I have a teen client who can't eat more than 1100 calories a day without gaining 3-4 pounds in a day. She does an hour cardio and strength training everyday. She is 5'6" and weighs 132. Her ideal weight is 125. She eats very healthy. I assumed it was her thyroid; but after having it checked her TSH is below 2.5. Any suggestions?

Answer:
This is the common theme of most Americans these days. We see either most people eating lots of CRAP (Caffiene, Refined/Processed foods, Alcohol or Aspartame and Pasteurized Milk) foods within some fad diet program or cutting calories back in order to loose weight. I can tell you from my clinical experiences, that neither one works. Remember, it takes life to give life!

The body actually needs about 1500 calories a day just to survive. The body is a fine tuned piece of machinery that needs the right amount of energy in order for things to happen, be produced, eliminated and so forth. So we actually need more than 1500 calories when we are active, are in school and thinking a lot, have kids, are pregnant and so forth in order to keep up with the demands of what we are doing. The Chinese believe that the more we think, the more we use our spleen (which makes qi and blood) and the more qi and blood deficient we become. This can lead to a lot of issues, but internal stagnation being one of them. Which in TCM, excess weight is typically due to qi or blood stagnation.

The thing I see most is that most people yo-yo diet. There are many downfalls to this:
1. You don’t learn anything from dieting. All you learn is how to imprison yourself for 3-6 months. Nutrition is a lifestyle that needs to be taught so one can apply it for a lifetime!
2. You create more lipogenic enzymes (fat storing) each time you diet
3. You decrease the number of lipolytic enzymes (fat burning) each time you diet
4. You create increase in the size of fat cells
5. You decrease lean body mass and basal metabolic rate
6. Each diet makes it harder to restore normal basal metabolic rate
7. You create insulin and blood sugar handling problems, which most of the time creates fat storage and hypoglycemic symptoms = cravings!
8. Any time insulin goes up, estrogen goes up, which creates estrogen dominance (not enough progesterone to oppose estrogen). You can read up on this by reading work done by Ray Peate (www.raypeate.com).
9. With dieting, which is a stress, the body converts more hormonal precursors (cholesterol and pregnenolone) to cortisol, than to progesterone. This leads to estrogen dominance, which leads to excess weight around the midsection and gluteal cleft area (according to Charles Poliquin, this is where there are a lot of estrogen receptors). Estrogen is stored and produces in fat cells. The more you have or the more dominant you are with estrogen, the harder it is to loose fat.
10. With dieting, which is a stress, more cortisol is released. When cortisol goes up, insulin goes up to protect the body. Both of these are convert glucose into fat =fat storing hormones.
11. With dieting, most decrease the amount of protein intake. The liver needs protein in order to detoxify estrogen. Estrogen inhibits T4 to T3 conversion, which slows down the thyroid and metabolism.
12. Most people decrease the amount of good fat when dieting. You can’t get fat from eating fat. Fat requires bile to be broken down, not insulin (which is a fat storing hormone). It actually takes fat to loose fat!

Eating, life and nutrition is supposed to be fun. I personally feel that most Americans have turned eating into their own prison. You can’t eat this, you must do that, shame for eating this, shame for doing that. How fun does that sound? The goal here is fun, that is what life is all about. It should be celebrated and not just lived!

It is impossible to loose weight and keep it off while cutting calories. The more you cut, the more stress it is, the more you body will eat itself, the more your hormones will be out of flux, the more fat storing hormones are released in order to keep fuel (fat) for the body, and the more you tell you thyroid to slow down as a protective mechanism in order for the body to keep what little fuel it has to live on.

In the beginning it will be tough. She might gain weight, but in the end she will loose a bunch and keep it off. You need to educate her on how to eat and how to live, not how to cut calories. Loosing weight is all about the physiology in your body and getting healthy within. That will create the body she wants.

As for the lab test, well if they did not run a full thyroid lab and test for everything, than it was a waste of time. Just testing TSH, which is released by the pituitary to signal the thyroid to turn on, is not valid.

Here is why:
1. Most are blood tests that are done to be cost effective. Most of the function of the thyroid cells happens inside the mitochondria out of reach of standard tests.
2. The thyroid might be inhibited by adrenal stress or if one is estrogen dominant. So the thyroid typically just ignores the signal from the pituitary. So one might show up with high levels of TSH, because the pituitary keeps releasing TSH so the thyroid will respond or vice versa.
3. The thyroid does much more than just release TSH, according to Rothfeld in Thyroid Balance, total T4, FT4, total T3, FT3, rT3, TBG, RAUI, antithyroid microsomal antibodies and anti-TPO antibodies need to be tested as well in order to get a true function of what they thyroid is doing.
4. Some will disagree, but from my experience, I find most have thyroid issues as the byproduct of an adrenal gland issue or from being estrogen dominance. This can come from many areas such as poor nutrition, stress, the birth control pill and so forth.

Here is what I would do to get her on track:
1. Find someone that can run some labs on her. She would want to do an adrenal test and full female hormone profile. You can sue the company BioHealth Diagnostics (www.biodia.com).
2. Begin educating her that you have to get healthy to loose weight, not loose weight to get health. Some resources you can use are local Holistic Health Practitioners, CHEK Nutrition and Lifestyle Coach, www.mercola.com, finding a Metabolic Typing Advisor (www.metaboliced.com) or to a skilled nutritionist that is schooled more in the holistic aspect of healing. There is more to health and loosing weight, than just nutrition.

With Qi,
Joshua Rubin