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failing at dieting

I have an over active thyroid probably since the early 2000's.  Recently I started to gain weight without trying.  I haven't changed my eating habits in years.  For breakfast I have a glass of Tropicana probiotics banana/mellon.  Lunch is a half sandwich with turkey on rye bread with a pickle.  Supper is a usual meal.  In the evening I do have some fruit strawberries, blueberries, cantaloupe, or melon.  In October at my appt. with my PCP I weighed 142, 6 months later 146.  I am not obese, I am 5'5" tall.  I'd like to lose 15lbs but unable to lose 1.  I am also taking the diet pill Alli which has been no help at all.  Exercise is hard because of RA.  What do I have to do to lose a lb?????
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649848 tn?1534633700
COMMUNITY LEADER
My usual advice to anyone whose doctor refuses to order a full thyroid panel, even after the patient has provided information on how important it is, is to find a different doctor.  I understand that your doctor is very close to where you live and is in the network of your insurance.  Insurance companies, however, rarely only have one doctor in their network, so there's bound to be someone else you could see to get adequate testing/treatment for your thyroid.  That doctor could be a primary care doctor, internist or another kind of doctor.  Another doctor might not be as handy as 1/2 mile up the road but if you get better treatment, it's well worth traveling further to see someone else.  If you're not willing/able to do that, you're right, you won't make much progress unless you're willing to change some of your own habits to try to make improvements on your own.

Green vegetables aren't the only ones that have fiber in them, nor are vegetables the only foods that contain fiber.    Vegetables come in all colors of the rainbow and each of them has a certain amount of fiber, though some have more than others plus they each have different nutrients we need.    That's where a nutritionist might come in handy.  There are a lot of ideas you can use to acquire a taste for new veggies.

I'm not much of a vegetable eater either, but I've done some experimenting with herbs/spices, steaming, roasting, etc and figured out ways to fix a variety of veggies I never used to eat, that make them quite tasty.

There are several supplements you could try that might help boost your thyroid, but of course, it would be helpful to know what all your thyroid levels are, along with ferritin, vitamin D, B-12, cortisol, etc.  

In addition, there are places from which we can order our own thyroid panels at reasonable prices (less than $100 for TSH, Free T4 and Free T3) available in most states, without a doctors order.  This is an option I recommend when one can't get their doctor to order the tests. Many times if one can get the tests done and show the doctor that levels are too low, they can get the treatment they need.   If the doctor still insists that because levels are in the "normal" range, the only options are to find a different doctor, try to self-treat (not recommended) or stay sick (also not recommended).
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Details
Past Results
Graph of Past Results
Component Results
Component Your Value Standard Range Flag
TSH 1.97 uIU/mL 0.27 - 4.2 uIU/mL
FREE T4 REFLEXIVE NOT APPLICABLE ng/dL 0.9 - 1.7 ng/dL

This is the result of the thyroid test that was done on April 5th 2018

I hate to change Dr's as I have been with this organization since 2003.  That's a long time.  I like the people there, I like most of the Dr's, I just hate to change and get to know a new DR, it's hard to place your trust in someone new.  I need a knee replacement but because the Dr has absolutely no personality I chose to suffer over going to see him as he can't get me out the door fast enough.  He never gives me time to ask questions, his main objective is to get to the next patient.  That's what you get when you live in a small town, and I hate driving in unfamiliar territory.





Just to say, veggies aren't really where we go to get fiber.  Not sure how fiber fits in here, but fruits have much more fiber than veggies, depending on the fruit you choose to eat.  Apples are one of the better sources of fiber.  The fiber in the most nutritious veggies, the green leafy ones, isn't all that digestible, which is why cooking or juicing is important when you eat kale, collards, mustard greens, broccoli, and the like.  I mention these because they are the mineral rich veggies with the proper balance of calcium to magnesium and have the antioxidants that protect the body from cancer.  Cabbage is one of the best for this, but again, the fiber in cabbage can be very hard to digest if you don't cook it or ferment it or juice it -- juicing breaks down the fiber.  The best fiber for digestion comes from whole grains and from legumes, which are a vegetable but are thought of more for their protein and fiber than their antioxidant content, and so does some of the best fiber for heart health -- some grains have soluble fiber and some have insoluble.  This is why a variety of foods if you get it can be helpful, though throughout human history and even today most people in countries that are not affluent or who still live in tribal cultures tend to eat the same things as they don't have access to global trade.  As for your thyroid test, again, a holistic nutritionist will give you the best thyroid tests you can get, the most comprehensive, but as mentioned above, you will have to pay for it as insurance won't cover it if it's ordered by a nutritionist.  Only holistic nutritionists do this, not your basic nutritionist, which I think I already mentioned don't know much about nutrition unless they're research nutritionists.  Again, these are the people who design the menus at hospitals and schools, along with dietitians, and we've all seen these menus and know they are not healthful.  Studies show they are not healthful.  It sounds like the poster suffers from anxiety -- I'm a big anxiety sufferer and I get the fear of going to doctors.  But if you have a doctor who isn't helping you, or you have a doctor who you lack confidence in so much you won't go see him, you really have no choice if you have medical problems but to find a different doc.  As an anxiety sufferer I've been practicing avoidance with the best of them, but it doesn't lead to anything good.  As for docs not giving you time, that's going to be true for most doctors.  They are pressed between insurance companies and the owners of their practice -- most general practitioners today work in groups that are owned by hospitals or other groups, and so it goes.  Sometimes you just have to be annoying to get what you need.  Good luck.
If I recall correctly, we went over this in the Thyroid Disorders forum and I wouldn't even go into it now if weight and the thyroid weren't intertwined so often.  Free T4 Reflexive means that the order the doctor actually wrote was "TSH w/Reflex Free T4".  That's an order to the lab to test TSH and if TSH is normal they should do nothing further, but if TSH is out of range in either direction, they should then test Free T4.  There is nothing that refers to Free T3, which is the active hormone that's actually used by individual cells in the body.  This is a very outdated way of testing for thyroid conditions and indicates that your doctor's knowledge of thyroid is limited and he does not stay up on the latest testing.  This is also an indication that he may not stay up on the latest treatments.

The problem with this test is that he's missing the whole aspect of testing your thyroid because TSH is not a thyroid hormone, it's a pituitary hormone and is only an "indicator" of thyroid status and not really a true one at that.  What we see, very often is people with a TSH like yours which leads doctors to believe thyroid function is "normal", but in reality they also very low thyroid hormones, which can be an indication of a pituitary problem in which there isn't enough TSH to adequately stimulate the thyroid to produce adequate thyroid hormones to keep metabolism, heart rate and other body functions going properly.  

I'm not going to go into a lot of detail, but reference ranges for thyroid hormones are actually calculated without eliminating people with hypothyroidism, so the entire bottom half of the ranges for Free T4 and Free T3 are suspect, meaning that anyone in the bottom half of those ranges, most likely has hypothyroidism and most doctors are oblivious.  Of course, you have no way of knowing because your doctor refuses to test them.  Doctors like yours tend to keep their patients very ill.  If I had stayed with a doctor like yours who would only test TSH, I'd be dead by now because he'd be telling me I was hyper for the past 10 yrs and would have removed me from my thyroid medication, just as the doctor who diagnosed me tried to do when my TSH dipped below the reference range, but my Free T4 and Free T3 were below or low range, which means I was still hypo, not hyper.  I'm a classic example of how TSH does NOT always correlate with actual thyroid hormones.

I, too, had been with my doctor for a lot of years and did not want to leave his practice, but I could see that I had no choice because the treatment I was getting was making me sicker and fatter.  My blood pressure kept going higher, I swelled with fluid, my cholesterol rose way above normal, my blood glucose was going out of range.  He prescribed blood pressure medication, fluid pills, insisted that I go on cholesterol medication, accused me of over-eating and under exercising... He did everything except prescribe an adequate dose of thyroid hormones, even though all of these things are thyroid related, simply because of my TSH... Had I not left his practice I've no doubt, I'd either be disabled or dead by now.  I've just left another endocrinologist who has the same idea for treating hypothyroidism.  I'll not stay with someone who insists on keeping me ill and/or making me struggle for my health simply because of lab tests, especially if the lab testing is inadequate, to begin with.

A doctor is not a good doctor simply because they have good bedside manner or nice staff.  They have to provide good/adequate testing/treatment as well.  I read an article just the other day, saying that many doctors are approximately 17 yrs behind when it comes to thyroid testing/treatment because they don't read medical journals and/or peer-reviewed articles and keep up with current research.   According to the article even when presented with current information, many of them refuse to change their way of practicing.  Your doctor is definitely one of those.  A doctor takes an oath to "do no harm" - inadequate treatment is harmful.

It's nice when we find a doctor that is close by, has a great personality, a nice staff, knows what they're talking about, and treats us exactly as we want to be treated, all rolled into one - that's who we call "Dr. McDreamy"... most of us never meet our Dr. McDreamy.  

We all have to make a choice whether we should go out of our comfort zone to seek that which might make us feel better.   I wish you the best of luck.
649848 tn?1534633700
COMMUNITY LEADER
You've posted in the Thyroid Disorders community in the past, and reading over the thread you posted it would appear that your thyroid testing/treatment is not optimal, or even close to adequate, for that matter.  I know you've posted here, that your thyroid is overactive, but you posted in the Thyroid Disorders community that you are on Levothyroxine, which means it's actually under active, after being overactive.  Without adequated testing and treatment for any thyroid disorder, it's likely one will have a difficult time with weight.

The thyroid controls metabolism, along with many other body functions and we must have optimal thyroid function in order for everything to work the way it's supposed to.  

Of course, one can lose weight with the Alli diet because it cuts out all fat; the problem is that our bodies need some fat in order to be healthy.  As the others have stated, we also need the nutrients we can't get if we eliminate vegetables and other foods that contain fiber.  

Herbs and spices can go a long way toward making foods we don't care for taste good.

I'm a boomer, with hypothyroidism, too and one of my previous doctors actually prescribed Xenical, which is the prescription strength of Orlistat, the active ingredient in Alli, along with the diet to me some years ago.  Prescription Xenical was expensive so I got Alli to try instead.  I lost some weight rather quickly, but it wasn't without a cost as it can be quite "messy" and somewhat "surprising" if one isn't meticulous about the amount of fat consumed.  I only stayed on it a couple of weeks... I've begun to see a holistic Nurse Practioner who has helped me with my thyroid, diet, and supplementation.  The main thing was balancing my diet with adequate protein, fiber, fat, carbs, etc and as long as I stay away from the bread, sugar, dairy, etc, I can lose weight slowly, but surely.  

As has been noted, sugar is an inflammatory and exacerbates pain of all kinds, including that from RA, hypothyroidism, etc.  Along with sugar, anything that is converted to sugar quickly in the blood, such as things made with white flour, white rice, etc do the same thing and should be eliminated from the diet.

Your original question indicates that you can't lose weight, and in the end, you say you're losing weight, so I'm not sure how we can really help you.  

We don't, typically, advocate diet pills for weight loss.  We advocate healthy eating and exercise.  But first, thyroid function must be optimal before one will be able to accomplish much of anything.

I understand that RA makes it difficult to exercise, but I know from friends/relatives that have RA, most doctors recommend as much exercise as possible because not using the muscles and joints can make them stiffer and less usable over time.  Some exercise, if possible, is better than none.  Of course, one should always consult their doctor.  
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When I stated I couldn't lose any weight I meant it took so long to lose a few lbs.  Years ago when I would diet lbs came off the first week as long as I kept my calorie intake below 1200, but now as I get older I was thinking it was next to impossible to lose it but after about 6 weeks the scale showed a loss of 6lbs.  I haven't weighed myself in about 2 weeks I'm giving the Alli pills one last shot them I'm finished with them and this diet.  Thank you again for your reply.
I did mention the additional testing to my Dr in my last visit in April and like I said he refused saying my T 4 levels are within the stable range.  I asked, he declined, what else am I suppose to do.  I can't quit this place as this is "in the network" of Dr's I can see with my insurance.  If my thyroid is to blame for the weight gain, who else can I go to?  Like I said I did ask him I gave him information that was given to me on this particular testing he agreed to read all of it but what else can I do? I tried, he refused, and I'm stuck at 140lbs.
134578 tn?1693250592
I'd check the contents of your breakfast; what is its carb count? And drop the diet pill, I've never heard of even one of them that works.
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I just looked at the label, 28g of sugar in the bottle I checked (I think it was 16 ounces, can that be right? It was somewhat greyed out.)
Actually, looking on another site, it was 28g of sugar in one 8-ounce serving. Seriously, that cannot be good for someone with RA, sugar is an inflammatory agent in the body. You'd do better with a couple of poached eggs.

As to why your old reliable food has suddenly caused you to gain, it could just be time going by, we do burn food more poorly and retain more of it as body weight as we get older.
Sorry to disappoint you but I've already lost 6lbs along with this unknown diet pill and a lessening of my calorie intake.
The probiotics is what I went for as I've had some problems with my digestive system, and drinking this eliminated them completely.  That's it on my sugar intake for a day.  I drink 4oz of caffeine free diet coke and diet peach tea, no candy at all.  That's my sugar intake for 1 day.  Maybe I should switch to a probiotic pill instead,  if all you think I have too much sugar in the measly amount of food I consume on a daily basis.  I don't have IBS but I did suffer from bouts of constipation, here & there.  I hate fiber but I still try to get enough of it  through meals, it's just so many of the foods that contain most of it, I hate.  I tried fiber pills and my stomach blew up like a balloon, extremely uncomfortable.  I hate spinach and all the other veggies that contain most of it.  So when I tried this juice it cleared up everything, and I have never felt better, I just want to lose 15 lbs, I'm not obese, I'm 5'5" tall @ 140lbs,  I'd like to get to between  125 - 130lbs.   So I guess I quit the juice and try a probiotic pill, since fiber pills do nothing but make me feel miserable.
I've responded to this person already as she has also posted on another forum.  She's pretty determined to do what she does and that's fine, we all get to decide how we want to live.  But for anyone else reading this, losing weight is great but health is more important.  Losing weight by doing unhealthy things probably isn't what most people are seeking on here.  If you want to lose weight and don't care about anything else, then just take speed.  It works.  It wreaks havoc on your life, but it does work.  Not eating will obviously cause weight loss eventually, as you will start to starve.  Not eating sufficient nutrients will also eventually kill you.  As for probiotics, again, the probiotics in that drink are dead.  Light and oxygen and heat kills them, they are very fragile.  They also need food to eat if they are not in state of hibernation.  People think yogurt has live probiotics in it, but it doesn't unless they add them back in after pasteurization, as the heat from that kills them off.  Some expensive natural yogurt companies add them back in after pasteurization, but the main benefit of yogurt is it is good prebiotic, meaning food for probiotics already in your system.  The other issue is the amount of organisms in the product -- because most of them will die before successfully implanting in your intestinal tract, a good always-refrigerated (for hibernation) probiotic will have billions of organisms in it so that some will survive the process.  The main one people take for digestion is bifido-bacteria, so if this isn't one of the ones in your product you might not have any digestive benefit although you might get other benefits.  The main objection to this poster's breakfast is it's all a sugar-laden drink, as it's a fruit drink, and one made by a company that isn't at all concerned about your health.  Tropicana ain't doing this for your health, folks.  If you really want the benefit of a juice, get a juicer and juice real live fruit and greens and other foods, but you really should get some protein in there too so you don't waste away all morning.  I think this poster would benefit, really benefit, by seeing a holistic nutritionist but I'm guessing where she lives this isn't going to be a likely option, unfortunately.  That leaves a selection of books on nutrition to get different opinions and then make a plan.  Eating very little food isn't a great way to lose weight -- again, if you don't get all the nutrients your body needs to make fuel, you can't burn.  Best of luck.
I can't believe it, I posted and it just went away.  The short of it is, I've replied on another forum to this poster, but for the rest of you, Tropicana isn't in this for your health.  For a probiotic to work, it has to be alive and get implanted in your digestive tract.  A good supplement is refrigerated all the way down the line to keep the organisms hibernating, as they are killed by heat, light, oxygen, and lack of food if they're awake.  Bifido-bacteria is the main ones we know of to take safely that affects digestion the most, so a probiotic with an emphasis on that type is best for this purpose.  If you don't eat enough nutrients, you will lose weight eventually because if you don't eat enough you will eventually start to starve, but you need all the nutrients you need to make the fuel your body needs to produce the energy necessary to lose weight healthfully.  I would recommend this poster read a lot about nutrition.  It would be great to see a holistic nutritionist, but I fear where she lives makes this unlikely.  Best of luck.
As you claim Tropicana isn't in it for your health, why then since starting this drink do I feel so good, my digestive system is working perfectly, 100% perfectly.  I cut the glass if half so now I am only getting 4oz or less per day.  I am from the baby boom era, why then did I live so long if I'm eating so poorly as you state.? Sorry but all the smoothies out there are not appealing to me as I hate all green veggies except for lettuce, cabbage and string beans, I will never eat spinach, kale or any of the others that go into these drinks. By the way I am able to see a nutritionist I live in the USA.
I meant a holistic nutritionist, not just any nutritionist.  The reason is, just look at the menus at high school cafeterias or hospitals and the like -- they will kill you and they're designed by nutritionists and dietitians.  Holistic nutritionists practice more in line with healthier eating.  I only said this because you noted you're far away from practitioners.  And if that drink is making you feel great then don't listen to me, listen to your body.  If it works for you, don't change a thing.  I was only responding to you stating what you're doing isn't working for you.  If in fact your feeling great and everything is going fine, don't change a thing -- this is what your body wants.  Now, long-term, I think your diet isn't going to work well for you, but if you're a baby boomer like me, you're getting on in years and if you're fine then don't change a thing.  Your post, again, suggests you're not doing at well fine, but maybe you just wanted to vent a little or have some communication.  As for being alive, we live a long time now because of water that is treated and a year-long supply of food thanks to refrigeration and somewhat because of the medicine we've developed over the centuries.  Mostly, it's the water.  It's also not dying in violence for young men and not dying in childbirth for women and children.  But living longer doesn't mean living healthier.  Americans live long, sick lives.  It's better to live a long healthy life, as people in other developed countries do much better than Americans do.  Part of that is learning to like healthy food because they start eating that way very young and we don't.  Us baby boomers grew up with docs telling our Moms not to breast feed because formula was better so Nestles could sell more milk.  We were told to drink way too much milk so to many bones got brittle.  We were exposed to so many toxic chemicals that we suffer epidemic levels of autoimmune diseases, mental illness, obesity, etc.  It's great to live long.  It's much better to live long and healthy.  By the way, cabbage is really really good for you.  Full of antioxidants that help prevent certain cancers.  If you eat fermented cabbage such as kim chi or sauerkraut, it's even better for your digestion than taking probiotics.  Lettuce generally has no nutritional value, but some lettuces do -- the really really green ones and the other things you put in salad, such as dandelion greens and chopped carrots and watercress -- watercress and dandelion greens are much more nutritious than kale.  There are so many veggies out there and so many ways to prepare them that, as we become adults, we usually find ways to enjoy them.  As for smoothies, nobody has to drink them to be healthy.  Eating is fine.  You don't have to drink your meals.  Juicing fresh organic produce is really good for you because it lets you ingest a lot more nutrients than you can eat, but most smoothies are pretty loaded with sugar.  Anyway, I didn't intend to get back into this with you because you have already indicated you're fine with things as they are, and you're repeating that here, and I'm accepting that.  I only got involved because you seemed to be saying things weren't working out and I tried to suggest some things that might help.  I was wrong about that -- you're doing great.  Keep it up, and a long and healthy life to you.  Peace.    
I'm sorry if I offended you in any way but it just took so long to lose 6lbs I was thinking it would never happen.  I'm still aiming for 130 lbs if possible, but I feel great, I am not in any way house ridden, I do many things around the house especially since spring/summer is here.  Lots of garden work along with taking care of a large ranch house.  I absolutely love the turkey sandwich for lunch with a pickle on it instead of Mayo  and for supper I enjoy a good meal.  IOn the evening I go with 1 of 3 fruits, strawberries, blueberries, or cantaloupe.  Its just the green veggies I hate, I refuse to eat spinach, kale  or many of the others that are high in fiber, so when I found this  Tropicana juice I was happy, it completely cleared up my digestive problems and I feel great but I have cut back to only 4oz maybe less so I am not getting that much sugar.  My PCP has a helper who contacts me every few months to see how I am doing and all I have to do is contact her and she will put me in touch with a nutritionist,  not sure if it's the kind you mentioned but I told her I'd like to try and lose the weight myself first and if I couldn't I would call.  I live in Pennsylvania and my PCP office is 1/2 mile away so its not a problem.  It has just taken a little longer than I expected.  With the warmer weather here I will be doing a lot more work outside which will or should help.  Thank you for everything you have told me I really appreciate it.   On my ;ast visit in April to my PCP I did mention and I gave him reading material to read up on how Dr's test the thyroid.  He told me there was no need for this extra testing as my T4 levels have always been in the normal range since I went underactive a few years being overactive.  I can't force him to have these tests done, I already asked and he said what I stated.  I can't go to another PCP because of my insurance, they must be in a certain network.  Sorry this is a bit lengthy, I get carried away sometimes, but I do appreciate everything you have said, when it comes down to it, I am just a picky eater, I like my certain foods.  
Again thank you
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