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Sara Gottfried MD
  • Home
  • About Dr Sara
    • Media
    • Contact
  • Books
    • Women, Food, and Hormones
    • Younger
    • Brain Body Diet
    • Hormone Reset Diet
    • The Hormone Cure
  • Upcoming Events
  • Blog
    • Recipes
    • Women’s Health
    • Hormones
    • Weight Loss
    • Cleanse
    • Stress Management

Posts Tagged ‘pre-diabetes’

I Weigh: Women, Hormones, Diet Culture, and Body Positivity

By Sara Gottfried MD | September 18, 2021
Sara Gottfried MD Women's Health Article | Body Positivity | I Weigh: Women, Hormones, Diet Culture, and Body Positivity

When I read an intake form for a new patient and she requests help with weight loss, I pause and I take a deep breath. The territory is full of landmines. On one end of the spectrum, we have diet culture, touting crash diets or unrealistic body-size standards or the latest miracle weight-loss supplement. On…

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Borderline Fasting Blood Sugar: Why It’s a Problem and 5 Ways to Fix It

By Sara Gottfried, MD | October 2, 2017
Hormone Article |Blood Sugar| Sara Gottfried MD

The patient I am going to describe is unique in her own issues with blood sugar, but her frustration with conventional medicine could be duplicated in my practice many times over. Louisa is a forty-five-year-old teacher and mother of two. After the birth of her children, she was unable to lose the twenty-five pounds she…

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“For the first time in my adult life I feel that I have gained control over food. I feel healthier, look better and have gained an interest in making sure that what I am putting into my body is the best it can be. And I lost 10 pounds in all the right places.”

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“You don’t have to settle for being stressed out, binging on sugar and chocolate, and aging prematurely. Stop blaming yourself and step into sacred action. It’s your birthright. You can have the joyous, mission-driven life you want, and Dr. Sara is here to show us how.”

– Marci Shimoff, New York Times Bestselling Author of Happy for No Reason and Love for No Reason

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“Dr. Gottfried’s book and detox came at a time when I was ready to give in to old age. Hot flashes, low energy and libido, weight gain, increasing blood pressure and cholesterol levels were unacceptable to me. I now know that hormone levels and what I eat are a huge influence on how I feel and look. To now be able to control something that was out of control is empowering…”

Cheryl V., Dr. Sara’s Detox Challenge Participant

“My health coach told me about your book and I took the [hormone] test, and lo and behold, I found I was a mess, hormonally speaking. Now I’m getting on track and I love your videos and your book. I feel like I’m getting my life back again, when not long ago I truly thought I was losing it!”

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Maybe you aren’t a numbers person, but I urge yo Maybe you aren’t a numbers person, but I urge you, when it comes to your thyroid, to pay attention. T4 is the inactive version of thyroid hormone. Essentially, that means you need it, but it’s mostly a precursor of the more important or “active” version, which is T3 (triiodothyronine). T4 makes up more than 90% of your thyroid hormones, but it must be converted into T3 before it can be used. Unfortunately, too often women are treated with only T4, with no acknowledgment that T3 should be in the mix. Despite being present in such small amounts, free T3 has a greater effect on the way you use energy. It is the primary influence on your weight, cholesterol, energy, memory, menstrual cycle, skin, hair, body temperature, muscle strength, and heart rate. A recent study published in JAMA, compared patients with hypothyroidism who were treated with T4 versus the combination of T3 and T4 found that half the patients preferred the T3 and T4 combination (Feller, 2018). Another randomized trial (Hoang 2013), found that desiccated T3/T4 was associated with modest weight loss compared to T4 alone. For those of my patients who are over the age of 40 and have hypothyroidism and are in perimenpause or menopause, this is an important deciding factor in treatment. We need more trials to confirm this to use desiccated T3/T4 in combination. However, I have found it to be very effective in the thousands of patients that I’ve treated. Refer to the slides above for the thyroid function tests I order for my patients and the optimal ranges I use. When I’m treating a patient, I want the TSH to be less than 2.5 and to be consistent. We aim for the free T4 and the free T3 to be in the top half of the normal range and the reverse T3 to be in the bottom half of the normal range, though that’s not always possible. So for example, for reverse T3, I want a range of 10 to 17 ng/dL Save this post for future reference😍 . . . #womenfoodhormones #thehormonecure #thyroid #hypothyroidism #hypothyroidism #hashimotos #hashimotosdisease #hyperthyroidism
Can stress affect your thyroid? The answer is yes. Can stress affect your thyroid? The answer is yes. Long-standing stress is the enemy of a balanced hormonal system. Tenacious stress causes you to make less free T3, the active thyroid hormone, and too much reverse T3, which blocks thyroid-hormone receptors. The adrenal glands secrete hormones—the most important of which is cortisol—that regulate your response to stress. As countless studies have shown, chronic adrenal stress affects the proper functioning of your hypothalamus and pituitary glands, which direct the production of thyroid hormone. The hypothalamic-pituitary-adrenal (HPA) axis controls cortisol levels. Similarly, the hypothalamic-pituitary-thyroid (HPT) axis is modulated by levels of cortisol and melatonin (and their circadian rhythm), which then affect thyroid levels. Too much stress throws off this delicate balance; in folks with excess cortisol, there’s a proportional decrease in thyroid function. When you have excess cortisol, your body does not respond appropriately to TSH. That may weaken your gut’s ability to absorb the micronutrients—including copper, zinc, and selenium—that you need most to make thyroid hormones. Do you want a quick stress-relieving tip? Follow the link in my bio to watch one of my favorite yoga poses to combat stress. . . . #womenfoodhormones #thehormonecure #thyroid #hypothyroidism #hypothyroidism #hashimotos #hashimotosdisease #hyperthyroidism
If your thyroid is healthy, it produces hormones i If your thyroid is healthy, it produces hormones in the correct amounts: mainly thyroxine (T4), triiodothyronine (T3), T2, T1, and reverse T3. The amount of T4 you produce is dependent on iodine and thyroid-stimulating hormone (TSH). The main reason people in the United States develop low thyroid symptoms is because they’re producing too much TSH, not because they have an iodine deficiency. When your thyroid is neither underactive nor overactive, but working normally, thyroid hormones reflect that and you make less TSH. TSH is the most basic test of thyroid function. Optimal range? It is debated, but evidence favors 0.3 to 2.5 mIU/L. In patients who still feel symptoms or have a diagnosis of autoimmune thyroiditis, I will sometimes optimize to 0.1-2.0. Ideal is to know the baseline TSH from an earlier age when a patient feels great and in balance. When you are hypothyroid (underactive), you don’t make a sufficient supply of thyroid hormones (T3 and T4) to meet your body’s needs and the feedback loop causes your body to produce more TSH in the brain. If you have the DIO2 gene variation, it might reduce thyroid hormone signaling and cause hypothyroidism. What causes your thyroid to become underactive? In the US, the cause is most commonly Hashimoto’s thyroiditis, when your immune system attacks your thyroid. Over time, the battle causes your weakened thyroid to stop making as much thyroid hormone, and a feedback loop tells your control system to make more TSH. When you make more TSH in your pituitary, it travels to your thyroid in the blood and orders the gland to make more thyroid hormone. You either keep up with the orders from headquarters, or you don’t. If your immune system has destroyed your thyroid, or an environmental toxin is disrupting your thyroid function, your thyroid can’t keep up so you end up with a high level of TSH but low levels of thyroid hormones. Symptoms, such as fatigue, weight gain, hair loss, and mood changes begin to appear. More tomorrow on subclincal hypothyroidism. . . . #womenfoodhormones #thehormonecure #thyroid #hypothyroidism #hypothyroidism #hashimotos #hashimotosdisease #hyperthyroidism
It’s not fair but it’s a fact: women are much It’s not fair but it’s a fact: women are much more vulnerable to hormonal imbalance than men. 👉An underactive thyroid affects women up to fifteen times more often than men. The thyroid gland secretes hormones that regulate the activities of almost every cell in our bodies. It controls the body’s sensitivity to other hormones, such as estrogen and cortisol. It regulates how quickly we burn calories and maintains our metabolism, which explains why weight control is such a problem when the thyroid is out of whack. In other words, your thyroid is your very own metabolic thermostat. When your thyroid is working properly, you feel energetic, think clearly, and are upbeat. Your weight is easier to manage. Your bowel moves food along at a normal pace, in a transit time from ingestion to elimination of twelve to twenty-four hours. And you don’t need to wear socks to bed. Thyroid hormones often get out of balance as we get older and I commonly see a triad of symptoms in midlife women—fatigue, weight gain, and depression—that I like to call thyropause, a term coined by a colleague of mine, Mary Shomon. Conventional physicians often respond with skepticism, and even hostility to women who earnestly ask for thyroid help. There are a couple of reasons for this. One is that doctors are well-intentioned but woefully underinformed about the thyroid, in particular, what are considered to be the normal ranges for thyroid hormones. Another reason is that women are disempowered in the doctor’s office. I’ve heard countless stories from my own patients as well as here about women getting dismissed with a pat on the back and the remark, “You’re just getting older,” in response to thyroid complaints. For years now, I’ve been on a mission to amplify the message around thyroid health and help people struggling unnecessarily due to low thyroid function. I’m going to share symptoms, optimal ranges, and solutions so you can become an educated healthcare consumer and have a frank yet firm discussion with your doctor about your thyroid. . . . #thyroid #thehormonecure #womenfoodhormones
I gave a keynote last week on Personalized Medicin I gave a keynote last week on Personalized Medicine for Mental Health. As my daughter and I flew together to Denver before the lecture, I reviewed my slides and thought… wow, that’s a lot of slides and an overwhelming volume of data. My heart’s desire is more of a group process where I invite the audience to get out of their chairs and dance with me, and instead of 45 slides, I use 5. I tell stories to illustrate personalized medicine in action. I ask the group to share their stories. That’s the future of medicine. A whole body yes. Then I got scared. I told my leadership coach that this group of mostly physicians was still conventional and it may not work to ask them to dance, to inhabit their bodies more fully. Doctors are conservative, I rationalized. So I compromised: I cut out half the slides, shared stories, but didn’t dance. A few hours later, my mentor Joan Borysenko gave a “lecture,” led the group out of their seats to gather in a circle, holding hands, and singing verses from Leonard Cohen’s song, HALLELUJAH. It was a sweet celebration of mind, body, and spirit triumphing through the past 2.5 years of the isolating and heartbreaking pandemic—and now we are finally reuniting in person. Joan is fearless. At the young age of 76, she is still showing me the way. Watch out, next time, we’re dancing! 💃🏻 What would you do if you had no fear? Let me know in the comments below👇🏼
Your cortisol level should naturally wax and wane Your cortisol level should naturally wax and wane with the highest levels in the morning, gradually decreasing throughout the day and into the evening. How do some people end up with a flat diurnal pattern? Addison’s disease is a rare cause in which your adrenal glands produce too little due to autoimmune attack of the adrenals, but it’s rare. Flat diurnal levels of cortisol are often due to burnout. Burnout is a silent, insidious process. Many of my patients describe exhaustion, apathy, lack of interest in eating healthy food or getting regular exercise. For me, burnout makes me feel numb. Relentless workplace stress erodes health and identity until you’re a shell of who you once were. Burnout is not a disease; it’s a cluster of symptoms that emerge from dysfunction. It leads to the downstream consequences of hypothalamic-pituitary-adrenal-thyroid-gonadal axis dysregulation, chronic stress, inflammation, and blood sugar abnormalities. If your HPATG is in a state of chaos, your body will go into survival mode — the opposite of thriving. Elevated cortisol levels can then lead to low cortisol, or you might have high and low levels simultaneously. This makes you feel exhausted and drained, like a car trying to run on an empty gas tank. Low cortisol is the end game of an overtaxed stress-regulating system. Irritability, burnout, and depression are common symptoms, along with low blood pressure, orthostatic hypotension (which is when your blood pressure drops when you stand and you feel light-headed), and uncharacteristic pessimism. You feel out of sorts and out of sync with the natural rhythm that you once had. After 25 years of practicing precision and integrative medicine, I can tell you that burnout is far easier to prevent than to treat, so do your body a favor and implement at least one stress-relieving tactic I’ve talked about this week, starting today! Your physiology will benefit! Like, save, and share😍 . . . #stressrelief #stressfree #stressmanagement #stressrelieving #brainbodydiet #theyoungerbook #cortisol #heartratevariability #hpaaxis #hpaaxisdysregulation #hpaaxisdysfunction #burnout #burnoutrecovery #burnoutprevention
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