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Stress, Your Thyroid and Your Weight

Stress, Your Thyroid and Your Weight

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Expert Author Scott Isaacs M.D.

Did you know that stress can cause thyroid problems?  It has been well documented.  Stressful situations, chronic stress and even the stress from being overweight can be a major catalyst in disrupting the normal performance of the thyroid.  Your weight doesn’t need to be held captive by your thyroid.

When under stress, the body sends messages triggering responses from many hormones.  Many of these responses are short-lived and beneficial: the production of adrenaline (epinephrine), for example, provides people with the extra shot of energy and excitement often needed to get through a stressful situation.  (Think of how you feel when making a public speech: the palms sweat, the heart beats faster, you feel very afraid and very alive — all part of the “fight-or-flight” instinct developed over millions of years.)

But if the stress lasts for a long time, such as the kind felt after surviving a tragedy or losing a loved one, your endocrine system and your immune system become overburdened.  Naturally, this can lead to health problems.  In particular, the immune system becomes dysfunctional, because your brain — using the flood of stress-inspired chemicals as a guide — is focusing its responses elsewhere.  With the immune system out of whack, the body is helpless against viruses, and other toxins that attack the thyroid.  The immune system can become overactive, attacking and destroying the thyroid gland, or stimulating it to produces excessive amounts of thyroid hormone.  Autoimmune problems are the most common cause of both an underactive and overactive thyroid gland.

Moreover, stress isn’t just psychological.  Being overweight can cause physical stress because dysfunctional fat cells produce cytokines and other inflammation hormones.  The resulting impact, however, is similar — the immune system is weakened and thyroid comes under attack.

But when the body is under stress, other problems can occur.  In one scenario, the wrong iodine — the inner-ring iodine — can be removed from thyroid hormone.  This creates a totally inactive form of the hormone called reverse T3.  Given the inert state of reverse T3, metabolism is slowed to a crawl.


Millions of Americans suffer because their thyroid hormone levels are too lower than they should be.  It’s easy to overlook the effects of a dysfunctional thyroid gland, as easy as blaming a weight problem on not dieting or exercising hard enough.  The thyroid controls metabolism and therefore plays a major role in body weight regulation. The thyroid helps maintain psychological well-being, appetite, body temperature, sleep, energy level, sex drive, mood and so much more.

Thyroid disease is the third most common disease in America, after arthritis and asthma.  It is estimated that more than 30 million Americans have some form of thyroid disease.  Women are 10 times more likely to get thyroid disease than men.  And thyroid disease is more likely to affect you as you get older.  It is also more common when pregnant or in the year after having a baby.

When weight problems begin, many people suspect that the thyroid gland may be at fault.  They may have noticed other symptoms, such as a diminished sex drive, mood swings, constipation, dry skin or fatigue.  But when they go to the doctor, they get a standard “TSH” test and are told the thyroid is “normal.”

More and more physicians are becoming aware of underactive thyroid and the role it can play.  When your thyroid is low it’s easier to gain weight and harder to lose weight.  Endocrinologists have been treating milder and milder cases, and scientific data is finally coming out confirming what clinicians have known all along — that you can have “normal” thyroid tests and still have thyroid dysfunction.  Without a diagnosis and treatment that includes the thyroid, many patients — who could be well on their way to better health and losing weight — may have unnecessarily slow metabolism and poor overall health.   And that’s something no diet can cure.

A lot of my patients have been told by their doctor that their weight problem is not caused by their thyroid because their thyroid is “treated” and their blood tests are “normal.”  But I’ve seen so many cases were the doctor was using the wrong dose or the wrong type of thyroid medication, while blaming the patient for not dieting or exercising hard enough.  I’ve also treated many patients with previously undiagnosed hypothyroidism who then lost a lot of weight without a major change in their diet or exercise routine.  For others, treating the thyroid is just one piece of the puzzle.  When one hormone is dysfunctional, other hormones may also be out of balance.

Many patients I see have been treated for thyroid problems but still can’t lose weight.  This is often because they are on the wrong dosage or wrong type of thyroid medication.  Just a small “tweak” in the dosage, changing brands or adding another medication can boost metabolism and energy levels and help get the scale moving in the right direction.

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