Puberty occurs when areas within the brain awaken beginning a cascade of hormone signals which conclude with the gonads (ovaries and testicles) increasing their production of the female and male sex hormones estrogen and testosterone. Under the influence of these hormones a child begins the transition from childhood to sexual maturity. In boys puberty is associated with a growth spurt, the appearance of facial, axillary (arm pit) and pubic hair, acne, deepening of the voice, growth of the testicles and penis while girls undergo a growth spurt, develop breasts, acne, pubic and axillary hair, and growth of the clitoris.
Historical data shows the average age of puberty today is many years sooner than in previous generations. Most experts attribute earlier puberty to better nutrition. A recent article in metabolism.com reviewed how “over-nutrition” accelerates obese children into puberty sooner (referred to as precocious puberty) than normal weight children. The latest studies on causes of precocious puberty suggests that a child’s social environment also exerts an important influence on the timing of puberty. Researchers in Madrid publishing in The Journal of Clinical Endocrinology and Metabolism 95:4305 2010 analyzed the age of puberty in normal children, adopted children and children whose families immigrated (children not adopted but subject to high levels of personal stress) to Spain. Adopted children were 25 times more likely than other groups of children to undergo precocious puberty (breast development before the age of 8 years in girls, and boys under 9 years of age with testicular growth). Over-all girls were 11 times more likely than boys to demonstrate precocious puberty.
Researchers speculate that socio-emotional stresses early in life of children who are later adopted result in changes in the brain that cause premature maturation of vital nerve pathways. This early brain maturation later results in stimulation of the pituitary gland, turning on the hormone pathways that cause puberty. This seems strange to me because various forms of deprivation in childhood can also delay puberty. For example, girls who have anorexia remain child-like in their body development and may fail to menstruate even into their late teens. A decade ago I studied hormone levels in adults during the stress of illness and surgery and found this lowered the sex hormone levels in their blood. This makes sense from an evolutionary point of view because during stressful conditions nature wisely cuts off the reproductive hormones. Why make babies if the environment is hostile in some way? Why the opposite occurs in children under stress of adoption is an interesting but unanswered question.
Gary Pepper, M.D.,
I am reporting to you from this year’s meeting of the American Thyroid Association now taking place at the opulent Breaker’s Hotel in balmy Palm Beach, Florida. Cushy job if you can get it, I’d say.
Not a lot of laughs during the typical lecture at this three day meeting of the world’s experts on thyroid diseases and treatment but I did hear a few guffaws, giggles and snorts today during the single lecture devoted to using combination t4 and t3 therapy for treating hypothyroidism. The speaker on this topic, Dr. Michael McDermott a Professor of Medicine and Pharmacy at the University of Colorado, was actually significantly more open minded about using combination t4/t3 therapy then speakers from previous meetings on the same topic. He prefaced his comments by acknowledging that about half of patients treated with synthetic t4 continue to experience symptoms typical of thyroid hormone deficiency. What, if anything, doctors are to do to help their patients in this situation appears to still mystify the experts.
The laughs came when Dr. McDermott polled the audience of professionals about their opinions regarding treatment of a hypothetical hypothyroid patient with normal thyroid function blood tests continuing to complain of symptoms suggestive of thyroid hormone deficiency. The speaker put up a slide with 5 or 6 treatment options which the audience then voted on. Although a good portion of experts here gave a philosophical shrug of the shoulders by not choosing any of the options, it was reassuring to see a significant portion of the audience agreed with the statement that some hypothyroid patients appear to improve when t3 is added to traditional t4 treatment. This is far short of a strong endorsement of combination therapy but I would say it is a least a nod to those of us who routinely make use of this treatment option. The laughs and giggles came when the next to last option was read to the audience, proposing that Armour Thyroid was the best choice of treatment in this case. The last choice, that this type of patient should see a psychiatrist also got a few chuckles.
Not much more about dessicated thyroid treatment was mentioned after this curt dismissal but Dr. McDermott expressed his opinion that Armour Thyroid was a poor choice for treating hypothyroidism because it contains too much t3 and that synthetic t3 should be used exclusively if combination therapy was attempted. No one seemed aware that as of this month Armour Thyroid and similar dessicated thyroid medications were no longer available in the United States.
Despite the disturbing aspects of the first part of Dr. McDermott’s lecture he did end with some exciting ideas that I will soon be reporting on. The main idea he reviewed is that a genetic defect may cause resistance to t4 treatment in hypothyroidism. Those with the genetic defect would require the addition of t3 to achieve a healthy thyroid balance and elimination of the symptoms of hypothyroidism. I am sensing that this may be a breakthrough in thinking about why some people require combination therapy with t4 and t3. If so, endocrinologists will be forced to reconsider their reluctance/refusal to provide combination therapy for treatment of their symptomatic and dissatisfied hypothyroid patients. More to come on this breakthrough in my next installment.
Gary Pepper, M.D.
I write a lot about nutrition, good eating habits and healthy lifestyles. But as is so often the case, knowing what’s right, and doing what’s right are two different things.
When January rolled around, I realized I had gained a few pounds over the holidays, and hadn’t lost any of the weight I wanted to last summer. Not to mention there are a few upcoming social events where I’d like to look my best. So, I devised a little diet/exercise program for myself and launched into it. I decided to have one of those nutritional shakes for breakfast and follow a popular diet program using a point system – having a low fat/low calorie frozen entrÃ©e for lunch, and a portion- fat- and calorie- controlled dinner. I also signed up for an exercise program at our local recreation center, and got some exercise tapes to do at home.
After six weeks, I’ve lost ten pounds, and am starting to notice the loss by the way my clothes fit and the way I feel. But, I wasn’t sure this was the way to go for a long-range weight loss program. (Although I have decided to go public with telling people I am losing weight, I still refuse to let anyone know how much I want to lose.)
Anyway, while browsing through this website’s bulletin board, I came across a question from “mommyrn” asking about the safety of using SlimFast in a diet plan. The response from Certified Nutritionist Robert L. Pastore, (see the bulletin board postings from 1-27-00 for the complete question and answer), got me wondering if my regimen was a safe and effective one.
Taking advantage of this website’s creator, I e-mailed Dr. Gary Pepper, and explained to him what I was doing. He arranged for our website nutritionists to answer my questions and evaluate my self- made program.
After outlining my eating program, how the exercise class I take is a combination of strengthening/toning and moderate aerobics (I’d probably pass out if it was too strenuous), and adding that I do take a multi vitamin and B complex daily, I waited for Dr. Pepper and the Metabolink crew to tell me how clever I was.
Well, they almost did. But better yet, was the valuable information the nutritionists provided me, and hopefully other readers as well.
Michele Champeau, CN, noted that the strengthening/toning classes are an important part of a weight loss program because they help tone muscle and allow you to increase your metabolism with time. She also mentioned that her experience with Weight Watchers was that many people sacrifice healthy food to fit in less nutritious food (saving up their “points” to have the pizza, chips, etc.) in their diets. Michelle said that while this may work calorically, you could deprive your body of vital nutrients. But, if you are eating a wide variety of foods, including an abundance of vegetables and quality sources of protein, you can do well on Weight Watchers.
Regarding the “nutritional shakes,” (SlimFast, Sweet Success, etc.), Michelle felt these may be okay for short term or intermittent use, but they are not optimally health promoting. She suggested I try real (steel cut) oatmeal for breakfast, a piece of fruit with a half cup cottage cheese or a couple boiled or poached eggs with a piece of whole grain toast with a teaspoon of butter. These foods provide valuable nutrients and are also more likely to satisfy and carry you through to lunch without snacking.
Robert Pastore, Ph.D., CNC, CN agreed with Michelle in his response to my inquiry. He felt the point system has a caloric total too low to support basal metabolism, and if prolonged, weight loss slows due to the reduction in metabolic rate, and sets the stage for increased weight gain as soon as a very low calorie diet is stopped. Robert agreed the best way to establish long-term weight loss is to consume a whole food diet, within a healthy caloric range, to support daily activity levels and basal metabolic rate. He thought an exercise program containing both strength training and aerobics offers numerous health benefits, and increases resting metabolic rate over time.
The third response Dr. Pepper forwarded to me was from Kathy Shattler, MS, RD. While agreeing with both Robert and Michelle, Kathy also mentioned the psychological component of weight loss. She reminds us that many individuals fail to maintain weight loss once it is achieved, because they never got rid of the “fat me” body image. She recommends fixing your goal image firmly in your mind to help motivate weight loss and then modify body image as the weight comes off.
The final evaluation of my “regimine” came from Astrid Matthysse, Clinical Dietitian. Astrid mentioned something very important. She said to remember the problem with some weight loss systems is maintaining your goal weight once regular eating patterns resume. Permanent changes and healthy eating habits should be adopted which will allow the pounds to stay off. She also said not to let a slip in the diet make you loss heart. When this happens, she recommends getting back on the right track immediately, not tomorrow or next week. Don’t let a slip up be an excuse to give up on the success already achieved. And finally, she said to reward yourself with something you like or enjoy doing (not food!) for reaching each small goal along the way.
This is all great advice and information that I hadn’t thought of or known. I’m dropping the shakes (except in the rare case when I’m late and running out the door, then I will supplement it with a piece of fruit that can also be eaten on the run). I’m also adding some new foods, different types of greens and squash, as well as tropical fruits. Some day in the near future, I may even take the big step and try tofu! I’ve readjusted my mental body image as Kathy suggested, and am making a list of rewards to choose from as I reach each goal. I’ll keep you all posted as to my successes (and even setbacks)!
I’m not the only person who can benefit from the advice of Metabolink’s experts. Anyone can post a question to the bulletin board, and receive information helpful to themselves as well as others.
“Aisa,” a 17 year-old, who is 5’2″ and weights 151 lbs., writes she has been trying to lose weight for about a year, but doesn’t seem to drop any pounds. Even with a regular exercise program and 1500-calorie a day diet, the weight isn’t moving. She wonders if she could have a slow metabolism and what can be done.
Michelle recommends Aisa get checked for an underlying imbalance such as anemia or a sluggish thyroid. Diet, sleep, intensity and duration of exercising are also important considerations in determining why Aisa is not losing weight. Michelle suggests Aisa consult a doctor to determine the cause her tiredness.
I learned some interesting information when I read “Jean_Rigua’s” question about gaining weight while sleeping. Kathy Shattler tells us that you gain weight when your caloric intake exceeds your caloric expenditure. Its not the specific act of “laying around” that puts on weight, but rather the lifestyle behavior of inactivity that breeds an imbalance in your energy expenditure vs. intake. Her suggestions are to:
- Eat a balanced diet with a variety of foods high in fiber and low in fat.
- Begin and maintain an exercise program that develops strength, flexibility, stamina and endurance.
- Pay attention to your mind-set. If you are an emotional eater, learn to identify your triggers and develop a healthier plan for dealing with anger, joy, anxiety, stress etc., don’t use food.
The information on the bulletin boards is interesting and informative. If what you read doesn’t pertain to you, it may help a friend or relative.
If you don’t find what you’re looking for, and feel you need more detailed, personalized help, you can sign up for a nutrition plan tailored to your personal needs. A comprehensive personalized nutrition service is available, through which you have access to your own nutrition expert. An initial assessment is made of your specific nutrition habits and goals, and a follow-up is conducted on a weekly basis for four weeks to track your progress. You can also get a one-time nutrition consultation if you want a thorough nutritional program addressing your personal health goals.
Everyone at Metabolink is ready to help you with reaching your personal health goals. So, take advantage of the information at your fingertips, and explore our site.
See you next month!