Tests that may reveal your true inability to lose weight

So you can relate to last week’s article and are constantly depriving yourself and doing regular exercise.  But you can’t seem to lose weight or keep it off.  What next?!  Here are a few tests that I would recommend you get from your doctor.   We as physicians, must do a much better job assessing and addressing these physiologic barriers patients have to successful weight loss. Unfortunately, an accurate assessment may take more than the typical eight minute office visit and more than the basic laboratory assessment typically done for patients.

Tests to request from your physician:

  • Basal Metabolic Rate — this measures the number of calories burned per day at rest. It is done via a device that measures the amount of oxygen burned over a ten minute period  in the office.  If low, this is diagnostic, but if normal it does not rule  out a low metabolic rate because stress during the test can falsely elevate the results and studies show that while some may have a “normal” metabolic rate at rest, the problem is that they burn significantly less calories than normal during exercise.
  • Leptin – a leptin level above 12 shows leptin resistance (laboratory “normal” ranges cannot be used because they include overweight and insulin resistant individuals)
  • TSH, free T4, free T3 and reverse T3 to adequately assess tissue thyroid levels (free T3/reverse T3 ratio should be > 2 to be optimal)
  • Glucose, average glucose (HgA1C) and insulin levels to check for insulin resistance.
  • Sex hormone binding globulin (SHBG) can be an indicator of low tissue thyroid levels (should be greater than 70 in women and 25 in men).
  • Urinary iodine — low iodine can cause thyroid resistance (too much can cause low thyroid, as well).
  • C-reactive protein (CRP) — inflammation decreases cellular T3 production (should be less than 1).
  • Homocysteine – a marker for low thyroid and low B vitamins (should be less than 9)
  • Lipids — high cholesterol is a marker for low thyroid and high triglycerides is a marker for insulin resistance
  • Iron and ferritin – adequate iron levels are required to activated thyroid, so many symptoms that people attribute to anemia with low iron is actually due to low tissue thyroid activation
  • Vtamin D — should be greater than 80
  • Thyroid peroxidase antibodies (TPO) and antithyroglobulin antibodies — looks for autoimmune thyroid disease.
  • The muscular reflex time — this has been shown to correlate with the degree of tissue hypothyroidism and to be a better indicator of tissue thyroid levels than standard thyroid function tests

If the physiologic barriers to weight loss are not assessed and treated, you will likely suffer from a life-long inability to lose weight, resulting in an increased risk of heart disease, diabetes and mortality, as well as a life-long frustration and reduced quality of life and self esteem.  After a thorough assessment to determine the physiologic abnormalities is complete, proper treatments and options that address your dysfunction are presented, then you too can be on the way to your optimal body weight!

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10 Responses to Tests that may reveal your true inability to lose weight

  1. Belinda Meredith says:

    Is the Free T3/ Reverse T3 ratio > 2 or >20?

  2. larry says:

    from what I understand >2

  3. Dale says:

    Should be > 20

  4. It depends on how your FT3 and Rt3 are measured. If the ranges for FT3 top out at 4.2 and RT3 at 32 it will be over 2, if the ranges for FT3 are topped out at 420-450 and RT3 350, it will be over 20 so it is the same measurement just different ways to measure the same thing.

  5. Janet says:

    If I am taking T3 but just found out my iodine levels are very low – could this be why I feel fatigued by afternoon?

  6. Pingback: Tests That May Reveal Your True Inability to Lose Weight | National … | Thyroid Testing

  7. brads says:

    Two years ago my then 15 year old daughter, who was an elite swimmer, inexplicably gained twenty unwanted pounds in the midst of a brutal training regimen. She also was maintaining her daily calories at 2000 to 2500. Not only was she unable to lose this weight, the same type of weight gain was repeated last summer while training with Olympic athletes. Her BMI is now 29 and her once bright athletic future teeters on the brink. As of her last labs, she has high normal leptin (24.3 ng/mL), very high T4 (4.17 ng/dL) and T3 (12.1 pg/mL) counts, high RT3 (59.2 ng/dL), high antithyroglobulin (41 IU/mL), high LDL Cholesterol (103 mg/dL), high normal triglycerides, normal CRP (.8). Despite her labs, she mainfests no sign or symptoms of being hyperthyroid; her signs and symptoms trend hypothyroid. She has taken a desiccated thyrid supplement on and off for the past year, which seems to give her some relief. If her training regimen, as suggested in the previous article, has flipped her metabolism, how can she reverse the effects? How can she train to be an elite athlete in the future?