Hashimoto’s Thyroiditis and the Weight Gain Dilemma
Published October 27 2014
Many people with Hashimoto’s Thyroiditis have problems with weight gain. This shouldn’t be surprising, as this is an autoimmune condition which damages the thyroid gland, and thus affects the output of thyroid hormone. And since thyroid hormone is important in regulating the metabolism, it doesn’t take a rocket scientist to figure out why so many people with this condition have problems losing weight. However, many people continue to gain weight even when taking thyroid hormone medication, which makes this condition even more frustrating to deal with.
So why do so many people with Hashimoto’s Thyroiditis who take thyroid hormone have problems losing weight? Unfortunately there isn’t a specific answer which applies to everyone. In addition to balancing the thyroid hormone levels, obviously eating well and exercising regularly are both important when it comes to losing weight. But many people I consult with eat well and exercise frequently, yet still have problems losing weight. One thing I should bring up is that while exercise is important, if your job involves sitting down for most of the day, then doing 30 minutes of cardiovascular exercise three or four days per week isn’t going to cut it.
Although having balanced thyroid hormone levels, eating well, and frequent movement is important to maintain a healthy weight, there can be other factors which will cause weight gain and make it very challenging to shed pounds. So if you have normal thyroid hormone levels, eat well, and incorporate regular movement into your daily routine, yet still have problems losing weight, then one or more of the following factors probably are responsible for this:
1. Inflammation. When someone has an autoimmune condition such as Hashimoto’s Thyroiditis, inflammation is a factor. This inflammation in turn can affect the metabolism, as well as adipose tissue, and can lead to insulin resistance and metabolic dysfunction (1). I’ve discussed the immune-gut connection in other articles, and intestinal inflammation can cause or contribute to obesity and insulin resistance (2).
Why is this important? Well, many people with Hashimoto’s Thyroiditis who have problems losing weight think that this is due to the low thyroid hormone levels. And while this no question can be a factor, inflammation is perhaps an even greater contributor to weight gain. And it’s a vicious cycle, as not only can inflammation cause an increase in adiposity (fat tissue), but adipose tissue also secretes adipokines (cytokines secreted by adipose tissue), which can cause systemic and vascular inflammation (3). So essentially what I’m saying is that an increase in inflammation can cause an increase in fat tissue, and an increase in fat tissue can result in more inflammation, which in turn will cause more fat tissue, etc. Are you beginning to see the dilemma?
So the obvious goal is to try to break this inflammatory cycle. But how can one accomplish this? Well, eating an anti-inflammatory diet and taking anti-inflammatory supplements such as omega-3 fatty acids, vitamin D, turmeric, and resveratrol can help. However, one also needs to remove the factors which are causing the inflammation. For example, if someone has a gluten sensitivity and continues to eat gluten, then taking mega doses of anti-inflammatory supplements isn’t going to help. Similarly, if someone is reacting to dairy, corn, or another food allergen, then this allergen must be removed. If someone has a gut infection then this can also cause inflammation, and so this needs to be addressed.
2. HPA-Axis Dysregulation. Chronic stress can also lead to weight gain. In fact, numerous studies show a relationship between stress and obesity (4) (5) (6), and this might be due to dysregulation of the hypothalamus-pituitary-adrenal axis. Another study showed a relationship between 24-hour urinary free cortisol and metabolic syndrome in obese children (7). Also, elevated cortisol levels decrease the conversion of T4 to T3, and so this is yet another way that elevated cortisol levels can cause weight gain. However, another study showed no relationship between BMI, waist circumference, and cortisol (8).
Although elevated cortisol levels might be a culprit in obesity, one also can’t dismiss the health issues that depressed cortisol levels can cause. Cortisol is important for controlling inflammation. As a result, if someone has depressed cortisol levels, they will have problems controlling inflammation. And I’ve already discussed how inflammation can cause an increase in adipose tissue. So having compromised adrenals can be a factor with weight gain, and therefore needs to be considered in those who eat well and exercise regularly, yet have problems losing weight.
Also keep in mind that the best method to determine if someone has healthy or compromised adrenals is through testing. For example, on my patient questionnaire I have people rate their stress levels and stress handing skills. It’s not uncommon for someone to rate their stress levels as being low and their stress handling skills to be high, yet when doing an adrenal test through the saliva it shows compromised adrenals. So just because you feel like stress isn’t a factor doesn’t mean this is the case. Sure, every now and then I’ll run an adrenal panel and it will look fine, but for most people, chronic stress is an issue.
3. Toxic overload. Environmental toxins can also cause weight gain. Dr. Walter Crinnion discusses this in his excellent book entitled “Clean, Green, and Lean”. There are numerous studies which show a connection between toxins and obesity (9) (10) (11). A few studies show a possible connection between toxic metals and obesity (12) (13). Apparently Bisphenol A (BPA) affects the glucose transport in adipocytes and can be a factor in diabetes and obesity (14). Phthalates might also play a role in obesity (15).
The scary part is that there are thousands of other toxins in our environment, and we don’t know the impact of all of them on our health. One can’t possibly conduct clinical trials on all of the different toxins we’re exposed to, although I’m sure many of these toxins are factors when it comes to gaining weight. Since there is no way to eliminate your exposure to toxins, the only thing you can do is to 1) do what you can to minimize your exposure to these toxins, and 2) do things to help eliminate toxins from your body on a continuous basis.
Although I’m a big proponent of liver detoxification programs, sometimes doing one of these isn’t sufficient to lose weight. For example, I commonly recommend a 21-day liver detoxification to my patients. And while it’s common for people to lose weight when following such a program, some people need more aggressive forms of detoxification, such as sauna therapy, and in some cases colon hydrotherapy.
4. Estrogen dominance. Keep in mind that estrogen dominance isn’t necessarily due to too much estrogen. Although excessive amounts of estrogen is one cause of estrogen dominance, the most common cause of estrogen dominance is a progesterone deficiency. Of course many experience both problems, as they might be exposed to xenoestrogens from drinking a lot of water out of plastic bottles, and also suffer from a progesterone deficiency, which is commonly caused by weakened adrenals.
I of course have spoken about the adrenals and the role they play in weight gain. And when talking about toxins I discussed how BPA can potentially cause obesity. I mentioned the problems with inflammation earlier, and how inflammation causes an increase in fat tissue, which in turn causes more inflammation. Well, the same can be said of estrogen, as estrogen will cause the formation of fat tissue (16) (17), which is why women tend to have a higher percentage of body fat than men. Although it is normal for women to have a higher percentage of body fat than men, it becomes a problem when someone is exposed to too much estrogen, whether it’s through bioidentical hormones, or xenoestrogens. Too much estrogen will lead to excess fat tissue formation, which not only can lead to inflammation, but the fat tissue will also produce more estrogen, as well as other hormones such as leptin. So too much estrogen will lead to excess fat tissue production, which in turn will produce more estrogen, etc.
What can be done to correct estrogen dominance? I’m not going to discuss this in detail, as I’ve written a separate article entitled “Estrogen Dominance and Natural Treatment Solutions“, and so I definitely would check this out when you get the chance. Obviously if someone has too much estrogen they want to try to minimize their exposure to the source. If progesterone deficiency is the problem, then in most cases the first area to look at is the adrenals. While I’m not opposed to women taking bioidentical progesterone, many times this is unnecessary. Improving the health of the adrenals/HPA-axis will frequently help to increase the output of progesterone and will thus make taking bioidentical hormones unnecessary. At the very least one should focus on improving the health of compromised adrenals before taking bioidentical hormones.
In summary, weight gain is a problem for many people with Hashimoto’s Thyroiditis. And while eating well, exercising regularly, and correcting any thyroid hormone imbalance is important to maintain a healthy weight, often times other factors are responsible for the weight gain. These factors include inflammation, dysregulation of the hypothalamus-pituitary-adrenal axis, toxic overload, and estrogen dominance. These problems can admittedly be very challenging to overcome, but for many people with Hashimoto’s Thyroiditis who have problems losing weight, the solution lies with one or more of these imbalances.