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Thread: Any tips for this patient?

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  1. #1
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    Jun 2012
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    Any tips for this patient?

    I have a patient in my office who is gaining weight, but it seems to me like she's already doing everything right. I'm looking for any insight that could be helpful! Thanks so much

    34 year old female- 5 foot 1, about 250 pounds.

    Her max weight was 380. She initially lost 150 lbs+ on weight watchers. When she switched to "primal weight watchers" her weight loss slowed. When she stopped weight watchers, and strictly followed a primal type of diet, she started gaining weight.

    She has done a "whole 30" and continued to gain weight throughout. (but this is whens he felt best)

    She claims to be consuming about 1200-1300 calories per day- including some raw dairy. All meat is grass fed/free range. She eats about 2-3 servings of fruit/day. (one whole grapefruit and sometimes an additional serving)

    She has been seadily gaining weight since going primal and has gained about 50 pounds total since last fall.

    She has hypothyroidism, and is on medication for this. Only other medication is birth control.

    She is also having her adrenals tested

    Currently I'm thinking there might be an autoimmune issue?

    Has anyone out there dealt with anything similar to this? What recommendations would you have for this frustrated patient? elimination diet? Any other suggestions for me in terms of tests I should have done?

    Thanks so much in advance.

  2. #2
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    Is the patient on T3/T4 combo meds? As someone that doesn't have a thyroid (more or less) I can't begin to tell you how much worse I feel on T4 only meds.

    Are they weighing/measuring foods? Many people lose weight on packaged diets because they guess on portion sizes and they way underestimate what they are eating when they prepare their own food.

  3. #3
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    Interesting point. She is on levothyroxine- which looks to be a T4 only. Thanks for the tip.

  4. #4
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    Cortisol?
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  5. #5
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    Another important symptom I forgot to mention...she has a pretty severe sulfur allergy, and experiences hair loss when she eats sulfur containing foods.

  6. #6
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    Allergies certainly affect the whole system, I too am allergic to sulphites, plus, dairy, egg and gluten, plus a host of other things. Removing the offending food caused my weight to scream down. Makes eating out really tough though.

    Maybe have an allergy panel done? It really helped me. I also get a bad burning scalp and hair loss. Sounds like me... needing a multi pronged approach.
    Started Primal June 2012 at 148.5lbs, and 5' 1", reached goal weight in 5 months.
    Lowest weight 93lbs - too thin. Now stable at around 100lbs much better weight for me at my age.
    Primal, minus eggs, dairy and a myriad of other allergens.

  7. #7
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    I am also wondering about the thyroid pills. What were her results Free T4, T3 and reverse. What is daily temperature? Wilson's? Going full primal with much lower carb may have really affected her thyroid even more.

    Ahh I now see Synthroid. I was on that for years, did nothing for me. Getting thyroid right can be a real struggle, taking a while to really figure out what is needed for each individual. After going on the natural dessicated I have now ended up on T3 only. I would definitely look harder at thyroid.
    Last edited by Silvergirl; 04-14-2013 at 11:42 AM.
    Started Primal June 2012 at 148.5lbs, and 5' 1", reached goal weight in 5 months.
    Lowest weight 93lbs - too thin. Now stable at around 100lbs much better weight for me at my age.
    Primal, minus eggs, dairy and a myriad of other allergens.

  8. #8
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    She hasn't brought in her thyroid panel results to my office just yet- has been working with her endocrinologist on this.

  9. #9
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    That doesn't seem like enough calories for her size. It may sound crazy, but she could be gaining because she isn't eating enough. Signal to the body that the famine is over so it will start burning fat. I know I start gaining if I drop my calories to ~1200, and I only weigh 175.

  10. #10
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    Quote Originally Posted by teach2183 View Post
    That doesn't seem like enough calories for her size. It may sound crazy, but she could be gaining because she isn't eating enough. Signalto the body that the famine is over so it will start burning fat. I know I start gaining if I drop my calories to ~1200, and I only weigh 175.
    Yep, it sound outright crazy!

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