Tag Archives: fatigue

If Hypothyroid and Unhappy, Which Came First?


If Hypothyroid and Unhappy, Which Came First?

By Gary Pepper, M.D.

Sad LadyMedical specialists increasingly accept that some patients being treated for hypothyroidism continue to be symptomatic and “unhappy”. The degree to which patients experience this problem while on conventional treatment for hypothyroidism with levothyroxine (Synthroid, Levoxyl, Unithroid, T4) has motivated many specialists to look for other approaches to treatment such as adding T3 (Cytomel, liothyronine) or switching to desiccated thyroid extract (Armour, WPthyroid, Westhroid

Not all experts are convinced looking for new treatment options for hypothyroidism is the right approach. Continue reading

Can a Blood Test Identify Those Who Need T3 for Proper Treatment of Hypothyroidism?


Dr. Gary Pepper and Dr. Paul Aoun discuss recent findings about thyroid hormone treatment at the 15th International Thyroid Congress

Dr. Gary Pepper and Dr. Paul Aoun discuss recent findings about thyroid hormone treatment at the 15th International Thyroid Congress

According to experts, 10 to 20% of hypothyroid individuals fail to respond completely to T4-only (levothyroxine, Synthroid) treatment. Dr. Anthony Bianco, the president of the American Thyroid Association, and his associates believe this is due to genetic variations in the way thyroid hormone is converted in the body from T4 into T3. T3 is the much more potent form of thyroid hormone and unless the cells of the body receive enough T3, normal function cannot be achieved and symptoms of low thyroid such as fatigue, mental fogginess, constipation, muscle aches etc, persist. Based on the research conducted by Dr. Bianco and colleagues it is thought that in those with the genetic trait making T4 treatment ineffective, blood tests would show low T3 levels. Continue reading

Eight Suggestions to Help Get Your Booty Back


jumpingladyBy Gary Pepper, M.D.
The views and opinions expressed here are those of the author and may not reflect the opinions of your health professional. Please consult your own doctor before embarking on any new exercise routine.

Lack of energy and inability to lose weight are constant challenges for many people and are every day complaints encountered in the doctor’s office. Studies show that almost everyone can find some relief from these problems by accessing the healing properties of physical activity. In my experience, mentioning the need for “more exercise” often results in rolling of the eyes, sighing, shrugging, snorting or worse yet, the hundred yard stare. Yes, we all know exercise is important but who has the energy for that? It seems like a vicious cycle. What is surprising is that when done correctly, exercise can actually improve energy with the additional advantage of promoting weight loss, and restoring tone and stamina. It is helpful to remember that the human body was designed for a lot more physical activity and a lot less food than we are privileged to experience in present day life. It therefore takes will power and knowledge to maintain the environment required for optimal health. Here are eight steps to get in the swing of regular exercise. Some suggestions may surprise you. Continue reading

How Light Effects Your Metabolism by Jim Rollince


A guest contributor, Jim Rollince, shares this informative article on how the amount of light in our environment can have a big impact on health.

Jim writes:

Ambient Light During Sleep and The Affect on Metabolism

By Jim Rollince of Gym Source, distributor of home gym equipment, including treadmills, ellipticals and other home gyms.

Frustrated that your exercise routine and constantly calorie counting has not yielded any weight loss results? Are you in fact gaining more weight then before you began exercising and monitoring your food consumption? The key to your weight gain could be a result of an external factor that you never took into account, the exposure to light at night.

New research in sleep science has shown that prolonged exposure to light during the regular nighttime sleeping hours may cause weight gain. This weight gain occurs independent of daytime calorie consumption and physical activity.

These research findings came out of a study by the Proceedings of the National Academy of Sciences. The study tested animals, and the findings have begun to raise discussion from the scientific community based on whether the human body experiences metabolic sluggishness and weight gain as a result of too much light exposure at night.

A research team from Ohio State University discovered that mice exposed to a dim light during the course of a night for roughly a two-month period, gained 50 percent more body mass than mice exposed to a regular light-dark cycle. “Although there were no differences in activity levels or daily consumption of food, the mice that lived with light at night were getting fatter than the others,” said Laura Fonken, a neuroscience doctoral student at Ohio State and director of the study.

Although the lab mice were exposed to nighttime light they did not become less active nor eat more. However, they did eat at times when they normally wouldn’t. In fact, in one part of the study when the mice were exposed to light at night and then restricted from eating with the exception of their normal feeding times, they did not experience more weight gain.

“Something about light at night was making the mice in our study want to eat at the wrong times to properly metabolize their food,” Randy Nelson, professor of neuroscience and psychology at Ohio State and co-author of the study.

The researchers found that levels of the stress hormone corticosterone were not different among the mice exposed to the dim light and mice exposed to standard light-dark. This finding was surprising for the research team since corticosterone is connected to changes in metabolism. The research has shown that changes in metabolism have the potential to cause weight gain independent of corticosterone levels.

What is the link between dim light at night and fat-causing changes in one’s metabolism? The Ohio State research team postulates that the presence of light during the night works to disrupt hormone melatonin. Hormone melatonin plays a significant role in the functioning of the metabolism. To this end, light exposure at night could in fact disrupt expression of clock genes, which aid in controlling the time animals choose to be active and eat.

Dr. Nelson furthers her comments by saying that if her team’s research results are confirmed, eating late at night is a serious contributing factor to obesity. “Light at night is an environmental factor that may be contributing to the obesity epidemic in ways that people don’t expect,” he said. “Societal obesity is correlated with a number of factors including the extent of light exposure at night.”

Past research similar to this study have been prolonged television and computer use as contributing risk factors for obesity. Yet these studies were centered in the idea that engaging in prolonged television or computer usage contributed to a lack of physical activity. The current connection between weight gain and the light coming from a TV or computer, is related to the disruption of the metabolism via the negative bodily effects of getting too much light exposure at night and eating at the wrong time.

“Clearly, maintaining body weight requires keeping caloric intake low and physical activity high, but this environmental factor may explain why some people who maintain good energy balance still gain weight,” Dr. Nelson’s press statement.

What is My Correct Thyroid Dose?


Lots of members at metabolism.com with hypothyroidism ask what is their correct thyroid hormone dosage. For those who are still confused I am posting the latest Q and A addressing this issue.

Member ecchho received radioactive iodine for hyperthyroidism (over-active thyroid) and as commonly happens, developed hypothyroidism (under-active thyroid). Despite t4 levels which appear to be normal symptoms persist, so ecchho inquires about ways of dealing with this common problem.

Here is the Q and A regarding ecchho’s post:

Hi Dr. Pepper:

I had Graves disease at 23 and then had RAI at 28 and have been on synthroid for 18 years. I did try ARmour once, but I found it had too much t3 (I think the pig’s ratio of t4 to t3 is much more potent than humans) and I actually had a real hard time regulating. I don’t have a thyroid anymore, and I take 225 synthroid. i still suffer a bit with impossible weight loss (despite running, dieting, etc) and some depression that feels quite hormonal at times. My dr. brought up adding t3 last visit and tested me, and then said, oh, you don’t need any xtra t3, you seem to be converting fine.
what are the levels that the t3 should be, and is this free t3 or t3? thanks.

My reply to Ecchho’s post:

Your question regarding the correct level for thyroid functions, is frequently raised on this website. I would respond to your question with this question, ” What is the correct shoe size?” Obviously, the answer is, whatever shoe size fits best. Similarly with thyroid function, everyone has a different “comfort zone” where their body functions best. That is their “correct” thyroid hormone level. You also refer to a t4 to t3 ratio for pigs versus humans. These ratio’s are averages of several hundred individuals (human or pig)and do not apply to any particular individual. Some people function better at a t3 to t4 ratio which is higher than the average. As pointed out in my article,https://www.metabolism.com/2009/11/07/breakthrough-discovery-thyroid-hormone-therapy-part-2/ , there is recent evidence that due to genetic differences, a percentage of the population does not convert t4 to t3 efficiently and therefore are likely to require t3 supplementation when treated for hypothyroidism.

Rather than spend the money for genetic testing to discover whether the genes for conversion of t4 to t3 are abnormal, some doctors recommend simply adding an appropriate dose of t3 to the standard t4 (levothyoxine)treatment and following the patient for improvement in clinical symptoms. You might want to consider discussing this approach with your doctor.

Gary Pepper, M.D

Sally Anne Wins Our Free Nutrition Consultation


Sally Anne’s submission was chosen by Beth Ellen DeLuglio as the winner of a free nutrition consultation. Beth and Sally have already been working together for the past week. We look forward to keeping members of metabolism.com posted on their progress.

We thank those of you who submitted your thoughts to this contest and hope that by keeping up with Sally’s comments, problems and progress that you can gain useful information to help you achieve your own goals. We also plan to rerun the contest in the near future so keep your eyes open for more information.

Sally’s winning comment is as follows:

The biggest obstacle to acheiving my weight loss is many-fold and complex as I believe it is for most. I believe my sleep apnea is the worst “culprit”. I also have Hashimoto’s thyroid disease and in 2006 I crash dieted and lost 82 lbs in 11 months only to suffer a rapid rebound weight gain of 40 pounds. For over two years, I have not been able to get this weight off. I was previously insulin resistant and had surgery on PCOS. The fibromyalgia affects working out. I feel that all of these issues feed off one another. It is crystal clear to me that feeling poorly every day from debilitating fatigue is the biggest obstacle to acheiving the weight loss I so desperately need. I really do need help. I want to live before I die.

EMT Offers Advice for Coping with High Metabolism


While many members of metabolism.com struggle with low metabolism, fatigue and weight gain, there are those who struggle with the opposite. Being underweight can be as difficult to cope with as being overweight. Here is advice from one of our members who is an emergency medical technician, on how he has adjusted to this issue.

BeachEMS writes:

I am 28 y/o 5′9″ and I weigh 146 lbs. I have a high metabolism and it bothers me, too. I currently go to the gym at my rescue squad (which is free, thank god!) 3 days a week. I know that I have to eat more protein, carbs and high calorie foods in order to “pack on the lbs” especially since I workout regularly, but it is difficult to really discipline myself to eat them daily and in abundance because I get tired or sick of eating them. Anything worthwhile isn’t easy so its discipline, discipline, and more discipline.. and its pasta, pasta, and more pasta lol

I used to be really stressed out through highschool and college, too.. because of being in school, being underweight, having mild acne, not sleeping much at night, etc. Finally, I am in a good place in my life. I am with EMS, got a good job as an EMT, I go to the gym frequently, manage my stress levels with quiet/down time to myself and have cleared my acne.. I am slo getting plenty of sleep at night, which is a huge factor for those of you who work out in the gym.. because you know your muscles need time to repair and rebuild (plenty of water helps, too.. ) STRESS can cause weight loss so it might be a good idea for those of you with high stress levels to MAKE time for yourself to reduce stress. Consider every day events and feelings that cause you stress and work on eliminating them.. not for peace of body, but for peace of mind, too. Pilates, yoga, breathing exercises, meditation and a good self image are all good sources of stress relief.

How you see yourself is who you are. If you see yourself as being weak and nothing then you are telling yourself thats who you are.. and ultimately that is who you will be. A huge part of becoming someone you want to be (the best version of yourself) is to become that person from the inside out. Think like the beast and tell yourself “I am a raging beast!” When you’re at the gym, let out some groaning and moaning or shout something aggressive when you reach your peak rep of whatever set you’re doing. It will push you to go harder. What you put into the gym is what you get out of it and I have learned that recently. I’ve got to “step it up”.

Plenty of water, good/lean protein, carbs, vitamins, sleep at night (at least 8 hrs) and aggressive workouts are doing it for me, little by little, but I’ve got to step it up. My goal is 160 lbs by summer 2010. I am going to acheive my goals.. ARE YOU??