My wife has PCOS, endometriosis, and hypothyroid. She is currently being treated by her OB/GYN. That was great when we were dealing with fertility issues. As we move on from having little Groks I’m just not convinced that he is her best resource. Wouldn’t an Endocrinologist be a better resource?
Right now she is on the Metfomin, Glucophage and a thyroid replacement med. She runs and lifts on a regular basis and has been grain and simple sugar free. She is very frustrated with all the normal symptoms of the conditions above but is of course most frustrated with an inability to mover her weight any direction but up.
Any dietary, resource or other advice would be welcome. Also, who can best manage her triple-threat and help her get to optimal health?
Lots of women have their OBGYN as their PCP. I think this is normal but ridiculous. If your wife's OB/GYN is ALSO a reproductive endocrinologist - she's right where she needs to be. If her doctor is ONLY an OB/GYN - that's no good. PCOS is a metabolic disorder as well as a gynecologic one.
She likely needs to be more than grain or sugar free. She should probably be VLC as well. Under 20g as she's likely pretty insulin resistant.
Most hypothyroids do need to go VLC. Seriously... under 25G for sure. We just tend to be more sensitive to carbs, and sometimes that balances out eventually and sometimes not.
Beware of endocrinologists in general, you have to interview them like any other doctor. The majority of endocrinologists deal mostly with diabetes (go figure!). Many of them have very little knowledge of the thyroid in general. My advice would be to do some reading on your own about the thyroid (if you haven't already, you may very well have), and then if you try an endo ask them a lot of questions before switching.
some things to consider with hypothyroid is that some people do really well on synthetics (Synthroid/Cytomel), which is what I'm on. Some people don't see any gains and do better on the porcines (Nature-throid, Armour, etc.). Also, you do mention tlhyroid replacement, but not what kind. I take T4 (Synthroid), and T3 (Cytomel), because apparently my body isn't converting the T4 into T3 very well on it's own. Without the T3 (ran out one time for about a week until I could get my prescription filled), and I was tired, lethargic and no energy again right away. I definitely notice the difference, but that's me!
Also, most hypothyroids have their levels checked every 4-6 months (I do 4). You can do fine on one strength for a while and then all of a sudden your levels spike or drop. So if not being monitored that could be a problem there as it depends on what you're doing, what you're eating, how much you weight, your activities, etc. (Example: if you take your meds within 4 hours of calcium-laden foods the calcium will block the absorption of your meds.)
I recommend three spots for getting thyroid info:
1) Google Mary Shomon and thyroid. There's a lot of info there.
2) Stop The Thyroid Madness
2) On SparkPeople there is a forum board for thyroid sufferers. On that board are the most knowledgeable people I have ever met in regards to thyroid. You can get info and help on your levels/labs what they mean, types of medications, issues, etc. It is to thyroid what Daily Apple is to primal. I learned a lot there...
What symptoms is she still having?
I know I threw a lot out there, but I got undertreated for my thyroid for almost 5 years and it just makes it that much harder to come back. And know it may take some experimentation to see weight changes. There are so many things that affect it, that you have to get control of one at a time. (Trust me I understand the frustration of doing everything right and not losing, or even gaining weight!)
Hope some of this helps a little...
Thanks for the great insight. I will talk with my wife about this and to better define the symptoms she is having. If she weren't trying so hard I'd probably not really understand. But I really think she is doing the right things. Maybe VLC is where she needs to be?
I remember when she was training for marathons that she'd start visibly shaking in the middle of a run but within 30 seconds of drinking Gatorade she'd be fine.
Her dad is diabetic, on glucophage and had a stroke at 48. Her sister has hypothyroid and extremely high cholesterol (were sending her a cookbook). Her mom seems OK but has interstitial-cystitis (IC). And of course my wife has her endo, PCOS and hypothyroid.
One thing affects another. I have Leaky gut and improving it seems to improve my ill-functioning Thyroid (go fig!). I also have high cholesterol, but doc says it's in correlation to my parasitic infection (possibly tooth, we have yet to work on that yet), so my inflammation is causing high cholesterol levels. I love having a Paleo doc.
I would look for a practitioner of functional endocrinolgy. You can email for a practitioner list here:
I get a weekly newsletter with updates and current info on the thyroid and today's had a link to a page specifically regarding thyroid and weight loss.
There's an interview with Dr. Kent Holtorf who specializes in patients with hormone imbalances, with some cool info regarding leptin resistance which is increasingly being shown to be an issue with thyroid disorders. Definitely some good info to start with...
That might give a starting point for some ideas and research.
i do think you need to find a doc that's more knowledgeable specifically about thyroid disease, they are just tough to come by. And I do stress interviewing the doc to see what his take on thyroid treatment is-- is he open to many different treatment types, or does he do one thing for everyone. Like with PB, it's not a one treatment fits all kind of thing-- all of us work differently and have other issues that may be affecting us (like leaky gut with Sass, and I suspect I had that too), so you want someone who's going to look at the whole body and endocrine system.
You also want to become knowledgeable so you can ASK your doc questions and for testing. I've had a lot of different testing, but leptin levels is one I haven't had, and am going to try to get soon.
I'm going through some real issues right now. I've had hypo symptoms for seriously 10 years. This past year they got much, much worse. Here's my Dr. history this year
I was on pill birth control for many, many years. Even when I was having severe reactions to the pill in my 20s, no doctor ever suggested me getting off. Last year I found out that I cant have extra estrogens because I get these certain types of migraines which I was told would increase my risk of stroke by 60% if I have estrogen based BC. I switched to progesterone based and felt like I was going crazy. I decided to stop all BC pills completely. After a little over a year, I was having more and more hypo symptoms coupled with 16 day long periods with 4 or 5 days in between (that would tire anyone out).
I went to my OB/GYN who thought it might be thyroid issues. tested my TSH levels- no shocker, nothing wrong. She suggested I get an IUD for the long periods but offered no help on the exhaustion and anxiety.
Then I went to an endocrinologist who did more in depth tests. Super, super low vit D (I'm super active and always outside in the sun) and indications of low thyroid by T4 test levels. Put on Synthroid, low, low dose. Started to do my research and learned about the pig T4 drugs as well as some bioidentical options and the importance of having T3 as well. Called Dr. and learned she refuses to prescribe anything but synthroid to her patients. WTF?!
Then I found a holistic dr who ran my blood tests again, talked to me, and is having me do a spit test to test my other hormones. He believes I am hypothyroid but that I am really estrogen dominate and that is throwing off all of my other things. He thinks that my many years of synthetic hormones has really messed up my body's ability to make its own. I was on BC for 14 years! He also said that the level of synthoid that the other dr prescribed really would do nothing but get my blood test results in the "normal" range. From my 3rd blood results, he feels that I have thyroid hormone conversion issues possibly but that most of it stems from the hormonal issues.
Unfortunately I took my first dr's advice about the IUD and got it put in. I did my research but was confident when she told me there would be little or no pain. That was so completely wrong and it was the most painful thing I've even experienced. I have a high pain tolerance but this was unbelievable. I tore my shoulder up in a mtb crash and continued to ride another 2 miles with it messed up. That was nothing compared to this. I passed out and had a seizure during the insertion. I'm going to get it taken out because once I talked to the holistic dr, he said that it would be very hard to get my levels back in check with the IUD.
I have a friend who has been on synthoid for years and has seen no improvement. I asked her why she didnt go to someone else and she just shrugged and said the dr. knew what she was talking about (same endo I went to) and that she'd just deal with it and keep taking the synthroid.
sorry for the long post- just wanted to share my story so far to give info and see what other's experiences are.
I read somewhere (a couple studies done, found'em on google scholar, still parsing the data) that there's a HEAVY link between Hashimoto's thyroiditis and celiac/ other autoimmune diseases. Hashimoto's is actually a form of hypothyroidism most people don't realize they have because their doctor does no more testing after determining they're hypothyroid. Symptoms (other than standard hypo symptoms): a feeling of fullness or heaviness in the throat (around the thyroid), a distaste or outright hatred of things close to the neck, a history of other forms of inflammation, low T4 while the TSH is normal. I've noticed after eating celiac style for a while (PB has taken care of that quite easily), my symptom's are slowly going away and really only come back if I eat something that has wheat in it. If it's Hashimoto's, she may also have other autoimmune issues (same genetic marker.) The PCOS and endometriosis are what's throwing up the red flag for autoimmune diseases to me. Have her get tested for Hashimoto's thyroiditis.
I have to stay below 30 g carbs and minimal sugar to have any hope of weight loss.
Yes- Hashimoto's is first, and foremost, an [I]autoimmune disease[/I] and must be treated as such. Just treating hypothyroid symptoms does nothing to address the core issue. Hashmoto's patients are nearly ALWAYS gluten intolerant (and many are casein intolerant, too), and that is the biggest part of why the immune system attacks the thyroid (because, to the immune system, the thyroid resembles gluten molecules!) Most are also Vit. D deficient.
Here is a short educational video explaining more:
Here is a Dr. talking about reversing Hashimoto's by treating the root causes and stopping the immune system from destroying the thyroid:
Again- practitioners of functional endocrinolgy are the people to seek out in order to successfully reverse Hashimoto's. Email these folks for a practitioner list: