What kind of tests/doctors should I see?

Sesame85

Hi guys!

There's a wall of text below, so let me summarize first:

I can't afford to see a ton of doctors since I'm poor and my insurance is practically nonexistent. I can't lose weight, something is wrong with my body. What kind of doctor/tests should I look into to find out what is out of whack?

Ok, the wall:

I'm a 29 year old woman. 5'2, 260lbs. I have been obese in some fashion my entire life. I have always been healthy under the flab, much to the surprise of many. I grew up in a sugar free, fat free, low cholesterol, low sodium, kosher and vegetarian household. I've spoken to doctors before about my inability to lose weight despite making a concerted effort and they say my body is in some kind of permanent starvation mode. I have already had my thyroid tested (nothing unusual), and had a hormone screen (nothing unusual).

Back in April, I joined MFP and made another push, this time with the goal of getting healthy. It's working! My endurance is up, and under all the fat is some muscle. It's great. With the exception of 2 or 3 days, I have worked out every single day since April. I alternate my workouts to make sure I am getting different areas and proper cardio. I am logging the calories of every single thing that goes into my mouth. I am not the healthiest of people, but I keep within my target calorie amount and generally avoid bad foods. I went into this to get healthier and it is working.Still, I don't think it is unreasonable to hope for a fringe benefit of weight loss if I am dieting and exercising and being good. Six months in of this and I haven't lost a single pound. I took my measurements the other day and those haven't changed either. I've seen people posting these amazing progress pictures, losing 60lbs in 6 months. I knew I wouldn't have those kinds of results, but I had hoped to see SOMETHING after 6 months of nonstop effort.

I would love to know what is wrong with me. I have tried reaching out to a few weight loss places but they all want to push bariatric surgery on me (which I am not against, but I am not ready to accept that yet). When I tell them that isn't what I want, they push powders and shakes on me. I'm also not against that, but I am a true believer that if you work hard enough, diet and exercise are the best route to weight loss. There is obviously something wrong with my body. I want to find out what and then figure out how to fix it. I am willing to put in the work.

So, with that wall of text, any suggestions? If you skimmed over it, I've already had my hormones and thyroid tested. Is there some blood panel that can be drawn to see if something is completely off the charts? Is there a drug I can look for to kickstart my body? I am making the effort and will continue to, but I probably should consult SOME kind of doctor for insight.

z_bra

Are you weighing your food

shexy16

Check and see if you have a community health center in your area. They accept uninsured patients or underinsured patients and offer a discounted fee program.

LeanButNotMean44

How many calories are you eating each day and are you weighing and logging EVERYTHING?

independant2406

Edit: sorry missed the part where you've already had tests.

Have you tried reducing carbs? Sometimes that helps those of us who can't seem to get the scale to move with just a calorie deficit. Sometimes reduced carbs + same number of calories = success.

ethompso0105

I was in a very similar boat.

With the thyroid/hormones, "nothing unusual" is kind of a vague term when it comes to most GP's. Mine were "nothing unusual", too. I went to a specialist who tested again and found that my thyroid was within "medically acceptable limits", but on the very low end. My hormones seemed to be fine with the exception of my estrogen. My estrogen was off the charts high--but since all other hormones looked fine and because of my age, my GP said everything was okay. The specialist treats me for hypothyroidism and high estrogen. For years, these treatments were incredibly helpful and I was slowly but surely having success. Maybe similar things are going on in your body.

Best of luck!

ETA: Don't take my ticker as an indication of my past success. I've started having other health problems that have been causing issues.

Sesame85

Are you weighing your food

I am. I have a scale and measure everything accordingly.

How many calories are you eating each day and are you weighing and logging EVERYTHING?

MFP put me on an 1820/day calorie limit and while some days I go over by a little, I'm usually about 100-200 calories short. I am including everything, down to single bites of things.

My concern here is that even if I WASN'T logging every thing (which I am) or if I was eyeballing my portions (which I'm not), exercising daily and eating a balanced diet ought to have SOMETHING to show for it after this much time. You people don't know me and I'm used to not being believed, but I know I'm doing things right and something is messed up internally. My goal is not to find out what I'm doing wrong, but what is wrong with me.

z_bra

Are you eating back exercise calories? You might be overestimating them

TavistockToad

Opening your diary might help

RodaRose

I know that you said you had tests. Did they test for Vit D?

AnnaVee84

Besides not being able to lose weight, do you have any other symptoms? Abnormal hair growth or increased hair growth in abnormal places, abnormal menstruation cycle, abnormal bowel movements (no one likes talking about BMs haha but as a medical student sometimes that's the only thing I care about with my pts, so the shock factor wears off) etc? If you had a hormonal issue or a food insenstivity/issue, it would show up in these other ways too - so just trying to brainstorm ideas of what it could be.

But the number one reason for no change is overestimating cals out and underestimating cals in. Using a food scale to relearn portion sizes and getting a HRM for exercise (as MFP overestimates cal burn) really helped me focus in on what was really happening. Stick with it, wishing you the best!

edit: spelling

Sesame85

Whoa Anna, back up and elaborate. My hair grows SUPER fast (I cut it to my neck 2 months ago and it's past my shoulders), I have never had a normal period without the help of birth control and while I'm not sure what you mean by abnormal BMs, I definitely do it frequently (yay TMI!). I'm curious to hear if you think that is indicative of something!

I had a hormone panel done, but I'm willing to second guess those results. It was the type you pee on and mail out to a clinic.

Thanks to MFP I did learn I used to eat far too few calories to be healthy (it used to be 1200), so I've made an effort to eat a bit more, but this go-round, I'm following the proper steps.

kimny72

Just wanted to chime in on bits and pieces of what has already been said.

Exercising and eating a balanced diet will make you healthier, but not necessarily lose any weight. Weight loss is all about eating less than you burn.

The first suggestion is maybe you aren't logging correctly. Since you say you are, are you eating back your exercise calories? If you are, you might be over-estimating your calorie burns.

If you are eating 1800 cals and staying the same weight, you should be able to eat a little less, like 1700 and start to see small weekly weight losses.

As someone else mentioned, was it a GP who did the tests? If it was, you could try seeing an endocrinologist. They specialize in hormones, so they might catch something a GP wouldn't.

The comment about hair growth was about body hair. If your hormones are out of whack, you might have excess facial or tummy hair, that sort of thing.

Sorry I don't know anything more useful. I hope you get to the bottom of it!

AnnaVee84

Whoa Anna, back up and elaborate. My hair grows SUPER fast (I cut it to my neck 2 months ago and it's past my shoulders), I have never had a normal period without the help of birth control and while I'm not sure what you mean by abnormal BMs, I definitely do it frequently (yay TMI!). I'm curious to hear if you think that is indicative of something!

I had a hormone panel done, but I'm willing to second guess those results. It was the type you pee on and mail out to a clinic.

Thanks to MFP I did learn I used to eat far too few calories to be healthy (it used to be 1200), so I've made an effort to eat a bit more, but this go-round, I'm following the proper steps.

Any excessive hair growth on your chin or face?
What hormones were tested, cortisol and thyroid included?

happyfeetrebel1

Are you weighing your food

I am. I have a scale and measure everything accordingly.

How many calories are you eating each day and are you weighing and logging EVERYTHING?

MFP put me on an 1820/day calorie limit and while some days I go over by a little, I'm usually about 100-200 calories short. I am including everything, down to single bites of things.

My concern here is that even if I WASN'T logging every thing (which I am) or if I was eyeballing my portions (which I'm not), exercising daily and eating a balanced diet ought to have SOMETHING to show for it after this much time. You people don't know me and I'm used to not being believed, but I know I'm doing things right and something is messed up internally. My goal is not to find out what I'm doing wrong, but what is wrong with me.

I walk between 10k steps and 12k at work each day. I run 3 miles also as I'm training for a 5. I also have a kid, and a hubby so it's not like I'm a sloth

I maintain on 1600 calories AT THAT exercise level. You weren't losing weight and people told you to eat more and you believed them?! Try creating a bigger deficit. Weigh everything. Contrary to the holy grail of MFP, you are not a special snowflake, you do not eat more to lose more (that's what got you here in the first place), starvation mode is NOT real, and you are somehow eating at maintenance.

Barring a truly rare medical condition (which could happen, but probably not), you should simply lower your intake and/or move more.

I am not being unkind. I promise. I am trying to help.

*sits and waits for either denial or flaming*

TavistockToad

*sits and waits for either denial or flaming*

Oh, it'll come... :drinker:

fleetzz

Your diary is closed.

Memowe

Cortisol and prolactin are some hormones that may indicate a pituitary tumor, which some of the side effects are weight gain, might be something to check in to. I had a full hormonal blood panel and they found my prolactin levels were way beyond normal for my age, and I had an MRI done last week to see if it is a tumor. Next week I go in for my follow up to see what it is, if it's normal then I'm back at square one.

WalkingAlong

Are you weighing your food

I am. I have a scale and measure everything accordingly.

How many calories are you eating each day and are you weighing and logging EVERYTHING?

MFP put me on an 1820/day calorie limit and while some days I go over by a little, I'm usually about 100-200 calories short. I am including everything, down to single bites of things.

My concern here is that even if I WASN'T logging every thing (which I am) or if I was eyeballing my portions (which I'm not), exercising daily and eating a balanced diet ought to have SOMETHING to show for it after this much time. You people don't know me and I'm used to not being believed, but I know I'm doing things right and something is messed up internally. My goal is not to find out what I'm doing wrong, but what is wrong with me.

I walk between 10k steps and 12k at work each day. I run 3 miles also as I'm training for a 5. I also have a kid, and a hubby so it's not like I'm a sloth

I maintain on 1600 calories AT THAT exercise level. You weren't losing weight and people told you to eat more and you believed them?! Try creating a bigger deficit. Weigh everything. Contrary to the holy grail of MFP, you are not a special snowflake, you do not eat more to lose more (that's what got you here in the first place), starvation mode is NOT real, and you are somehow eating at maintenance.

Barring a truly rare medical condition (which could happen, but probably not), you should simply lower your intake and/or move more.

I am not being unkind. I promise. I am trying to help.

*sits and waits for either denial or flaming*

I agree.

girlviernes

I recently saw a reproductive endocrinologist and she asked questions and is going about doing blood tests in a way no previous doctor has done.

I think with the abnormal periods maybe you have PCOS. I don't know enough to say what else could cause them, and I'm sure other conditions could also cause irregular periods.

Just as an FYI, I also have irregular periods as well as signs of insulin resistance.
my doctor put me on progesterone for a week to start a "real" menstruation, and she wants me to do the blood work on the 3rd day of of my cycle. She is having them measure:
fsh
lh
estradiol
prolactin
TSH, free T4
CMP
Insulin
Hbg A1c
Testosterone (total and free)
and DHEAS

I hope this is helpful.

7aneena

My short response to your question, I'd go to an endocrinologist. There is such a thing called subclinical hypothyroidism where the test looks somewhat normal but you actually do have a thyroid problem.
There's also PCOS which someone mentioned already

You said you were not ready to go the weight loss surgery route, I know I didn't want to either despite the push from doctors. You could try it without actually doing it, in principle it is portion control. If you think there is a chance it is the amount of food try the intermittent fasting or something like that where you can "test" the theory that you are eating more than you should.

btw I sent you a request

Sesame85

First of all, I'd like to say thank you to the handful of people who sent me messages. You were very helpful with ideas and I am very excited to look into them. The same goes for the people with helpful suggestions. I am doing a lot of research on all of the helpful tips.

To everyone who replied with the assumption that I'm hiding something/not doing it right, or who want access to my diary to find some proof that I'm doing it wrong, you have completely missed the point of my post. When you eat right and exercise and have almost nothing to show for it, something is wrong with the body. My question was not what I needed to do differently (in which case your responses would have been completely welcome and valid) but instead, "how do I figure out what is wrong with me?"

I wasn't asking for people to question that. I know my body and I've tried everything I can think of at this point, I was hoping not to be doubted, here of all places. We're a community of people looking to lose weight. While I know a lot of people on here are fit and many people are only out to lose 10lbs, I'm willing to bet a lot of people here have been fat their whole lives. In a world of people doubting that I'm not a fat load and assuming I'm lying about my diet and exercise, I had hoped that this place of all places would understand the struggle.


Again, thanks to the people who gave great suggestions to look into and ideas of what to ask for/doctors to visit. I already made a few calls today! If someone sees this with more ideas, I'm all ears. PM me please though.

WalkingAlong

exercising daily and eating a balanced diet ought to have SOMETHING to show for it after this much time.

No one is doubting you. We're just saying that daily exercise and a 'balanced diet' is not enough to make the scale move. You have to have a calorie deficit. If the scale isn't moving, you're eating at maintenance level calories OR you've negated all your fat loss with muscle gains, which can happen to a new exerciser but not like 20 lbs. worth. And you would probably feel like you'd made a difference in your measurements.

MFP's BMR tool overestimates the calorie needs of obese people. 1800 isn't going to cause weight loss for many people with your stats.

It'd be easier than seeing a doctor you can't afford to try a lower calorie target for a week.

Memowe

Medical conditions can change the In out ratio, so a reasonable calorie deficit doesn't always work completely the way it should.But 1800 calories is a bit much for someone trying to lose weight, so maybe knock it down to 1500-1600! I hope you get your medical issues solved so the weight can finally come off!

leeann0517

she's 260 pounds and 29 years old - 1800 calories is in no way too much.

definitely see an endocrinologist and ask about PCOS. since you take birth control it's possible that some of the symptoms are less severe.

SideSteel

Can you open your diary please?

rml_16

I have already had my thyroid tested (nothing unusual), and had a hormone screen (nothing unusual).

Do you know exactly what tests they ran? I'm going through this crap right now and finding out my PCP is kind of an idiot about it. I demanded a referral to an endocrinologist (which you should do, anyway, since endo is about more than thyroid).

If your doc only ran TSH, normal doesn't mean there isn't a problem. I had mine tested in August and it was more than double what it should have been (HIGH END). Two weeks later, it was normal. In doing some research, I've found out that Hashimoto's can cause extreme fluctuations in TSH -- as can other issues.

Did he test free T3 and T4? Antibodies?

Aside from that, are you actually weighing and measuring your food to make sure you're eating what you think you're eating? Are you being honest about exercise calories burned?

socajam

Can you open your diary please?

I wonder the same question, asking for help my keeping diary close.

amusedmonkey

I have PCOS and my maintenance is actually 200-300 calories lower than what MFP said it should be. Since you have not been losing on 1800, you would assume this is your maintenance (I maintain at around that number and I weigh 215 lb at 5'6). Do get checked for PCOS, but even if you don't have any medical issues what MFP suggests is just that, a suggestion. It's based on a population average, so it has a standard deviation and you may fall on the lower end. Some people tend to have a more/less efficient body than usual.

Take a look at this calculator

http://www.thedietdiary.com/diet/nutrition/RestingEnergy.html

and you will see how much formulas differ. In my case, for example, my basal metabolic rate according to these formulas ranges anywhere from 1300s to 1700s.

So what you need to do if all your tests come back normal is to reduce your current intake by 500 calories (since it's your maintenance) and make up for it with more exercise. It sucks to be on the lower end, I know. It does make things harder but it's not impossible. have you tried the every other day diet or other kinds of intermittent fasting or a combination/modification? For people with lower goals it may help with adherence since you are not having to stick to 1300 calories every day.

osothefinn

MFP's BMR tool overestimates the calorie needs of obese people. 1800 isn't going to cause weight loss for many people with your stats.

This. I eat 1800 calories as a 360 pound male and lose a pound a week.

Deipneus

Can you open your diary please?

I wonder the same question, asking for help my keeping diary close.

She's already addressed why she's not. I don't blame her. She's not asking you to critique her eating habits.