Posted by MERM on 4/17/2009, 5:44 am
Studies have shown that people suffering from Fibromyalgia and Chronic Fatigue Syndrome gain an average of 32.5 pounds, but what factors truly drive the increase in weight gain? Research has shown that the most common contributors to the increase in weight gain are thyroid dysfunction and hypothalamic dysfunction.
Let’s address the most common — thyroid dysfunction.
As many of you are aware, your thyroid plays a very important role in metabolic dysregulation in fibromyalgia.
The main function of the thyroid hormone is to stimulate metabolism and keep the body fueled. In hypothyroidism, the metabolism actually slows down and causes a reduction in energy.
This means that the food you eat is not efficiently burned for energy, but is stored as fat. On the opposite end of the spectrum, hypothalamic dysfunction contributes to inappropriate hunger, which results in an increase in caloric intake with a state of low caloric burning.
Hypothalamic-pituitary-thyroid/adrenal/ovarian/testicular deregulation contributes to many of the concerning symptoms that often accompany weight gain: fatigue, dry rough skin, little bumps on the upper arm (follicular hyperkeratosis), poor sleep, and emotional symptoms, to name just a few.
To understand these two functions, here is how the normal system should work.
The hypothalamus links the nervous and hormonal systems via the pituitary gland.
The pituitary gland secretes, among other things, thyroid stimulating hormone (TSH), which in turn prompts the thyroid to secrete more T4 and T3 to maintain metabolism.
Adrenocorticotrophic hormone (ACTH), from the pituitary, stimulates the release of cortisol from the adrenal cortex. Luteinising hormone (LH), also from the anterior pituitary, stimulates progesterone secretion in the female and testosterone in the male. Follicle stimulating hormone (FSH) stimulates estrogen secretion by the ovaries.
The pituitary gland also secretes growth hormone, the master hormone, which helps maintain healthy muscle bulk and decreases adiposity.
Considering the above complexity of hormones, it is easy to see how hypothalamic malfunction can cause weight gain.
If these hormones are low or resistant, it creates a metabolic slowdown and high cortisol, which increases fat deposition, causes continuous carbohydrate cravings, and ultimately results in weight gain.
Is it important to get my thyroid tested?
Yes, your physician uses both laboratory tests results and clinical observations to assess your thyroid status.
Clinical observations need to be confirmed by laboratory testing.
Can I be hypothyroid even if my blood tests are normal?
Yes! There are many factors, but let’s look at TSH first. T3 is the main biologically active thyroid hormone. 90% of thyroid hormone output is T4 and 10% is T3. T4 is then changed to the active T3 by deiodinase enzymes mainly in the liver and alimentary tract.
Testing for free T4 and free T3 is therefore a more reliable indicator of actual thyroid hormone status.
There are two ‘buts’ here: Reverse T3 (rT3) is a product of a rogue enzymatic conversion that actively blocks thyroid receptors, making any given level of T3 less effective physiologically, and thyroid receptor resistance.
Sadly, most family physicians only measure TSH and sometimes T4 to determine thyroid function, which is grossly inadequate.
A more accurate way to determine actual physiologic thyroid status is to measure levels of TSH, free T3, free T4, and reverse T3 and then correlate the lab findings with clinical observations.
If you have normal or even high-normal thyroid hormone levels, but you are overweight, tired, have dry rough skin, suffer from constipation, decreased libido, depression, or any of the many different symptoms of hypothyroidism, it is obvious that the levels are not high enough for you or that you have thyroid hormone resistance.
Treating a thyroid condition can be very tricky; here are a few signs and symptoms to watch for:
fatigue
weakness
weight gain
cold intolerance
muscle aches headaches
decreased libido
depression
hair loss
dry skin
Conditions associated with hypothyroidism include:
hypertension
atherosclerosis
hypercholesterolemia
hyperhomocysteinemia
menstrual irregularities infertility
premenstrual syndrome
chronic fatigue syndrome
fibromyalgia
fibrocystic breasts polycystic ovary syndrome
depression
diabetes
insulin resistance
After everything is said and done, the process starts with making sure the right tests are done and that the findings are reviewed with more than the laboratory reference ranges in mind — laboratory tests are a poor substitute for a grounded clinician’s observations and a sharp ear attuned to interpreting related symptoms posted by MERMIE wellnesstrain
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