This is the last segment in a podcast series all about thyroid health. In this episode, I continue my conversation with thyroid specialist Dr. Izabella Wentz. Dr. Wentz’s expertise has been spurred on by her own personal struggle with Hashimoto’s Thyroiditis. Through extensive research as well as trial and error on herself, Dr. Wentz has greatly improved her condition.
How to Lose Weight with Thyroid Problems
Is it possible to lose weight with Hashimoto’s or other thyroid problems? Absolutely!
According to Dr. Wentz, one of the biggest keys to losing weight with thyroid problems is eating a nutrient dense diet. It’s important to realize that a low-calorie diet will actually not be helpful for you. Low-calorie diets, as well as over-exercising, will essentially cause adrenal dysfunction, which only makes things worse for your thyroid. So contrary to what you may have heard, it is important to eat really balanced, glycemic breakfast, lunch and dinner every day.
Medications may also help you lose weight while experiencing thyroid problems. Work with a doctor to see if you are properly converting thyroid hormones T4 to T3. T3 is the more metabolically active thyroid hormone and having medication to supplement that will help you start to lose weight.
Additionally, eating fermented foods and intaking probiotics will also often help. Oftentimes people with Hashimoto’s will have dysbiopsis, an imbalance of gut flora. The bacteria in your gut is critical to extracting proper nutrients from food. When we are not digesting our food properly then we’re not extracting our nutrients properly, making us constantly hungry. An intake of probiotics and supplementing with digestive enzymes can help regulate your gut health, helping you lose weight.
What if you need to gain weight?
If you have hyperthyroidism, also known as overactive thyroid, you may actually need help gaining weight. In this case, it may be helpful to increase your calorie intake for the short term. You may also want to talk to your doctor about natural medications for balancing hyperthyroidism and curing potential gut infections, such as H Pylori.
Whatever the symptoms of your thyroid issue are, the first and most important step is to get a proper diagnoses. Get tests for TSH, thyroid peroxidase antibodies, and thyroglobulin antibodies as well as a thyroid ultrasound test done. That’s a great place to start.
Also, don’t be afraid to try different medication. What worked for your friend may not work for you. In some cases, doing a T4/T3 containing medication like Nature-Throid or WP Thyroid may be the better bet for people who continue to not do well on a medication like Synthroid.
Finally, consider eliminating foods you’re sensitive to from your diet (often gluten, dairy and soy). Addressing nutrient depletions in your diet is a safe and necessary step in helping you deal with weight gain and other symptoms of thyroid problems.
Resources I Mention:
- Dr. Izabella Wentz
- Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause
Get the Overcoming Thyroid Fatigue Guide!
If you struggle with thyroid disease or symptoms, get a free copy of Dr. Izabella Wentz’s “Overcoming Thyroid Fatigue Guide” by clicking here.
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Katie: As a last leg of this interview, I want to touch on specifically some advanced questions that readers have asked and that I’ve noticed reoccur on my website that I’m not qualified to answer and I love that I think you’ll be able to. Rebecca said, is it possible to lose weight with Hashimoto’s or other thyroid problems? If so, were there special considerations?
Izabella Wentz: Yeah, absolutely. That’s a really great question, Rebecca. There’s a lot of decent things you can do to try to lose weight. First and foremost, I am not a fan of restrictive calorie diets especially for anybody but especially for people with Hashimoto’s. One of the things that happens is when you’re put on a low-calorie diet is you’re going to be putting your body into basically adrenal dysfunction where your body is going to say, no, I’m starving. Let’s control everything. Let’s slow down our metabolism. Let’s prevent us from gaining weight … From losing any weight and extending any calories.
One of the first things you can do is actually eat a really nutrient-dense diet and eat enough calories to support your body so eat until don’t go hungry, don’t skip meals, making sure that you eat a really good, balanced, glycemic breakfast, lunch and dinner every day. It’s going to be very, very helpful for most people. Don’t do the binge dieting. Actually, over-exercising can also put a person in adrenal dysfunction which basically can shut down their thyroid glands. Those are two things you might have been told to do where I’m telling you don’t do them because they can make things potentially worst obviously doing sensible eating and weight-bearing exercises is going to be helpful for everybody but putting yourself on a very low-calorie diet and starvation mode is only going to make it things worst.
The other thing is looking at your thyroid medications. Looking at whether or not you are converting your T4 to T3 properly. Looking at getting your thyroid labs and making sure that those are all in order so making sure that the T4 and T3 is in the mid to the upper part of the reference range and that your TSH is somewhere between 0.5 and two or wherever you feel best with it. If that’s isn’t doing the trick for you then talking to your doctor about maybe a dose increase or to a medication that contains T4 and T3 which is the combination thyroid medication that provides us with some of that T3 pre-converted so we can start losing the weight because T3 is the more metabolically active thyroid hormone.
Looking at getting probiotics or fermented foods on board, what’s interesting is a lot of people with Hashimoto’s will actually have dysbiopsis or an imbalance of gut flora. There are certain types of gut flora that are associated more with gaining weight. What they do is they take out more calories from whatever food we eat. You can have a friends that’s eating the same exact food that you’re eating and having everything else, same metabolism, same everything but if you have different bacteria than your friend has, then you’re going to be potentially at risk for gaining weight and she will stay the same weight.
There was a history of somebody who became obese through a fecal transplant unfortunately. Making sure that you’re getting good probiotics on board eating fermented foods is going to help. I have seen people who about 25% of people who start taking digestive enzymes will say that they actually start losing weight as well. When we are not digesting our food properly then we’re not extracting our nutrients properly and that may make us constantly hungry. Making sure that you have enough nutrients on board through the use of really great nutrient-dense diet through fermented foods, through making sure you’re digesting everything correctly and through making sure that you’re taking supplements if necessary. Doing, sometimes, a multivitamin supplement can be very, very helpful and I recommend one that’s going to be free of iron and copper.
Katie: That’s really good to know. On the flip side of that, Sonia asked, what
about people who are having trouble gaining weight, who have
hyperthyroidism?
Izabella Wentz: Yeah, it’s not just people with hyperthyroidism that have trouble gaining
weight, some people with Hashimoto’s also experience them. Of course
they are minority and we always focus on losing weight because that’s
one of the bigger things. With hyperthyroid, you’re going to be potentially,
your basal metabolic rate is going to go up. You’re going to be losing
weight and calories faster than you can eat them. Obviously, making sure
that you’re eating enough is going to be the first step. Making sure that
you’re getting enough calories to support your body and maybe even
increasing that caloric intake for the short term can helpful for you to try to
maintain your weight.
Looking at whether or not your TSH is balanced, talking to your doctor
about potentially increasing medications for balancing hyperthyroidism or
I know some people work with endocrinology specialists and natural
medicine that may use herbs. Trying to get that balance and then looking
at gut infections. A lot of times gut infections, especially H Pylori, can
trigger Grave’s disease as well as Hashimoto’s and they can lead to
weight loss.
Katie: That’s great advice. Thank you. Another question that I get reocurringly is,
is it ever possible to really recover thyroid function back to a normal
functioning thyroid if you’ve been diagnosed by thyroid disease and to
wean off of medication and to eventually just recover full thyroid function?
Izabella Wentz: It’s definitely possible. I’ve seen it happened quite a few times. There was
once study that looked at basically recovery of thyroid function in people
how had been on long-term thyroid medications and they found that, even
though, it’s pretty striking, was about 20% of people with Hashimoto’ were
able to recover their thyroid functions over a course of a decade or so of
being on thyroid medications. The interesting thing is though once you
take thyroid medication, it can be built into your physiology so you, in
some cases, you may not know that you can get off of it. In other cases,
you will become hyperthyroid. You’ll have symptoms of irritability, those
palpitations, symptoms of hyperthyroidism and then you’ll go to your
doctor and you’ll be tested hyperthyroid.
Definitely the beginning stage is to get you to feel best. The next stage is
to get your thyroid antibodies reduced. Once they’re in the remission
range under 35, looking at making sure that you have enough iron on
board, making sure that you have enough zinc on board and this is going
to be helpful for helping your body heal and regenerate.
Katie: Yeah. That’s really helpful. Like I mentioned, I’m still on thyroid medication
but we’re seeing the nodules of my thyroid go down. I’m hopeful that
that’s going to be a progression for me but I also realized like you said
that can be a very long process because you’re trying to really rebuild
your body and that’s not something that happens overnight. Speaking of
building our body, another question that I get a whole lot with especially
my specific readers is what about pregnancy and thyroid disease? Are
there any special considerations?
I’m learning first hand right now because this is my first pregnancy where
I’ve known I’ve had thyroid disease so I’m learning some of those special
things as I go but can you talk about that and specific things that maybe
some boot want to watch out for while pregnant?
Izabella Wentz: Absolutely. Just so you ladies know, pregnancy actually increases your
need for thyroid hormone. You want to make sure you have your thyroid
test done before you conceive. You want to be under 2.5 with your TSH
for optimal conception purposes. Some reproductive endocrinologists or
fertility specialists will actually, if a woman has a any kind of hint of a
thyroid disease, they’ll put them on thyroid medications to help prevent
any kind of miscarriages and to help them conceive. Thyroid can definitely
be, an unbalanced thyroid can actually be a root cause of fertility issues.
Making sure that right after you get pregnant, as you soon as you confirm
your pregnancy and if you’ve been on any thyroid medications, go see
your doctor right away and get your thyroid functions done. You’re likely
going to need a dosage increase and medications because that’s going to
be something, like we said, it’s going to increase your body’s need for
thyroid hormone. Making sure that you’re going to be sufficient in iron is
going to be helpful because a lot of times, pregnancy can increase our
demands on iron production and making sure that we, iron is necessary
for proper thyroid hormone function. You do that.
Selenium can be very, very helpful for taking during pregnancy. That’s
going to be something that reduce the risk of post-partum thyroidistis and
helps to prevent the progression of your thyroid condition in pregnancy.
Some women will say that they actually say feel better during pregnancy
with their thyroid condition and you might see a remission of it. Some
women may see an exacerbation of it. One other thing that I would
caution women is any kind of women with autoimmunity may be at higher
risk for post-partum depression.
Just make sure you let your partner know that, hey, we have, because of
my history of thyroid disease, please watch out for me for these things
and be mindful of it because chances are if you’re on post-partum
depression, you’re not really going to know when it’s going to be the
people around you that help you uncover it.
Katie: Yeah. That’s a really important point for sure. On that same hormonal vein
as far as pregnancy, obviously, affecting hormones, Colby asked, what
about things that affects hormones if you already have a diagnosed
thyroid disease for instance Maca or hormonal contraceptives, are those
safe if you have thyroid disease or can they make things worse or better?
Izabella Wentz: Unfortunately with oral contraceptives, they do seem to have an impact
with the Hashimoto’s and autoimmunity. I don’t have any studies to back it
up but what they can do is they can induce estrogen dominance when we
have excess estrogen-to-progesterone ratio. That has been implicated in
triggering thyroid disease. Oral contraceptives can, unfortunately, do that
for us. I know, Katie, you’ve got a fertility monitor that you work with. I use
one as well. It’s called the Lady-Comp fertility monitor. If you’re just using
birth control for those purposes, there’s a lot of really great natural
alternatives that can be very, very helpful.
Maca can be something that is going to be helpful. It’s considered an
adaptogen and generally that’s going to be supporting your hormones
and adrenals. Adrenal adaptogens are often going to be very, very helpful
for people with Hashimoto’s. Maca Ashwagandha are some of my favorite
ones. What they do is they help stabilize the production of our adrenal
hormones whether they’re overactive or underactive and that can have
very positive effects on how people with Hashimoto’s feel as well as on
their overall hormone production.
One thing that I don’t think a lot of people are aware of is that sometimes
adrenal dysfunction can be at the root cause of some hormonal issues
including infertility. Getting your adrenals balanced can help, in a lot of
cases, with PMS, mood swings, breakouts around the cycle and in some
cases even with infertility. Sometimes those adaptogens can be helpful
with it.
Katie: Yeah, I saw that in my own life actually. For me, sleep was the key. If I
didn’t get enough sleep, that alone would mess up my hormones and it
probably went back to that adrenal thing and the cortisol that we talked
about earlier but I want to echo what you said about the fertility monitors.
I’ve actually tried several of them over the years. The one I was using
before I got pregnant, I tell people this one was planned. It wasn’t an
accident is called the OvaCue. I like it because it looks at electrolyte
levels in two different ways and also you can input temperature like the
Lady-Comp tracks and symptoms.
Anybody who’s familiar with any kind of natural way of tracking fertility like
that, you can input all of those things and it was really a scientific output
for me and it was very black and white. That helps with my type A
personality and it was really effective for us. That’s one thing I’ve
recommended to a lot of friends.
Izabella Wentz: Yeah, I definitely always recommend, a few of my friends have gotten
fertility monitors for Christmas, birthdays.
Katie: Yeah, exactly. Kath asked, what about people who have trouble falling or
staying asleep especially people who may be around third shift or have
sleep pattern issues due to a job? Are there any special considerations
that can help improve sleep for those who already have a thyroid
problem?
Izabella Wentz: Definitely working third shift can be very, very tough on the body overall. I
would recommend if you can, possibly, to see if you can come on first
shift because third shift workers, they’ve had increased rates of adrenal
dysfunction, autoimmunity, cancers and things like that. Part or the
reasons why these things happen is basically due to melatonin. Melatonin
is something that’s produced when it’s dark outside. It’s produced in our
pineal gland and gets released in the body and helps us fall asleep. That
also seems to have an immune balancing effect.
If possible, if you could go into a really, really dark room with blackout
curtains on your off shift and maybe take some melatonin, that might be
helpful if you’re a third-shift person. If you’re a person who just has
insomnia or difficulty sleeping with Hashimoto’s, I would look at doing a
magnesium supplement at bedtime. That can sometimes help or looking
at getting your adrenals tested because some people can have low levels
of cortisol are going to be associated with low energy throughout the day
and then high levels of cortisol can be associated with having too much,
often anxious energy throughout the day.
Some people might have high cortisol at bed time and this can actually
prevent them from falling asleep. There’s different intervention we could
do to both raise cortisol and reduce cortisol. You would want to get an
adrenal saliva test and figure out if that’s an issue for you or not.
Katie: Yeah, definitely. Like I said, sleep was my nemesis and I found out that if I
just make sleep a priority, it actually fixes so much. Probably sleep is a
trigger for me. Another question that I get a lot that I have no first-hand
experience with thankfully is what about, are there any differences for
people who have their thyroids removed? Obviously, those people would
need to be on medication but are there any differences as far as what will
help lifestyle-wise and diet-wise or things that they can do?
Izabella Wentz: That’s a very, very common question I get as well. Obviously, first and
foremost if you have had a thyroidectomy or your thyroid removed or
radioactive iodine, you do want to make sure that you’re going to be on
proper thyroid hormone support. Often times, that’s going to mean the T4,
T3 medication like Armour, Nature-Throid or WP Thyroid or compounded
T4, T3 meds for you to fill your best. That’s something that you’re going to
have to take exogenously, probably, lifelong unless there are some
instances of thyroid tissue regenerating if it’s not all surgically removed or
whatnot but that’s generally, you’re going to need to be on that lifelong.
As far as the lifestyle interventions go, a lot of times the reasons why
people may get a thyroidectomy or RAI are going to be due to the
immune system imbalance. A lot of the same things that we recommend
for Hashimoto’s are going to be recommended for people with postthyroidectomy.
One thing to be really, really mindful of is I know some
doctors may recommend thyroidectomy as treatment for an autoimmune
thyroid condition but if you … Removing the thyroid basically removes the
target of the immune system but it doesn’t change the immune system.
The immune system may still be overactive and it may actually find
another target. Unfortunately, I’ve seen people who have had
thyroidectomy who go on to develop additional autoimmune conditions
like rheumatoid arthritis when they don’t work on balancing their immune
systems. Going gluten free, figuring out your food sensitivities, addressing
your nutrient depletions, figuring out your stress response and of course
sleep deprivation is the fastest way to get into a stress response making
sure you have enough sleep, testing for any types of infections that can
be potentially setting off your immune system and looking for toxins.
Those were all things I would definitely recommend doing for anybody
who has had a thyroidectomy just to get the ease of mind that your
immune system get all those ducks in a row so your immune system can
be rebalanced.
Katie: That’s so important and probably something that’s important for even
people who may be don’t have thyroid disease. We’ve talked about all the
triggers of modern society, it would seem like trying to balance the
immune system or at least remove some of those triggers that can be
more universal and make sense for all of us not just as unless you
already had something as drastic as a thyroid removal. I have seen that
too and even in friends. It’s quite sad they’ll have their thyroid removed or
another problem, they think whether it be autoimmune-digested issues or
whatever it is and they have a part of their body removed and then it’s like
the autoimmune disease just shifts and then they end up with a new
whole problem that they have to address.
Izabella Wentz: It’s really, really sad. I just hope we can get the word out to make sure if
you’ve had a thyroidectomy or you’re having any of these, just make sure
that you do all these other things that we recommend from a lifestyle
perspective and you can really prevent or slow down the progression of
another type of condition.
Katie: Yeah, again, it’s good to know that there are still steps you can take that
do make a difference even if you already had to have part of your body
removed for that. Another struggle that I think so many women have and
that you and I both mentioned having is the hair loss that can come with
thyroid disease. Obviously, everything we talked about for balancing your
immune system and getting rid of the sugars and working on your gut,
those were obviously all helpful but are there specific things that can help
reverse the hair loss itself?
Izabella Wentz: Hair loss can be such a difficult thing for a woman to go through.
My hair is always been my lion’s mane and
it represents our femininity. It’s seems superficial for women to worry so
much about their hair but it’s really not because hair is the first indicator of
your health. What’s happening in thyroid disease is basically the body is
saying, hey, we need to save our metabolism. We need to save our
nutrients because there’s something happening here with this thyroid
networking. Do we really need to have beautiful hair?
Beautiful hair is probably not a priority right now so let’s shunt all of our
nutrients and all of our growing into other parts of our bodies. Definitely
being thyroid-hormone deficient is going to put us at risk for losing hair. I
probably loss about a third of my hair when I was going through
Hashimoto’s. It’s very, very difficult. It was a constant reminder every time
I took a shower or brush my hair that I was sick. Getting on a proper
dosage of T4 and definitely T3 can help with the hair loss. T3 is actually
more so implicated in growing hair than T4. Keep that in mind if you’re not
on an Armour, Nature-Throid or WP Thyroid or a T3 containing medication
and you’re losing hair then perhaps consider getting on that kind of
medication because it can make a huge difference.
Looking at other types of root causes of hair loss, biotin deficiency so
taking a biotin supplement 5,000 micrograms per day can be helpful,
making sure that you are not iron deficient. Dosages optimal for … You
want to test your ferritin level. Ferritin is the iron-storage protein. That’s
going to be the most sensitive. The optimal numbers for that seemed to
be somewhere between 70 and 90 for hair regrowth and having nice,
shiny hair. The other thing is getting enough essential fatty acids into your
hair. You can do that through making sure that you’re eating plenty of
good fats, omega-3 supplements, evening primrose oil and another trick I
like is actually putting olive oil honey mixture on the hair.
That penetrates the hair with a lot of those good fats right away because
fats actually help us with making our hair grow more and more shiny and
prettier. I used to volunteer on a lab where they were doing studies on
rats with high-fat diet and low-fat diet when I was in college. All I
remember is that the high-fat rats have beautiful, long shiny hair from
those times but basically making sure that you have enough fatty acids on
board whether through, definitely through a supplement and through a
hair mask and through diet is going to be helpful for preventing some of
that loss and starting some of that regrowth and getting back some of that
shine.
Katie: Awesome advice. Marybeth asked, is there anything that can help with
thyroid enlargement. I know that you mentioned already that can be
related to Hashimoto’s and it can be a sign of Hashimoto’s but are there
things that can actually help reverse it or are there other things that can
cause it as well?
Izabella Wentz: Yeah, thyroid enlargement, sometimes it can be caused by Hashimoto’s.
There’s two types of Hashimoto’s. One type basically enlarges your
thyroid. That’s something that
can happen. Taking thyroid medications can be one of the most helpful
things you can do for reducing thyroid size and also looking at toxins,
looking at getting enough nutrients on board is also going to be helpful.
For some people, the enlarged thyroid can be due to iodine deficiency.
Always be in check for iodine deficiency if you do have the enlarge thyroid
can be helpful.
Katie: Great to know, perfect. It’s like you’ve given us a wealth of information in
this series on thyroid. What would be, maybe, just give us a few baby
steps and I’ll definitely link to both your blog and your book because it’s
full of really good specific advice that maybe would help someone
pinpoint a problem but for someone who may be still is in that stage that
we both were of trying to find answers, can you give a couple of good
baby steps to get started. I know we talked about so much and it might be
overwhelming. Where’s a good place to start?
Izabella Wentz: Usually, I start with proper diagnosis. Making sure that you know what you’re dealing with so getting sure getting TSH, thyroid peroxidase antibodies, thryroglobulin antibodies as well as a thyroid ultrasound test done. That’s a great place to start. Looking at medication management so getting appropriate medications for you, you might need different medications than your neighbor or your cousin. In some cases, doing a T4, T3 containing medication like Nature-Throid or WP Thyroid may be the better bet for people who continue to not do well on Synthroid.
Looking at your diet, getting rid of foods that you’re sensitive to, gluten, dairy and soy are the biggies. Sometimes we just hear a reversal of Hashimoto’s with those. Addressing nutrient depletions, selenium, vitamin D and iron as well as B12 or going to be some of the bigger ones. Looking at adrenal dysfunction so anything that you can do to reduce the amount of stress in your body is going to be super, super helpful. Looking at your gut function, trying to figure out working with your doctor to see if you have any gut infections can be helpful.
Balancing your blood sugar, making sure that you’re eating plenty of good fats and plenty of proteins with every meal and then reducing the toxic exposure in your body and in your home so considering drinking a fluoride-free water or getting a fluoride filter for your home. Flouride can suppress thyroid function and can contribute to the damage of your thyroid gland. Looking at getting all organic skin care and hair care products because we can be … Basically, a lot of our skin care products have hormone disrupting chemicals in them that can potentially exacerbate autoimmunity or any hormonal imbalances. Those are big things you can do at home and I’m sure many of your readers are already doing that. You provide so many great resources for them to do so.
Katie: Awesome. Izabella, you are such a wealth of information. I have personally loved this conversation and getting to chat with you. I know it’s going to be helpful to so many people as well. I will make sure to also send them to your website and your book for more information than we can cover in just a couple of podcast episodes.
Izabella Wentz: Wonderful. Thank you so much, Katie. I had so much fun chatting with you and hopefully your readers will find this and listeners will find this information helpful.
Katie: Thanks so much for being here.
Izabella Wentz: Thank you.
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