Vacation: Rejuvenation Station

In my work as a hormone guide, I find the adrenals are the hardest to nurture and tonify. Our lives are so hectic, particularly in the Bay Area. But nothing nurtures and tonifies as much as a fabulous vacation.

In Ayurveda, they say that illness develops when you move to fast, when your body cannot catch up with your Being. This happens with trips that require airplanes or long car-rides. Solution? Bolinas!

I'm blessed to own my integrative medicine practice and to set up at the outset that I will be unavailable (the doctor is "out") for the month of August and for a month mid-December to mid-January. My adrenals demand it. It allows me to connect to my true Self, to reconnect to what is important, and to develop new ideas about to help you even more deeply and efficiently.

Here are some highlights of what was particularly helpful and healing on my August vacation.

First, one word: Bolinas. Ah, I just love to say it: Bolinas, Bolinas, Bolinas. We stayed in the house above for three days. It was so deeply relaxing, it felt like three weeks. Why? Soulful space.

We, as a family, did yoga daily, meditated, ate amazing local food from the Bolinas' People's Co-op, drank tea, had Big Thoughts, Big Conversations, Lingering Dialogues.

And then there was the Japanese soaking tub. OMG. Fantastic. I'm sitting there, chillin', or perhaps more accurately, sweatin', and in hops a little frog.

Hello, Sweet Frog. He hopped away before I could kiss him.

Darling Husband, David Gottfried, loved Bolinas because we were off the grid. He loves that in a vacation destination.

I just love getting re-energized about my path. Spent the month thinking about how aligned I am with my dharma or purpose. How can I make adrenal buoyancy more a daily part of my life for both me and my patients. Ideas? I'm reviewing Ayurveda and the wisdom it offers to us householders and forest dwellers. Stay tuned! Vacation ends Monday, August 30.

Input > Output

A funny thing happened on the way to my massage therapist: I met a mystic and received a transformative massage. Stan Barrett is a brilliant healer and the wisdom he shared during my time on the table was nothing short of miraculous.

I arrive this morning a few minutes late, jogging the last few blocks on Piedmont Ave to limit the damage to our first impression. I'm out of breath, sweaty and my monkey mind is at full throttle.

Stan is calmly seated in the waiting room. I take a deep breath. I'm so not zen. He is. He's got lovely energy. He shakes my hand, introduces himself and genuinely reassures me with "no worries" on my late arrival.

I'm liking things so far. I'm a week into my supposed August vacation, and I'm failing miserably at the vacation aspect. I'm checking email too much. I'm texting my assistant obsessively. I'm guzzling oolong tea. You could argue that I'm overexercising. I'm freshly back from a trip to Point Reyes that was supposed to be two weeks on the Inverness Ridge, but our rental was on a highway and peaceful it was not. I'm nuts. I'm acutely aware that I'm obstructing the expansion of my consciousness with busyness and overinvolvement with work. My output is unsustainable. I've been looking forward to this vacation all year and I'm hopelessly squandering the opportunity.

I also know a therapeutic opportunity and a fellow seeker when I see one. This man is the Real Deal.

I ask: "How do you find balance?" Stan's response was exactly what I needed to hear, especially since I'm mildly burned out and struggling significantly to get into my August-vacation-state-of-mind.

"Low output!" says Stan. He is vigilant about how he books sessions, sees only three to four 90-minute clients per day, four times per week, and takes a 30-minute break in between so he can clear the space and not rush, uses a great online scheduling system that keeps no-shows to a minimum.

I rush from one patient to the next and often lack the time to pee in between. Not Stan:  "I schedule 30 minutes at the end of each massage session, which gives you time to collect yourself unrushed, for us to chat and bring closure to the intimate connection, and for you to have my time and attention exclusively without the baton being passed to my next client with you standing right there in lane 5.  That simple step allows me to remain more grounded throughout the day.  It looks different for each of us."

How sane is that? I left Kaiser four years ago but I still stack up the patients like Mother Kaiser is my employer. Hello? I'm self-employed. Like Stan, I run the schedule and set the flow but I'm running the schedule as if I were drill sargent and not a sentient being.

He claims Tuesday mornings for fun mountain bike rides: "I often go alone, but I have a couple friends who join me every so often.  I find it's important to carve out time for things that feed my soul and make me scream Yahooooo!  I first had to figure out what that was, and I'm still working on it."

Process work: therapy, mending his connection with his father. It's usually either your mom or your dad that's bringing you down, depleting your energy, limiting your output, he tells me. Time to get conscious, People.

He adds: "I'm a fan of psychotherapy, but currently not sitting/talking with anyone.  I've been in the clear for a few years now and in a 'productive' stage.  Meaning the barriers that held me back regarding family are no longer in my path.  It's nice to have a light heart and strong arms from having put down all that baggage.  Also, I find the more I'm enmeshed with my partner and my clients, the less I'm able to be present for myself and for the moment.  Maintaining the space where I end and you begin is a learned skill, I find."

Light heart and strong arms from putting down the baggage? Sign me up!

Then there's Stan's self-care or INPUT: 7+ hours of sleep regularly. Pilates weekly one-on-one with a woman who works out of her home. Chiro semi-weekly, alternated semi-weekly with massage. He expounds on this input thing: "It helps create the foundation on which to build other things.  I know myself well enough that my first appt. is never before 11am.  Many people look forward to evening massages post-work, so a full day takes me until 8pm.  I always take an hour for lunch. For brain chemistry, it's fish oil, B and C."
 
Stan contrasts his measured output with that of his much-revered Pilates instructor who is, in his words, "Agro." I request a translation. "She's got more on her plate than anyone I know."

OMG, I think I'm agro.

"My incredible Pilates instructor has big output." Stan continues. "She's got 3 kids and her belief is that more fun fills the cup. You know? Fun with the kids: trapeze arts - things like that."
 
I want to channel Pilates Mom and Stan. But can I do both?

I ask for more details about Pilates Mom Who Has Fun With Her Kids. I have fun with my kids sometimes, maybe 20%, but a lot of the time I’m nagging them to get dressed, eat their broccoli, brush their teeth and floss, do their homework, get their tushies out the door because we're late again, buckle their seat belts, or I'm bribing them.

He continues, "She's is an advocate of the fun factor.  No matter what commitments we have on our plate (and she has the most of anyone I know), so long as we fill our cup with hilarious fun no matter the flavor, our energy will go further.  She loves looking at hats and Adidas shoes for example.  Sometimes she buys them, most often she just tries them on and smiles, gives them back to the salesperson and goes home.  Sometimes she and her youngest kid go to Sports Authority and play with all the toys in there.  Again, not necessarily buying anything.  And her girl time is essential.  Once a week she leaves the man and kids at home for a night in the city with her CRAZY girlfriends.  A little tequila... you're a doctor, you know these things.”

I ask his permission to blog about him.

"What is a blog really? An online journal?" he asks.

Clearly, low connectivity is another crucial part of managing output that I've failed to master, but meanwhile he agrees to let me blog about him.

I ask if he'll hand me my iPhone so I can record his genius commentary, because I'm 43 and my memory is more shot than my adrenals.

"Dude, you'll remember what you need," he replies.

He refuses to hand me the iPhone. He adds: "Besides, I won't look at it, so it doesn't matter whether you get the quotes right."

"I find it's best to offer up my own experience and let people ask questions of themselves.  But here's a loving nudge for you... what does your self-care and input look like? Feel like?  Would carving out some you time, time with your girlfriends over a beer, or whatever it takes to help push the reset button - would that do the trick?  Regular date night with your man?  Make a list of all the crazy ideas you wish you could do and work towards one of them.  Running is the you time?  Workshops - giving back and connecting with your community in a leader role - awesome.  You know all this stuff, Woman!"

"I usually talk with my hands, so you threw me a good curve, got me gabbing, and wanted to record it!  So funny!  Enjoy yourself."

Wow. I got a massage from an enlightened being. I feel transcendent; the massage was phenomenal. He's a gifted, intuitive and strong body worker. I give him my highest endorsement. For those of you women who won't go to guy for a massage, you're missing out on something special. Stan is a powerful hybrid of sacred masculine and feminine, and he's got the energy flow of input and output down like nobody's business. Thank you, Stan!

Stan Barrett

Massage Therapist
4315 Piedmont Avenue
Suite # 203
Oakland, California 94611
510-907-0285

How to Raise Your Good Cholesterol

If your doctor is still ordering the standard cholesterol test of total, LDL, HDL and triglycerides, you are in the dark ages. See, the problem is that 75% of the folks who have a heart attach have a normal LDL and HDL. Get your doc to order the most current tests: a VAP cholesterol or a Berkeley Heart Lab test so that you can check your subfractions; that is, check your good vs bad subfractions of LDL and good vs bad subfractions of HDL. And in women in particular, your Lipo(a) is crucial to know. We also like to measure the level of inflammation with both the cardio (or high-sensitivity) c-reactive protein (hscRP) and homocysteine.

Seventeen years ago I did a fellowship with the American Heart Association while at Harvard Medical School. To this day, one of my favorite aspects of preventive medicine, or as I call it aggressive preventive medicine, is to help my patients understand the importance of their markers of heart disease, particularly since this remains the most common cause of death among men and women. After menopause, women catch up to men by age 60 in terms of their risk of heart disease.

Cardiology has advanced hugely in the past 30 years, mostly because heart disease is the leading killer of productive white corporate men. Lots of research dollars = lots of research achievement and progress.

For women, it's all about the triglycerides (I recommend TRG < 100) and HDL > 50 (your "good cholesterol."

Here's the short version....

These lipid subfractions are all good: HDL2, HDL1, LDL2, LDL1, Large-HDL, Large-LDL

These lipid subfractions are all bad: sdLDL (small dense LDL), HDL3, Small-HDL, LDL3, Small-LDL

What lowers HDL2?

• American Heart Association Low-Fat/Step 2 Diet - makes your particles dense
• Lack of lean muscle tissue
• High insulin (fasting insulin > 6)
• Lack of exercise or overtraining 
• Belly fat
• Adrenal dysregulation
• Too many carbs
• Sugar, processed foods
• Inadequate fish oil (omega 3s)
• Smoking
• Too much alcohol (Per day: 2-3 or more drinks for men; 2 or more for women)

What raises HDL2?

• Paleo Diet
• Estrogen
  
• Andogens (taking DHEA, testosterone)
• Niacin (see below)  
• Vitamin D (Note that you need a higher dose if you have a problem with your vitamin D receptor)
• Intermittent fasting  
• Generation of ketone bodies (low carb, mod-high prot/fat)  
• Exercise (avoid excessive endurance training)  
• Strength/resistance training  
• Reduction in belly/visceral fat  
• Reduction in insulin (eliminating wheat, reducing carbs)  
• Tobacco cessation  
• Elimination/moderation of alcohol 
• Eating protein, esp Leucine, Taurine, etc 
• Carotenoids (astaxanthin, krill oil, seafood, grassfed meat, etc)  
• Fish oil/EPA+DHA: supplemention, grassfed meat/dairy; fatty fish, mackerel, tuna, herring, hamachi, trout, cod liver oil, mollusks, krill, crustaceans, etc  
• If high inflammatory state: Ultra high dose 8-10 g/day EPA DHA fish oil for 6-18mos (Goal: fatty acid profile test, omega-6 to omega-3 ratio = 1.5)]  
• ALA, monounsat fats: flaxseed oil, olive oil, nuts/seeds, etc  
• Plant sterols, grass-fed ghee  
• Eating some saturated fats (not TRANSFATS which are toxic to HDL2)  
• Eating some CHOLESTEROL (via omega-3 eggs, seafood, grassfed meat/dairy, etc)

Niacin & HDL2

Niacin raises HDL2 by 200-300% in 18-36 months.

Fish Oil Studies in Greater Detail

• Take 4.5 g/d x 6wks EPA + DHA resulted inHDL2 increase of 74% with a concomitant 19% decrease of HDL3-C (Metabolism, 1991).

Toxins Muckin' with My Thyroid

A kind gesture from my dentist today - she graciously offers plastic bottles of water in her waiting room - turns out to be a disaster for your thyroid. My daughter eagerly grabbed a bottle and started drinking. I love my dentist, but those bottle contain bis-phenol A (BPA) and they slow down our thyroid receptors. My TSH may not reveal the injury, but my weight does, as does my sluggish morning energy.

You’ve heard the dire news on environmental pollution. I used to pitch it into the file of “things I can’t worry about right now,” but then I realized that I too was affected. Turns out my lazy thyroid was rooted in mercury toxicity and too much BPA. What I thought 5 years ago was a healthy lunch once/week of brown rice/tuna sushi rolls from Whole Foods was slowly poisoning my system as mercury mounted and shut down my thyroid hormone production. My hair fell out, I gained weight despite an aggressive exercise campaign and I was tired most of the time.

Second-hand smoke has also been shown to impair your thyroid, particularly in younger kids and infants.

If your bod can’t keep up with the steady diet of toxins that we encounter, your liver metabolism takes a hit. Leptin rises. You become cranky, irritable and tired. You develop dark circles under your eyes. The main organ tasked with detoxification is your liver, and toxic backlog is a common diagnosis in my integrative medical practice. This is well-summarized by integrative nutritionist Byron Richards:

“It is like pouring sand into the gas tank of a car, It does not matter whether the car is old or new, when the engine gets clogged, it will not run correctly. The liver must be clear all such chemicals.”

There is a definite correlation between the severity of hypothyroid symptoms and toxic exposure. Being overweight is especially complex, because toxins are stored in fat. Toxic folks have tremendous difficulty losing weight, and here’s the worst part: when you manage to lose a few pounds of fat, you get re-exposed to the toxins stored in the fat you’re burning. So unfair!

What’s a thyroidista to do?

1.    Reduce exposure – you know that it’s best to drink from glass or stainless steel containers. Use them exclusively. Read Time Magazine’s recent review of what toxins do to your endocrine system and how to limit your risk. Recent data also shows that probiotics limit your absorption of BPA. Cracks in your metal dental fillings are another source of mercury – if you have metal amalgams, consider replacement with your dentist. http://tinyurl.com/GCtoxins

2.    Cleanse your liver – I recommend to my patients a 30-day cleanse every 6 months. Check out our website for more information. http://gottfriedcenter.com/

3.    See if you have mercury toxicity – there are many tests available commercially. I recommend a provoked test with a chelator such as DMPS. Testing is available for $79-100. Contact my staff for more info and to order your test at 510.893.3907.

For more info, check out the NRDC's excellent article on BPA-free water containers.

 Reposted from DearThyroid.org

Thyroid Yoga

You've heard the analogy that your thyroid acts as your body's "gas pedal" by releasing energy hormones that modulate the metabolism of your organs and cells. Your thyroid determines how fast your engine runs.

In previous posts, I've commented on the interdependence of your thyroid with other key glands, particularly your adrenals and ovaries. The adrenals act, as we continue the car analogy, like a steering wheel. Your sex hormones (estrogen, progesterone, testosterone), on the other hand, serve as the ignition -- sparking the life of your engine. I think of the engine as your liver: our livers govern how we metabolize hormones, and the liver in turn is significantly controlled by leptin and insulin.

How complicated. 

Where can we simplify and just find a little relief? What can I offer when your gas pedal is sluggish or sticky or slammed to the metal of the car floor? When your slow progress toward euthyroidism (normal thyroid labs AND normalized symptoms) is frustrating you endlessly, Yoga comes to mind. Not just because I’ve found yoga to be the best system I’ve encountered for extraordinary living, but because yoga has helped my thyroid provide a smooth ride for 35+ years (I started practicing yoga as a kid, seriously) as well as those of my patients.

We know that yoga provides balance. It is a middle path, and for many of us with lazy thyroids, this is welcome news. We know that most of us seek yoga to manage stress, and that yoga is incredibly effective at balancing stress hormones such as cortisol. It lowers cortisol when it’s high and giving you that tired-wired feeling, and it raises cortisol when it’s low and giving you that “I-need-to-lie-down,-immediately” vibe (provided you don’t have the severest form, called Addison’s Disease).

In the yoga tradition of the past 2500 years, the thyroid is related to the vishuddhi chakra, which is the psychic center that purifies the toxins of the body and turns them into nectar of immortality. Good health of the entire neuroendocrine system is understood to be vital to our higher awareness.

OK, OK, Get Me to the Practical Stuff….

Here’s a Yoga Class, featuring the yoga practices that best balance your thyroid.

Shoulder Stand

If you’ve ever practiced yoga, you probably know that shoulder stand is the mama of all poses (asanas) for healing your thyroid. When you properly come into shoulder stand, you place robust pressure on your thyroid, squeeze out much of the huge blood flow of our little butterfly organ with the chin against your trachea (windpipe), and when released, new and fresh blood infuses your little gland. Old secretions and hormones get washed away, circulation improves, and the nerves are stimulated, reminding the gland to wake up and assume more tasks. In the yoga tradition, you send awareness and prana to your thyroid in shoulder stand, and prana or life force is the vehicle of healing.

Shoulder stand also places robust pressure, in fact the weight of most of your body, onto your little cervical vertebrae in the back of your neck. Make sure you do the pose properly, with an experienced teacher watching your every move until you are safe and skillful at it.

After shoulder stand, we traditionally perform matsyasana or fish pose, to allow all that delicious prana to move into the thyroid.

If daunted, move on first to some of the other asanas described below which are less risky.

Ujjayi Pranayama (“Victory Breath”)

This breathing exercise acts also directs prana to the throat area and stimulates some of the reflex pathways of the through associated with breathing and swallowing. Many call it the “Ocean-Sounding Breath” or more colloquially, “Are you trying to breathe like Darth Vadar?” Learn this from a teacher – it is the basic breathing practice of Ashtanga and many vinyasa classes.

Viparita Karani (“Legs Up the Wall Pose”)

This is a really simple exercise that nearly all of us can do with little experience. Lie on the floor next to a wall. Create an L-shape with your legs up the wall, at a 90-degree angle to your torso, which is on the floor. Lie here for 10 minutes with your eyes closed and allow the pressure to weigh down on your thyroid and breath like Darth Vadar, constricting your glottis as you inhale for 5 seconds and exhale for 5 seconds.

There are many other scrumptious practices for the thyroid such as Nadi Shodhana (another breathing exercise that balances your hormones), Surya Namaskara, Supta Vajrasana, and Jalandara bandha, but that’s all I have time for today.

Thyroid Goddessness

When I was 38, I discovered that my thyroid was a laggard. After having trouble losing weight post-partum from my second baby, and had a vague feeling that Kaiser's version of what constituted a normal thyroid test was different from my version. I decided to test my T3, and low and behold, the sucker was low. Soon I started a small dose of Armour Thyroid, and all was good in the world again: my body responded to exercise by losing fat, I didn't have to be as fastidious about what I ate, and my energy was vastly improved.

 As with many issues in integrative medicine, there's a gigantic gap between what conventional medicine has to say about what is normal thyroid function and what integrative or functional medicine offers. Daily I discover that my patients have a low free and/or total T3, the active version of thyroid hormone that makes you leap out of bed in the morning.  Or I find that they have autoimmune thyroiditis, and even thought their Thyroid Stimulating Hormone (TSH) is normal, they are making antibodies to their thyroid and heading toward a crash.

Many symptoms characterize an underactive thyroid but the top two are: weight gain and fatigue. Here are some other common symptoms: constipation (which I define as less than two bowel movements per day), cold hands and feet, depression, hair loss, joint achiness, poor memory and executive functioning, and increased cholesterol. The list is long and I have a questionnaire for you on the blog right here. Take the quiz to see if you should test, and consider performing a thyroid panel home test via Canary Club for free T3, TSH, free T4 and thyroid peroxidase antibodies. I am also a big fan of following your reverse T3 but I don't know where you can order that as a home test.

When you have thyroid issues, your diet requires your rapt attention. Got goitrogens in the food you're eating? I’ve never heard a conventional doc talk to patients about foods (called goitrogens) that lower your thyroid function. Tell me your stories of docs who are sharing this info! Yet, as with most things, the info is easy to find online. Raw foods are lightly goitrogenic (cooking inactivates the goitrogenic compounds). Short version: strawberries, pears, peanuts, pine nuts, cassava (yucca), Brassica veggies such as broccoli, bok choy and brussel sprouts. I know, I know – they help your estrogen metabolism but recall the see-saw analogy.

For more info on thyroid, I highly recommend Mary Shomon's excellent books as well as Thyroid Power by Dr. Richard Shames, MD. I challenge you to have goddess-like thyroid function, which is, after all, your birthright.

Imma Be Queen of Leptin

Many of us are waking up to the rather unwelcome slow-down of our metabolism now that we've hit 35 or 45 or 55 years. What helps? Becoming a master of the forces that shape your metabolism and how they interact with your other hormonal systems. Leptin is a major driver, and a lesser-know hormonal cousin to insulin, so I thought I'd repost my guest blog from Dear Thyroid on the leptin scoop - how it controls metabolism, how it relates to your sluggish thyroid and the muffin around your middle.

Ever wonder why you still feel hypothyroid yet your TSH is normal? Or why the weight you gained while hypothyroid hasn’t fallen away? A key intermediary hormone that many of us are unacquainted with is leptin, a regulator of both body weight and your thyroid control. Let leptin become your new BFF by getting to know her intimately and learning how she rocks your thyroid and weight.

If you haven’t heard of leptin, that’s because it was discovered relatively recently in 1994. It’s similar to insulin in its job description. Leptin acts as an important control system that makes telephone calls to other organs about the state of your fat balance and whether to go or stay in low-metabolism survival mode. It’s made in your fat cells, and more fat cells = higher leptin levels. The high leptin normally tells your hypothalamus that you don’t need to eat as much, so metabolism slows (you make more TRH, and this raises TSH) and the TSH tells your thyroid to crank out more thyroid hormone. This is when your leptin is communicating clearly and functionally, and your hypothalamus is responding appropriately.

Optimal Leptin

Ideally, leptin should be between 4-6. If your leptin is 4-6, your hypothalamus is getting the correct phone calls from leptin. If your level is above 10, your leptin receptors are fatigued, and the phone calls are no longer getting to or from the hypothalamus. Result? Metabolism slows inappropriately because the hypothalamus is interpreting the messages inappropriately.

Problem with Chronic Dieting

Chronic dieting and/or major stress are a common cause leptin resistance. As a result, leptin no longer has a clear line of communication with your hypothalamus and thereby your metabolism. Leptin resistance makes the hypothalamus believe that you are in starvation mode, and you make more fat, and slow down thyroid hormone production. TSH goes down, you don’t convert as much T3 (active thyroid hormone) from T4 (inactive), reverse T3 goes up, appetite increases (crazy unfair, sorry about that), and often you become insulin resistant, and slow down lipolysis (fat breakdown). More fat accumulates, you’re hungrier and you age prematurely. Not good!

Over time, you get fatter, especially at the mid-section, and it becomes increasingly difficult to lose the weight and fat. In fact, it takes herculean efforts.

High Leptin Renders TSH Unreliable

As if herculean efforts weren’t enough, If your leptin is high, TSH less reliably reflects your tissue level of thyroid hormones. For example, in diabetics who are almost universally leptin-resistant, T4-to-T3 conversion is cut in half without a change in TSH. While you may not be diabetic, you may still experience a significant reduction in your conversion before your TSH picks it up. This is where, yet again, measuring your free T3 (fT3) and reverse T3 (rT3) can help elucidate the issues.

More Bad News: Leptin & Thyroid Cancer

When your leptin rises in the blood, it increases (upregulates) leptin receptors on thyroid cancer cells causing them to become more aggressive. Does it help transform normal thyroid cells into malignant cells? We don’t know. But we do know that overzealous leptin receptors were found in 80% of thyroid cancers in one series published in 2009. Leptin has been shown to stimulate growth of thyroid cancers and reduce cell death.

How About PCOS?

Short version: leptin problems cause PCOS, both in lean and obese women. The science is quite complex, and involves loss of the timing of certain hormonal rhythms of both growth hormone and luteinizing hormone. From your comments to the last post, I’d like to offer a future blog post on all things PCOS, so please comment your questions and concerns.

OK, OK… Tell Me What to Do

Measure your leptin level. If it’s above 10, use nutrition as a first strategy to reset your level. I find that 70-80% of my patients are successful just by making the nutritonal changes that are recommended for reversing leptin resistance, such as Dr. Ron Rosedale’s program (http://www.drrosedale.com) or Byron Richards 5-step plan. Dr. Rosedale presents a food program in his book that includes elimination of fruit except avocadoes and olives for three weeks and limited starchy foods. There is far more detail in his book. I find the food changes are the primary way to lower leptin; nutraceutical supplements are another approach that may augment your success with leptin-sensitizing foods.

Here again (similar to what we reviewed in my blog post last week), we want to normalize both the thyroid and the leptin levels simultaneously for the best results. What works in those who are not successful with the nutritional program to lower leptin is to add prescription therapies. I don’t like the prescription approach – I favor using natural therapies but they require deep commitment to change old eating patterns. HCG treatment has also been successful, but that’s a hugely controversial approach that merits it’s own blog post!

While leptin resistant, make sure your free T3 and reverse T3 are being managed properly. I like to see the free T3 mid-range for your lab, and the fT3/rT3 >1.8 (when fT3 is in units of ng/dl).

As leptin lowers, your TSH will more accurately reflect your tissue levels, assuming you are also limiting stress and exposure to endocrine disruptors such as bis-phenol A (BPA) and other lovelies that mess with your thyroid receptors. One side note: probiotics have been shown to reduce BPA absorption, but that’s a big topic for another post too!

If I’m making this sound as if we have the whole leptin scene figured out, let me also mention that there’s a lot we don’t know. How insulin resistance interacts with, or causes leptin resistance, for instance, is still not completely clear.

Personally, I’ve found that optimizing leptin makes my thyroid care and weight management much more successful. I’ve reversed my leptin from 11 to 4 in 6 months. As the Black Eyed Peas might put it: “Imma be Queen of my leptin, getting it down lower than 6, Imma be the flyest chick….”