Sunday, June 23, 2013

Thyroid And WEIGHT?

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Thyroid And WEIGHT?

It has been appreciated for a very long time that
there is a complex relationship between thyroid
disease, body weight and metabolism. Thyroid
hormone regulates metabolism in both animals
and humans. Metabolism is determined by mea-suring the amount of oxygen used by the body
over a specific amount of time. If the measure-ment is made at rest, it is known as the basal
metabolic rate (BMR). Indeed, measurement of
the BMR was one of the earliest tests used to
assess a patient’s thyroid status. Patients whose
thyroid glands were not working were found
to have low BMRs, and those with overactive
thyroid glands had high BMRs. Later studies
linked these observations with measurements
of thyroid hormone levels and showed that low
thyroid hormone levels were associated with low
BMRs and high thyroid hormone levels were as-sociated with BMRs. Most physicians no longer
use BMR due to the complexity in doing the test
and because the BMR is subject to many other
influences other than the thyroid state.
What Is THE Relations Hip Be Tween BMR
and WEIGHT?
Differences in BMRs are associated with chang-es in energy balance. Energy balance reflects the
difference between the amount of calories one
eats and the amount of calories the body uses.
If a high BMR is induced by the administration
of drugs, such as amphetamines, animals often
have a negative energy balance which leads to
weight loss. Based on such studies many people
have concluded that changes in thyroid hormone
levels, which lead to changes in BMR, should
also cause changes in energy balance and simi-lar changes in body weight. However, BMRs are
not the whole story relating weight and thyroid.
For example, when metabolic rates are reduced
in animals by various means (for example by de-creasing the body temperature), these animals
often do not show the expected excess weight
gain. Thus, the relationship between metabolic
rates, energy balance, and weight changes is
very complex. There are many other hormones
(besides thyroid hormone), proteins, and other
chemicals that are very important for control-ling energy expenditure, food intake, and body
weight. Because all these substances interact on
both the brain centers that regulate energy ex-penditure and tissues throughout the body that
control energy expenditure and energy intake,
we cannot predict the effect of altering only one
of these factors (such as thyroid hormone) on
body weight as a whole. As a consequence, at
this time, we are unable to predict the effect of
changing thyroid state on any individual’s body
weight.
What Is THE THYROID Gland?
The thyroid gland is a butterfly-shaped endocrine
gland that is normally located in the lower front
of the neck. The thyroid’s job is to make thyroid
hormones, which are secreted into the blood and
then carried to every tissue in the body. Thyroid
hormone helps the body use energy, stay warm
and keep the brain, heart, muscles, and other
organs working as they should.
HOW You can Help
A tax-deductible contribution to the American
Thyroid Association supports valuable patient
education and crucial thyroid research. New
discoveries and better understanding will translate
into improved ways to prevent, diagnose, and treat
thyroid disease.
Hyperthyroidism
What Is THE Relations Hip Between
Hyperthyroidism-and WEIGHT?
Since the BMR in patients with hyperthyroidism
(see Hyperthyroidism brochure) is elevated,
many patients with an overactive thyroid do,
indeed, experience some weight loss. Further-more, the likelihood of weight loss occurring is
related to the severity of the overactive thyroid.
Thus, if the thyroid is extremely overactive,
the individual’s BMR increases which leads
to increased caloric requirements to maintain
that weight. If the person does not increase
the calories consumed to match the excess
calories burned, then weight loss will ensue.
As indicated earlier, the factors that control
our appetite, metabolism, and activity are very
complex and thyroid hormone is only one fac-tor in this complex system. Nevertheless, on
average the more severe the hyperthyroidism,
the greater the weight loss observed. Weight
loss is also observed in other conditions where
thyroid hormones are elevated, such as in the
toxic phase of thyroids (see Thyroiditis bro-chure) and if one is on too high a dose of thy-roid hormone pills. Since hyperthyroidism also
increases appetite, some patients may not lose
weight, and some may actually gain weight,
depending on how much they increase their
caloric intake.
WHY DO Gain WEIGHT When
Hyperthyroid Ism Is Treated?
Because the hyperthyroidism is an abnormal
state, we can predict that any weight loss
caused by the abnormal state would not be
maintained when the abnormal state is re-versed. This is indeed what we find. On the av-erage, any weight lost during the hyperthyroid
state is regained when the hyperthyroidism is
treated. One consequence of this observation
is that the use of thyroid hormone to treat obe-sity is not very useful. Once thyroid hormone
treatment is stopped, any weight that is lost
while on treatment will be regained after treat-ment is discontinued.
Hypothyroid Ism and
THYROID Hormone
WHat Is THE Relations Hip Between
Hypothyroidism And WEIGHT Gain?
Since the BMR in the patient with hypothy-roidism (see  Hypothyroidism brochure) is
decreased, an underactive thyroid is generally
associated with some weight gain. The weight
gain is often greater in those individuals with
more severe hypothyroidism. However, the de-crease in BMR due to hypothyroidism is usually
much less dramatic than the marked increase
seen in hyperthyroidism, leading to more mod-est alterations in weight due to the underac-tive thyroid. The cause of the weight gain in
hypothyroid individuals is also complex, and
not always related to excess fat accumulation.
Most of the extra weight gained in hypothyroid
individuals is due to excess accumulation of
salt and water. Massive weight gain is rarely
associated with hypothyroidism. In general,
5-10 pounds of body weight may be attribute-able to the thyroid, depending on the severity
of the hypothyroidism. Finally, if weight gain
is the only symptom of hypothyroidism that is
present, it is less likely that the weight gain is
solely due to the thyroid.
HOW Much Weight can I Expect TO
lOsE OncE THE Hypothyroid-ism Is
Treat Ed?
Since much of the weight gain in hypothyroid-ism is accumulation in salt and water, when
the hypothyroidism is treated one can expect
a small (usually less than 10% of body weight)
weight loss. As in the treatment with hyper-thyroid ism, treatment of the abnormal state of
hypothyroidism with thyroid hormone should
result in a return of body weight to what it was
before the hypothyroidism developed. How-ever, since hypothyroidism usually develops
over a long period of time, it is fairly common
to find that there is no significant weight loss
after successful treatment of hypothyroidism.
Again, if all of the other symptoms of hypo thy-druidism, with the exception of weight gain, are
resolved with treatment with thyroid hormone,
it is less likely that the weight gain is solely
due to the thyroid. Once hypothyroidism has
been treated and thyroid hormone levels have
returned to the normal range of thyroid hor-mone, the ability to gain or lose weight is the
same as in individuals who do not have thyroid
problems.

Help ME lose WEIGHT?
Thyroid hormones have been used as a weight
loss tool in the past. Many studies have shown
that excess thyroid hormone treatment can
help produce more weight loss than can be
achieved by dieting alone. However, once the
excess thyroid hormone is stopped, the excess
weight loss is usually regained. Furthermore,
there may be significant negative consequence-es from the use of thyroid hormone to help
with weight loss, such as the loss of muscle
protein in addition to any loss of body fat.
Pushing the thyroid hormone dose to cause
thyroid hormone levels to be elevated is un-likely to significantly change weight and may
result in other metabolic problems.

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