Fast Weight Loss & Hunger Hormones
Posted: January 27, 2012 Filed under: Blog, Research Reviews Comments Off| Summary: Short-term very-low-calorie dieting disrupts powerful hormones that control appetite, hunger, and satiety for up to a year after a strict diet. Crash diet now, feel hungry later… even several months later. |
What is the top New Year’s resolution? Lose weight.
Every year, people with good intentions set out to lose weight, only to have even more weight to lose the next year later. (Resolutions seem like such a good idea when you’ve got a party horn in your hand and a gold cardboard top hat on your head, swimming in a champagne-induced fog.)
One problem is that people try to lose weight quickly. Unfortunately, even if they manage to drop a few pounds fast, they bounce right back… and often, keep on gaining.
By slowing down the weight loss process and teaching life-long healthy habits, PN’s very own Lean Eating program is designed to avoid the cycle of perpetual weight loss.
Now, research confirms our methods. (But we knew that already.) Only slow and steady progress leads to lasting change. Why?
Appetite hormones: Why self control is not the problem
Myth: weight loss is all about self control.
People berate themselves or are judged by others for carrying a few extra pounds. To be fat means you’re weak-willed, spineless, and/or impulsive.
Fact: Powerful hormones control our perception of appetite and hunger, as well as our eating behaviour.
While you still have the option of self-control, your body definitely has a strong voice in the matter. And “willpower” breaks down easily under stress; when blood sugar is low; and/or in environments that don’t support weight loss (like an office where everyone has a candy dish and it seems like someone has a birthday cake every day).
Here are some of the more well-known hormones that influence appetite, hunger, and satiety.
| Cholecystokinin (CCK) | Released in the small intestine when fats and proteins are eaten. Receptors that respond to CCK are not only found in the gut but also in the brain. In the brain CCK depresses hunger, meaning the more CCK you have floating around the less hungry you are, and the less you’re likely to eat. This is why a lower-carb, higher-protein, higher-fat diet tends to make people feel fuller longer. |
| Glucagon-like peptide-1 (GLP-1) |
Delays stomach emptying time that may make you feel more full. |
| Gastric inhibitory polypeptide YY (PYY) |
Secreted by small bowel and colon in response to food. Inhibits hunger. |
| Leptin | Mostly released by fat; decreases hunger. If you want to lose weight you’d want to have more leptin. |
| Ghrelin | Made mostly in the stomach; acts on the brain (hypothalamus) to stimulate hunger. If you want to lose weight, you want less ghrelin. |
For more about leptin and ghrelin take a look at another research review of mine on leptin and ghrelin.
The ideal hormone combo to suppress appetite and help you lose weight would be:
- more CCK, GLP-1, PYY, and leptin
- less ghrelin
What happens to hormones over the long haul?
The study I’m reviewing this week looks at what happens to appetite hormones after 10 weeks of dieting up to 1 year later. Yup, your lemon-cayenne diet from last year may be making you feel more hungry this year.
Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011 Oct 27;365(17):1597-604.
Methods
This year-long study involved 50 people with BMI between 27 and 40 (classified as overweight and obese), who went on a crazy low-calorie diet for 10 weeks (though the researchers called it a very-low energy diet).
What’s a crazy low calorie diet? Oh, say 500-550 kcal for people that had an average weight of 95 kg (209 lb), which is one-third of their basal metabolic rate. To live without moving at all, these volunteers would need about 1700 kcal on average. No question they were really hungry and needed a hell of a lot of will power to stay on this diet.
The problem with calorie math
Basal metabolic rateBMR is the amount of energy you need to live when at rest. The most common equation to calculate BMR is the Harris-Benedict equation. BMR calculation for men BMR = 66.5 + (13.75 x weight in kg) + (5.003 x height in cm) – (6.755 x age in years) BMR calculation for women BMR = 655.1 + (9.563 x weight in kg) + (1.850 x height in cm) – (4.676 x age in years) Here’s an online BMR calculator, if you don’t want to do the math. |
This intake of 500-550 kcal means that each day these volunteers are eating at least 1200 kcal less than they need.
Since fat has 3600 kcal/pound, you could use basic (and flawed) calorie counting to figure they should lose a pound (0.45 kg) of fat every three days. At the end of 10 weeks (70 days) they should lose just over 23 pounds (10.6 kg), or 11% body weight in fat.
The problem with thinking of yourself as just fat that’s burned like a candle is that you overlook things like hormones that through evolution respond to starvation by storing calories more efficiently.
A few hundred years ago, it was a good thing that your body responded to starvation by storing as much fat as possible. Thrifty hormones saved lives. Now when starvation is self-induced in a sea of food it causes problems.
Results
During the first 10 weeks of the study, when the volunteers were eating a very low calorie diet, they lost 9.4 kg (20.7 lb) of fat and 4.1 kg (9 lb) of lean body mass, but that didn’t last over the next year.
As the year went on after the diet, they slowly gained half the weight they lost. At first glance, that doesn’t sound too bad. They lost a fair bit of weight in a short period, and then a year later, they were still ahead of the game.
Hormonal effects: short term
The problem is what happens to these volunteers’ hormones — the hormones like leptin, ghrelin, peptide YY, etc. — that regulate appetite, hunger, and satiety.
After 10 weeks of starvation the volunteers had less leptin, peptide YY, and cholecystrokinin, as well as more ghrelin and gastric inhibitory polypeptide. The result: The volunteers felt more hungry. Cue the need for even more will power to keep the weight off. Sound familiar?
Hormonal effects: long term
We knew that crash dieting messes up appetite regulatory hormones for a short period, but until now, nobody had looked at the long-term effects of very low calories on these hormones.
Why didn’t anyone look at what happened a year or more later?
Well, it’s hard to get people signed up for a year-long anything, let alone having them go on a starvation diet for over two months first. Plus, it’s a bit of a surprise that a short term diet would do much a year later. These scientists must have had to convince a lot of people that this study was worth doing.
One year after dieting the volunteers still had less leptin, peptide YY, and cholecystokinin; and more ghrelin, gastric inhibitory polypeptide and pancreatic polypeptide.
What happened to hunger? Still higher after a year. Think about that. A full year after dieting, the volunteers still felt more hungry. No surprise that most dieters regain weight lost and more… eventually.
Conclusion
If you try to lose weight quickly, you’ll end up trying to lose it every year instead of taking a year to lose the weight once.
It’s clear that very low calorie dieting has long term impact on hunger and appetite hormones lasting at least a year. Now imagine what multiple crash diets might do.
By the way, stringent and chronic restriction also affects hormones that control gastric motility (the speed at which food is processed) and neurotransmitters (brain chemicals).
Thus, if you regularly “diet”, not only do you end up always hungry, you have indigestion and “brain hamsters” like anxiety or depression, and you rarely feel psychologically satisfied by eating — you always want more, or have strong cravings. Show me a “professional dieter” and I’ll show you someone who feels generally lousy physically, mentally, and emotionally. Hormonal disruption is strong stuff.
Could yo-yo dieting lead to cumulative changes in appetite regulation hormones? Very likely. Several years of yo-yo dieting later, you may feel much more hungry than when you started. Good luck with willpower then.
Bottom line
Lose weight quickly while nearly starving, only to gain most of it back (or more) and feel hungrier than when you started. Or lose weight slowly, for good, and feel better than ever… eventually.
What would you choose? If you want door #2… well… have we got a program for you.
Click here to join the waiting list.
The Skinny on Sodium Intake: Is Salt Bad for You?
Posted: January 26, 2012 Filed under: Blog, Cressey Performance, Is Salt Bad, Jordan Syatt, Salt, Salt Intake, Sodium Consumption, Sodium Intake, Sports Nutrition, Strength and Conditioning, strength and conditioning program Comments OffToday’s guest post on sodium intake comes from current Cressey Performance intern, Jordan Syatt.
Sodium intake is a highly controversial topic within the fitness industry, mainstream media, and even the medical community. Very simply, everyone wants to know: “Is salt bad for you?” Nobody seems to have a clear-cut answer.
While many are quick to demonize the tasty mineral, I’ve long wondered if the evils associated with salt are the result of poorly constructed and misinterpreted research or actual cause for concern.
In an attempt to settle the debate once and for all, I began to dig up all the research I could find pertaining to sodium intake, high blood pressure, cardiovascular disease, and general health.
To make things as simple as possible, I’ve outlined my findings below. I think the results may surprise you!
Sodium Intake: What Does the Research Say?
First and foremost, high-blood pressure is perhaps the most prevalent risk factor associated with cardiovascular disease (CVD). Bearing in mind that CVD is currently the world’s leading cause of death, any information we can find to aid in reducing the risk of CVD is of the utmost importance.
Therefore, considering it is well established that diets excessively high in sodium may result in increased blood pressure (BP), it should come as no surprise that doctors and health professionals alike strongly encourage maintaining a low-sodium diet in the long-term. Epidemiological research suggests high-salt diets may not only affect blood pressure (BP) and thereby cardiovascular disease (CVD), but could also “increase the risk of stroke, left ventricular hypertrophy and renal disease.”
Perhaps worst of all, great sodium consumption tends to cause water retention, thus giving leaner individuals a noticeably “softer” appearance. In other words, their abs won’t appear to be as cut-up.
What the hell, salt!?!?
Based on the information provided above, it would appear as though high-salt diets are the primary cause of illness, death, and guys making excuses for why they don’t look as lean as they should.
We should probably cut it out of our diet, right?
Not so fast.
While high BP is certainly a major risk factor of cardiovascular disease, recent research has clearly shown the ratio of sodium intake to potassium intake within the diet has a much greater effect on BP than sodium (or potassium) alone.
Other studies have confirmed this finding and even the USDA recommends individuals place an emphasis on increasing potassium-rich foods and/or lowering sodium intake in order to lower BP.
While excessive sodium consumption can have a negative impact on BP (thus increasing one’s risk of various diseases), simply increasing the amount of potassium consumed on a daily basis holds the same benefits as lowering salt intake. As low-sodium diets are rather difficult to maintain in the long-term, placing an emphasis on potassium-rich foods may help individuals keep BP in check without causing undue stress notably in social situations.
In addition to the ratio of salt to potassium within the diet, other factors such as age, gender, genetics, activity level, and body fat are tremendously significant in determining ones risk of high BP, CVD, and other related illnesses. Not surprisingly, exercise and weight loss significantly reduce the risk of CVD. As such, rather than solely focus on reducing salt intake, beginning an appropriate training routine and maintaining a healthy body weight would most likely be the ideal first step in preventing CVD.
Finally, one need only look at the extremely high amounts of sodium in processed foods to understand why greater sodium consumption is associated with high BP and CVD. I’d venture to guess that those individuals who base their diets largely on processed foods are not only consuming too much salt, but are also not eating enough potassium, neglecting to exercise, failing to get an adequate amount of sleep, not maintaining an appropriate body weight, nor living a healthy lifestyle in general.
Taking the above into consideration, is it really the heavy sodium consumption causing high BP and CVD? Or, could it possibly be the overall sedentary lifestyle, overconsumption of processed foods, being overweight, etc?
I bet it’s the latter.
If otherwise healthy individuals are eating a diet largely consisting of whole/unprocessed foods, consuming adequate potassium, regularly exercising, and maintaining a healthy bodyweight, they can probably stop worrying over the minutia and feel free to add a dash, or two, of the ever-so-tasty mineral.
My General Recommendations:
Individuals should maintain a diet largely consisting of whole/unprocessed foods and make a concerted effort to acquire enough potassium on a daily basis. Examples include, but are not limited to, baked potatoes, cooked spinach, bananas, oranges, and cooked beans. For a detailed list of potassium-rich foods, click HERE. Additionally, I encourage individuals to follow an appropriate strength and conditioning program designed specifically for their individual needs.
Note: those who already have high blood pressure, first and foremost, you must consult with your primary care physician and follow his/her directions, as various anti-hypertensive medications can interact differently with food and exercise. Plus, you want to find out why you are hypertensive in the first place in order to individualize your treatment approach.
I hope you enjoyed this article, and if you have any questions please feel free to leave them in the comments section below.
About the Author
Jordan Syatt is a strength training and nutritional consultant out of Boston Massachusetts. He is Westside Barbell Certified, currently interning at Cressey Performance, and studies Health Behavior Science at the University of Delaware. In addition to actively competing in various Powerlifting Federations, Jordan works with a diverse population of clientele, focusing on fat loss, mass gain, and athletic performance. Jordan is the owner and operator of www.syattfitness.com. Feel free to contact him directly at: jsyattfitness@gmail.com.
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Using the Ground in Training – An Under-Rated Tool
Posted: January 25, 2012 Filed under: Back Pain, dyna discs, golf, Sport-Specific, Unstable Surface Training Comments Off John Izzo is a lot like me. A hard-working guy that genuinely cares about getting better as a coach and trainer, so that his clients and athletes get better results. John offered to write a guest post for today, and … Continue readingDoctor Detective with Bryan Walsh
Posted: January 25, 2012 Filed under: Blog, Expert Tips, Hormones and Physiology, Weekly Newsletters Comments Off| Summary: In this month’s case study, Doctor Detective meets a woman suffering from adult acne. But he quickly discovers that acne is the least of her problems. With sex hormone, cortisol, and blood sugar imbalances, can Doctor Detective help get her back on the right track? Find out below. |
Eat less and exercise more. It’s generally a great prescription for improving health and improving body composition. However, it doesn’t always work.
In a small number of people, even with an awesome exercise plan and a rock-solid diet, the results are less than stellar. They suffer from mysterious symptoms and complaints that they just shouldn’t be experiencing based on how much effort they put into their fitness and health.
Make no mistake; exercise and nutrition can make everyone better. But, for some people, it doesn’t take them all the way. Because there’s a physiological log-jam. Something on the inside that’s preventing their progress.
Here at Precision Nutrition, when we meet clients who have issues that exercise and nutrition – not to mention their own doctors – can’t seem to solve, there’s one guy we call. His name is Bryan Walsh.
Dr. Walsh has a sharp mind, a fitness background, a degree in naturopathic medicine, and extensive additional training and certifications. His wife is a naturopath too. (We bet his kids are the healthiest on the planet.)
So, when clients have nowhere else to turn, Dr. Walsh turns from mild-mannered dad and husband into forensic physiologist. He pulls out his microscope, analyzes blood, saliva, urine, lifestyle – whatever he has to. And he frees up the physiological jam.
That’s why, when Dr. Walsh volunteered to work on a monthly case study feature with us, we jumped at the chance. By following along with these fascinating cases, you’ll see exactly how a talented practitioner thinks; and you’ll also learn how to improve your own health.
In today’s case, we’ll meet a client who came to Dr. Walsh with a single complaint: adult acne. However, upon further investigation, Dr. Walsh discovered that she was suffering from problems with her sex hormones, blood sugar, and stress hormones.
Learn how “Doctor Detective” Walsh unraveled the mystery and helped this client achieve surprising results.
The client
It’s not every day that a young woman with a great diet, exercise plan, and attitude walks into my office with health complaints. Lots of them, in fact. That got my attention right away.
Jill was 34 and healthy. But she had adult acne. Yeah, acne – y’know, the stuff you’re supposed to grow out of, right around the time you lose your crush on Justin Bieber and quit breaking into your parents’ liquor cabinet? Well, Jill’s acne never got the memo that it was time to move on.
Jill was a woman on a mission. She’d been to many conventional doctors who merely put her on a variety of topical and oral medications, which included antibiotics (minocycline, tetracycline, clindamycin), as well as Differin®, Retin A, and azelaic acid. When that didn’t work, she tried alternative treatments such as natural acne washes, zinc and chromium supplementation, and honey masks.
Nothing helped. Doctors told her nothing was wrong, and that she’d just have to live with the breakouts.
After two years of trying everything, not only was her acne unimproved, but she now experienced frequent urinary tract infections (likely from the antibiotics). She was frustrated. She knew something was wrong.
But what? She looked fit and healthy. She ate well on an organic diet. She exercised regularly. At 5’9” and 130 lb, her weight was normal. She was even upbeat and positive.
Yet acne was only one of her issues.
Jill believed she also had hormone imbalances. She’d been trying to get pregnant for 10 years with no luck. She and her husband had pretty much given up on her dream of having a baby.
The client’s signs and symptoms
I examined Jill when she came into my office. She had significant acne and mild facial hair growth. Other than low blood pressure (100/70), all other physical exam findings were normal.
I dug deeper, scribbling notes as I went. Jill described the following:
| Symptom | My thoughts – potential issues |
| Depends on coffee to get going in the morning | Adrenal hormones, anemia, low thyroid |
| Feels lightheaded if she skips meals | Blood sugar |
| Has cravings for sugar and salt during the day | Blood sugar, adrenal hormones |
| Feels tired in the afternoon | Thyroid, adrenal hormones, sex hormones, anemia |
| Suffers from bloating and gas | Dysbiosis, infection, poor digestion |
| Experiences breast pain, swelling, cramps, pelvic pain and irritability during her menses | Sex hormone imbalance |
| Battles with bouts of depression, anxiety and “emotional instability” | Neurotransmitter imbalance, sex hormone imbalance, blood sugar |
Aha, I thought. Based on her medical history, her signs and her symptoms thus far, Jill’s probably experiencing blood sugar issues (i.e. reactive hypoglycemia), sex hormone imbalances, digestive dysfunction, and possible adrenal hormone imbalances.
After being “Doctor Detective” for many years, I like to think my instincts are pretty good. Still, I’m a cautious guy. I don’t like to jump to conclusions. So I turned to the diagnostic tests for confirmation.
The tests and assessments
Taking a good medical history and critically evaluating symptoms often tells you everything you need to know about a case. However, there are some things you can’t learn just from asking questions.
I can’t see into clients’ blood vessels or cells, or guess the chemistry of their urine. Lab testing gives me insight that I can’t get from conversation. In fact, labwork is one of the most useful tools in my arsenal.
I like to start small with some basic tests. Sometimes these are all I need. I always start with a good blood chemistry panel plus a salivary hormone panel. Jill is also a candidate for a digestive function panel, but we opted against it for now.
The test results
Blood chemistry panel
When read correctly, a good blood chemistry panel speaks volumes about a patient’s internal physiological processes. Here are some of the significant findings from Jill’s blood chemistry panel:
| Marker | Result | Lab Reference Range | Thoughts |
| BUN | 7 mg/dL | 5-26 | Borderline low – possible liver issues or protein metabolism issues (i.e. digestion) |
| Globulin | 2.4 g/dL | 1.5-4.0 | Borderline low – Possible protein metabolism issues related to digestion |
| LDH | 133 IU/L | 100-250 | Borderline low – reactive hypoglycemia (blood sugar fluctuations) |
| WBC | 4.7 x10E3/uL | 4.0-10.5 | Borderline low – possible immune suppression |
| MCV | 94 lF | 80-98 | Borderline high – B12/folic acid deficiency (common with digestive issues) |
| Alkaline Phospatase | 35 IU/L | 25-150 | Borderline low – Possible zinc and/or vitamin C deficiency |
| Uric Acid | 2.5 mg/dL | 2.4-8.2 | Borderline low – possible B12, folic acid and/or molybdenum deficiency |
| TSH | 3.087 uIU/mL | 0.450-4.500 | With borderline high TSH and borderline low thyroxine, these were enough to suspect thyroid issues, but would be evaluated later. |
| Thyroxine | 6.9 ug/dL | 4.5-12.0 |
You’ll notice that even though none of these values were outside the lab reference range, I still flagged some of them as problematic. Why?
Well, what most people don’t realize is that, except for lipids (cholesterol, HDL, LDL, etc), the range provided by the laboratory is derived from blood samples taken from people visiting their doctor. In other words, sick people. Healthy people go to the doctor far less often than sick ones do.
Therefore when your doctor says your blood work is “normal”, s/he’s really saying: “You are as healthy as 90 percent of people visiting the doctor today” and “Congratulations! You probably don’t have a weird unusual disease!”
That’s not enough for me. I don’t just want to know that people are surviving. I want to know how to make them thrive.
So we look at blood panels a different way: as a means to evaluate health and optimal function.
In addition to the findings above, we also saw evidence of possible dehydration (slightly elevated albumin, hemoglobin and hematocrit) on the blood chemistry, which could be masking an anemic tendency on her blood work. If someone is dehydrated, their anemia will be harder, if not impossible, to spot on a blood chemistry test.
Is it plausible there are a lot of dehydrated anemic patients walking around today being told there is nothing wrong with them today? You bet. More than most people realize.
Hormone panel
Hormonally, Jill had a number of things going on.
We ran a month-long female hormone panel to track her hormones over the course of an entire month. The results appear in the graph below. Note that normal estrogen for a female cycle is in blue, normal progesterone is in red. Jill’s results are in dashed green.
Hormone panel results - click to enlarge
Based on this graph, you can see that Jill has fairly normal progesterone levels and timing, but estrogen starts and ends elevated throughout the entire month. This tells us that estrogen is dominant. This consistently high level of estrogen, and its effects on her tissues, helps explain many of her symptoms during menses.
But perhaps the most significant finding with regard to her acne was what we found when testing her testosterone.
| Marker | Result | Range |
| Salivary testosterone | 67 pg/ml | 5-20 pg/ml |
Although many people assume that testosterone is a “male” hormone and estrogen is a “female” hormone, both men and women produce both types of hormones. They just differ in the relative amounts.
Elevated testosterone in women is more common than people realize. High testosterone causes everything from infertility, low libido, mood issues, difficulty losing weight, to the more obvious signs like acne and facial hair growth.
As far as Jill’s acne was concerned, we felt this was the smoking gun we were looking for.
Cortisol panel
To add insult to injury, Jill also showed chronically low cortisol levels throughout the day (as you can see below — her results are mapped on the blue line), which is consistent with reactive hypoglycemia.
Cortisol, also known as a glucocorticoid, has powerful influences on maintaining healthy blood sugar levels. When people with low cortisol skip meals, their blood sugar drops too low, and epinephrine is released as a backup plan to increase glucose. It is epinephrine that causing the shakiness, lightheadedness, and irritability experienced between meals.
Cortisol panel results - click to enlarge
The prescription
We may be “health gunslingers for hire”, but we ain’t supplement junkies. Nor do we respect practitioners that send patients out with grocery bags of supplements. It’s simply not necessary. Some people need more than others, but there is no need to take a supplement without proof that you need it.
We also don’t believe in protocols for specific conditions. For example we don’t have an acne protocol, or even an acne supplement. Instead, we look at which physiological pathways are dysfunctional and seek to improve those pathways using targeted nutritional approaches.
That being said, let’s find out what we did for Jill.
Issue #1 – Blood sugar imbalances
Her symptoms and blood work (low LDH) suggested reactive hypoglycemia, otherwise known as excessive blood sugar fluctuations. This is critical to address, as reactive hypoglycemia in women often increases testosterone production.
It’s crucial for women with this condition to eat small, frequent meals, whether they feel hungry or not. Anytime Jill feels lightheaded or shaky between meals, she’s waited too long and created hormone havoc in her body. Addressing low cortisol will also help correct her blood sugar fluctuations.
Issue #2 – Vitamin deficiencies
Jill seemed to be deficient in a number of nutrients (vitamin B12, folic acid, vitamin C, zinc) solely based on her blood work, so we gave her a high-potency multivitamin-mineral called Complete Multi by Designs for Health (2 caps, three times a day).
We also gave her additional sublingual vitamin B12 (1mg three times a day), as digestive issues can inhibit vitamin B12 absorption. This was designed to help what appeared to be a sub-clinical macrocytic anemia.
Issue #3 – Digestive dysfunction
We had Jill start with a three-week elimination diet to help reduce gut inflammation caused by possible food sensitivities. We also supplemented digestive enzymes (Digestzyme by Designs for Health, 2-3 capsule per meal). Later in her protocol, we also put her on Designs for Health Probiotics Supreme (2 caps a day) to help combat the assumed dysbiosis she had from antibiotic use.
Issue #4 – Hormone imbalances
We needed to eliminate her excess hormones, specifically estrogen and testosterone. This is most easily accomplished by improving liver and gall bladder detoxification pathways, since this is the primary pathway steroid hormones are cleared out of the body. Specifically we used Designs for Health Amino-D-Tox (2 caps, three times a day), LV/GB (one cap three times a day) and Clearvite by Apex Energetics (one scoop three times a day, which also addresses gastrointestinal health).
Issue #5 – Adrenal imbalances
Normally we don’t address adrenal imbalances right away. Rather we support other systems for a period of time, re-evaluate, and see if anything improved. However, given that high testosterone was a key finding, we needed to address the low cortisol to stop the vicious hormonal cycle happening anytime her blood sugar got too low. We prescribed an adaptogenic formula called Adaptocrine by Apex Energetics (2 caps, three times a day) designed to help support the body’s stress response.
Obviously there were other things to address, and additional directions we could go, but this was enough for the next 12 weeks, at which time we’d redo lab testing and evaluate her symptoms.
While this may seem like a lot, it’s all for good reason. For example, if her testosterone is high, we need to stop its overproduction (i.e. due to blood sugar fluctuations) and get rid of the excess levels (i.e. liver support).
The outcome
A few weeks after finishing the protocol, Jill submitted follow-up blood chemistry panel and salivary hormone testing. However, while we were pleased with her symptom improvement, we were initially puzzled by the lab results.
Symptomatically, Jill reported a complete resolution of her acne. She also had an “abundance of energy”, no more gas and bloating, emotional balance for the first time in 10 years, and she felt “happier and more alive” than she had in a long time.
Mission accomplished, right? Not really.
Her testosterone had lowered considerably from 67 pg/ml down to 15 pg/ml, which is a good thing. However her estrogen and progesterone remained very elevated. And now she had high glucose, alkaline phosphatase, white blood cells, and lipids (cholesterol and triglycerides).
Not exactly the direction we wanted to go. Scratching our head we wondered where we went wrong, and where we were going to go next.
But then we got our answer.
One week later, we had our answer. Jill was finally pregnant! As she told us in an excited email:
“…Yet the best, most joyous and most unexpected result was … I found out that I was pregnant! Never in million years did my husband and I think we could fall pregnant with the current state of my hormones and so quickly, after addressing my health concerns.”
Her pregnancy explained the odd lab values that came back post testing. So yes, apparently mission accomplished.
Summary
So what can we take away from Jill’s story?
- Symptoms of reactive hypoglycemia, including shakiness, lightheadedness and irritability between meals are often correlated with low cortisol.
- Blood sugar fluctuations will almost always cause hormone imbalances in women, specifically elevated testosterone.
- High testosterone in women can result in mood issues (i.e. depression), infertility, difficulty losing weight, low libido, as well as external manifestations such as acne and facial hair growth.
- Getting rid of excess testosterone requires balancing blood sugar to slow down its production, and supporting liver detoxification pathways to clear out the excess that is already present.
In the next article . . .
Jill contacted us a year later, elated with a new baby boy, but with a whole new set of symptoms: extreme fatigue, depression, and difficult weight loss.
We ran a blood chemistry, and it showed a very high TSH (Thyroid Stimulating Hormone) coupled with low thyroxine and T3 (Thyroid hormones). However, low thyroid hormone was not her primary issue. Her problems were being caused by something very common today, which we’ll cover next month.
Stay tuned, detectives.
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Strength and Conditioning Stuff You Should Read: 1/24/12
Posted: January 25, 2012 Filed under: Blog, Bret Contreras, deadlift, deadlift technique, Deadlifts, Dean Somerset, How to Deadlift, Resistance Training Comments OffHere’s this week’s list of recommended strength and conditioning reading:
How Much Strength Do Our Athletes Need? – I thought this was an outstanding piece from Rob Panariello at Bret Contreras’ blog. It’s a question I’ve asked myself a lot over the past few years, and Rob does an excellent job of discussing how the answer is likely different for every athlete.
Paula Deen’s an Idiot – On the surface, this blog post from Dean Somerset seems to be a rant on this outrageous example of hypocrisy with respect to Deen’s announcement that she had Type 2 Diabetes. While that would have been spot-on, Dean kicked it up a notch when he busted out some great statistics to show that her “it was my genetics” argument was bogus. Wildly entertaining; well done, Dean.
What a Puppy Can Teach You About Resistance Training Progress – I came across this article while I was searching for another one in my archives. I wrote it shortly after we got our dog (who is now about 1.5 years old), but the message still resounds.
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