Hypothyroidism and Weight Gain; A Hidden Functional Disease

Often during an initial interview, when I ask about blood tests and general health, people suffering from weight gain and the inability to lose those few gained pounds despite proper exercise and a reasonably good diet tell me that everything is fine – they’re in perfect health.  I might inquire about the thyroid and I would be told that the thyroid has been tested and it is working properly.  In the past I have taken this information to mean that everything is functioning well, and I’m looking for some dietary indiscretion, an allergy, food reaction or just the wrong kinds of foods for the individual.  Often this helps.  However, for some, appropriate changes implemented perfectly do not produce the desired results.  Sure, anybody can lose weight on a starvation diet – the trick would be keeping it off in the long term and maintain a healthy body and mind in the process.

Recently I’ve begun to realize that a lot of people (women mostly, it seems), are going through life unaware of a poorly functioning thyroid.  The result:  weight gain, fluid retention, poor mood and energy, possible hair loss, dry skin and a whole host of other potential problems.  All this and yet the TSH (thyroid function test) is normal when checked by their doctors.  How could this be so?

Here’s the story

1.  The reference range for TSH is grossly imprecise.  Most doctors are looking for a mountain, when they need to be looking for a mole hill.  The American Academy of Clinical Endocrinologists have already recommended tightening up the reference range for TSH – anything over 3.0 would be considered high.  Here in Canada, only readings over 5 are taken seriously – at this stage people are really overtly hypothyroid and know that something is definitely wrong.

2.  For some, the TSH never really indicates the true functionality of the thyroid or the rest of the body’s ability to convert thyroid hormone to its more active form (T3).  TSH can be suppressed by T4 alone.  But T4 is not the most active form of the hormone, T3 is, and although found in smaller quantities it stimulates metabolism more than T4.  A conversion is necessary and certain mineral deficiencies will prevent this conversion.

3. L-thyroxin – is T4 alone, not a combination of T3 and T4 and it doesn’t provide the substrate (minerals, etc.) to either build of convert thyroid hormones.  “Properly” medicated people may be getting adequate amounts of T4 and have low TSH values and still not be getting enough T3, thus their metabolism will still be slow and they will not feel at their best.

4. Reverse T3 – the body preferentially makes reverse T3 (aka rT3), when it is under duress:  illness, fasting, etc.  rT3 does not function as T3 and actually slows the metabolism, to help preserve energy.  In these cases, we do not want to add T3, this would speed up the illness and cause unnecessary additional stress to the body.

The conclusion and point of this whole story is simple.  If you are experiencing weight gain, or have difficulty losing weight, you must have your thyroid condition properly assessed and investigated by a qualified practitioner.