What tests can determine if I have physiological barriers to weight loss?

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Paula Greer
Midwifery Nursing
If you are ready to lose weight you want to check in with your health care provider and make sure there is nothing physical contributing to your weight gain. Some conditions like Hypothyroid , Metabolic syndrome, Polycystic Ovary Syndrome, low levels of vitamin d, and iron may be contributing to your problems. Increased levels of leptin and lipids may also be a factor. Chose a provider knowledgeable in weight loss who will give you a complete workup and refer you to a nutritionist to personalize your necessary lifestyle changes of stress management, diet and exercise.
Kent Holtorf, MD
Endocrinology Diabetes & Metabolism
Tests to request from your physician to assess and address physiologic barriers to successful weight loss include the following:
  • Basal Metabolic Rate -- This measures the number of calories burned per day at rest. It is done via a device that measures the amount of oxygen burned over a ten-minute period in the doctor's office. If low, this is diagnostic, but if normal it does not rule out a low metabolic rate because stress during the test can falsely elevate the results and studies show that while some may have a "normal" metabolic rate at rest, the problem is that they burn significantly less calories than normal during exercise.
  • Leptin -- A leptin level above 12 shows leptin resistance (laboratory "normal" ranges cannot be used because they include overweight and insulin resistant individuals).
  • Thyroid-stimulating hormone (TSH), free T4, free T3 and reverse T3 to adequately assess tissue thyroid levels (free T3/reverse T3 ratio should be > 2 to be optimal)
  • Glucose, average glucose (HgA1C) and insulin levels to check for insulin resistance
  • Sex hormone binding globulin (SHBG) can be an indicator of low tissue thyroid levels (should be greater than 70 in women and 25 in men).
  • Urinary iodine -- Low iodine can cause thyroid resistance (too much can cause low thyroid, as well).
  • C-reactive protein (CRP) -- Inflammation decreases cellular T3 production (should be less than 1).
  • Homocysteine -- a marker for low thyroid and low B vitamins (should be less than 9)
  • Lipids -- High cholesterol is a marker for low thyroid and high triglycerides is a marker for insulin resistance.
  • Iron and ferritin -- Adequate iron levels are required to activated thyroid, so many symptoms that people attribute to anemia with low iron is actually due to low tissue thyroid activation.
  • Vitamin D -- should be greater than 80
  • Thyroid peroxidase antibodies (TPO) and antithyroglobulin antibodies -- look for autoimmune thyroid disease.
  • The muscular reflex time -- This has been shown to correlate with the degree of tissue hypothyroidism and to be a better indicator of tissue thyroid levels than standard thyroid function tests.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.