This is an extensive topic that cannot be covered fully in one article. The goals for this article are as follows:
- To give you a base understanding of what hypothyroidism is.
- To give you an understanding of what hypothyroidism isn’t.
- To give you a base understanding of the best testing options used currently.
- To provide my opinion of the best course of action for fat loss if you have thyroid problems.
What Does Your Thyroid Do?
Your thyroid is located in your neck and produces hormones that are essential to various processes in the body ranging from oxygen use, to heat production, to the use of nutrients and vitamins. And these just touch on how important the thyroid is to so many vital processes.
What Is Hypothyroidism?
When T4 (thyroxine) drops too low it causes different processes in the body to slow down and become less efficient. The symptoms of this range based on the severity of the illness. The more severe the decrease in T4, the worse the symptoms. The symptoms for hypothroidism are vague and can apply to many illnesses and issues. For example, depression and fatigue can be symptoms of many different diseases. In my opinion, the most important symptoms to indicate a potential problem are:
Dry Skin/Brittle Hair
Low Body Temperature
Noticeable Water Retention
Each of those could have nothing to do with your thyroid either, but they can alert you to the fact that there may be something wrong.
Weight gain and fat loss will be discussed later in the article.
How to Get Blood Tests Done Properly
There are two things you need for treatment of a thyroid problem.
- The right tests
- The right doctors
The problem with diagnosing a thyroid problem is not that tests are unable to show the problem, but that usually the right tests aren’t used and the doctors don’t know how to read them. I have caught heat in the past for saying that tests show if you have a thyroid problem and they do. That doesn’t mean I believe that doctors can’t mess it up.
If you use this guide the next time you go to the doctor, then at the very least, you should get the test information you need. Before you get your tests done, talk with your doctor about the information you have and don’t be afraid to go somewhere else if you don’t get the response you think you should.
Ask your doctor to check the following levels to cover as much ground as possible.
Free triiodothyronine (fT3)
Free levothyroxine (fT4)
There are other tests such as imaging and urinalysis, but in my opinion these should signal if something is off in your system and that further investigation is needed.
How to Read the Results
The problem with results is that different labs have different ranges. There is also disagreement as to what is considered too high/low of levels. Also, it isn’t just the individual levels, but how they correspond with one another.
Currently, your best bet to feel optimal is to have your TSH land at the lower end of the normal range and your T3 and T4 at the upper end. Based on research, it would be cautious but wise to think that any TSH level above 2.5 is starting to lean toward less than optimal function.
There are a lot of ways the results can go. You can have normal TSH levels but low T4 levels which could mean you are entering into a subclinical phase. Subclinical does not mean full blown. I have seen clients go from having subclinical to normal levels simply from taking proper diet breaks. In fact, that is one purpose of
The Metabolic Repair Manual Starve Mode.
This is not about self diagnosis though; you want a doctor involved. This is merely about looking out for yourself and trying to eliminate any frustration you may have. If you come back with levels you or your doctor feels are not optimal, then you need to be ready for the next stage of action.
What to Do If You Are Diagnosed With a Thyroid Problem?
The first thing you need to do is be very clear in your communication with your doctor. If this isn’t your doctor’s field of knowledge, you might be better served getting a referral to an endocrinologist. Medication may or may not be needed depending on your levels. Below is a brief explanation of what you can do for the different stages of diagnosis.
If you are diagnosed with full blown hypothyroidism with very extreme and obvious levels, then chances are you are going to be on medication for life so that you can function well. Don’t let this scare you though. If you are communicating with a doctor who is knowledgeable, this does not have to be a negative event. When treatment for hypothyroidism is done correctly you merely feel better. The problem is when the patient and the doctor aren’t communicating properly and dosage levels are wrong.
Make sure to explain to your doctor how your medication is making you feel and discuss with them the specific issues and signs that your dosage may be too high or too low.
Nonthyroid Illness/Subclinical/Euthyroid Sick Syndrome
All of the above basically mean that you are messed up, but not necessarily broken. Most people who are dealing with less than optimal thyroid function fall in this category. Ever since Oprah proclaimed her thyroid woes, we have books filling the shelves (and internet ebooks) about how it “isn’t your fault.” Men and women everywhere are running out and getting themselves diagnosed with full blown hypothyrodism, when that may not be their problem at all.
There are a lot of things that can contribute to TSH levels being normal, but other levels being low. One in particular is constant dieting down and overtraining which does not mean you have hypothyroidism.
The program in the Metabolic Repair Manual has two main goals.
- To help people reload on calories with as few side effects as possible.
- To help normalize low aggression hormone problems like thyroid and menstrual problems.
To give you an abbreviated version of the book, the goal is to train smart and treat your body well. I merely constructed a step-by-step method of doing that; I also discuss how constant dieting down can harm your metabolic burn. And that doesn’t mean you are broken yet or that medication should or should not be used. I would look into other options first and make sure you are getting what you need.
“But Isn’t My Thyroid Making Me Fat!?”
Hypothyroidism is often blamed for weight gain in both adults and children. With the exception of some water retention in more severe cases, weight gain isn’t usually an issue. Energy balance still works in those with thyroid dysfunction, it may just be lowered. If you are treating yourself with proper medication, or if you take the time to take proper breaks and refeeds from dieting, it really shouldn’t be an issue.
Only extremely rare diseases or life threatening illnesses can cause massive osmosis and retention, and these are usually followed by hospital stays or death.
The most you can expect with slow thyroid function is either a higher tendency to retain water on low levels or slower metabolic function causing your rate of burn to be slightly lower than normal.
Dieting and Training for Hypothroidism
It is exactly the same as it would be for anyone else except you have to be smarter, listen a little more closely to your body, and potentially embrace having to take things a little slower. In short, you don’t really get lucky and can’t get by on crap habits.
With any dieting down situation, you want to find a balance of enough of a deficit to achieve results with smart training and diet breaks to keep things moving along smoothly. If you are dealing with thyroid issues, there are a few things to keep in the front of your mind.
- Watch your training volume and keep it lower. Less is more. I would not recommend lots of HIIT mixed with even a moderate deficit (25% below daily caloric need).
- Schedule refeeds a little more frequently. The harder you diet down, the more you need to break.
- Don’t be overly carb restrictive for extended periods of time. If you are sensitive to dieting down, I recommend keeping to a very minimum of protein intake (.08 – 1xbw) so that you can maintain a higher fat and carbohydrate intake on a regular basis. Ideally, a carb cycling program is best; however, due to water retention issues, you are going to be more likely to retain water on your “ups” so keep this in mind. You can diet down just as low as anyone else though.
- If you are on medication it should be much easier, but make sure to consult with your doctor if you are dieting down for an extended period of time.
Overall, you would follow the same core beliefs in The Fat Loss Troubleshoot. If you are someone that has been having long term overtraining and dieting down issues and think that your low levels or issues may be because of that, then I highly recommend Starve Mode.