“I was always skinny but … now I don’t even recognize myself.” Jennifer pulled out some old college pictures from her purse. “See! This is what I used to look like!”
I nodded empathetically, realizing that Jennifer couldn’t believe what happened to her body, and she worried that no one else would believe it either.
“You looked pretty athletic. Let me guess, tennis?”
“I was varsity at Radcliffe. I still play six days a week.”
Jennifer continued, “Anyhow, you wouldn’t know it from looking at me. Ever since I had David eleven years ago, I’ve been gaining almost ten pounds every year.”
“Hmmm, your symptoms sound a lot like POSTPARTUM HASHIMOTO’S THYROIDITIS, where something related to pregnancy causes women to need more thyroid hormones than they can make on their own ”.
“They actually tested me for that. My doctors always told me my tests were normal.”
“There is a difference in having labs ‘in the reference range’ and having an ‘optimal thyroid state’. Dr. Leslie DeGroot, of Brown’s Alpert Medical School, described the ‘Dangerous Dogmas in Medicine’ as they relate to treatment of thyroid disorders . Unfortunately, there are quite a few doctors out there that rely highly upon the gospel they were taught twenty years ago, without paying enough attention to new data, or their patient’s clinical symptoms.”
I continued taking my history. “So what have you tried to lose weight?”
“My diet was always pretty clean, so even when I tried going ‘low-carb’ or ‘low-fat’, it didn’t seem to make any difference. One health spa in Brazil cut me down to 300 Calories a day and had me exercise all day. I didn’t lose a pound!” Jennifer blushed a bit, “I’m ashamed to admit it, but I fall for whatever the latest diet fad that promises ’30 pounds in 30 days!’ ”
“I’m glad you’ve realized that these bogus diet clinics should really say, ‘I lost $350 in two weeks! Ask me how!’ ”
“It was worse than that. One diet clinic sold me ‘vitamin supplements’ from their office pharmacy, but they really contained amphetamines, diuretics, laxatives, and other stuff I still don’t know what was in them. I had the worst palpitations, headaches and I couldn’t sleep through the night . My primary had to put me on anti-depressants for six months to handle the withdrawal symptoms after I stopped them.”
“I’m glad you survived that ordeal, but honestly, you got off lucky. Crash diets are known to cause hair loss (sometimes permanent), muscle weakness, and potentially fatal heart arrhythmias . The latest diet craze, the ‘HCG Diet’, is nothing new; it was debunked back in the 1970’s as a fraudulent scheme by doctors to exploit their patients for financial gain . Just last October, the Texas Attorney General forced hCG clinics in that state to stop defrauding patients with their unethical marketing tactics .”
“Well, I’ve finally decided to make my health a priority. I checked you out on www.vitals.com, so I know you are board-certified and legit. So what are you going to do for me?”
“I scheduled 80-minutes with you today, so I have plenty of time to do a complete history and physical exam. There are some tests I would like done to pin down exactly what is going on with your metabolism. Untreated thyroid disorders can lead to pre-diabetes, and that can also lead to weight gain .”
Jennifer did test positive for hypothyroidism and insulin resistance, as well as a low metabolic rate measured by indirect calorimetry . After being put on a regimen of behavior changes, diet, exercise, OTC supplements, and prescription medications, steadily, but surely, her weight decreased an average of two pounds per week until she lost the 60 pounds she put on over the last ten years.
“Dr. Woliner, ever since you fixed my metabolism, I’m not hungry anymore. Really, I don’t even feel like I’m on a diet. I just eat normally.”
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