By Dr. Rachael Schindler
In the first article of this series, available at 5tjt.com/the-real-key-to-weight-loss, I explained how I teach my clients how to work on speeding up their metabolisms and understanding the key hormones in terms of weight loss. Metabolism is dynamic, not static, and can be modified. Hormones inform you that you are hungry and some inform you that you are full. When you eat, hormones tell your body what to do with the ingested food—whether to store it or burn it as fuel. When you exercise, hormones are responsible for telling your body how to move and consume energy stores, and how to boost or shut down different parts of your body.
Insulin’s most important function is to lower the concentration of glucose in the blood. Insulin also helps to turn glucose into fatty acids and forces adipose (fat tissue) to store this energy reserve in the form of utilizable fats. This is the storage place for fuel for future needs. Food (glucose) that is not utilized immediately for fuel, is stored as fat. That is why, when we have too much fuel, greater than our metabolic expenditure, we gain weight.
In contrast, decreased insulin release causes impaired glucose tolerance in diabetes type 1 and type 2 (at the end stage). It results from many years of insulin resistance; obesity and inactivity leading to high insulin output; and finally pancreatic “burnout.” This elevated circulating insulin increases hunger and fat storage. Ultimately, this is at the expense of the hard-working pancreas, which is doing its best to keep up with glucose control, but eventually can’t keep blood sugar levels normal. Consequently, the pancreas fails and the clinical element of type 2 diabetes sets in with slightly higher sugar levels being the hallmark from a blood test. People often ignore this, and you know that if you ignore a problem like this it only gets worse.
In Part 2, available at 5tjt.com/the-real-key-to-weight-loss-2, I wrote about the function of the thyroid gland—to take up iodine from food and incorporate it into the two primary thyroid hormones: thyroxine (T4) and triiodothyronine (T3). When the thyroid hormones are out of balance (they need to be in a specific ratio to each other), chemical reactions all over the body are thrown off. In the case of thyroid deficiency (hypothyroidism), my clients complain of fatigue, depressed mood, “brain fog,” constipation, dry skin, cold intolerance, and other symptoms including weight gain. Additionally, the thyroid gland is itself under the control of the pituitary gland, the brain’s master control center. The pituitary gland secretes TSH, thyroid-stimulating hormone, which kick-starts your thyroid gland to make more thyroid hormone when levels get below normal. Your thyroid then takes up iodine from the blood and synthesizes thyroxine (T4), which is largely inactive until it is converted to T3, whereby it then acts as a primary brain feedback tool and is our natural “speed” enhancer that makes our bodies feel more energized and work more efficiently.
Now, I will outline the role of estrogen and progesterone, and how they interplay with insulin and thyroid hormone.
Men and women both produce estrogen and progesterone. As expected, women make more than men. In women, estrogen is composed of three main compounds: estriol, estradiol, and estrone. Estriol has an impact during pregnancy. Estradiol is responsible for female characteristics, sexual functioning, and bone health. Estrone is widespread throughout the body in tissues and muscles even after menopause. In addition to influencing a woman’s entire development from child to adult, estrogen also has a major impact on blood fat storage, digestive enzymes, water and salt balance, bone density, heart function, and more. Men naturally have a small amount of estradiol produced in the adrenals and testes. At normal healthy levels, estrogen helps protect men’s bones, heart, brains, and, in part, libido.
In women, the estrogens are involved in the maintenance of general physiologic homeostasis or keeping all functions balanced, including body weight. Estradiol lowers insulin, but it decreases with age and menopause. Estradiol also naturally lowers LDL or bad cholesterol and increases our HDL or good cholesterol! It is also true that women with more estradiol tend to have a higher level of muscle mass and lower level of body fat. Additionally, estradiol helps regulate hunger by creating the same satisfied feeling that comes from serotonin. Similarly, that serotonin-like feeling keeps your moods more stable and energy high, which makes you more motivated to exercise.
After menopause, estrone then becomes the main estrogen. Estrone shifts fat storage from the hips and buttocks (the opposite of estradiol) to the stomach (called visceral fat, which is much more dangerous because it surrounds the organs). As women lose more of their ovarian estrogen, their bodies become more desperate to hang on to other estrogen-making areas of the body, including fat, making it harder to lose the dreaded belly fat. What makes matters worse is that women with higher fat levels will produce more estrogen, because fat tissue turns fat-burning androgens into fat-storing estrone—a vicious circle! Unfortunately, according to data from the Mayo Clinic, estrogen levels are greatly enhanced in obese post-menopausal women more so than in thinner post-menopausal women. This may account for greater prevalence of breast and endometrial cancer in the more obese group as well.
Progesterone, the next primary female hormone, helps balance estrogen and serves as a precursor to cortisol (stress hormone), testosterone, and estrogen. When progesterone drops just before menstrual bleeding occurs, the imbalance of hormones may be what triggers cravings to eat carbohydrates in particular. At menopause, progesterone drops even more dramatically than estrogen. Because progesterone is also the precursor for testosterone and estradiol, when progesterone production falls off, women start to lose the fat-burning effects of those metabolically positive hormones. Stress makes this imbalance even worse! When cortisol is overproduced, it competes for the same receptors as progesterone and therefore the progesterone may be compromised.
In my practice, many of my clients thought that all women’s hormone-balance problems stemmed from declining levels of estrogen, especially during perimenopause and menopause, postmenstrual syndrome, or postpartum. But in Western culture, women tend to have more estrogen, rather than too little. We all notice that the signs of puberty in girls have been occurring much earlier. According to new data, rates of breast cancer have increased by 40% in the past 35 years. Additionally, men have seen signs of the rise in their estrogen levels (which occur naturally for them anyways), as decreasing sperm counts and increasing prostate cancer rates. This excess in estrogen can lead to further problems with decreased metabolism, muscle-building, and libido.
So what is to blame for this rise in estrogen? (Got milk?) A large part of this hormonal disruption may come from the overwhelming explosion of industrial, man-made compounds with estrogenic effects, called “xenoestrogens,” now ever-present in the environment. Our bodies are getting slammed with “endocrine-disrupting” synthetic estrogens from the ingredients in our cosmetics, cleansers we use around the home, the preservatives in our foods, and the plastics wrapping them. When it comes to these endocrine disruptors, the scope of impact is staggering. In the case of young men, rising levels of estrogen are frequently environmentally induced and up the chances of potential cancer, infertility, diabetes, dysfunction, and other serious conditions.
In contrast, phytoestrogens or “dietary estrogens,” which are a large group of naturally occurring plant compounds with estrogen-like qualities, can have a much milder effect on the body. Phytoestrogens include soy and flaxseed, and their derivatives.
So what can one do to battle this huge estrogen hurdle? Eat your fiber! (Certain fibers especially at certain times are more productive than others, depending on your thyroid and insulin levels.) Why does fiber work? Soluble and insoluble fibers are very effective in managing excess estrogen. Normally estrogen is pulled from the bloodstream by the liver and sent to the intestinal tract via the bile duct. The more fiber you get at the right times, the more estrogen gets soaked up and carried out with the other waste! So eat the peel of your fruit, beans, oats, and leafy greens.
Additionally, plant compounds called flavanols can potentially keep testosterone from converting into estrogen (they are aromatase inhibitors). Some of the more common flavanols include black olives, onions, green tea, and apples.
Last but not least, indole-3-carbinol is an estrogen-blocking antioxidant. So eat your cruciferous veggies such as kale, cabbage, broccoli, and Brussels sprouts in moderation; they will affect your thyroid function when eaten in excess. I usually give my clients exact amounts of these veggies to eat daily, depending on the hormone/thyroid/sugar numbers in their bloodwork.
While other compounds affect hormone regulation, I usually use those foods on a case-by-case basis because they can mean the difference between losing weight or plateauing, especially if they interact with insulin metabolism. (So when people say certain foods are healthy or good to eat, it may not work for you.)
In my next article, I will review testosterone and DHEA and their effects on weight loss. Hopefully your approach and perception of weight loss will be more balanced. Understanding this process and how to optimize it on an individual basis will lead to lasting success!
At this point, I would like to thank all of my loyal customers (especially on Pesach), who enjoy my gluten-free, no-added-sugar cauliflower pizza and are making it a huge success! From all the testimonials and thanks I get from parents of kids, clients, and even seniors, I feel great about making a healthy, vegetable-based, convenient, and yummy food that the whole family can enjoy together. v
Rachael E. Schindler, Ph.D. is a psychologist, founder of Litenlow.com and The Five Towns Diet gourmet meals delivery, lecturer and author, certified pediatric and adult nutrition counselor, certified personal trainer, and group fitness instructor and Pilates master for over 22 years, practicing in Cedarhurst, Lawrence, and Manhattan. She specializes in fitness, food, and behavioral issues for both children and adults. She can be reached to order, for an appointment, or for questions and comments at Teichbergr@aol.com or 917-690-5097.