Coming up on this episode of The Doctor’s Farmacy.
Dr. Mark Hyman:
It’s really important to get this right, because if you don’t, you’re going to struggle with weight gain, you’re going to struggle with all these symptoms. And often, low thyroid function is a big player if you’re struggling with weight loss and you can’t figure out why.
Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman, that’s Farmacy, we then have a place for conversations that matter. And have you ever struggled with weight loss and found it’s just tough to get those pounds off, there may be hidden reasons for your resistance to weight loss. So that is what we’re talking about today on The Doctor’s Farmacy, a place for conversations that matter. And it’s in the form of one of our health bites, little tips that can help you make big changes over time, or small changes that create big results over time.
Often, I hear from patients, “I’ve hit a summer weight loss plateau. Even though I seem to be doing everything right, I’m eating right, I’m exercising, and what do I do? I just can’t lose the weight.” Now, I’ve discussed reasons for weight loss resistance before, and there are many obstacles that have nothing to do with what you eat or how much you exercise. Things like imbalances in your nutritional status, chronic inflammation from infections of viruses, metabolic problems, toxins, and in your environment, leaky gut, your microbiome, huge impact on your metabolism, even your genes. So I cover all those things in the past. What I want to talk about today is one specific category of resistance to weight loss, which is hormonal imbalances.
Now, it’s no contest, when it comes to hormones, what the worst thing is for weight. It causes inflammation, it causes weight gain. It’s the driver of chronic disease, aging, pretty much everything that goes wrong as we get older, and it’s too much insulin. Insulin resistance. Insulin is basically, the fat storage hormone. In my book, Eat Fat, Get Thin and the 10-Day Detox Diet, I talk about how we can regulate insulin. So you can shift your body from storing fat to burning fat. So if you want to get more detail, check those out.
But today, we’re going to talk about things beyond insulin. How other hormones affect your weight and your health, your thyroid hormones, your stress hormones, and your sex hormones. So let’s get right into it. Today we’re talking about these three big disruptors. I talk about them in my book, The Blood Sugar Solution, but let’s talk about each of them today, because they are often the cause of weight loss resistance.
Now, thyroid is really common. We are inundated with a thyroid problem, because our thyroid is like the canary in the coal mine. It’s super sensitive to all sorts of environmental toxins, to stresses in our diet, to gluten. And low thyroid function affects one in five women, and one in 10 men. That’s a lot. And half of those cases, they’re not diagnosed. And even if they are diagnosed and treated with conventional therapy, which is usually Synthroid, or T4, it’s not adequately controlled or treated.
So what causes low thyroid function or thyroid imbalances? Well, there are a lot of things that cause them. What are the symptoms? Let’s just go over those first. You may not really identify this as a thyroid problem, but you might have a little of this and a little of that. A little depression, a little dry skin, a little hair falling out, a little constipation, low sex drive. Maybe your cholesterol’s a little high, maybe your nails are cracked, maybe your hair’s thinning. Maybe you’re having eyebrow loss, and a lot of through your eyebrows. Maybe you have muscle cramps, maybe you have trouble sleeping. Maybe you feel a little fluid retention, and tired all the time. You have trouble getting up in the morning. These are all clues that your thyroid might not be working right. And often, you just go to the doctor, and you get the regular test, which we’ll talk about, and it may not actually indicate what’s really wrong.
So one of the main things that causes dysfunction of thyroid in Hashimoto’s, which is an autoimmune thyroid condition, the most common one, is gluten. Gluten is often associated, probably in about 30% of cases, with Hashimoto’s. And the other big one is environmental toxins, heavy metals, mercury, lead. Also, nutritional deficiencies affect your thyroid function. Things like low selenium, low zinc, low iodine, low omega-3 fats, low vitamin D, all impact thyroid function. And most doctors don’t even properly test for it, and they don’t know how to diagnose it. And they don’t treat it effectively, because they just give you the precursor of your thyroid, active thyroid hormone, which is T4. And they don’t know how to optimize your health otherwise, with diet, supplements, or the right thyroid replacement. So it’s really important to get this right, because if you don’t, you’re going to struggle with weight gain. You’re going to struggle with all these symptoms. And often, low thyroid function is a big player, if you’re struggling with weight loss and you can’t figure out why.
So what are the strategies for optimizing your thyroid function, and for getting your weight in check? First, get the right tests. Now, the right tests include TSH, or thyroid stimulating hormone, which is pretty much the only test that most conventional doctors do. You also have to ask for free T3 and free T4. And not only that, you have to ask for thyroid antibody tests, something called thyroid peroxidase, and anti-thyroglobulin antibodies. These are looking for low level antibodies, or even high level antibodies. And you can have perfectly normal thyroid tests, but have high antibodies, and you still need to be treated. Or you can have a normal TSH, but a low T3 or a low T4, and you can still need thyroid replacement. So you’ve got to kind of figure out what’s really going on here.
We’ll also look at reverse T3, which is the brake that stops your thyroid from working. So sometimes toxins, inflammatory factors, can actually increase reverse T3, which is like the brake on your thyroid. So even if your regular tests look normal and your have high reverse T3, you might not have good thyroid function at the cellular level.
Eat right for your thyroid is really important. If you don’t eat right, you’re not going to be on the right track, because your diet influences your thyroid function. You need all the raw materials for thyroid function, but you also have to make sure you don’t include things that are hurting your thyroid. One of them is raw, cruciferous vegetables, broccoli, collards, kale, Brussels sprouts. And people are often having kale juice a lot, and that can interrupt thyroid function, and usually not eaten in cooked forms, not eaten in the normal amounts we’d eat them, which is even a couple of cups a day. But they can interfere with thyroid function.
I had a woman, who was in a New England Journal study, who I saw eating bok choy, which is one of these cruciferous vegetables, was good. And she ate, I think, two pounds a day of raw bok choy, and she ended up in a hypothyroid coma. So it sounds crazy, but I would encourage you not to be juicing kale.
Also, make sure you add foods that are including the nutrients you need, to actually activate your thyroid function. Which include, for example, iodine, which is in fish. You can get it in seaweed also, so you want to make sure you’re having low mercury fish. Often people are eating iodine free salt, because they don’t want to eat iodine in their salt. There’s more iodine deficiency out there than we might realize. It has to do with where it is in the soil, and we don’t often eat foods with high levels.
Also, making sure you don’t eat, have fluoride in your water or chlorine, which are common. These are thyroid blockers, so you can filter your water at home. I think that’s important. Also, you want to add extra nutrients that contain the other additional things like zinc, for example, as in pumpkin seeds. Brazil nuts have selenium. As I mentioned, seaweed has iodine. Vitamin D, you can get as a supplement, but also through fatty fish and even mushrooms. Although, porcini mushrooms are highest, they’re hard to find, and they’re hard to grow.
Now, also, you need the right supplements. So in order to activate the thyroid function, for example, the converter from T3 to T4, you need selenium in order to make it bind to the, to make thyroid unit itself, you need iodine to make it bind to the receptor of your nucleus. To do all its thyroid functions, it has to have vitamin D and so forth. So you need basically, a multi fish oil and vitamin D as a foundation. You may need iodine supplements, but I would be very cautious about those. You can really overdose and interfere with your thyroid function.
Also, when you’re taking thyroid, you want to take the right stuff. Often doctors recommend Synthroid or Levoxyl, which is the inactive form. Some people do well with that if you add a little T3, but I prefer people stay on a comprehensive bioidentical hormone. And the one I recommend is Armour Thyroid, or Nature-Throid, or Westhroid. These are a combination of T3 and 4, but their whole glandular thyroids. Now, it sounds kind of weird, but these came from a pig, very identical to our body’s own thyroid hormone. And we’ve been using these glandulars in medicine for decades, and decades, over 70 years, for cortisol, for thyroid, for many things we use them for. And so, I think that it’s important to understand how to properly adjust this.
Now, if you get on a bioidentical thyroid, your TSH is going to drop, and your doctor will go, “Oh, you’re over treated.” But you can’t just look at the TSH. You need to look at the T, free T3 and free T4. And those have to be in a good range. And I have all that in my book. And there’s a great guide online called How to Work with Your Doctor to Get What You Need. I wrote a whole guide called The Ultra Thyroid Solution. You can look that up online, a little PDF handbook.
All right, let’s talk about the next hormone, cortisol. Cortisol is a big one. Now, cortisol makes you gain weight. Now it’s a stress hormone. Most of us are overactive in our stress response, and don’t reset our nervous systems. When you have high levels of cortisol, it causes you to gain belly fat. It causes your muscles to break down, and makes you more in insulin resistant. It raises your blood pressure, it shrinks your memory center in your brain.
And what happens is, stress also affects your fat cells. Literally, your nervous system, your autonomic nervous system, your sympathetic nervous system, your fight or flight nervous system has like neuronal connections to your fat cells. So literally when your stressed, your fat cells are listening. And when your body is actually in a state of stress, it’s not designed to actually lose weight initially, because you want to be flooding your body with sugar and fatty acids. And so, you’re basically, inhibiting the process of metabolism, and you’re increasing your fat storage, and you’re doing all these things that are really bad. And they’re good if you’re running from a tiger for two minutes, but not if you’re doing this every day.
So stress often isn’t just a real event in the world. It can be a tiger chasing you, but it can also be an imaginary event in your mind. You could think, oh, your spouse is cheating on you, because they came home a half an hour late or something, and it could be a total fabrication that gets stuck in traffic. And so, the same event can cause stress depending on how you interpret that event. So stress is really an interpretation of an event. Even a gun, for example, to your head, would be a highly different experience for James Bond or Woody Allen. So same trigger, but different response.
So most of these short-lived traumas we can learn how to mitigate, but it’s the sort of long-term trauma we often have to deal with. And that may be PSD, and there’s a lot of emerging therapies around that, that help reset the nervous system. Whether it’s daily ganglion block, whether it’s MDMA assisted psychotherapy, which is being researched now in Phase III clinical trials, that should be approved by 2024. So there’s a lot of things out there, but basically, if you’re chronically stressed, you can just gain weight.
I had a patient who was struggling to lose weight, her daughter lived in Israel, it was time of Palestinian uprisings with a lot of bombings, and she was really constantly freaked out about her daughter getting killed. And as soon as her daughter moved back to the States, she lost 40 pounds. So it’s a real thing.
Now, you want to learn how to reset your nervous system. We can’t get away with being in a stress-free life, but we can learn how to reset our nervous systems, whether it’s breathing exercises or breath work, meditation, yoga, massage, guided imagery, binaural beats. I mean, the list goes on. There’s all sorts of apps and programs for this, and you can really reset your nervous system. There’s Apollo, Sensatee, things that help to reset your parasympathetic nervous system to kind of a more calm state. So you have to practice that regularly, and I encourage people to do that every day.
So what should you do? Well, first of all, our thoughts are the biggest driver of our stress response. So make sure you’re interpreting reality in a way that actually isn’t constantly seen as a threat. And that may take some work and therapy, but may take from coaching, or different kind of examinations of your thinking, but it’s really important to do.
Also, practice active relaxation. Like I said, you can’t just do nothing and expect to relax, like watch TV. You have to do something. It can be something more active, like breath work, or meditation, or yoga. Or it can be something like a sauna, or a steam bath, or ice plunge, a cold plunge. These reset your nervous system in a powerful way and change your physiological state. You can also try meditation. I love Ziva meditation, I use regularly. It’s basically a mantra based Vedic meditation. It’s very simple, 20 minutes, once a day, twice a day, really easy.
And also, sort of our social connections are a huge mitigator of stress. Whether it’s cuddling with a friend, or even cuddling with a pet, makes a big difference. So make sure you have time to be a human being, not a human doing. And just, friends and family connections, super important. So make sure you take the time to do that.
All right, so we covered thyroid. We covered cortisol. Let’s cover the last hormone that can go, hormones that can go off that affect your weight, which are sex hormones. So there’s, main ones are estrogen and testosterone. We talked about also, progesterone plays a role. A lot of women took Provera, which is a synthetic progesterone, and that makes women gain weight, makes women depressed, so it’s not great.
Now, estrogen is often a problem. We live in an estrogenic society. We actually do all the things that make our estrogen levels as men and women go up. So men have estrogen too, and when estrogen goes up, men get big fat belly, they lose the hair on their legs and their chest, and essentially, they become an estrogen producing factory, because fat cells produce estrogen. They’ll convert testosterone to estrogen. So really, really important to make sure that you’re not doing things that are leading you to that body state, which is all the sugar and starch. So basically, our carbohydrate rich, starchy, sugary diet is driving high estrogen levels. Also, environmental toxins do that. Alcohol is a big one. You know, the beer belly thing, that really is something we need to pay attention to, because estrogen will basically make you gain weight. When you look at how they fatten up steer for slaughter, they basically put an estrogen pellet in their ear, and the body absorbs all this estrogen. They get all this marbled fat and it sells for more money. But it’s essentially because they’re giving male steers estrogen to make them fat.
So a lot of things also affect your hormones. Your gut flora play a big role, lack of fiber, too many antibiotics. As we mentioned, pesticides, all sorts of things can interfere with estrogen. So when women get too much estrogen, what are the symptoms, the men we talked about? But you get breast tenderness, fluid retention, PMS, fibroids, heavy menstrual bleeding. And also in men, what happens is, is you get low testosterone. So not only your estrogen go up, but it’s converted to testosterone, it’s estrogen, and your testosterone drops. When your testosterone drops, that’s a big one, because then you lose muscle. You actually end up with a poor metabolism. And a lot of things cause low testosterone, but lack of exercise, too much drinking, too much stress, environmental toxins, pre-diabetes, diabetes, pituitary problems can lower testosterone. So you want to check that.
And if men have low testosterone, they tend to lose motivation. They lose muscle, they lose sexual desire, they lose sexual function. They might have fatigue, mental fogginess, they have bone loss, they can cause osteoporosis, and obviously, muscle loss. So you really, when you lose muscle, your metabolism slows down, you gain more weight, and it just creates a vicious cycle. And you need, for example, to take, to make testosterone, you need cholesterol, and eating a low fat diet and statin drugs can often interfere with male testosterone.
So how do you balance your diet and lifestyle to correct sex hormonal imbalances? Pretty easy. Following, I’ve been saying forever, which is the approach that’s in Eat Fat, Get Thin, or in my 10-day Detox Diet, or my Pegan diet, is pretty much similar principles about how to eat a diet, which is low in starch and sugar, high in good fats, high in fiber, has adequate protein, lots of phytochemicals, and it can actually balance your gut flora. So my testosterone went up about 300 points when I changed my diet to eat more fat and less starch and sugar.
Also, fiber is really important. Flax seeds are great, because they help regulate hormonal balance in men and women. You can add two tablespoons a day with a shake or salad. Eat lots of fiber rich vegetables and fruit. Make sure you’re having daily bowel movements. If you’re constipated, you can help cause reabsorption of estrogen, which is really bad. So you want to make sure you’re going every day. Take magnesium citrate, vitamin C, probiotics, flax seeds, all that helps you go.
Alcohol, again, not great for all your sex hormones. Increased risk of all sex hormone cancers, breast, uterine, ovarian, even prostate cancer. So not a good thing to do on a daily basis. It also affects your detoxification of hormones, and your estrogen levels go up.
Also, get moving. Exercise is a huge regulator of hormones. So make sure you’re exercising regularly, you’ll balance your hormones, you’ll increase testosterone, you’ll lower estrogen, you’ll build muscle, lose fat, all in a positive virtuous cycle.
So if you really are struggling with resistance to weight loss, check out all the other things we talked about. Make sure you check your hormones, thyroid, cortisol, stress hormones, and your sex hormones, and you’ll usually find a way to heal a lot of it, and overcome that resistance.
So I hope you’ve learned a lot from this podcast. I hope you’ll share it with your friends and family on social media. I think a lot of people struggle with these issues. And we’ll see you next time on The Doctor’s Farmacy.
Hi everyone. I hope you enjoyed this week’s episode. Just a reminder, that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.