Hello
I just started listening to your podcast and love it! I heard you mention menopause and how you gained weight and lost it. I would love to hear you elaborate on this subject. Menopause and Hashimotos and weight gain and what to do. I feel desperate with trying to lose and so many different ideas out there from intermittent fasting to keto and I don’t know what to focus on that will work. Please consider doing a podcast show about this.
Thank you
Beth Axxxxxxxx
Thanks for this question Beth.
Weight loss in menopause while also having Hashimoto’s can be a bit challenging. There are a lot of things to consider.
It’s not about calories in and calories out. Calories do matter and what kind of calories you are eating matter but what matters more is what is gong on in your body hormonally.
If you are struggling with weight loss, you could be dealing with a hormonal imbalance of some kind. Maybe your thyroid medication isn’t optimized well. Maybe some other hormone is off, like cortisol, insulin and/or leptin.
Maybe you have estrogen dominance or low testosterone. These things will determine how fat you get from the calories you do consume.
Most of the time the weight loss struggle, when not thyroid hormones, might be an issue of cortisol. When cortisol is high over a period of time it can create lower levels of serotonin affecting mood (depression), keep you from sleeping well (increasing sugar cravings) and can cause you to store fat.
Too much cortisol can create that dreaded muffin top and this needs to be fixed before much of anything else can be taken care of. Higher cortisol can give you that wired but tired feeling, make you quick to anger and make you feel irritable. It also is a cause of fat gain. I spent years like this though the weight gain in my late 30’s and all of my 40’s was really minimal because I was still cycling so estrogen was helping to keep me thinner.
When dealing with low cortisol you can get tired easily or have poor stamina and low cortisol can cause you to look at things in more negative ways, you might find you get sick more often, and of course it contributes to thyroid dysfunction.
Cortisol is 100% related to stress and how you react to it which will sabotage your fat loss. When high, cortisol increases blood sugar which leads to higher insulin levels which can increase fat storage.
Remember stress can be mental/emotional, strained finances, toxic relationships, infections, poor or little sleep (even shift work), food allergies/sensitivities and over exercise.
Bottom line, working to lower stress and manage cortisol will help reduce body fat.
When cortisol is high it will also decrease conversion of T4 to T3 which causes a slowed metabolism which will probably lead to fat gain.
I mentioned leptin before. This hormone tells your body when you are full so if leptin is blocked, you don’t get the full signal and you may end up eating more calories than you need/want leading to poor blood sugar regulation, higher insulin, and fat storage.
Gut health is also important. Many of you know a large percentage of your immune system lies in your gut aka GI tract aka intestines. If your gut is unhealthy, so are you, and this includes your ability to lose fat.
GI dysfunction very simply can look like gas, bloating, undigested food in your stools, terrible smelling gas, constipation and/or diarrhea, bad breath, nausea.
If the bacteria in your gut are out of balance, this can affect the conversion of thyroid hormone from T4 to T3, slowing metabolism. It can also affect the body’s ability to excrete estrogen creating a recycling of the hormone and cause you to gain fat.
If you are not properly breaking down the foods you are eating then you are not absorbing nutrients either. You need adequate protein to be digested and absorbed in order to make neurotransmitters, repair tissues and build a healthy immune system. If you have poor digestion this can lead to anemia which causes muscles to fatigue easily and can make it difficult to exercise and will decrease your ability to lose fat.
Inflammation in the GI tract can cause a stress response in the body which will increase cortisol production which can cause immune system problems in the gut itself leaving you susceptible to infections which will cause more inflammation and more cortisol leaving your body in a cycle of inflammation.
Eating foods you are sensitive to can cause a stress response in the body leading to release of cortisol and, you guessed it, fat storage.
Now you all know that when your thyroid is sluggish it means difficulty losing weight and easy gain of weight. All the stuff I’ve talked about can affect thyroid function and poor thyroid function which can include being on medication that isn’t fully supporting optimal function can affect all the stuff I’ve already discussed.
Sex hormones like estrogen and progesterone, when out of balance, will definitely cause you to hold on to fat as well. These hormones impact your ability to feel emotionally well, have will power and have any kind of motivation. In order for your sex hormones to be in balance, you have to have balanced blood sugar, balanced adrenals, and a healthy GI tract. If your testosterone levels are high you will have trouble losing fat. In addition, if you are dealing with any kind of toxicity at all from xenoestrogens, fat loss will be difficult.
All of this needs to be corrected before fat loss happens and fat loss should not happen if you are not reasonably healthy because you don’t want to be losing fat tissue which will mobilize toxins from that fat tissue and if you are not eliminating them, they will redistribute in other tissue. Not good.
Think if you have some of this stuff going on and then you hit menopause. Our estradiol is lower in menopause and estradiol helps us be more sensitive to insulin. So now we are at higher risk for insulin resistance.
Insulin resistance means your blood sugar levels could be normal but you might have too much insulin in your blood. High insulin with no where to go means fat storage. This means that for some of you for the first time in your life, what you eat will greatly effect your weight. Sugar and anything that converts to sugar will be a problem for you in excess. This means less dessert, less treats, avoiding sugary drinks and for some of us it might mean quitting these things altogether. It just depends on how important getting rid of the belly fat is to you. And it isn’t forever. Just long enough to give your body a minute to get insulin levels regulated and then you can figure out what you can enjoy and how much of it. It’s called finding your carb tolerance. This doesn’t mean you need to go low carb either because that is a problem for hashimoto’s but you might need to reduce the amount of bread, white potatoes and rice until you get things regulated. This is something I can help you with and I recommend having some labs done to see just where your biggest problems lie with this. There are some extra markers you should ask your doctor for but before you do, I recommend meeting with me to figure out what might be going on, then you can go to your doctor and get your labs done with what ever add ons I think you need.
Now, a topic all on its own is detoxification and I’m giving a talk at an online summit in January. Sign up for my newsletter at outofthewoodsnutrition.com for info in that in the coming weeks. There is a fair amount of research tying pesticides to fat gain and to poor liver health. Some in the scientific community suggest that our body creates more fat to handle the load of toxins we get exposed to. I have a couple of different questionnaires you can take to asses your toxin level when you work with me. It is the best and cheapest way to determine toxic burden because most testing is not reliable.
There is an immune system marker called Interleukin-6 or IL-6 and when that is increased due to inflammation of some kind, it can make it difficult to lose weight and keep it off and it may be a trigger for fat gain. Fat tissue is now considered to be an organ in the endocrine system and it likely causes inflammation while inflammation causes us to store body fat. Another vicious cycle.
Decreasing inflammation through diet is a great first step in beginning to lose fat. Cutting sugar, processed foods and eating real whole foods is important. If you need meal plans, I can help you with that. If you are a client in my 6 month package, you get meal plans for free. If you just want a meal plan consult, we can work something out.
All of this is tied to your brain health which I won’t go into detail here but what’s going on in your brain physiology impacts sex hormones, thyroid hormone, neurotransmitters like dopamine, serotonin, GABA and more.
Dopamine helps to keep our metabolism going and when we have low dopamine we have low energy and the worst part- sugar and junk food binges. Don’t let anyone tell you this is about will power. They can seriously suck it if they do. If you are low on GABA, it can also cause cravings for fat and carbs. This is not to say you should supplement with GABA because you can do that but that won’t fix why you are low on it in the first place.
I’m not about bandaids for problems unless they are needed to get your body on the right track while we figure out what problems you are dealing with.
Most of this info really applies to anyone but this question was about dealing with menopause. I went in early. I think I was 46 or 47. Either way I was super happy to not have a period anymore because my periods were horrible my whole entire life. I’m reading a book about hypothyroidism that was written at least 40 years ago and thinking back on my childhood and my first periods- I had so so many signs that my thyroid might not be functioning well all the way back to 13 years old. Sometimes this makes me so mad because I feel like a huge part of my life was just subpar. It’s really why I worked so hard to get my masters and my nutritionist license. I have so much to offer you guys in the way of experience and knowledge around these topics so that you don’t have to suffer like I did. It’s the only way I can not just sit and wallow in losing so many years of well being. I’m so glad I woke up and fought for better health. Some days are still a struggle but those are fewer and farther in between as long as I manage my stress and diet. In all honesty, I’ve gone off the rails a bit with my diet. Sometimes eating super healthy all the time just gets old. And, I’m paying for it a bit. My digestion sucks right now and today my energy level is in the tank but I think that is mostly due to getting up too early, working out too hard and a couple crappy things in my personal life.
I really need to start meditating and journaling again. I have a locked document on my computer where I write out things I would never say out loud or want anyone else to read. It’s where I get all the anger off my chest and just let it go. I highly recommend it for a release, especially if you don’t have anyone you can talk to regularly or you don’t want to always be complaining about certain people.
Anyway, back to menopause. As I said, I was around 46 when it hit for me. The average age is around 51. And let me just tell you- life is not over once you hit menopause. Before you hit it though, you might be having some crazy symptoms- even if you are fit and your diet is dialed.
Anxiety, racing thoughts, heart palpitations, hot flashes, insomnia, depression and so on. You can even have these symptoms in your thirties if your body is going to go into early menopause. If you are fit, these may be milder than someone who isn’t but very few of us make it through perimenopause without some symptoms. Peri-menopause occurs because your hormones, estrogen and progesterone, are all over the place.
Abdominal fat gain in menopause is real and so is loss of lean muscle. This is due to decreased sensitivity to insulin as I mentioned earlier. Your blood sugar is likely higher and there is likely some insulin resistance which lead to fat storage.
Any high cortisol, again, also leads to fat storage. We also become less able to build muscle and you are losing bone mineral density. It becomes pretty imperative at this stage in life to start exercising if you don’t already, and lifting weights is the most beneficial.
Let’s talk estrogen, specifically estradiol or E2. This form of estrogen declines in menopause. It promotes muscle growth and muscle strength- you need to lift heavy weights to make up for loss of estradiol.
You have to watch inflammation and blood sugar too. When estradiol declines but estrone or E1 might be a little higher and progesterone is low, it can cause sore joints.
The average weight gain in menopause is 5-8 pounds. As I mentioned before it was 28 pounds over a couple of years for me. It didn’t help I was mostly sedentary for 2 ½ years sitting at my desk doing homework and not changing how I ate much at all. In fact, I probably ate more sugar and crap due to stress in school which contributed to my weight gain. The change in estrogen levels and cortisol make us gain fat in our stomach which puts us at higher risk for heart disease. If your fat is in your thighs however, you are less likely to be at risk for heart disease.
Exercise and a dialed diet are going to be key to fat loss in menopause. I’m not a trainer so I can’t speak well to exercise but Stacy Sims in her book Next Level recommends sprint interval training for fat loss along with lifting heavy.
Her book gives you plenty of ideas on what kinds of exercise you can do but if you are new to exercising, buy the book and ask a trainer to help you work out based on the principles in the book.
It might take you some time to find a trainer willing to do it- I hired a guy who agreed to read my copy of Next Level and he never did. He told me he knew enough that he didn’t need to after he had the book for a few months.
Then, when I got it back it looked like he spilled water or something all over it. I was slightly annoyed over the whole situation- also I didn’t speak up for myself- still a work in progress there!
Alright- so sprint training and lifting heavy. I use an airdyne bike at my gym and do 8 rounds of 20 seconds high intensity and then 10 seconds off. I also lift heavy using a program from the book Hangry by Sara Fragoso and Dr. Brook Kalinak. I’ve definitely gained muscle and lost some fat but the biggest change has been body composition. My thighs are smaller and the dimples on my behind are getting smaller.
This has been two years in the making for me. In order for this to be sustainable and enjoyable I go to the gym 3 days a week and I foam roll, warm up, lift heavy, sprint and then stretch. I hate working out but after 2 years, it feels good to go. I feel stronger and more confident and the weight is coming off slowly which in my opinion is the only way to do it.
I’ve been more mindful of what I eat but that needs to get more dialed in as well. Like I said, I’m kind of off the wagon which for me just means eating more gluten free bread and too many nuts. I’ve also cut back on chocolate and rarely drink coffee.
By the way, lifting heavy as defined by Stacy Sims is lifting six reps or less of the most weight you can of things like deadlifts, chest press and squats. Get the book, read the book and then find someone to help you write a program from the recommendations in the book. Don’t try to figure it out on your own unless you are well versed in the gym already.
Doing this will help increase your metabolism, help you lose fat, improve your stability so you don’t fall and break a hip and improve your body composition.
Let’s talk diets.
If you are exercising, it will be super important to fuel yourself before you exercise otherwise your body will be stressed which messes with your muscle gain and fat loss. Eat a little protein and a carb like banana and nut butter, toast and nut butter, or something like that.
I tend to forget to do a carb in the morning but I do cold brew and protein powder before I go to the gym and I eat as soon as I get home. Sims states in her book that women specifically need to eat within 30 minutes of a workout in order to build muscle and keep our body from further breaking muscle down.
If you don’t eat right after your workout, your body is in a stressed place, blood sugar is likely high and you are more likely to store body fat. So working out while intermittent fasting is a big big no no. Eat some protein- whey protein is ideal, animal protein is also good. Chicken, eggs, nuts, fish, greek yogurt, cottage cheese. Any of these before or after are good.
Then do your best to get around 100 grams of protein per day or around 30 per meal.
If you google Stacy Sims and Intermittent fasting you will find a good article on why you should not do it. A very brief summary of why you shouldn’t intermittent fast or the ketogenic diet is because both of these diets mess with a neuropeptide called kisspeptin which, when it is disrupted will make our brain think we are deficient in nutrients, especially carbs leading to increased appetite and increases insulin resistance which leads to fat storage.
Fasting and exercising leads to higher cortisol which leads to fat storage. Short term, the keto diet might be great- long term it can mess up your endocrine system and increase fat gain. The article is called Yes! You are an athlete. No! You shouldn’t practice intermittent fasting. It’s a quick read and pretty easy to understand.
Bottom line- no to dieting, yes to exercising. Yes to figuring out your carb tolerance. Yes to looking at your blood work. Yes to joining me for 6 months every other week to help you get and stay on track with all of this. If you are sick and tired of being sick and tired. If fatigue is winning at keeping you on the sidelines of life more than you are winning at having the life you really want, then we need to talk.
You can schedule a discovery call at outofthewoodsnutrition.com under the work with me tab. Let’s see if we are a good fit. I know I can help you get your life back! Let’s do this together! I am compassionate and I have a real passion for helping people just like you get rid of their fatigue!
If you haven’t signed up for my newsletter you can do so on my website as well and get 5 things your doctor won’t tell you about hypothyroidism. I send out recipes almost every week in my emails.
Thanks to Beth for sending in this question. I love when you guys do that. If you have a question, please email me at stephanie@outofthewoodsnutrition.com or fill out the contact form on my website. It’s so much more fun to answer your questions than come up with content or guess at what you might be interested in.
Thanks for tuning in. Until next time.