Get your hormones checked and lose weight

Do you want to lose weight? Here’s number 15 of my 17 best tips. All of the published tips can be found on the How to Lose Weight page.

Before we get started, here’s a short recap of the tips so far: The first and most crucial piece of advice was to choose a low-carb diet. The next were eating when hungryeating real foodmeasuring progress wiselythinking long-termlimiting fruitalcohol and artificial sweetenersreviewing your medicationsstressing less and sleeping more, eating less dairy and nut products, stocking up on vitamins and mineralsexercising and finally, getting into ketosis.

This is number fifteen:

15. Get Your Hormones Checked


So you’ve followed the previous tips, implemented major lifestyle changes and established that neither medication nor vitamin deficiency is an issue. You’ve even tried raising your ketone levels for a while (ensuring low insulin levels). And you still can’t hit the normal weight mark?

If this applies to you, it’s high time to consider the possibility that hormonal imbalances are the cause of your troubles. There are three common problem areas:

  1. Thyroid hormone
  2. Sex hormones
  3. Stress hormones

Thyroid hormone

Some people, especially women, suffer decreased metabolism as a result of thyroid hormone deficiency – hypothyroidism. Common symptoms are:

  • Fatigue
  • Cold intolerance
  • Constipation
  • Dry skin
  • Weight gain

In these cases, weight gain resulting from decreased metabolism usually does not exceed fifteen pounds.

Your doctor can easily arrange for you to take a blood test to measure the concentration of thyroid stimulating hormone (TSH). If the test comes back and everything looks good, your thyroid gland is probably fine. For a more exact diagnosis, you can ask them to measure the actual levels of thyroid hormone in the blood (T3 and T4).

Two ways to avoid becoming deficient in thyroid hormone:

  1. Make sure you consume enough iodine, which is a building block of thyroid hormone. Good sources are fish, shellfish and iodised salt (or sea salt).
  2. Very low levels of thyroid hormone can indicate an autoimmune reaction to the thyroid gland itself. This means you’ll have to take thyroid hormone supplements orally, usually the stable form T4 (Levaxin), which your doctor can prescribe for you. Your body will transform this into the active T3 hormone when necessary. The supplement dose should be adjusted so that you reach normal hormone levels (TSH, T3, T4) and sufficiently alleviate symptoms – though a few people feel best when keeping TSH slightly below normal.

Some people feel better supplementing the already active T3 (sometimes prepared from pig thyroid glands), as it can give a stronger effect than the T4 hormone, but its effect is often harder to control. Swedish healthcare rarely prescribes or offers such T3 treatment, as it often lacks advantages and may pose a risk when doses are high for an extended period of time.

“Hypothyroidism Type 2”

Some alternative health coaches will diagnose you with the condition “hypothyroidism type 2” if you’re experiencing symptoms of fatigue etc., despite normal blood levels of thyroid hormones, and will recommend supplementation anyway. Be skeptical of this. You’ll likely end up trying to mask other health issues (i.e. the real causes of your symptoms) by slathering your system with overdoses of thyroid hormone.

Of course, some people will certainly feel more lively and alert (at least in the short term) running on an overdose of thyroid hormone. On the other hand, many people feel more lively and energetic when using amphetamine, too. That doesn’t mean their fatigue was caused by a lack of amphetamine!

Sex hormones

Sex hormones also affect your weight:

Women: Women can suffer from the endocrine disorder PCOS – polycystic ovarian syndrome – which elevates testosterone and insulin levels. This can mean weight gain and menstrual disorders (very common), infertility, acne and male pattern hair growth (such as facial hair). A low-carbohydrate diet is a good treatment for this. More on PCOS.

During menopause, a woman’s level of the female sex hormone estrogen drops. This often causes some weight gain, especially around the gut (so-called central obesity). Any excess weight gained after menopause will tend to be less femininely proportioned, less curvy.

Men: From middle age and onwards, men experience gradually declining levels of the male sex hormone testosterone. This leads to slight weight gain, also typically around the gut, and decreased muscle mass.

What can you do about sex hormones?

Testosterone deficiency can be at least partially treated naturally by engaging in smart exercise routines and supplementing vitamin D.

Of course, you can also affect testosterone levels by getting your doctor to prescribe a testosterone supplement (a blood test will confirm any deficiency). Women can use estrogen supplementation for climacteric problems.

It’s important you take into account, however, that supplementation of testosterone or estrogen for years on end, in doses that are abnormally large for your age, may increase the risk of prostate cancer (in men) and breast cancer (in women).

A better option might be to try and focus on a healthy lifestyle instead, and to be as happy and grateful as you can for the body you have.

Stress hormone

The final possible culprit behind stubborn weight issues may be the stress hormone, cortisol. Too much cortisol can increase hunger levels, bringing along subsequent weight gain. The most common cause of elevated cortisol is chronic stress and lack of sleep (see tip #10), or cortisone medication (tip #9). It’s a good idea to try your utmost to do something about this.

In rare and extreme cases, you could be dealing with a specific kind of tumour that drives cortisol production. The condition is called Cushing’s syndrome. If you suspect you’re suffering from this, consult your doctor and they will run the appropriate tests.


All 15 tips: How to Lose Weight


  1. Paul the rat
    I read in one of today's Australian newspapers that one of the "Professors" responsible for running the newly established, $500 million center for fighting obesity and diabetes in Sydney said: 'I worked with mice most of my life, mice are not that different to humans, the best macronutrients diet composition for mice and humans is 20%protein, 60% carbohydrates and 30% fat".
    If I was multi-millionaire I would hand-picked cream-of-a-cream-smart-ass lawyers, pay them obscene amount of money and we would prosecute in a court of law "Professors" like this one from Sydney for intentionally causing bodily harm, pain and suffering.
  2. Lari
    I know my inability to lose (more) weight is due to a prophylactic total hysterectomy 17 years ago and subsequent refusal to use HRT, but I'd rather live with the excess pounds than the ovarian/breast cancers that have taken so many women in my family. I just wish my previous and current doctors could see the big picture - I'm healthy despite the 30 extra pounds.
    Replies: #28, #29
  3. Stan Slonkosky
    According to andh-testing/ , TSH testing misses about 80% of the cases of hypothyroidism. Elsewhere on the web sitre is information why T4 supplementation alone may not help in many cases. A person may have sufficient T4 but problems converting it to T3. I had a test that showed normal TSH and normal T4 levels, but the T3 was at or just below the minimum, so I may have a minor case of hypothyroidism. When I asked about getting a reverse T3 test, my doctor said that test is rarely ordered (I think because of the price). Besides that, it is the policy of the clinic not to make T3 prescriptions anyway (probably because T3 is expensive).

    In several of his teleseminars, Dr. Richard K. Bernstein says he routinely tests new diabetes patients for hypothyroidism and says that more than half of them have it to some degree. He doesn't even bother with TSH tests but uses mainly T3 and T4 tests. He often prescribes a mixture of T4 and T3, but has to use a compounding pharmacy. This adds about a dollar per capsule, so it can get very expensive.

  4. Camila
    At some point down this list you mentioned something about the effects of caffeine in low carb diets. Can we have an english version of it, please? :)
    I'm very curious. Is going decaf going to help me to lose weight in any way?
    Reply: #5
  5. Maggan A

    Is going decaf going to help me to lose weight in any way?

    Very sorry but prophably´not in a milion years, If you like coffie - drink coffie and enjoy it with full creame ;-)

  6. Mark.
    I thought that most sea salt was low in iodine (some production methods raising the concentration a bit, supposedly). I eat seaweed or take dried kelp tablets myself.
  7. eddy
    Holy Moly Doc, it is bad enuff I have to give up my bread , pasta, wheat and rolled oats to fit with LCHF diet

    Now the dairy and nuts have to go!!!! WOW????

    No more high fat yogurt, milk, tasty butter and eggs????

    No more healthy almonds, hazlenuts, pistachios to munch on???
    OH NO!!!!

    No more fresh fruit raspberries, blueberries, and blackberries on my Yogurt? No more tasty crunch apples and tasty peaches, pears, bananas and oranges???

    Well I am keeping my eggs, yogurt, butter, fruits and berries as well as my whole grain past and bread and even my red wine. I am on a Mediterranean diet , oh ever so much more fun.

    But I will look into those hormones.

    Reply: #8
  8. Luis Rodas
    Today, I had a discussion with my wife because she keeps feeding our 2 year old apple sauce and bananas. I recommended berries or apples instead should she feed her fruit. No matter how much I talk about LCHF and got her to try it with me, she has lost weight and is happy, she still doesn't understand it. Some people never will. I wish we could just have people take a pill like in the movie, The Matrix, to be able to see the truth.
    Reply: #11
  9. Andrea
    I'm menopausal. One fine day an extra few kilos appeared around my middle, even though I've been paleo the last few years. I can't explain it, but the extra weight feels different from times in the past when I gained a few kilos (I'm not really overweight in general).

    I'm sure this is hormonal. I have the feeling that traditional women (like the kind Weston A. Price visited) didn't get this middle age spread at menopause.

    If they did, I'd say it's natural part of aging and nothing to be done. If they didn't, then it's probably fixable and may be a symptom of something not being optimal in the diet.

    So many things that people think are a natural part of aging are actually accumulative reaction to eating the wrong foods.

    So my question is a) is this really a normal part of aging? and b) what natural things can I do to counter act the hormone imbalance. I'm not about to start HRT.

  10. Ondrej
    measuring progress wisely -

    94-102 cm waist is decent? Only for men 1.88 m or more tall.

  11. FrankG
    As you say Luis "No matter how much I talk about LCHF ... [someone] still doesn't understand it. Some people never will."

    In eddy's case it is a clear case of deliberate reading misapprehension (although I seriously doubt he has even read the recap tips Dr Andrea's linked to)...

    Anyone who consistently reads the words "avoid" or "less off" as meaning that these are "completely off limits", is making the same ridiculous argument as those who choose to read LOW-carb as NO-carb and attack it on that false premise.

    Oddly these often seem to be the same who will say things like "how can it be healthy to cut out an entire food group" (based on that same false premise) and yet remain strangely silent when the cry is "LOW-fat diets for everyone!"

  12. Tony Nguyen
    i like your post. I think that losing weight by eating is safely and nautrally. but, it is difficult to find out the right program that can help me lose my belly fat. after reading your article. I know that you has a lot of exeprience in the dieting industry. I will follow your advice. I am building my own webiste, so I am very happy if you visit it at here:
  13. Ktina
    # 8 Andrea

    From what I'm learned, the estrogen levels go down at menopuse, and as they are fat-stored, and the body want to keep the estrogen, the body will encrease the bodyfat to preserve the estrogen as long as possible. Even if you look at traditional women, you will never find a 50 year old that have the body of a 20 year old woman. They do have bellies even if they're slim. I don't know if I'm correct about this, but I think it is a part of the problem.

    # 11 Tony Nguyen

    Have you ever heard of Charles Poliquin and his method BioSignature? He says that why the body stores fat at different places is because of different hormones. The beer belly has to do with carbohydrates and the stresshormone cortisol for instance. His method has found 12 different places where the body stores fat because of hormones. And this applies to slim and fit people also. There are thousands of slim persons with tiny lovehandles at the waist and the upper back (insulin).

  14. Sapphire
    Dear Dr. Eenfeldt:

    I don't know where else to post this, so I'll post it here. I'll also put it on your facebook page. I don't want you to miss it!

    I sincerely hope you read this message. I just want to thank you for your generosity in posting the wonderful LCHF for Beginners. I cut and paste it into a word document to post on my fridge for a quick reminder! I bought the wonderful book Life Without Bread and basically everything you summed up is in that book! How generous of you to give a succinct summary for free to those who just want a quick summary of "how to do it", without investing in any books.

    Thank you again. The Oopsie rolls recipe you posted is so wonderful. This is truly a healthy way to live.

  15. waqas
    Lose Weight by World Most Effective Methods for Only AED 149

  16. mike
    Please remove the joker above from this thread!
  17. luckilou
    As a former marathoner, bodybuilder, and jogger now in the mid 60's...the LCHF lifestyle seems to be the the answer to "the fountain of youth!" Low thyroid levels due to age/disease, high doses of prendazone to fight a lung/ sinus infection, and finally back surgery in May 2013....left me hovering at the 300lbs. mark! My "Italo American" heritage filled with pasta, bread, and pastry added to the weight explosion, and prediabities markers! As the saying goes " you can't out exercise a bad diet" so the more I exercised (and ate pre LCHF) ...the more frustrated I became!

    Enter counter intuitive as it was...the science of it all sunk in. Lustig convinced me of the science, and the "clear, conscise, and complete" Diet Doctor site mapped the way in an "exacting manner" that MADE SENSE! (Emphasis Intended). Now ...the evolution is underway. Jeans are falling off my waste. Aching body hurts less. Hunger is in control. Physical activity elevated. No sweets, no pasta, no bread, pizza, potatoes, morfing back to where it should be!!! (Did I mention I do drink whiskey and club soda- tall please!). I have yet to get to the desired goal...but I am getting there...slow and steady....! I am no kid at 64 but my old lean 6'4 frame is beginning to feel familiar (for years at 210 lbs)

    My bio markers are due for regular check up in Jan 2014......that piece of the puzzle to follow. My activity level (after back surgery) needs to improve and now I FEEL like moving...
    LCHF has made a believer out of me....because "eat less exercise more" just doesn't get it anymore!
    Well gotta go for breakfast of ....steak and eggs with extra butter.....Happy Thanksgiving to all and especially to The Diet Doc.....and LCHF!

  18. Anette
    I've been reading up on LCHF and am about to start. I have a question regarding the high fat content as I've just had a scan of my gallbladder and found out there's a gallstone. My doctor told me to eat a very low fat diet. It was also talk about having the gallbladder removed.
    To be honest I'm confused of what to do..
    Reply: #19
  19. Zepp
    Well, for some it comes out the natural way!

    But if it is a big one.. they seldome diseaper by them self!

    If one have gall stones, and have problems with that.. they have to be removed.. but not befor one have problems.

    Many have gall stones witout any problems.

    And then.. there are different stones of different origin and composision.

  20. Jeanie
    I'm finding that for men, varicocele is a causal factor for fractured sperm & low testosterone. Many men see a rise in their T levels after surgery.
  21. Marie
    I found out i had hypothryroidism which was causing all sorts of problems, including not being able to lose much weight. I got on Thyroxin and believe it or not a supplement that contains forskholii (Yeah the dr. oz forskolin stuff). I've got great energy now, not depressed and losing a bit of weight. The forskolin I got here The Thyroxin you would obviously need a dr prescription for, but definitely consider getting your thyroid checked if you have some of the symptoms I had.
    Reply: #22
  22. Bjarte Bakke Team Diet Doctor
    Interesting Marie. What did you measure and how did the doctor conclude that you had hypothyroidism?
  23. Naomi
    I suffer from hypothyroidism. I was on synthetic thyroid for 28 years, as I have only a tiny portion of thyroid left after two biopsies.
    I recently read "Stop The Thyroid Madness", found a good integrative GP, and now take NDT (Natural Desiccated Thyroid) .
    Just saying......your information is a bit out-of-date.
  24. Dev
    This looks great the way you layed it all out there, but the problem is, at least where I live is that stress and sex hormone tests are close to $400 each out-of-pocket. A look around online shows similar prices as well. If your problem doesn't turn out to be stress/sex hormone related, you've just wasted close to $1000 on testing.
  25. Adila
    I have thick grown hair between my breast and 4 to 6 I found under my chin with gapes, I pluck them with hand and after few days they grow and increase one more tell me what should I do
    I have the problem of concipation and slow metabolism and I do excercise with a lot of effort but my weight is stuck in between 70 to 75
  26. 2 comments removed
  27. Gerri

    I know my inability to lose (more) weight is due to a prophylactic total hysterectomy 17 years ago and subsequent refusal to use HRT, but I'd rather live with the excess pounds than the ovarian/breast cancers that have taken so many women in my family. I just wish my previous and current doctors could see the big picture - I'm healthy despite the 30 extra pounds.

  28. Gerri
    We’re all going to die and cancer is one way - it’s a natural way of dying. I would rather enjoy my life while I can without the extra kilos and cancer can meet me later on. Yes I know many close to me who have died from cancer. I probably will too

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