Ask Dr. Mike: Intense Cravings, Weight Loss Equation & More

Additional Info

• Segment Number: 4
• Audio File: healthy_talk/1518ht5d.mp3
• Organization: Life Extension
• Guest Website: Healthy Talk MD
• Transcription: RadioMD Presents: Healthy Talk | Original Air Date: May 1, 2015
  Host: Michael Smith, MD
  
  It's time for you to be a part of the show. Email or call with questions for Dr. Mike now. Email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 877.711.5211. What are you waiting for? The doctor is in.
  
  DR MIKE: AskDrMikeSmith@RadioMD. So, I went through...Obviously, today I'm talking a lot about weight loss issues. We're getting into summer. People want to start looking good. That's all good, so I do have three weight loss questions that I thought I would answer first. So, let's make sure you get through all three of these.
  
  The first question comes from Melanie and she asks:
  "When I try any diet, I get intense cravings and ultimately fail." And then she says, "Help!"
  
  Melanie, I think I can help. First of all, let's talk about why you might be getting the cravings. By the way, appetite and cravings are two different things. Melanie, cravings-- that intense desire for a certain type of food--usually it's sugary for most people. There's salt cravings but usually it's sugar. That craving, by the way, that sweet craving is usually linked more to stress than anything else. And it could be mental stress or it could be actual physical stress. When you're dieting you get both of it. I mean, think about it.
  
  You're dieting. You're trying to lose weight. You're really stressed out about that anyway, so there's already some emotional stress involved with dieting. But then, dieting, physically speaking, when you cut calories, that stresses the body.
  
  The body for years or months, whatever, was used to a certain amount of calories every day and you might have been getting heavier and heavier. You know, body fat going up but your body alternately was just fine. Let's just keep eating and it's good. But then all of a sudden you cut calories and it's like, "Oh, what's going on?" That's the whole diet shock thing I've talked about before where if you cut calories too much, you shock the body into reversing your weight loss efforts. You're shocking the body into putting weight back on. So, it's a stressor. So, you have this emotional stress thing going on with dieting and then you got the physiological stress of simply eating less. And that's probably where the cravings are coming from. Whether it's an emotional stress, Melanie, or a physical stress, the cortisol is all behind it.
  
  So, cortisol, the stress hormone, is being released and cortisol, it's job is to prepare you to deal with that stress and how do you do that? Well, you need energy. So, the cortisol wants to mobilize sugars. It wants to get your sugar into your blood stream and once you've broken down your sugar stores called "glycogen", and you've dumped that sugar in and once that's gone, which goes pretty quick, and you don't have a lot of sugar stores, it'll start going into the fat stores a little bit but, ultimately, what cortisol does is it causes you to crave sugar.
  
  Because now your muscle cells in your brain, in your nerves, they're starting to function more. Cortisol is raising metabolism. You're trying to deal with this emotional stress of dieting, the physical stress of decreasing calories, so cortisol is revving up your muscles in your brain and there's not enough sugar, so what do you do? You crave sugar. I'm assuming -- I'm making an assumption only -- because if you're an average person you're probably craving sugars.
  
  It's stress related. Cravings are usually stress related.
  And one of the best ways to handle that is to boost serotonin in your brain. Serotonin is the counter nerve transmitter to the hormone cortisol. So, if you want cortisol to behave and calm down, you need more serotonin in your brain. I might suggest for you, Melanie, saffron extract. Saffron is a serotonin reuptaking inhibitor but what that means is, is that it just keeps serotonin in your brain a little longer.
  
  So, serotonin can act a little longer and you'll feel better. That manages the stress better, brings down the sugar cravings. You could also just produce more serotonin through tryptophan. That's an over-the-counter amino acid. It's very easy to take and taken on an empty stomach--that's the best way. But tryptophan is the precursor of the serotonin. You can try that. Another one is called 5HTP. That's another over-the-counter supplement you could try to use to boost serotonin. But I think that would be the best thing for you. And it's just understanding that you're dieting. It's emotional stress. It's physiological stress. It's cortisol related - the cravings. Counter that by boosting serotonin.
  
  Next question. If my hypothyroidism is being treated, why am I not losing weight yet? That's a great question. So, this person had low functioning thyroid and they were missing a metabolic throttle--the accelerator that revs you up.
  
  So, metabolism slows, everything you eat turns into fat. That was recognized by his or her doctor and the low thyroid is being corrected. That's awesome. That's great. So, maybe you've just got to give it more time. Maybe you're not taking enough thyroid medication. Maybe you've got to improve the numbers a little bit - better TSH, Free T4, Free T3. The other question I might have for this is how are you correcting a thyroid hormone? Are you taking Synthroid which is the most commonly prescribed thyroid medication? The problem with Synthroid for some people is, it's only T4, which is the main form of the thyroid hormone that's produced by the thyroid gland and T4 travels to the tissues where it converts into the more active form called T3.
  
  Well, some people, simply because of the low thyroid state have more cortisol, more stress and that gets in the way of the T4 to T3 conversion.
  
  So, you might want to measure something called reverse T3. If you're taking Synthroid, which is only T4 and you're stressed out from the low thyroid state, which is common, that T4, that Synthroid T4 will not convert into T3, so you really aren't...Even though your numbers might be getting better, you're not making that active form T3 and, instead, you're making this inactive form called reverse T3. So, just go and measure it. If it's high, there is your issue.
  
  So, we got to get cortisol out of the way. So, maybe what you need is an anti-cortisol type regimen. Adaptogenic herbs like ashwagahnda, rhodiola, ginseng, in combination with the hormone DHEA, might be what you need. Maybe your thyroid is fine but you're dealing with a different hormonal imbalance. For men, low testosterone, low DHEA, low androgens.
  
  For women, it's the estrogen/progesterone ratio. Maybe you're estrogen dominate if you are a woman, and that needs to be corrected. Maybe doing a nice -- Now that you're being treated for the low thyroid, consider that whole reverse T3 thing. Maybe what you need to do is just do a nice hormone profile, a nice blood test and look at all your different hormones and correct those imbalances as well.
  
  Next question:
  
  "Some people say weight is only a matter of calories in and calories out but others say it's more complicated than that. So which is it?"
  
  Well, it's true because I've said this before. Your weight, on a moment to moment basis, is based off a very easy mathematical equation. Very simple math. Calories that you take in minus the calories you burn out through exercising metabolism. Calories in minus calories out.
  If that number is positive, you gain weight; if it's negative you lose weight. If it's zero, your weight stays the same.
  
  So, in one sense your day to day weight is maintained or goes up or goes down or is determined, I should say, by a very, very simple mathematical equation - in minus out. Where it gets complicated is what is causing you to eat more. What is causing you not to burn enough calories? That's where it becomes complicated and that's where the hormone issues have to be addressed. Insulin has to be addressed. So, it is a simple mathematical equation.
  
  It's just the factors that determine that equation. The result of that equation--that's where it gets complicated. This is Healthy Talk on Radio MD.
  
  I'm Dr. Mike. Stay well.
• Length (mins): 10
• Waiver Received: No
• Internal Notes: NO GUEST
• Host: Mike Smith, MD