Thyroid Thursday Episode 59: Why You Can’t Lose Body Fat!
Why can’t you lose body fat? Hi everybody. It’s Dr. Eric Balcavage, and we’re back for another edition of Thyroid Thursday. Today I want to talk about why you can’t lose fat. It’s one of the biggest challenges I hear from people when they come into my practice (whether they’re on thyroid hormone or not on thyroid hormone), is they just can’t burn fat. They’re eating less. They’re exercising hard. They just can’t burn fat.
Why is that?
All the cells of your body can use glucose or fat for fuel. But to burn fat, you need a process called Beta Oxidation. Beta oxidation requires T3 inside your cells. If you’re trying to burn fat as a fuel, and you’ve cut back on your glucose and carbohydrates so that you can burn fat, you’ve got to have T3 inside the cell.
If you have decreased T3 in the cells, I call that Cellular Hypothyroidism. I’ve shot a bunch of videos on this, and we differentiate cellular hypothyroidism from glandular hypothyroidism. In glandular hypothyroidism, the gland just can’t make enough thyroid hormone. That results in decreased thyroid hormone getting to the cells, because there’s a deficiency of thyroid hormone.
In cellular hypothyroidism, the gland may be fine. It may be able to produce plenty of thyroid hormone, but instead of the thyroid hormone getting into the cells, it’s being converted into inactive forms.
T4 is the primary thyroid hormone in the bloodstream. As it circles around and washes over tissues, if there’s a tissue that needs T4, T4 is released from the carrier protein, typically something called thyroid binding globulin. It’s transported across the cell membrane, and then T4 can be converted by an enzyme called D2 (Deiodinase 2), to T3. The T3 can go to the nucleus of your cells and stimulate metabolism, or in certain situations, T4 can be converted to Reverse T3, an inactive form of thyroid hormone by an enzyme called Deiodinase 3.
You could have sufficient levels of thyroid hormone being produced by the gland, no hypothyroidism at the gland, but you can have hypothyroid symptoms, because this process is going on. T4’s being converted to Reverse T3 instead of T3.
How do you know if you have sufficient levels of T3 inside the cells? You can’t just look at TSH and T4. I know conventional medicine uses just those two markers most of the time when they’re evaluating thyroid status. But as I talked about on multiple videos, TSH and T4 are not great indicators of what’s happening at the peripheral cells. They’re good for understanding what’s happening at the pituitary gland, but they’re not good for figuring out what’s happening at the peripheral cells, because the thyroid physiology isn’t a static mechanism. It’s variable from cell to cell, tissue to tissue, depending on the stress on the system.
What can you do? You want to look at T3 and Free T3 levels. We want to make see what those values are. We want to make sure we’re converting some of that T4 to T3. We want to look at Reverse T3, because Reverse T3 is this number. If we see elevations of Reverse T3, then we have a good indication that this process is going on. If Reverse T3 is greater than 18, which is the high end of the functional range … it could be as high as 24, depending on what’s going on, but if it’s greater than 18, there’s a good indication that this process is going on and that you have cellular hypothyroidism.
The other thing we want to look at is the T3/Reverse T3 ratio. If this ratio is less than 10, that means relatively you’re making more Reverse T3 than T3, and so this mechanism is going on. We’re having this cellular hypothyroidism. You can look at this ratio. That number in health is greater than 10. When there’s cellular hypothyroidism, it’s going to be less than 10. You could also look at the Free T3/Reverse T3 ratio, and in health, this number is greater than 0.2. But in cellular hypothyroidism, the number’s going to be less than 0.2.
If you have Reverse T3 greater than 18, T3/Reverse T3 less than 10, Free T3/Reverse T3 less than 0.2, there’s a good indication that you have cellular hypothyroidism. Until this gets addressed and fixed, you probably aren’t going to burn fat efficiently.
What should you do?
You must reduce the stress and inflammation on your system. Because stress, whether it’s physical, chemical, emotional, or microbial, can drive this thing that we’ve talked about on multiple videos called the Cell Danger Response, which is an inflammatory process, an immune process. When we trigger this Cell Danger Response, this mechanism really starts to kick in (conversion of T4 to rT3), and this one is decreased (conversion of T4 to T3). We need to reduce the stressors and the inflammation on the system.
You want to decrease the processed carbohydrates, if you’re eating a bunch of them (especially things like gluten), which we know there’s a high correlation between gluten sensitivity and thyroid disorders. You want to improve sleep quality.
A lot of people don’t have good sleep habits. The body heals and repairs when you sleep. It’s not about how long you just lay in bed. It’s about those stages of sleep, especially REM sleep, which is important.
You want to reduce the emotional stress in your life. That sounds simple, but I know for many, it’s not easy. You have a bad job. You have financial issues. You got marriage issues. You got child issues. But those emotional stressors, probably have some of the biggest impact on decreasing thyroid physiology at the cellular level than anything else.
You want to reduce inflammation, because this whole process is driven by inflammation, and you want to look for and address subclinical infections. That’s a big piece of what gets missed in conventional medicine. They’re looking for big infectious processes, diarrhea, constipation, something that would really trigger somebody to really do some testing. But , sometimes it’s these chronic low-grade infections, whether it’s in the GI tract, the oral cavity, or systemically, that continue to drive the Cell Danger Response and continue to drive cellular hypothyroidism.
What shouldn’t you do?
You shouldn’t work out longer and harder. You’re not going to outwork this thing away. If you have belly fat, and you can’t rid of it, working out harder, especially if you’re already working out three or four days a week, is not going to do it. That’s going to contribute, to some degree, to this stress response.
You shouldn’t go on a calorie-restricted diet. Sometimes people think if they just cut down to 500, 600, or 800 calories per day (and there’s doctors that are promoting this), that they’re going to fix their thyroid physiology. You probably will lose some weight the first time or the second time you do it, but in the long run, you change the metabolic set-point. Starvation diets trigger the Cell Danger Response to occur and increase the Reverse T3 and cause cellular hypothyroidism, because there’s not sufficient calories. You wind up inducing hypothyroidism with calorie restricted diets. Don’t do calorie-restricted diets. There’s things called intermittent fasting or time-restricted eating. This is very beneficial, but just decreasing calories consistently can really create a problem.
And the last, don’t take more T4. If you’re already taking T4, and it isn’t working (you still have symptoms), and your TSH is in normal range or low, don’t think that if you just bombard the system with more T4, that’ll make this system work. It’s not about T4. It’s about what’s happening to T4 once it gets inside the cell. Is it being converted to T3, or is it being converted to Reverse T3?
If your doctors don’t measure it (RT3), they don’t know. Therefore, I run a full and comprehensive thyroid panel when we run tests. If this mechanism’s going on (increased T4 conversion to RT3), more T4 won’t fix the problem.
Hopefully that helps. If you have any other questions, reach out to me at my office or wherever you watch this video. Tell your friends and family if they have thyroid issues to look for the Thyroid Thursday videos. Come to my websites, www.chronicconditionrecoverycenter.com or http://www.thyroidproblemsdoctor.com site and look for your solution.
Take care.
