Category Archives: fitness

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

Margie Reports Her Success with Armour Thyroid


Hello, Everyone

I was diagnosed Hypothyroid 10 years ago, I have two sisters and several aunts with the same problem. I was prescribed synthroid and it was a Godsend for the first three years even though I was up and down, however I began to be more and more tired and just generally did not feel good, my dosage was up and down, finally doctor prescribed cytomel to go with it. still no good my bones hurt all the time especially my hip going down my leg and in the middle of my upper back, my beautiful teeth damaged. I finally told my Doctor to either give me the Armour or I was going to find another Doctor who would, He did and shazamm all symptoms disappeared, I feel great Like before I ever had this problem, I Thank God for Armour, and I also avoid flouride, chlorine

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.

Bariatric Surgery Benefits Last for Years


One of the biggest problems with weight loss programs and diets is that even if they work the weight tends to come back on within a year or two. A recent study from the University of Utah of people who underwent bariatric surgery shows that not only do they lose weight quickly, after 6 years they continue to maintain their lower weight. After undergoing bariatric surgery the average weight drop was 35% of the original weight and after 6 years weight loss was still a very encouraging 28%. 75% of diabetics who had bariatric surgery were able to go off their diabetic medications, while improvements were generally seen in cholesterol levels and blood pressure.

Although this study shows a very high success rate, in the real world medical practice I have seen many people who are able to eat their way out of weight loss success after bariatric surgery. Eating small amounts of very high calorie food is still possible and unfortunately is not all that uncommon. Not to say that bariatric surgery is not helpful, because when it works the results can be spectacular, but as always the degree of motivation of the patient is crucial to success.

Gary Pepper, M.D.
Editor-in-Chief, metabolism.com

They Quit Smoking, Their Metabolism Slows, but Good Attitude Gets Them Through


Here are some encouraging stories from the front line against smoking. It’s a desperate struggle at times but our members share their gutsy approaches that have gotten them through the tough times.

Beach Gal writes:

10 months on Nov 15!
Weight has plateaued at 15lbs gained. 48 years old with perimenopause too.
So here are my thoughts….you have to surrender to the fact you might gain some weight or even maybe alot. We’ve done years of damage to our metabolisms and it will take time to correct that. Also, surrender to the fact you might not be your size 6 or 8 anymore. So what? We don’t smoke. Nothing is more ugly than smoking. There are plenty of heavier women out there who embody beauty. Their spirit shines and they have confidence and self esteem. Smoking robs us of both. Have you ever tried dating online? NO ONE wants to date a smoker.
Anyway, single or married, it doesn’t matter. We matter. I have never laughed so much in my life as I have in the last 2 months. Really laughed. And this while I’m unemployed, my father has cancer, my dog died, and my boyfriend and I are on the rocks. We come first. Period.

Regarding weight…..if you have an “orange theory fitness” near you, join. It’s the cost of 1 month of smoking and will reinforce your quit. Great for us gals in our 40′s 50′ and 60′s too. They know how to get your metabolism cranking. 3 days a week. And could you be drinking a little more wine than usual? I found that I started drinking too much wine….and i don’t even like wine. So had to cut that out!

Here is what V has to say about quitting the cigarette habit:

I agree that the weight was the worst thing. As unhappy as I am about the weight, I am so very happy that I have been quit for 1 year now. With the money I have saved, I have picked up some other hobbies that I enjoy so much, that I would never be able to afford by wasting my money on cancer sticks daily. And, not to mention the health benefits, like being able to breathe, by not sucking down those stupid things. I feel so free when I watch or listen to people scramble trying to figure out how long the cigarettes they have in their pack will last because they don’t have the money or the time to get to the store for another pack, or they can’t wait to leave a non-smoking establishment. I’m not unhappy because I’m fat, it’s just a minor set back. Maybe there are days I get upset over it, but it doesn’t cause me to be an unhappy person. I hope you can overcome your fear of whatever weight gain you may have (it is different for everyone).

Lizzy adds her experience:

Elisa, the benefits of quitting are unreal. I have my first cold since this all happened, yes I still have the weight gain, its not been a year quite yet and I have to say this cold is quite different then I have ever had, it has not settled into my lungs. The weight has leveled off and it seems i am turning the fat into muscle by walking so much. Elisa you have gotten over the nicotine in the system, you need to cut the habit of hands and grabbing, you will be fine, not all people gain 40 or 50 pounds. I have always been a size 6 and now a 12 to 14 and yes that’s killing me, but it too will pass, i have never breathed so deeply in my life. i have never smelt things quite the way I smell them now, and wow food is so different too. You will gradually find out all these things. Honestly the worst thing was the weight gain, but the other benefits make up for some of that.

New Drug Combination May Revive Post-Menopausal HRT (Hormone Replacement Therapy); Part 2


Probably the major cause for concern regarding post menopausal HRT (hormone replacement therapy) highlighted by the WHI study was an increased risk for breast cancer. This finding applied to women in the WHI who were using combination estrogen and progesterone replacement. Progesterone is given to counteract the effect of estrogen to cause uterine (endometrial) cancer but is not crucial for relief of post-menopausal symptoms. Interestingly, women who used estrogen replacement alone (without the progesterone) actually showed no increase and possibly even a reduction in invasive breast cancer after 7 years on treatment. In the group of women who started “estrogen only” replacement more than 5 years after entering menopause, the reduction in breast cancer was even more pronounced. Experts therefore conclude that “estrogen only” HRT is likely to be considerably safer from a breast cancer point of view, and starting estrogen 5 years after menopause reduces the cancer risk even further.
The relationship between estrogen use and breast cancer risk is further complicated by the finding that post-menopausal women using HRT who develop breast cancer appear to have better survival and less aggressive tumors than post-menopausal women who are diagnosed with breast cancer who never used HRT. Breast cancer may not be caused by estrogen, but cancer may grow more rapidly in the presence of estrogen. This doesn’t sound like an advantage but small undetected cancers may grow rapidly with HRT so that they can be seen on mammography and removed before they can spread.
New drug combinations in development offer hope to women who are looking for HRT alternatives. A class of drugs known as SERMS of which Evista is a member, used in combination with estrogen has shown promising results in clinical studies. A SERM will protect against the uterine cancer causing effect of estrogen so progesterone is no longer needed with HRT. This immediately reduces many of the undesirable effects of HRT found in the WHI including breast cancer risk and producing better cholesterol effects. This combination of drugs is referred to as a tissue-selective estrogen complex (TSEC). Other advantages of TSEC treatment are improvement in bone density (lower osteoporosis risk) and possible reduction in coronary artery disease development. Although TSEC treatment is not yet FDA approved for treatment of post-menopausal symptoms, individual doctors can prescribe this if they feel the available information is favorable and the risk/benefit ratio is in favor of the patient’s well being.
Finally, there is the issue of blood clots associated with estrogen treatment. This is likely due to the effect of estrogen to alter the balance of certain blood proteins that favor blood clot development. My thought is that adding a simple baby aspirin daily may reverse or significantly reduce risks associated with increased blood clotting with estrogen, just as baby aspirin is now recommended for those at increased risk of heart attack. Aspirin is unlikely to be helpful to prevent blood clots in veins referred to as DVT but this is not completely certain. As with all medications there are downsides to aspirin such as gastric irritation and ulcer bleeding but these risks can be assessed by the individual and their doctor.
(This information is for educational purposes only and does not constitute medical advise or establish a doctor patient relationship)
Gary Pepper, M.D.
Editor-in-Chief, metabolism.com