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Kent Holtorf, MD is a California-based expert on hormonal medicine. Kent Holtorf, MD

Updated December 16, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Kent Holtorf, MD: We try and investigate and treat as many dysfunctions and suboptimal metabolic conditions that we can. We have had success with a large range of individuals, from those who need to lose a few pounds to those who are over a hundred or more pounds overweight.

The most satisfying are the people who lose 50 to 100 pounds or more. It totally changes their lives.

We are also seeing more patients who come in after gastric bypass those who either didnt lose weight or have gained much or all of their weight back. Most have low tissue thyroid levels as well as significant leptin resistance. They can also have a growth hormone deficiency as well.

We had one person who was eating 800 calories a day after having gastric bypass and she was still gaining weight. Nobody believed that was all she was eating until they put her in the hospital and monitored her food intake. They insisted her thyroid was fine, as she had a normal TSH, T4 and T3. When we checked her reverse T3, however, and it was over 800 and her leptin was 75. We checked her metabolic rate and it was 45% below normal. Dieting alone would, of course, never work with such a patient.

Also, toxins such as biphenyl-A can block the thyroid receptors everywhere in the body except for the pituitary, which has different receptors.

So due to the ubiquitous nature of these toxins, I believe that everyone has a relative deficiency of thyroid activity that is not detected by the TSH. People blame food intake and lack of exercise for the obesity problem in this country, but I think a major problem is the thyroid-disrupting toxins, as well as stress.

Additionally, dieting is shown to not only reduce the T4-to-T3 conversion and increase reverse T3, but it is also shown to reduce the numbers of peripheral thyroid receptors -- but again, not in the pituitary -- so the same amount of thyroid has less of an effect, but the TSH is unchanged. This exemplifies the importance of clinical and target tissue assessment in the determination of overall thyroid activity in an individual. Also, women have fewer thyroid receptors than men, making them more sensitive to small decreases in serum levels of thyroid hormones.

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Long Term Weight Loss for Thyroid Patients: Hormonal ...

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Home » Long Term Weight Loss » Long Term Weight Loss for Thyroid Patients: Hormonal …