“I’ve hit a stubborn weight-loss plateau,” writes this week’s house call, “even though I seem to be doing everything right, like eating the right foods and exercising . How can I overcome that obstacle?”
I’ve discussed different reasons  for weight-loss resistance  in past blogs. Many obstacles have nothing to do with what you eat or how much you exercise. Instead, they involve things like nutritional imbalances, chronic inflammation, metabolic challenges, leaky gut , changes in your microbiome , environmental toxins  and your genes .
One huge but often-overlooked reason for weight-loss resistance involves hormonal imbalances.
No contest: The monster hormone that causes weight gain, inflammation and chronic disease is excess insulin . Think of this hormone as your fat cell fertilizer! My new book, Eat Fat, Get Thin , discusses how to naturally regulate insulin so you can shift your body from fat storage mode to fat-burning mode .
At the same time, insulin isn’t the only player; other hormones also affect your weight and health. Three big disruptors are: thyroid, cortisol and sex hormones. I discuss these hormones in-depth in The Blood Sugar Solution , however, let’s briefly look at each of them here.
Many things contribute to these imbalances. In my e-book The UltraThyroid Solution , I explain how diet, nutrient deficiencies, stress  and environmental toxins impact your thyroid and how to address these problems.
A common cause of hypothyroidism is gluten intolerance. 
Other major culprits that interfere with thyroid function include pesticides and heavy metals. Nutrient deficiencies can also slow things down. Your thyroid needs specific nutrients to run optimally including selenium, zinc, iodine and omega 3 fats .
Most doctors don’t test for thyroid function correctly. Even when they do diagnose it, they don’t treat it effectively by optimizing thyroid function through diet, supplements and the right thyroid hormone replacement therapy.
That’s unfortunate, since thyroid function plays a vital role in maintaining a healthy weight, and hypothyroid is a major player in weight-loss resistance. Among my patients, I’ve found these four strategies can optimize thyroid function and weight loss:
- Get the right tests. Ask your doctor to check your thyroid stimulating hormone (TSH and free T3 and T4, as well as thyroid antibodies including thyroid peroxidase (TPO) and anti-thyroglobulin antibodies. I cover this extensively in my e-book . Some people may need to dig deeper and get a special test called reverse T3 to learn if something like heavy metals (mercury), pesticides, yeast or nutritional deficiencies like selenium, vitamin D, zinc or even iodine could block thyroid hormone function. Reverse T3 is the brake that stops your thyroid hormone from working at the right times. Unfortunately, toxins and inflammation increase levels of reverse T3. Even if regular thyroid tests appear normal, high levels of reverse T3 mean your thyroid is not working properly!
- Eat right for your thyroid. Limit soybeans, raw kale and other raw cruciferous veggies, which might contain thyroid-blocking compounds called goitrogens. I know this sounds confusing. After all, I usually recommend plenty of cruciferous veggies. In this scenario, I am saying it’s okay to eat them…just not raw! You should limit the kale juice and kale salad. One study in The New England Journal of Medicine  looked at a woman who ate two pounds of raw bok choy a day and went into a hypothyroid coma! I know that sounds extreme, but it could happen. I also recommend wild-caught, low-mercury fish and seaweed for additional iodine, the mineral your thyroid hormones are made from. Since people eat less iodized salt, you might be iodine deficient. Over-exposure to fluoride and chlorine also create iodine deficiencies. Pumpkin seeds and oysters provide excellent zinc sources, and Brazil nuts provide selenium and iodine.
- Use quality supplements for thyroid health. A good multivitamin  that contains the above nutrients, plus fish oil  and vitamin D , makes an excellent nutrient base. Some people may benefit from iodine  supplements. Just be careful not to overdose and be sure to get your iodine levels measured regularly.
- Replace the right thyroid hormones. Most doctors will only prescribe T4 (such as Synthroid), the inactive form of thyroid hormone your body must convert to its active form T3. Most people do better on bioidentical hormones (like Armour, Westhroid or Nature Throid) or a combination of T4 and T3. A Functional Medicine doctor who understands how to optimize thyroid balance can customize a nutrient protocol.
Another source of weight-loss resistance is stress. Yes, you actually can think yourself fat or think yourself thin, and science  proves it. Stressful thoughts activate metabolic pathways that cause weight gain and insulin resistance.
Remember, stress is a response to stimulation that makes you feel threatened and not always provoked by real circumstances, rather a perception that you are being attacked.
Most stress isn’t real. A worry, thought, fear or projection into the future of what might go wrong can all become real stressors. While short-lived, we carry them with us and don’t know how to reset our mindset. If you have survived trauma, it can live in your body even after the original stressor is gone.
Regardless, stress is any real or imagined threat to your body or ego. While that might mean someone putting a gun to your head, it could also mean thinking your boss is mad at you (even when they aren’t).
Stress creates hormonal responses that cause weight gain and insulin resistance. Cortisol is an adrenal hormone that helps you to run faster, see further, hear better and pump fuel into your bloodstream for quick energy. It is the hormone that helps us survive in the face of true danger. It also shuts down digestion and slows your metabolism.
All of this is perfectly normal in the short term, yet if left unchecked, prolonged stress and high levels of cortisol cause high blood sugar, increased belly fat, high blood pressure, high cholesterol  and muscle loss.
You can’t eliminate stress completely, but you can reduce it with meditation, yoga or deep relaxation. These activities activate pathways that promote weight loss and health.
A few simple ideas I find helpful to reset the stress response include:
- Fix your thinking. This is the most powerful long-term way to be happy and reduce stress. We often get into habits of thinking, beliefs and ideas that keep us stressed. Don’t believe every stupid thought you have! 
- Practice active relaxation. That might be as simple as learning deep breathing or trying a sauna or steam bath, which elevates body temperature to help discharge stress from the body and help reduce stress hormones. Or try meditation. It can be powerful. Check out Ziva Meditation  for a great online course on meditation – I did it and it changed my life!
- Make time to be a human being, not a human doing. Make time to love and connect with others. Taking time with family and friends to love and be loved is powerful healing medicine.
Sex Hormone Imbalances
Sex hormone imbalances, such as estrogen and testosterone, can also cause weight problems. Having too much estrogen causes weight gain whether you’re a man or a woman. Do you know how ranchers fatten steer before they go to market? They implant them with estrogen pellets.
For both genders, too much sugar, refined carbs and alcohol spikes estrogen. Keeping your gut healthy also cultivates healthy sex-hormone metabolism. Too little fiber or too many antibiotics damage the gut, triggering estrogen spikes because your body can’t properly detoxify or excrete waste. Environmental toxins  thrive on pesticides called xenoestrogens, because even at lose doses, they act like estrogen in your body.
Symptoms of excess estrogen in women include breast tenderness, fluid retention, bad premenstrual syndrome, fibroids and heavy menstrual bleeding.
In men, excess estrogen can cause loss of body hair (including chest, legs and arms), a beer belly, and “man boobs.” Low testosterone in men can also accelerate aging. Lack of exercise, alcohol, stress, environmental toxins or diseases like diabesity  or even pituitary problems can also lower testosterone.
Low testosterone causes men to lose muscle and gain fat, leading to sexual dysfunction, low sex drive, fatigue, mental fogginess and bone loss that can lead to osteoporosis.
Interestingly, cholesterol produces testosterone and other sex hormones. Eating a low-fat diet and taking statin drugs that block cholesterol production can negatively impact your sex hormones.
If you suspect imbalances, you’ll want to get tested for imbalances. In my free e-book, How to Work with Your Doctor To Get What You Need , I explain exactly how to test for these and other hormone imbalances. These five strategies can help get you started:
- Eat a hormone-balancing diet. The nutritional principles in Eat Fat, Get Thin , which is low in sugar, high in good fats, and high in fiber, can help balance hormones. My own testosterone went up 500 points when I ate more healthy fats!
- Bulk up on fiber. Ground flaxseeds provide optimal fiber and lignans, which balance hormones. Even two tablespoons a day to a shake or a salad can help. You’ll also want to eat fiber-rich organic fruits and veggies.
- Eliminate daily. Constipation is bad for your hormones. Take magnesium citrate,  vitamin C , probiotics  and flax seeds daily to help maintain regularity. It’s a foolproof combo for most people.
- Limit or remove alcohol. Excess alcohol can compromise liver and kidney function, which inhibit detoxification and create hormonal imbalances, high triglycerides and fatty liver .
- Get moving. Exercise  helps balance hormones, reducing estrogen and increasing testosterone, which helps you lose fat  and build muscle.
While many culprits contribute to weight-loss resistance, I find addressing these three hormonal imbalances helps many patients lose stubborn weight. Hormonal balance might require working with a Functional Medicine practitioner, yet for most patients these strategies become the ticket to ignite weight loss.
If you’ve struggled to balance your hormones, what strategy would you add to this list? Comment below or on my Facebook page . Please keep submitting your great questions to drhyman.com . Let’s continue to inspire others to balance their hormones, ignite their weight loss and get healthy!
Wishing you health and happiness,
Mark Hyman, MD