Published July 1 2013
Many people with thyroid and autoimmune thyroid conditions have a difficult time losing weight. While this typically is the case with people who have hypothyroidism and Hashimoto’s Thyroiditis, occasionally I consult with someone who has a hyperthyroid condition and has problems with weight gain, although this usually is due to the effects of antithyroid medication. When someone has problems losing weight, in most cases the two areas they focus on are diet and exercise. And without question, eating well and exercising regularly are both important in order to maintain a healthy weight. However, there are some people who eat well and exercise regularly, yet still are unable to shed those unwanted pounds. When this is the case, insulin resistance may be the culprit.
I previously wrote an article entitled “Insulin Resistance and Thyroid Health“, and so I’m not going to get into detail about what insulin resistance is, the symptoms associated with it, and how to test for it, as you can refer back to this other article for this information. As the name implies, insulin resistance occurs when the body becomes resistant to the effects of insulin. Although dietary factors play a big role in the development of insulin resistance, once someone develops insulin resistance, eating well alone probably won’t be sufficient to correct this problem.
Inflammation and Adiposity
In the previous article I wrote, I briefly spoke about the effects of insulin resistance on inflammation and weight gain, and in this article I would like to expand on this. I want to begin by talking about the two types of adipose tissue (fat) in the body. One type is brown adipose tissue, and this consists of a large number of mitochondria and is metabolically active. This type of tissue is present in high quantities only in infants. The second type of adipose tissue is white adipose tissue, which is the main site of long-term storage of fat, and is responsible for abdominal obesity, along with conditions such as type 2 diabetes and cardiovascular disease. Fat cells, also known as adipocytes, also secrete numerous hormones, cytokines, and other proteins (1).
Let’s shift the focus now to inflammation. There are numerous factors which can lead to inflammation, including poor diet, stress, exposure to a pathogen, a leaky gut, as well as other factors. Although the inflammatory process is quite complex, what’s important to understand is that inflammation is due to the response of the immune system, and during inflammation the body will release histamine, leukotrienes, prostaglandins, cytokines, etc. These play important roles in the inflammatory process. I’m not going to get into too much detail about this, but something else that gets activated during an inflammatory process is something called nuclear factor kappa B (NF-kB), which also plays a big role in this process. And depending on the severity of the inflammatory response, you might see an elevation of inflammatory markers such as C-reactive protein (CRP).
Although many people think of adipocytes (fat cells) as serving only as storage cells, the fact is that they are quite active. Just as is the case with immune cells, adipose tissue can also produce cytokines (i.e. IL-1, TNF alpha, macrophages). But how does this relate to weight gain? Well, if someone eats a poor diet, then there will be an increase in glucose levels, and a resulting increase in adipocytes. In other words, excess carbohydrates will convert into triglycerides, and so eating a lot of refined foods and carbohydrates will increase the adipocytes, and thus lead to weight gain.
But many people aren’t aware that these adipocytes release inflammatory mediators into the peripheral circulation (2). And so essentially the more fat cells someone has, the more inflammation they have. In addition, there are also adipocytokines released by the adipocytes that are involved in the regulation of dietary intake, and one of the most well known adipocytokines is leptin. Leptin is involved in the regulation of eating. There are leptin receptors in the hypothalamus which regulate satiety, and when these leptin levels increase (which is the case in obesity), this results in a loss of feedback regulation, which essentially increases the appetite of the individual.
Putting This Altogether
I usually try to make the information in my articles basic so that most people can easily understand them. But I realize that the information in this article might be a little complex for some people, and so I’m going to attempt to simplify this. The overall point you want to understand is that eating a lot of carbohydrates will lead to increased glucose levels, and this will lead to an increase in fat cells. And the more fat cells you have, the more inflammation you have. And while eating well and exercising regularly is important, doing this may not be sufficient to break this inflammatory cycle.
And this really is a viscous cycle, as before I mentioned something called nuclear factor kappa B (NF-kB). NF-kB is a protein complex which is involved in the transcription of DNA. It helps to regulate the immune system response, but during certain inflammatory conditions it can become chronically active. This actually includes autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis. And chronically activated NF-kB can lead to other conditions such as leaky gut syndrome and estrogen dominance.
Addressing The Inflammation Is The Key To Losing Weight
If insulin resistance is responsible for weight gain, then the key to losing weight is to break the cycle that is resulting in the inflammation. But how is this accomplished? Well, one must first remove the trigger. This is where diet comes into play, as if a poor diet consisting of too many carbohydrates is still an issue, then this needs to be addressed. You also want to minimize your consumption of pro-inflammatory foods, such as red meat and dairy. However, this probably won’t be enough to stop the inflammation.
In order to stop the inflammation you need to inhibit NF-kB. This is where supplementation can help, as certain supplements which can help to inhibit NF-kB include vitamin D, omega 3 fatty acids, resveratrol, and turmeric (3) (4) (5) (6). In addition to eating well and taking some of these supplements, managing one’s stress is also essential.
However, remember that chronic activation of NF-kB can lead to other conditions, such as leaky gut syndrome (7). If this is the case then these issues need to be addressed. So as you can see it can become quite complex, as while eating well and taking certain supplements definitely can make a big difference in some people, for other people it can be very challenging. In fact, many of the people I consult with have already made dramatic improvements in their diet and have been taking numerous supplements, yet still have problems losing weight. These situations definitely involve some detective work.
So hopefully you have a better understanding of insulin resistance, and how having this condition can lead to weight gain. And those who have this condition not only need to focus on eating well, but also need to stop the inflammatory process, which involves inhibiting NF-kb. In addition, if someone has another condition such as leaky gut syndrome then this needs to be addressed as well.