Tag Archives: metabolism

Bariatric Surgery Benefits Last for Years


One of the biggest problems with weight loss programs and diets is that even if they work the weight tends to come back on within a year or two. A recent study from the University of Utah of people who underwent bariatric surgery shows that not only do they lose weight quickly, after 6 years they continue to maintain their lower weight. After undergoing bariatric surgery the average weight drop was 35% of the original weight and after 6 years weight loss was still a very encouraging 28%. 75% of diabetics who had bariatric surgery were able to go off their diabetic medications, while improvements were generally seen in cholesterol levels and blood pressure.

Although this study shows a very high success rate, in the real world medical practice I have seen many people who are able to eat their way out of weight loss success after bariatric surgery. Eating small amounts of very high calorie food is still possible and unfortunately is not all that uncommon. Not to say that bariatric surgery is not helpful, because when it works the results can be spectacular, but as always the degree of motivation of the patient is crucial to success.

Gary Pepper, M.D.
Editor-in-Chief, metabolism.com

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They Quit Smoking, Their Metabolism Slows, but Good Attitude Gets Them Through


Here are some encouraging stories from the front line against smoking. It’s a desperate struggle at times but our members share their gutsy approaches that have gotten them through the tough times.

Beach Gal writes:

10 months on Nov 15!
Weight has plateaued at 15lbs gained. 48 years old with perimenopause too.
So here are my thoughts….you have to surrender to the fact you might gain some weight or even maybe alot. We’ve done years of damage to our metabolisms and it will take time to correct that. Also, surrender to the fact you might not be your size 6 or 8 anymore. So what? We don’t smoke. Nothing is more ugly than smoking. There are plenty of heavier women out there who embody beauty. Their spirit shines and they have confidence and self esteem. Smoking robs us of both. Have you ever tried dating online? NO ONE wants to date a smoker.
Anyway, single or married, it doesn’t matter. We matter. I have never laughed so much in my life as I have in the last 2 months. Really laughed. And this while I’m unemployed, my father has cancer, my dog died, and my boyfriend and I are on the rocks. We come first. Period.

Regarding weight…..if you have an “orange theory fitness” near you, join. It’s the cost of 1 month of smoking and will reinforce your quit. Great for us gals in our 40′s 50′ and 60′s too. They know how to get your metabolism cranking. 3 days a week. And could you be drinking a little more wine than usual? I found that I started drinking too much wine….and i don’t even like wine. So had to cut that out!

Here is what V has to say about quitting the cigarette habit:

I agree that the weight was the worst thing. As unhappy as I am about the weight, I am so very happy that I have been quit for 1 year now. With the money I have saved, I have picked up some other hobbies that I enjoy so much, that I would never be able to afford by wasting my money on cancer sticks daily. And, not to mention the health benefits, like being able to breathe, by not sucking down those stupid things. I feel so free when I watch or listen to people scramble trying to figure out how long the cigarettes they have in their pack will last because they don’t have the money or the time to get to the store for another pack, or they can’t wait to leave a non-smoking establishment. I’m not unhappy because I’m fat, it’s just a minor set back. Maybe there are days I get upset over it, but it doesn’t cause me to be an unhappy person. I hope you can overcome your fear of whatever weight gain you may have (it is different for everyone).

Lizzy adds her experience:

Elisa, the benefits of quitting are unreal. I have my first cold since this all happened, yes I still have the weight gain, its not been a year quite yet and I have to say this cold is quite different then I have ever had, it has not settled into my lungs. The weight has leveled off and it seems i am turning the fat into muscle by walking so much. Elisa you have gotten over the nicotine in the system, you need to cut the habit of hands and grabbing, you will be fine, not all people gain 40 or 50 pounds. I have always been a size 6 and now a 12 to 14 and yes that’s killing me, but it too will pass, i have never breathed so deeply in my life. i have never smelt things quite the way I smell them now, and wow food is so different too. You will gradually find out all these things. Honestly the worst thing was the weight gain, but the other benefits make up for some of that.

Boyfriend Has Low Testosterone. What Can Lu Do?


Lu posts these concerns to Metabolism.com

My boyfriend is in his early 40′s and has been taking testosterone therapy. Instead of his levels increasing, they have decreased…his total is now in the single digits. He takes very good care of himself as he is a fitness trainer and body builder (takes vitamins, etc.). Obviously, with his total level being in the single digits, he has all the “symptoms” of low-T and is frustrated that the therapy is having a reverse reaction. He also suffers from Migraines and has recently been in a car accident that he suffered brain trauma in. I’m wondering if there could be a connection between the trauma and low-T or lower T. Any advice or direction you can head us in would be much appreciated.

In reply Dr. Pepper writes:

Hi Lu

You can’t pour water into a cup and wind up with less water in the cup then what you put in. Likewise, if someone takes testosterone supplement they will have more testosterone in their body then they started with. However, some things can influence the blood levels so one person will have higher or lower levels then someone else taking an identical dose. I have seen a wide variation in how testosterone gels are absorbed through the skin. These products include Androgel, Androderm, Testim, Axilron and Fortesa. One person may not see much of an increase in blood levels of testosterone on one of these gels while another will see levels zoom up to a 1000. Absorption of testosterone that is injected with a needle is less variable. Levels go very high in the first few days after the the injection but after 2 or 3 weeks levels will be low again. Here’s an important point. Since testosterone replacement turns off the body’s production of testosterone, if you stop taking replacement your body will not be making testosterone for weeks to months after resulting in very low levels on blood tests. People who abuse testosterone know this and will have the doctor check their testosterone level a month or two after their last dose, so the doctor will see the low levels and give them a prescription for more medication.

Can head trauma effect the testosterone level? For that to occur the pituitary gland would have to be damaged and that will often be associated with other obvious brain damage. In children less severe trauma can hurt the pituitary.

Hope some of this information is helpful in trying to figure out what is going on with your boyfriend. Good luck.

Gary Pepper, Editor-in-Chief, Metabolism.com

Zach’s Treatment Success with Cytomel


Zach points out that most of the posts about thyroid treatment issues at metabolism.com are from women. That makes sense because autoimmune thyroid disease is approximately 10 times more common in women than men. But man or woman, thyroid hormone treatment is still the same and his success with Cytomel is something worth noting.

Zach writes:

Hi everyone. From what I can gather, most posters here are women, well I’m a guy with similar problems. I thought my story might be useful so that men don’t think it’s a women only problem. I gained a hypothyroid diagnosis at the age of 25 due to Hashimodo’s. There was no direct cause, it runs heavily in my family. For a year, or two, maybe even three (it’s hard to tell due to widespread symptoms), I was feeling nervous, bad memory, attention problems, sleep problems, low appetite, and easily fatigued from a normal 8 hour work day. I assumed my lifestyle choices were causing these symptoms so didn’t go to the doctor for years.

Finally when I was diagnosed I was put on levothyroxine. The very first day I took it I felt IMMENSLY better. However, months down the road the symptoms gradually built up again. Every time my dose was raised, I would feel better for about 2 days, but the symptoms would gradually return. My endo decided to drop my T4 dosage and put me on a combo T4/T3 (T4 was dropped by 50 mcg and one quarter of the drop was added in as T3, so 12.5 mcg of T3). This is the first day I’ve tried it, and instantly the morning of starting on T4/T3 my body aches have almost disappeared and I am feeling much less sleepy at my desk during work.

How Greg Stopped Smoking and Overcame His Weight Gain Issues


In this emotional blog posted to metabolism.com, Greg (from Tampa) shares insights from his personal struggle to stop smoking and deal with the weight fluctuations that accompanied those efforts. Not everyone can achieve this kind of success but, according to Greg, by keeping your eye on the prize you can get through the worst of it.

Greg writes:

I hope what I am about to write will be an inspiration for those who are truly serious about quitting AND losing weight. I have now been almost five months without a cigarette (the longest I have EVER lasted) and unlike every other time I tried quitting, this time I FEEL its for good. Truthfully, no temptations other than a quick subconscious glance (like noticing cleavage on a woman)!

Every time I quit in the past, I gained at least five pounds, then lost it as soon as I started smoking again. This time I tried a different strategy overall and it has made a world of difference. Instead of making my goal “quitting smoking and holding weight”, I made my goal far more ambitious: “quitting smoking and losing weight..gaining muscle, and looking 100% better overall.”

I am now 42. About ten years ago (while I was still smoking), before I met my wife, I lost about 20 lbs (and 12% bodyfat) in four months by simply using a bodybuilder’s type workout (3-5 set pyramid, every five days upper body and lower alternating), light-medium cardio two to three days per week, plus eating on the “Zone Diet” (40 Protein/40 Carb/20 Fat) and five time per day. The results were so dramatic and so fast that one of my teachers at college thought I was sick or on drugs.

When I quit smoking in October, I started the same routine. At first, my goal was to hold weight only…not to gain. But now, four and a half months later, I went from 200 lbs to 184 lbs and over 29% bodyfat to under 22% bodyfat. Now that’s not nearly as dramatic as the last transformation when I was 32 and smoking, but hell, at 42 and no longer smoking I am beating the monster and looking and feeling better every day.

Truth be told, if I was smoking and my metabolism was up, I’d probably be losing faster. But who cares, the fact is I’m clean of smokes and feeling and looking better than I did this time last year.

This isn’t a pitch for supplements, a workout program, or any other BS. I am just saying, if you truly want to quit AND lose weight, it is possible even at 42. Just be smart about it AND totally committed. I think this time what made the big diffrence was making my mind up that I will settle for nothing less. Now, four and a half months into my quit, my goal is 170 lbs and 12% bodyfat. F#@k smoking! F$#k gaining weight! I want to breathe a full breath of air and see a six pack of abs in the mirror!

Anyone who tells you that gaining weight is the price of quitting is lying or, more likely, just doesn’t know otherwise yet. Keep the faith!

Dangerous Metabolic Supplements


A few weeks ago a new patient arrived at my office to discuss treatment for her thyroid disease. She was diagnosed with an under active thyroid several years prior but treatment with Synthroid was unsuccessful. She stopped using the medication on her own, at least a year ago. Blood tests obtained by another doctor a month before her visit with me, were diagnostic of hypothyroidism (low thyroid levels with elevated TSH) . During our session she described typical symptoms of hypothyroidism including fatigue, feeling unusually cold, dryness of the skin, brittle nails and puffiness around the eyes. On exam her thyroid was enlarged and had a gritty texture typical of Hashimoto’s Thyroiditis. Her sister and mother also had thyroid disease, increasing the likelihood of the diagnosis of Hashimoto’s. Since her latest thyroid blood tests were only a few weeks old I felt comfortable beginning her on thyroid hormone replacement, in this case, Armour Thyroid, which I prefer due to its excellent clinical effectiveness.

My new patient was also on a number of supplements and vitamins including a non-prescription “metabolic complex” given to her recently by her chiropractor. By law in the U.S. supplements like these do not possess thyroid hormone and, in my experience, have no impact on thyroid hormone levels, either to increase or decrease them. As a precaution, we obtained a new set of thyroid hormone levels along with the test for Hashimoto’s Thyroiditis (anti-thyroid antibody panel).

Several days later, the patient called complaining she was “allergic” to the Armour Thyroid, developing jitteriness, anxiety, feeling flushed and a rapid heart rate. My first thought was she received the wrong dose of medication but a quick check of her records indicated this was not the issue. I called the lab and was surprised to learn the TSH at the time of her visit was already low, indicating excess thyroid levels or hyperthyroidism. What could have caused the sudden switch from hypo to hyper thyroidism? Rarely, patients with Hashimoto’s Thyroiditis can convert to hyperthyroidism, an event I call the Zombie Thyroid because the thyroid comes back from the dead. More likely was that one of her supplements contained actual thyroid hormone, so I asked the patient to get me the labels from these products. In the meantime, I instructed her to stop the Armour Thyroid and the supplements until I could figure out what was happening. Her allergic symptoms resolved in a few days.

Examination of the supplements’ labels indicated that one manufactured in New Zealand did in fact have thyroid extract in it. It had so much thyroid hormone in it that the patient was already becoming hyperthyroid at the time she first came to the office. Signs and symptoms of hyperthyroidism didn’t develop until she started taking Armour Thyroid along with the supplement. The mystery was solved but I am left feeling much less secure that my patients will not injure themselves with products obtained from outside the country either via the internet or from practitioners who provide it, perhaps unwittingly.

As I have in the past, I urge everyone to avoid medications and supplements produced outside the country which can contain active ingredients with potential health hazards. Always check with a physician before beginning a supplement which is obtained from the internet or mail order.

Gary Pepper, M.D.
Editor-in-Chief, metabolism.com

This information is for educational purposes only and is not intended as medical advice or treatment. Some details of this case have been altered to protect the patient’s identity.