# Bad Advice from Endo? Please weigh in!



## smithfamily99 (Apr 17, 2013)

I need some advice. In February, I started following the Paleo diet - basically eating meat, poultry, veggies, fruit, seeds and nuts - no sugar, starchy carb (bread, potato, pasta, rice) and legumes. For 8 weeks, I was really good about sticking with it and lost 0 pounds - but didn't have any gastro issues anymore. My husband lost 15!I had some blood work done as a part of a routine check- up and was diagnosed with Hashimoto's Disease and was prescribed 25 mg of Levothyroxine. (TSH was 5.730, FT4 was 0.92, and TPO was 388)
The first week I felt great - the scale was moving a bit, I was waking up after 8 hrs of sleep and felt rested. In the last 2 weeks though, my weight has shifted up and down, fatigue and extreme sleepiness have set in and I'm having night sweats. I went to see an Endo today because I thought a specialist would be able to better guide me given that they focus on matters of the thyroid. This doctor, who had zero bedside manner, increased the Levo to 50 mg, but said that I would need to cut my calories to 800/day for a week, then the next week up it to 1000/day (+ exercise) and alternate back and forth until I reached my desired weight (I'm 5-5/182 pounds). I was so shocked that she would suggest such a drastic cut in calories - it just didn't sit well with me. She saw the shock on my face and said to just try cutting 30% of my calories. This just sounds really off to me&#8230; She also seemed to insinuate that I was blaming my thyroid for all my symptoms ! I'm totally new to all of this and I'm trying to sort it out based on what I've read -- 
Has anyone had an Endo recommend this kind of diet? I'm seriously considering ditching this doctor - does anyone know of a good Endo in the Dallas area? Ideally, it would be nice to find a doctor who is a smidge more empathetic and will look at everything and work with me to devise a plan to get my health to where it should be. Maybe I'm asking for too much - please help!

Thanks so much!
Molly


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## lainey (Aug 26, 2010)

Why are you so shocked at the low calorie diet?

I don't find her suggestions shocking at all. Personally, to maintain my weight, I can't go much above 1400 calories or so per day. To lose, I need to increase my exercise or temporarily take my diet down to about 1000 calories per day.

Paleo diet or not, you can still consume too many calories to lose weight.

She suggested it temporarily, to jump start things a little, so to speak, as you have about say, 40 pounds to lose?

While most people resent low calorie diets for weight loss, the truth is, you need to consume less than you expend. If you want to eat more, you have to exercise more. Even then, people often overestimate the value of exercise--for example, walking about a mile at a 15 minute pace is worth between 70 and 90 calories. Running for that time will get you up to around 100 calories.

I wouldn't be so quick to ditch the endo. She raised your dose on the basis of what you reported, no? She should, however, do you the favor of a full work up with antibodies and a baseline ultrasound.


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## bigfoot (May 13, 2011)

Sounds familiar. I was told to eat better and get more exercise, that my thyroid had absolutely nothing to do with it.

Years later, I've realized that was mostly BS. Sure, I had some wiggle room to clean up my diet, but I was exercising regularly. Not only did I have undiagnosed Hashimoto's, but also Autoimmune Hepatitis and a scorching case of gluten sensitivity (not Celiac), and sky-high Reverse T3. End result? I dropped 15+ pounds, lowered my A1C and fasting glucose, and my stomach issues are pretty much completely gone.

Paleo is a great way to eat. Eliminating gluten completely from your diet is supposed to not only help the thyroid via quieting the autoimmune attacks, but also helps with inflammation. The so-called 'super glutens' we have on the shelves now are a far cry from the breads and pastas 100 years ago. Besides, there are so many great gluten-free products on the market now to choose from.

You should not have to reduce yourself to 800-1000 calories a day if you are a busy person. There is likely something else going on here behind the scenes, whether it be thyroid, hormones, or something else. Bottom line: if you don't like the doc, definitely find a new one. Trust me, life is too short to be paying to see a doctor who doesn't want to work with you as a patient, but instead treats you like a number.


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## CA-Lynn (Apr 29, 2010)

I'm not shocked at the reduced calories. If I go above 1200 daily I can expect the weight to pile back on.

As someone with Hashimoto's since 1990 I can tell you that once I reduced my calories and got regular exercise I lost 51 pounds in one year. For me the Hashimoto's had nothing to do with preventing me from losing weight. I needed to take in less and move my butt more.


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## Andros (Aug 26, 2009)

smithfamily99 said:


> I need some advice. In February, I started following the Paleo diet - basically eating meat, poultry, veggies, fruit, seeds and nuts - no sugar, starchy carb (bread, potato, pasta, rice) and legumes. For 8 weeks, I was really good about sticking with it and lost 0 pounds - but didn't have any gastro issues anymore. My husband lost 15!I had some blood work done as a part of a routine check- up and was diagnosed with Hashimoto's Disease and was prescribed 25 mg of Levothyroxine. (TSH was 5.730, FT4 was 0.92, and TPO was 388)
> The first week I felt great - the scale was moving a bit, I was waking up after 8 hrs of sleep and felt rested. In the last 2 weeks though, my weight has shifted up and down, fatigue and extreme sleepiness have set in and I'm having night sweats. I went to see an Endo today because I thought a specialist would be able to better guide me given that they focus on matters of the thyroid. This doctor, who had zero bedside manner, increased the Levo to 50 mg, but said that I would need to cut my calories to 800/day for a week, then the next week up it to 1000/day (+ exercise) and alternate back and forth until I reached my desired weight (I'm 5-5/182 pounds). I was so shocked that she would suggest such a drastic cut in calories - it just didn't sit well with me. She saw the shock on my face and said to just try cutting 30% of my calories. This just sounds really off to me&#8230; She also seemed to insinuate that I was blaming my thyroid for all my symptoms ! I'm totally new to all of this and I'm trying to sort it out based on what I've read --
> Has anyone had an Endo recommend this kind of diet? I'm seriously considering ditching this doctor - does anyone know of a good Endo in the Dallas area? Ideally, it would be nice to find a doctor who is a smidge more empathetic and will look at everything and work with me to devise a plan to get my health to where it should be. Maybe I'm asking for too much - please help!
> 
> ...


Molly; I will be the first to admit that thyroid causes difficulty in the weight loss department.

However, no matter what diet you are on, it is always about calories in versus calories out and the diet has to be 7 days a week. No weekends off.










Stick w/us; we can help. We are very experienced dieters here!!!


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## Keba (Aug 11, 2012)

It is shocking but true.
http://nahypothyroidism.org/thyroid-hormone-transport/#dieting

This article (though dry read) best describes why it can be so hard to lose weight. I cut my calories to 1100 was eating clean and running 25-30 miles a week and doing bootcamp3x/wk, and won't lose unless I cut to under 900cals. Then I can lose but that's really hard to do. 
I say give it a week, or alternate days low cal to normal.


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## surge (Aug 15, 2012)

Uh, I'll chime in and say I AM shocked that she would recommend 800 calories a day. That's a good way to continue to slow down your metabolism, actually, and you don't need help with that. 1000 calories a day is about as low as I'd go, and I note that all the people who seemed to be agreeing with the endo also mentioned calorie counts that were 1000+.

As far as anecdotal evidence: when I have an elevated TSH, I gain a few pounds. They drop as my TSH lowers. If my TSH were @ 5+, I'd be about 6-7 lbs overweight.

I do agree with the endo that your levo could stand to be bumped. I also think it's pretty typical for endo's default line to be: I don't think we can blame this all on the thyroid (or at least that's my endo's mantra). I don't think that should necessarily rule her out, but I wouldn't be looking to her for diet advice. I'd consult a nutritionist about portions, in particular, and keep up your healthy behaviors. Even if you find euthyroid, you may find that you do have to watch intake carefully.


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## taniahench (Mar 27, 2013)

I have been seeing Dr. Kremati in Rockwall... She has a great bedside manner!


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## bigfoot (May 13, 2011)

surge said:


> I also think it's pretty typical for endo's default line to be: I don't think we can blame this all on the thyroid (or at least that's my endo's mantra).


Hey, do these docs all go to the same school, or what? I think I've heard that line a few times, too! LOL

:tongue0015:


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## CA-Lynn (Apr 29, 2010)

I agree with the endo's:

I don't think we can blame this all on the thyroid.


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## bigfoot (May 13, 2011)

Agreed, but I also think that many endo's are so focused on diabetes patients, that the rest of us sort of fall between the cracks. And those who do know a thing or two about thyroid issues seem to be working with information from 20-30 years ago. I get the impression that medical research makes its way into mainstream doctors' offices at a friggin' snail's pace.


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## Serendipity (Jul 5, 2011)

I have to disagree with the calorie cutting suggestion from the doctor. More and more research is showing that a low calorie/low fat diet diet does not work. Not all calories are created equal.

I had about 15lbs that wouldn't go away, even after having my levels more in check with my thyroid meds. I started on a modified paleo and it took a little while to get going, but once it did I lost those 15lbs pretty easily. You really have to be committed and stick to it. Once I got on track I started to feel much more energy and generally better about myself. Before changing my diet I watched what I ate and stuck around 1300cal/day. At that rate I should have lost about a lb a week. I now eat way more calories than that, but am eating better so I feel better. I eat lots of fresh veggies, protein, eggs every day, nuts, some dairy, no refined sugars and no grains. I say stick with what you are doing and be patient.


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## Phoenix016 (Apr 29, 2013)

smithfamily99 said:


> I need some advice. In February, I started following the Paleo diet - basically eating meat, poultry, veggies, fruit, seeds and nuts - no sugar, starchy carb (bread, potato, pasta, rice) and legumes. For 8 weeks, I was really good about sticking with it and lost 0 pounds - but didn't have any gastro issues anymore. My husband lost 15!I had some blood work done as a part of a routine check- up and was diagnosed with Hashimoto's Disease and was prescribed 25 mg of Levothyroxine. (TSH was 5.730, FT4 was 0.92, and TPO was 388)
> The first week I felt great - the scale was moving a bit, I was waking up after 8 hrs of sleep and felt rested. In the last 2 weeks though, my weight has shifted up and down, fatigue and extreme sleepiness have set in and I'm having night sweats. I went to see an Endo today because I thought a specialist would be able to better guide me given that they focus on matters of the thyroid. This doctor, who had zero bedside manner, increased the Levo to 50 mg, but said that I would need to cut my calories to 800/day for a week, then the next week up it to 1000/day (+ exercise) and alternate back and forth until I reached my desired weight (I'm 5-5/182 pounds). I was so shocked that she would suggest such a drastic cut in calories - it just didn't sit well with me. She saw the shock on my face and said to just try cutting 30% of my calories. This just sounds really off to me&#8230; She also seemed to insinuate that I was blaming my thyroid for all my symptoms ! I'm totally new to all of this and I'm trying to sort it out based on what I've read --
> Has anyone had an Endo recommend this kind of diet? I'm seriously considering ditching this doctor - does anyone know of a good Endo in the Dallas area? Ideally, it would be nice to find a doctor who is a smidge more empathetic and will look at everything and work with me to devise a plan to get my health to where it should be. Maybe I'm asking for too much - please help!
> 
> ...


Perhaps the doc should have explained more on why she was suggesting such a low calorie diet. It is known that thyroid problems cause problems with your metabolism - slows it down. Perhaps she was taking this into consideration when suggesting such a low calorie diet temporarily.

Are you familiar with BMR and TDEE? If you went to a nutritionist they would figure our your BMR and TDEE to figure out how many calories you should eat to maintain your weight and how many you should eat to lose weight.

BMR stands for basal metabolic rate and basically means how many calories your body burns by just laying in bed all day and doing nothing else but keeping your body running. If you eat fewer calories than your BMR number your body will slow your metabolism down even more.

Your TDEE is your total daily energy expenditures and this calculation is what figures out the total amount of calories you need in a day based on how active you are in your day to day routine. So basically it is the max amount of calories you should eat (if you want to maintain your weight) and your BMR is the minimum calories you want to eat. If you want to lose weight you should subtract 500 calories from the TDEE number to lose 1 pound a week.

For people who have hypothyroidism or Hashimoto your metabolism is already decreased. Therefore, the number you calculate for BMR and TDEE is probably not accurate and are actually lower. Those calculators do not take into account your thyroid function. I have read that your numbers could be off by as much as 40%.

You can find BMR and TDEE calculators all over the web.


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