Help, what questions should I ask endocronologist

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Just to give some quick background info, my wife began here weightloss journey last fall. She is 39 with a starting weight of 204 at 5'2". She was seeing slow progress (which is ok) and dropped about 30 pounds over 5 months. However, she has only been able to lose 4 pounds since February.

We thought maybe she wasn't getting enough calories. She has been honest with her calories and tracked them daily with MFP. She had been getting about 1500-1600 daily since last Fall. So we went to about 1800-1900 to see if that would ramp up her metabolism. It didn't.

She has been doing weight training 3-4x a week for about 60 minutes and Insanity for her cardio another 4x a week. Usually 1 rest day with a few days splitting the weights and cardio.

A month ago she got a Polar FT4 to track her calories and HR. Even during HIT it takes her about 15 minutes to get her HR over 120 and it shows that she is only burning about 250-300 calories for a 45-60 min workout. This is much lower than we anticipated given her effort level and the fact that she is still 170. Finally I used her Polar this morning to see if it's not accurately measuring. I confirmed it's not the device. I am 20 pounds lighter and burned 550 calories today doing 45 minutes of interval cardio.

I am thinking that something is going on hormonal that is preventing her body from torching calories during her workouts. I would expect someone to be burning in the 8-11 cal/min range for HIT when she is only burning 5-6. Wondering what hormone tests we should ask to have run to help give some answers. Thanks.

Replies

  • gobonas99
    gobonas99 Posts: 1,049 Member
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    it could be a HEART issue vs a HORMONE issue. I know someone that has a heart condition that makes it nearly impossible for her to get her heartrate over 150 without fainting (vs someone like me who has a naturally high active HR - I routinely am in the 170-190 range for a pretty hard but not all out workout).

    That is one of the downfalls of a HRM. If you have an unusually high or unusually low HR, a HRM will calculate artificially high or low calorie burns.
  • vismal
    vismal Posts: 2,463 Member
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    There really aren't a ton of questions for the endocrinologist, it will all come down to blood work results. If she has some kind of hormonal imbalance they'll need to check her labs. I'm thinking a full thyroid panel, vitamin levels, iron level, sex hormone panel, all that stuff. I'm guessing they'll recommend doing all that stuff anyhow. It's good to have a baseline of where all her levels are at, then they can address deficiencies if they find any.
  • 4theking
    4theking Posts: 1,196 Member
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    There are many things to check but the endocronologist is not going to be the best place to go. You need to ask around and find a good doc or nurse practitioner that specializes in metabolic problems. If she is indeed eating what she says, then she definitely needs checked out. You might try taking her calories to 1400 and then having her eat more one day a week at around 3000 calories before you see a doc. I have seen this kind of setup work when nothing else would.

    The most obvious place to look is thyroid (free T4 and free T3)but that is just the beginning. You also need to check progesterone/estrogen ratio, testosterone, vitamin B5, B6, B12, D3, cortisol via 4 time point saliva testing, and ferritin. You can also check her neurotransmitters to see if there is an issue there.

    A quick check you could do is measure her morning temperature. Morning temperature directly coorelates with metabolic activity in the human body and anything at 97 or below can signify a problem. At my worst, my morning temperature was 94.5 degrees.............yes I had problems.
  • AnnetteCorrado983
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    I am 53 5 2" and I was 210 19 months ago and have lost 60 lbs. I exercise 60 mins a day 5 days a week and track my calories of 1000 per day per my RD
  • lindsey1979
    lindsey1979 Posts: 2,395 Member
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    I'd also second the suggestion to find someone that is either a thyroid specialist or metabolism specialists. Many endos are very old school and not well-versed in such things. As some others have recommended, I'd get a full thyroid panel (which is TSH, Free T4, Free T3, TPO and Tg antibodies), common vitamin deficiencies (D, B series, magnesium, iodine, iron/ferritin), adrenals (cortisol, DHEA), glucose metabolism issues (A1C, fasting glucose) as well as the sex hormones (for PCOS and others).

    Good luck!