Category Archives: weight gain

Polycystic Ovarian Syndrome Is Common in Adolescent Girls


Polycystic Ovarian Syndrome (PCOS) sounds like a rare disorder but it is surprisingly common. This is a disorder with onset in early adolescence effecting up to 10% of young women. Characteristic signs and symptoms include increasing facial and body hair, hair loss from the scalp, muscular or heavy build, acne, thickening and darkening of the skin known as acanthosis nigricans, blood sugar problems including type 2 diabetes, high cholesterol and irregular menstrual cycles and infertility. In older women with PCOS coronary artery disease is more common. In severe cases deepening of the voice and enlargement of the clitoris (clitoromegaly) can be seen. Before the underlying hormone disorders were clarified, the main method of diagnosing this disorder was by finding multiple cysts on the ovary. We now understand that the main problem is not the ovarian cysts but metabolic disorders including insulin resistance and elevated male hormone levels (testosterone) in the blood.

Another misconception about PCOS is that it only occurs in overweight women. Obesity is common in PCOS but thin women are also capable of developing PCOS. The underlying hormone problems are complex but are thought to be at least in part due to high insulin levels in the blood resulting from insulin resistance. With insulin resistance the body requires high levels of insulin due to insensitivity of the tissues to insulin’s presence.
What treatments are available for PCOS? There are very few, if any, drugs specifically approved for the treatment of PCOS. This is probably because of the low profit potential for treating this disorder. Drug companies cannot afford to invest millions of dollars in research because almost all of the existing standard therapies are generic drugs. Some of the most useful medications for treating PCOS are drugs used to treat type 2 diabetes because of their effect to reduce insulin resistance. These drugs are metformin and Actos. Metformin is the most popular oral medication for diabetes treatment in the U.S. Actos has been available for about 10 years but due to recent negative publicity about an unproven risk of bladder cancer, its popularity is declining. Neither drug is approved by the FDA for treatment of PCOS but multiple studies confirm the clinical and hormonal benefits of using these medications in this disorder. In 2011 research was published in the Journal of Clinical Endocrinology and Metabolism suggesting that the generic cholesterol lowering drug, simvastatin may also show benefits similar to metformin for the treatment of PCOS.

In the late 1980’s, I along with Dr. Lester Gabrilove at Mt. Sinai Hospital in New York, published our research showing that an anti-fungal medication, ketoconazole, could reverse the hormonal, physical and metabolic problems associated with PCOS. Due to the potential toxicity of ketoconazole this therapy never gained wide spread acceptance. The manufacturer refused to fund additional studies to determine how to more effectively use this drug, due to the low profit potential and liability concerns.

This information is strictly for educational puroses. Due to high risk of toxicity of medical therapy in young women who can potentially become fertile under treatment for PCOS, no drug should be taken without the close supervision of a physician. The reader agrees to the Terms of Service of this website, metabolism.com

Getting the Right Amount of Sleep Helps Prevent Diabetes


One aspect of lifestyle that is often overlooked is time spent sleeping. Getting adequate sleep is often sacrificed due to the demands of job and family. In the Sleep Heart Health Study over 1400 men and women were surveyed about their sleep habits and its relationship to diabetes and prediabetes. It was found that sleeping less than 6 hours per night was associated with increased risk of having diabetes. Interestingly, in those sleeping more than 9 hours per night there was an increased risk of diabetes and prediabetes.The authors of the study recommend trying to get between 7 and 8 hours of sleep per night to minimize the chances of developing blood sugar problems. To learn more about ways of preventing diabetes see pages 90 to 98 in my ebook “Metabolism.com”

Maintaining ideal body weight with diet and exercise is also crucial for avoiding diabetes and prediabetes.In overweight adults for each2.2 pounds(1 kilogram) gained per year the risk of developing diabetes increases about 50% over the next ten years. By losing 2.2 pounds per year the risk of developing diabetes is reduced about33% for the next 10 years (J Epidemiol Community Health. 2000; 54(8):596-602).

Speak to your healthcare professional to find out if you are at risk for developing diabetes and to learn ways you can avoid it.

Gary Pepper M.D.

Editor-in-Chief, Metabolism.com

The terms of service for metabolism.com apply to this and all posts; https://www.metabolism.com/2008/09/06/terms-conditions-service-agreement/

SweetiePie Doesn’t Need a Shrink to Quit Smoking


Many members here at metabolism.com have shared their thoughts and experience on ways to stop smoking. There have been many who feel defeated because they can’t beat the weight gain that accompanies their efforts. SweetiePie has a clear message about how not to beat yourself up while achieving the goal of a smoke free (and healthier) life.

Here’s what SweetiePie has to say;

Hello:

55 Year old female here, 200 lbs, hypothyroid smoke free for 6 months. Feeling great about being smoke free and this time its permanent and for real.

I have quit smoking and relapsed so many times in my life. And dieting, on again and off again for 40 years. Pfffft…..This time what prompted me to go to the doctor and quit was that my heart feels heavy and hurts sometimes. Not angina yet, but scary and depressing. I’m fine, it turns out, but I definitely needed to quit smoking and still need to exercise more and lose weight . I am no expert in the weight loss department, having had limited success with that over the years. I can see from this interesting thread that I am not as weight conscious as most of you, but I still thought I’d share what my doctors told me because it may help and inspire you the way it did to me: When I tried to bring up the weight gain and the overweight with doctors heres what they said: CARDIOLOGIST told me I’d have to be about 100 lbs over my ideal weight of 145 for the weight to be as stressful and damaging on my heart and cardiovascular as SMOKING, GP #1 told me the key was, instead of focusing on an ideal weight and size, was to focus on preventing DIABETES through NONSMOKING, AND EXERCISE just as important as wholesome diet, and GP #2 (I moved and needed a new doctor for my thyroid perscription) told me, after my bloodwork tested all ok, “why don’t you just forget about losing weight for a little while and focus on quitting SMOKING? Well, I took all of that advice, and this time, it worked! I’ve really kicked the smoking habit and finally found freedom from that deadly addiction. The “permission” from doctors to stop beating myself up about my weight freed me up mentally to do what I needed to do (giving myself plenty of rewards, including food treats and being lazy treats!) in order to become smoke free and never going back! I am ready now to step up to exercise and weight loss this year with the same strategy: Increased exercise first, food modification instead of deprivation. The reason for my post is to say stick with it but your QUIT is SO IMPORTANT – don’t ever let your desire to be thinner or to get back down to an ideal outweigh your resolve to stay SMOKE FREE. SMOKING is the singlemost damaging behavior -don’t lose sight of that! Never take another puff! Oh, btw I gained about 5% while quitting and my first goal is to go back down 5%.

What’s Inside My Ebook, Metabolism.com?


My ebook Metabolism.com is now available; I think you will find it a great resource for many of the common problems members have asked me about over the past 15 years. Buy it now and use it for years to come. Don’t forget to check out the Weight Loss and Weight Gain Programs included for free!

Chapter 1: What Is Metabolism? 9

Turning Food into Energy 10
The Importance of Hormones 11
Role of Metabolism in Weight Loss or Gain 14
Is My Metabolism Healthy? 16

Chapter 2: What Makes Your Metabolism Fast or Slow? 17

The Role of the Thyroid 22

Chapter 3: How to Increase or Decrease Metabolism 25

Problems with Losing Weight 25
Problems with Gaining Weight 34
A Pleasurable Exercise Routine is a Must 39

Chapter 4: Fact vs. Fiction—Smoking and Weight Loss 41

Chapter 5: Thyroid Treatment 47

How Are T3 and T4 Regulated? 48
Types of Thyroid Diseases 49
Hyper- and Hypothyroidism 49
Thyroid Nodules 51
Is Your Thyroid Nodule Hot? 53
Thyroid Treatments 54
Using Thyroid Function Tests To Diagnose Disease 56
Hyperthyroidism Treatments 57
Hypothyroidism Treatments 58
T3 Plus T4 Combination Therapy 59
How to Talk to Your Endocrinologist 66
The Recent Shortage of Armour Thyroid 67

Chapter 6: Diabetes Treatment 73

The Bad News—Major Stumbles in the Treatment of Diabetes 74
The Call for Tight Glycemic Control 74
2010 Diabetes Treatment Guidelines Lack Credibility 76
Setbacks in Diabetes Drug Development 81
The Failure of Inhaled Insulin 86
Dangerous Commercial Weight Loss Programs 87
Perhaps the Biggest Stumble of Th em All 89
The Good News—What Really Works 90
Diet and Exercise 90
Weight Loss Surgery 94
Incretins 95

Chapter 7: Hormone Treatments 99

Hormone Replacement Therapy—Estrogen 101
Heart Health 101
Breast Cancer 103
Benefits of Estrogen: Brain Function and Blood Pressure 104
Testosterone Replacement for Men 106
Testosterone Replacement Options 107
Benefits of Testosterone Replacement 108
Potential Risks 109
Human Growth Hormone in Adults 111
Diagnosing Growth Hormone Deficiency 113
Benefits of Growth Hormone Supplementation 113
Adrenal Fatigue: Fact or Fiction? 115

Conclusion 117

The Birth Of Metabolism.com 119
My Path Into Endocrinology 121
Recent Contributors On Metabolism.com 125

Appendix 1: Personal Nutrition Profile 127
Appendix 2: Ultimate Weight Gain Program 145
Appendix 3: Food Journal 165

Relevant Studies

HCG is a Hairy Hormone



By Gary Pepper, M.D.
Editor, Metabolism.com
In the first article in this series, The HCG-Cancer Connection, I explained how HCG is made by some types of cancer and can serve as a marker for cancer activity. Now I want to explore another effect of HCG, the stimulation of male hormone (testosterone) production.
Just to review, there is no evidence that HCG will cause cancer although conceivably certain cancer responsive tumors may grow faster due to its effect to increase estrogen and testosterone. Every woman who has had a normal pregnancy has been exposed to high HCG levels for many months so if it did cause cancer that effect would be very obvious.
What concerns me is how HCG can influence the normal ovary and its hormone metabolism. HCG is a promiscuous hormone. It will hook up with different hormone “receptors” and masquerade as these other hormones. In the previous article I explained how at very high levels HCG can stimulate the thyroid to make thyroid hormone resulting in hyperthyroidism. Another hormone effect of HCG is to mimic LH (leutinizing hormone) which turns on the production of the sex hormones by the testicle in men and ovary in woman. Surprisingly the normal ovary makes testosterone which it then converts to estrogen. FSH (follicle stimulating hormone) from the pituitary helps the ovary change testosterone to estrogen. What happens when the ovary gets a lot of LH but not FSH? This is the situation when a woman gets HCG. Testosterone levels will rise more than estrogen levels. Research shows that after a single HCG injection a rise of 20% in testosterone levels occurs in normal women, confirming this theory. During pregnancy with HCG pumping in the blood from the placenta, testosterone levels can double, resulting in acne, oily skin and (in some women) an increase in sex drive. The situation would be far worse for a pregnant woman if the placenta wasn’t also pumping out 100 times the normal amount of estrogen to counteract all the male hormones.
So why should women care if HCG makes their testosterone levels go up? Acne, oily skin and horniness are one thing but there are other effects which might be less acceptable. Testosterone is a mischievous hormone. While it causes hair growth where you don’t want it, it causes hair loss in places you want to keep it. Testosterone stimulates hair growth on the face, chest, back and abdomen. At the same time it causes hair loss from the scalp particularly at the temples and crown. This is referred to as male pattern baldness. Other effects of testosterone in women are the growth of the clitoris, known as clitoromegaly. A clitoris the size of a man’s thumb has been described in a woman due to excess testosterone exposure. Generally this degree of clitoromegaly is seen only in more extreme cases. So you may want to think twice before starting an HCG diet unless looking like Bruce Willis is your thing.
In the final installment on the hazards of HCG I will focus on other possible nasty hormone effects of HCG such as fibroids, infertility and bulging muscles.

Lovey Needs Encouragement to Deal with Her Condition


Sad LadyLovey posts this sad message to metabolism.com. Many of the members here have been through this type of paralyzing doubt and have found a way to get the help they need. So, if you have a minute to spare, in the spirit of the season, why not offer Lovey a message that will help her get her nerve up to go to the doctor.

Lovey writes:

Hi, I’m too scared to go to the doc as I have a large lump in my throat. I don’t know much about thyroids or how it works an wat the worse case situations r. Alls I know is that the lump is about as round n size of a golf ball maybe abit smaller. I’ve had this lump for about 4 years an it’s recently started to get bigger. Ive gain about 12kg in about 8 months but I still do everything the same. I weigh 75 kg an MT height is 174cm. Something is wrong isn’t it!!!

Here is my reply to her;

Hi Lovey

A sluggish thyroid often produces a “lump” in the neck (which is the enlarged thyroid) and weight gain due to a slow metabolism. I’m not sure if you believe me but there really isn’t anything to be scared about. For example, if it turns out your thyroid is under active (low functioning or hypothyroid) the treatment is very simple. For most people taking one pill per day is all that is required to get back to normal. May people with hypothyroid are taking their thyroid pill and feel fine.

It’s hard to say exactly what the problem is in your case, but I wouldn’t be surprised if it is something like hypothyroidism, which could be fixed so easily.

So please get yourself to a doctor, clinic or whatever and have them look into this. Then you can stop worrying so much.

Okay? Let us know what happens. I’m asking other members here to give you their words of support as well, since many of the members here have gone through what you are experiencing and are happy they received proper treatment.

Dr. G. Pepper