But Doctor, I'm Telling the Truth, Part 2

Is Your Thyroid Making You Fat?
by Sanford Siegal, D.O., M.D.

(Page 2 of 3)

Since my particular interest is the patient's weight and how to get her to part with the excess portion, the subject of metabolism and the thyroid gland has become my passion. The problems that are associated with an improperly functioning thyroid gland and the resulting abnormal metabolism extend way beyond weight. After all, the thyroid gland is a major controller of how we feel, how we act, how we look, and how we function.

People know I'm obsessed with my patients' weight. That's what brings the patients to me in the first place. As with any other complaint, an early step in the process of managing weight is establishing a diagnosis. When I make a correct diagnosis of hypothyroidism, the weight problem is on its way to being solved, and the fallout from this success extends far beyond the pounds that are lost.

In the course of attacking my patients' obesity, I've seen the most fortuitous “cures” you can imagine. I've been given undeserved credit for benefits I never even contemplated. I've seen a moderately obese woman who was resigned to the fact that she was sterile become pregnant in her later years. What joy! All I was trying to do was get twenty-five pounds off her. Of course, such surprises were more dramatic in those early days. Today, I've come to expect these little miracles, even though I'm really not looking for them. I focus on my patient's weight problem. Whatever else happens is medical serendipity.

I have seen years of excruciatingly painful periods disappear in a flash as if by magic.

I have seen phlegmatic, depressed individuals who could barely motivate themselves to get up in the morning suddenly become upbeat dynamos.

I have seen debilitating pain that flits from one location to another, pain that had confounded a bevy of specialists over the years, quietly depart without fanfare.

I have seen hair come back, anemia disappear, memory return, laxatives discontinued, and chronic fatigue become a bad dream.

I don't mean to suggest that I'm the only doctor who knows about all of this. Plenty has been written about the miseries of hypothyroidism. There are even quite a few doctors who specialize in the thyroid gland alone. They and I do part company when it comes to the method of determining who has the ailment and who doesn't, and to a certain extent, what to do about it when we find that it exists.

As I've said, I specialize in treating overweight problems. Because I've seen so many patients over the years, I've developed some very definite and perhaps unique opinions on the subject. In the course of treating thousands of patients, one may change his opinion about ideas that he had previously believed to be incontrovertible.

It is my belief that when it comes to diagnosing problems involving metabolism, the laboratory not only fails us, it even gives us deceptive information about the patient. As a result, many of the patients who consult me have been told that their metabolisms are normal even though they display many of the signs and symptoms of a low metabolism.

The signs and symptoms of hypothyroidism are well known to most doctors. The subject has hardly been ignored in the literature that doctors read. I too read the literature. I'm sure that many doctors intuitively consider hypothyroidism when the patient gives them a history of her complaint. When my own intuition suggests to me that a patient has this affliction, I would naturally like some corroborating evidence. This is the point where doctors turn to the laboratory for help. The laboratory could supply the information that would confirm the diagnosis, but the fact is that it doesn't. I've come to mistrust the laboratory when it comes to the thyroid. Where, then, can I turn for help?

Years ago we had machines that were supposed to help us medical men with metabolic testing. I did thousands of basal metabolism tests with one of these machines, but I always regarded the results as suspect. There was another curious gadget that tested the response time of the Achilles tendon reflex in the ankle. It was an attempt to measure the known connection between the speed of our reflexes and thyroid function. I can still see that look the patient got when my nurse tapped her foot with a rubber hammer. Both of these machines were eventually discredited and yet as I look back, as imprecise as they were, they were probably more reliable than today's lab when it comes to hypothyroidism.

I haven't given up on the laboratory approach, but the search for adequate laboratory tests of thyroid function must continue.

In the 1970s there was a doctor who wrote on the subject. He also mistrusted the laboratory. He had great confidence in a test that he himself had developed. It was simple and easy to perform. Observing that those with hypothyroidism seemed to have a low body temperature, his patients were required to use the thermometer to help establish the diagnosis. I agree that the method has some value, but body temperature can be quite variable for a variety of reasons. I didn't feel that his test by itself could be relied upon as definitive.

Over the years, my own test evolved. Like so many nice discoveries, it was right “under my nose” all the time. It isn't as though one day I decided to invent a test for hypothyroidism. For a long time I had been aware that the inconsistency between what some people weighed and what they actually ate pointed in the direction of hypothyroidism. This knowledge, combined with other factors I observed in the patient, would lead me to make the diagnosis. What gradually emerged was a step-by-step approach to organizing that information so it would serve as a test applicable to all patients. With the testing method I now use, I feel I have at least a 90 percent chance of diagnosing hypothyroidism correctly. What's more, now you can actually do this on yourself, and in a later chapter I'm going to show you exactly how to do it. Stay calm. I'm not going to ask you to puncture yourself or to cause yourself any discomfort. You're going to be asked to eat certain things and to jot down some numbers. When you've completed the task, I believe that you will have a better idea of the state of your metabolism than you might receive from any medical laboratory.

The tests you will be performing will be the same tests that I use every day on my own patients. Whether your thyroid is at fault or not is information that could be invaluable to you if you've had difficulty losing weight, but the benefits could also extend far beyond simply regulating your weight. After you've done the testing, I shall instruct you as to what to do with that information. A low metabolism is correctable and reversible, but that will require the assistance of an attentive physician. I'm going to help you get that information to your doctor or help you find a sympathetic doctor.

If you learn that your thyroid is normal, and you have a weight problem, the testing will still be of value. You need to know that it is normal so that you may settle down to a serious diet with the confidence that it will certainly work.

Hypothyroidism is the medical term that is applied to an underactive thyroid, a gland that doesn't secrete sufficient hormone to allow the body to function normally. In many cases but not quite all, hypothyroidism results in an excess of weight. However, there are a host of other conditions and symptoms that also result from low thyroid function. Many who suffer from excessive fatigue are mistakenly told that they have chronic fatigue syndrome. A sizable number of women going through complicated and expensive treatment to facilitate pregnancy might have immediate success if their underactive thyroid glands were properly treated. Likewise, many menstrual abnormalities are the result of low thyroid function. Psychological problems are another manifestation of hypothyroidism. In general, a hypothyroid patient who receives proper treatment can experience an across-the-board improvement in her general sense of well-being.

Copyright © 2000 by Sanford Siegal

About the Author

SANFORD SIEGAL, D.O., M.D., lives in Miami, Florida, where he has directed fourteen weight-loss clinics catering to 500,000 patients. He's the author of several books, including Dr. Siegal's Natural Fiber Permanent Weight-Loss Diet and Hunger Control Without Drugs: The Doctor's Appestatic Diet.