Do you regularly see 40-something female patients who cannot budge the belly fat no matter how hard they try? Or 50-something mid-lifers who say they never had a weight problem until they hit menopause or andropause?
If you haven’t considered testing their hormones yet, this should pique your interest. There’s a hormone connection to “unexplained weight gain” (ICD-9 783.1), and it could be the missing link to helping patients achieve their weight loss goals.
Shifting Hormone Levels Can Lead to Fat Storage
It’s no coincidence that patient obesity rates in the United States are highest among adults over 40 – as this is the age when hormone levels begin to shift and decline. Fluctuating hormones lead to shifting lean muscle vs. fat ratios, with fat taking the lead – especially in the presence of chronic stress, lack of sleep, poor dietary habits and a sedentary lifestyle.
These are the patients who find it nearly impossible to stick with any weight loss program because their hormones are hardwired for overeating and fat storage. These are the patients who are on the fast track to metabolic syndrome, as well as heightened risks for diabetes and obesity.
Undetected hormone imbalances can defeat weight loss efforts and make it far more difficult for your patients to control their weight. Here are a few typical scenarios:
1. The patient has an existing estrogen to progesterone imbalance
Many women, especially those of child-bearing age or at menopause, have an estrogen dominance problem – when estrogen is too high relative to low progesterone levels. This contributes to weight gain in the hips and thighs, water retention, sluggish metabolism and slow or stalled weight loss. In the perimenopause years prior to menopause, fluctuations of estrogen and progesterone trigger fluctuations in weight that are difficult to control.
Men, especially those in andropause, can also become estrogen dominant relative to declining testosterone levels (hypogonadism ICD-9 257.2). Excess estrogen in males tends to promote a female pattern of fat distribution in the hips, thighs and breast tissue – a vicious cycle furthered by aromatization of testosterone to estrogen in fat cells.
2. The patient has elevated levels of the stress hormone cortisol and low levels of the androgens DHEA and Testosterone
High levels of cortisol – the “stress hormone” – are a big reason the human body tends to store fat, particularly in the abdominal area, and won’t release it until the stressor is minimized or resolved. This is a survival response as old as evolution.
The patient who tells you she wakes up at the crack of dawn every morning for spin class, then races home to get ready for work and take her kids to school, then crams in chores after they are tucked in at night more than likely has increased cortisol levels – which in turn increase blood sugar and insulin levels, which increases fat storage.
When it comes to weight gain, high stress hormones are robbers of available DHEA and testosterone, thus working against the patient’s goals of having a lean body. The more lean muscle mass we lose, the more it is replaced by adipose tissue – FAT.
Bottom line: if you have patients who feel like they need to be on a caffeine drip at all times, consider cortisol as the culprit. Testing will determine the extent of imbalance and help you assist these patients in normalizing levels with appropriate treatment, adrenal support and stress reduction techniques to help them shut off the hyper-vigilance.
3. The patient is vitamin D deficient
Possibly due to our awareness of skin cancer and the use of sunscreen, patient levels of vitamin D are lower than they were decades ago. We’re spending more time in front of computers, and exercising inside versus the great outdoors.
Vitamin D acts like a hormone in our bodies; and its deficiency can be linked to weight gain, particularly of deep visceral fat (the type that is most hazardous to human health), fatigue, food allergies, MS and even cancer.
4. The patient has a thyroid deficiency
Hypothyroid issues as evidenced by steady weight gain and slow or stalled weight loss are inextricably linked to imbalances of one or more hormones. Excess estrogen, for example, increases the production of binding proteins that reduce thyroid hormone bioavailability.
Adrenal imbalances, particularly high cortisol levels, are also strongly associated with hypothyroidism, sluggish metabolism and obesity. Many physicians have found that by detecting and correcting an existing thyroid hormone imbalance they can kick-start blocked thyroid function.
Simple Testing Reveals Hormone Imbalances
With all this bad news, is there any good news? Indeed there is.
A new test that provides physicians with a broader view of the hormonal connection to weight gain and sheds light on why so many patients cannot control their weight despite the best efforts just became available – the Weight Management Profile from ZRT Laboratory.
Rather than ordering a variety of individual tests, clinicians have the ease of ordering the new profile – which provides clinicians with a comprehensive collection of tests designed to spotlight areas of imbalance for more effective treatment.
Incorporating saliva and blood spot samples, this profile evaluates key areas that include steroid (sex) hormones, adrenal stress, thyroid, and vitamin D deficiencies. The profile also measures fasting Insulin and HemoglobinA1c for early detection of metabolic syndrome, and Type2 diabetes. Optional add-on tests offer more thorough evaluation of thyroid and cardiometabolic markers as well.