Health & Fitness

By Raquel D'Apice

It is not always your fault that you’re gaining weight.

With Oprah Winfrey’s public statement that it was her thyroid that caused her to gain an extra 40 pounds, those of you who spent your biology class either sleeping or passing notes to a guy three rows back (Do you like me? Check yes or no.) are suddenly wishing you still had access to that 15 lb. textbook with the mitochondria on the cover. What is the thyroid? How does it cause you to gain weight? How do I know if my thyroid is involved in my weight gain? How can I lose 20 pounds in time for my sister’s wedding? Did that guy in my Biology class like me or not?

Luckily, we have the answer to a few of those questions.

Dr. Kent Holtorf, founder of the Holtorf Medical Group in Torrance, CA, is an expert in endocrinology and thyroid dysfunction, including difficult thyroid cases. A board examiner for the American Board of Anti-Aging, Dr. Holtorf has the wonderful quality of being (or at least appearing) as excited about the thyroid and its functions as the rest of us are about YouTube videos of kittens falling out of trees. He was kind enough to answer several questions about the thyroid, including the first one – the one that no one wanted to raise their hand and ask because you suspected everyone was supposed to know it if we had done the homework last night.

What is the thyroid?

“The thyroid,” Holtorf explains, “is the gas pedal for the body.” The thyroid gland itself is a small, butterfly-shaped organ in the lower front of your neck, whose only purpose in life is to produce thyroid hormone. This controls your body’s energy flow, so a low thyroid (Hypothyroid), means your metabolism will be slower.

Who has a low thyroid, and why?

A low thyroid is genetic, “but,” says Holtorf, “can be induced by things like chronic stress. If you’re stressed you’ll produce 10-20% less thyroid than normal. So you gain weight. And people will diet, but dieting will decrease your thyroid by another 10-20%, with an average weight gain of 38 pounds.”

What are some of the symptoms of low thyroid?

Thyroid problems often remain undiagnosed because the symptoms seem so unrelated. “Muscle fatigue, weakness, weight gain, cold hands and feet, depression are all symptoms of a lack of thyroid in the tissues. But the main problem,” Holtorf says, “is that the standard blood test misses 80% of low thyroid.”

The standard blood test measures TSH (thyroid-stimulating hormone). When the thyroid is low, the pituitary should increase TSH, and doctors look for high TSH levels. This can be an ineffective way to determine if a person has low thyroid because factors such as stress will lower thyroid hormone in the tissue, but will not cause the TSH to go up.

Is there something out there more accurate than the standard TSH test and how can I be sure my provider is qualified?

“To get an accurate test,” Holtorf says, “check the T3/Reverse T3 ratio. Some endocrinologists are behind the curve on this and aren’t trained in T3.” If you’re thinking of meeting with an endocrinologist ask the following:

“Do you use T3 routinely?”

“Do you use reverse T3 as a test?”

Holtorf encourages asking both questions to make sure you get the most accurate diagnosis and treatment.

What exactly is T3?

No, this is not the T3 we are talking about. Please focus.

Yes. We are talking about T3 the hormone. Apologies to huge Arnold Schwarzenegger fans.

Dr. Holtorf has long been a proponent of using the T3 hormone. Triiodothyronine, known as T3 (three iodine atoms), is one of the two thyroid hormones produced by the body. While the standard treatment is to give patients with low thyroid T4, “in many patients the T4 isn’t converted to reverse T3, and ends up blocking the thyroid.” For this reason, it’s smarter to find an up-to-date provider that’s comfortable with T3.

What are some of the other causes of weight gain for people who’ve dieted and exercised and don’t seem to be getting the results they should?

“Leptin,” Holtorf offers, “can be part of the problem. It’s produced in fat cells and it should go to the brain and say ‘stop storing energy.’ The majority of people gaining weight have a Leptin resistance. It never activates the brain the way it’s supposed to and the brain always thinks the body is starving.” Think about getting tested – if your Leptin level is above 10, you have a Leptin resistance.

Another endocrine inhibitor, Holtorf mentions, is Bisphenol A. This is what you find in a lot of plastics, Coke Bottles, Fire Retardants. “And again,” he says, “it blocks thyroid in the tissue. Not in the pituitary gland, so it won’t show up on a basic TSH test.”

Where is Dr. Holtorf located? Just so I know.

Dr. Kent Holtorf is the founder of the Holtorf Medical Group, located in Torrance CA, with additional offices in the Bay area. His practice specializes in endocrinology, complex endocrine dysfunction, and low thyroid. The practice can be found online at http://www.hormoneandlongevitycenter.com.

Ok. How can I lose 20 pounds in time for my sister’s wedding?

That depends on a number of factors including your body type, habits and the date of your sister’s wedding. Eating well and exercising never hurt either. If you’re not getting anywhere and think you have a more serious problem, talk to a doctor.

So what’s the deal? Did that guy in my biology class like me or not?

He liked you, but not as much as he liked a much less interesting girl who was always chewing gum and wearing cutoffs and was willing to sit through his boring, junior varsity basketball games.

Odds are he had his own issues involving hormones. I’d forget about him and read up on that biology lesson you missed.

Originally published March 2009
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