you draw the line? When you're fluctuating on a daily basis how can you decide what your true weight is?
Then add the doctor's scale, which typically weighs 3-5 pounds higher than my scale. Which one is right? Did I somehow manage to gain 5 pounds from the time I left home until I got to my doctor's office?
No, in my experience it's not as simple as that. I was really hypo, am now on med, with good levels, my metabolism is spot on. I had a BMR test, at my doctor's office, which put me within 1.5 calories of what my expected BMR (per the above formula) would be. My metabolism is just fine and I still don't lose weight.
I have lost up to 35 lbs a couple of times in my life. Once when I was in my late 30's and again, mid 40's.... none of my doctors tested thyroid function during these "gains/losses" so I don't know if they were caused by Hashi swings; I suspect they might have been.
For many, the concept of getting on adequate thyroid hormones, will do the trick; for many others, myself included, you can't discount other contributors. In my case, I have to take insulin resistance into account, along with low protein levels that cause fluid retention. My weight can fluctuate anywhere from 3-7 pounds in a 24 hr period. Of course we know that's not all "fat" weight, but where do you draw the line? When you're fluctuating on a daily basis how can you decide what your true weight is?
Then add the doctor's scale, which typically weighs 3-5 pounds higher than my scale. Which one is right? Did I somehow manage to gain 5 pounds from the time I left home until I got to my doctor's office?
"It is ironclad, since there was no specific quantification of degree of hypothyroidism or specific weight loss specified. If you are hypo and take thyroid meds and raise your metabolism, you will lose weight. Simple as that. How much? It depends."
My point exactly! The math paints a pretty bleak picture of the time line. What I'm trying to reinforce here is the idea that weight loss is SLOW, it's TEDIOUS and unless you want to spend the rest of your life doing it, you have to tip the odds a little more in your favor that just relying on being (truly) euthyroid.
Sure you weren't a politician??? LOL
"If you are 150 pounds and your Basal Metabolic Rate says you need 1500 calories per day just to stay at that weight, you are not going to "balloon" up to 180 in a short time, unless your metabolism drops drastically due to becoming hypothyroid, in which case your actual BMR would be considerably lower."
I do make the assumption that your BMR would have dropped from being hypo.
"And by the way "ballooning" up 30 pounds would only cause your BMR to increase by a total of 130 calories per day (30 times 4.35), not 300, over the assumed baseline."
I've always used a simpler (and less scientific, I suppose) calculation, but it's always worked. I assume a sedentary person needs about 10 calories/lb/day to maintain current weight. Twenty minutes of moderate exercise can increase that to 12, half an hour of vigorous exercise to 15. You calculate how many calories it would take to maintain your current weight, subtract the number of calories you eat and the difference is your "savings". Interestingly, when I did this for my current weight using your BMR formula, I was within less than a handful of calories different from doing it my way.
"At any rate, it seems to me that whatever amount of weight you gain over time, after becoming hypo, logically you should see about the same reduction, over a similar time period when you get your meds increased to a level that makes you euthyroid (like you were before developing hypothyroidism). So I really don't see why would it be otherwise, unless you throw in some other variables (which I mentioned and established as constants for the sake of this discussion)?"
No other variable thrown in. Your logic is this: You have a covered container of water half full. You add a little to that every day until it's 3/4 full. You then stop adding water, close the lid and wait for the water to get back to half a container. You're going to be waiting a loooong time unless you actively do something to take some of that water out. I can see weight stasis when euthyroid, but I'd think that you would only lose the amount gained in the same amount of time if you actually tipped the thyroid hormones slightly hypER for the same amount of time you were hypO.
Anyway, my point is still that weight loss can be extremely difficult. I think many people who never had to address it before being hypo have no appreciation for how difficult it is. There's a delicate balance between maintaining health, enthusism for the weight loss plan, a reasonable time line, etc., and if we rely on the "natural" process to bring us back to our previous weight, we are probably going to be defeated on all those fronts.
My point exactly! The math paints a pretty bleak picture of the time line. What I'm trying to reinforce here is the idea that weight loss is SLOW, it's TEDIOUS and unless you want to spend the rest of your life doing it, you have to tip the odds a little more in your favor that just relying on being (truly) euthyroid.
Sure you weren't a politician??? LOL
"If you are 150 pounds and your Basal Metabolic Rate says you need 1500 calories per day just to stay at that weight, you are not going to "balloon" up to 180 in a short time, unless your metabolism drops drastically due to becoming hypothyroid, in which case your actual BMR would be considerably lower."
I do make the assumption that your BMR would have dropped from being hypo.
"And by the way "ballooning" up 30 pounds would only cause your BMR to increase by a total of 130 calories per day (30 times 4.35), not 300, over the assumed baseline."
I've always used a simpler (and less scientific, I suppose) calculation, but it's always worked. I assume a sedentary person needs about 10 calories/lb/day to maintain current weight. Twenty minutes of moderate exercise can increase that to 12, half an hour of vigorous exercise to 15. You calculate how many calories it would take to maintain your current weight, subtract the number of calories you eat and the difference is your "savings". Interestingly, when I did this for my current weight using your BMR formula, I was within less than a handful of calories different from doing it my way.
"At any rate, it seems to me that whatever amount of weight you gain over time, after becoming hypo, logically you should see about the same reduction, over a similar time period when you get your meds increased to a level that makes you euthyroid (like you were before developing hypothyroidism). So I really don't see why would it be otherwise, unless you throw in some other variables (which I mentioned and established as constants for the sake of this discussion)?"
No other variable thrown in. Your logic is this: You have a covered container of water half full. You add a little to that every day until it's 3/4 full. You then stop adding water, close the lid and wait for the water to get back to half a container. You're going to be waiting a loooong time unless you actively do something to take some of that water out. I can see weight stasis when euthyroid, but I'd think that you would only lose the amount gained in the same amount of time if you actually tipped the thyroid hormones slightly hypER for the same amount of time you were hypO.
Anyway, my point is still that weight loss can be extremely difficult. I think many people who never had to address it before being hypo have no appreciation for how difficult it is. There's a delicate balance between maintaining health, enthusism for the weight loss plan, a reasonable time line, etc., and if we rely on the "natural" process to bring us back to our previous weight, we are probably going to be defeated on all those fronts.
3 1/2 years ago I had RAI for graves. Before that I never really struggled with weight. I did gain 20 pounds after RAI and couldn't get it off with healthy eating and exercise. After first adding T3 meds, my weight dropped 5 lbs. After switching to Armour thyroid, going off birth control pills, I lost more. Much of it water retention.
Exercise has helped a lot. I do hot yoga or go to the gym(cardio/weights) 2-3 times a week. I also have been taking DHEA, which was low, and I feel this helped me regain the muscle tone I had lost. I take 5mg each morning, recommending by my dr. Since gaining more muscle tone, it's easier to keep my weight down.
Another thing I did to try and reset my metabolism was a detox. I cut out all alcohol, gluten, corn, soy, dairy and refined sugar for one week. No cheating. I ate a lot of homemade soups, eggs, avocados, lean proteins, veggies, coconut oil and nuts. This helped me drop the last 5 lbs. I am also always gluten free and limit dairy and soy.
Exercise has helped a lot. I do hot yoga or go to the gym(cardio/weights) 2-3 times a week. I also have been taking DHEA, which was low, and I feel this helped me regain the muscle tone I had lost. I take 5mg each morning, recommending by my dr. Since gaining more muscle tone, it's easier to keep my weight down.
Another thing I did to try and reset my metabolism was a detox. I cut out all alcohol, gluten, corn, soy, dairy and refined sugar for one week. No cheating. I ate a lot of homemade soups, eggs, avocados, lean proteins, veggies, coconut oil and nuts. This helped me drop the last 5 lbs. I am also always gluten free and limit dairy and soy.
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