? About BMR and TDEE and thyroid disease

All the burns & calorie counts are estimates, so it takes trial & error to find the "sweet spot" where you're eating at a true deficit—no matter what your thyroid's like.

I have Hashimoto's (autoimmune thyroid disease), and I lost the weight by following the advice in the Sexypants post: https://community.myfitnesspal.com/en/discussion/1080242/a-guide-to-get-you-started-on-your-path-to-sexypants/p1

Untreated hypothyroidism can slow metabolism up to 15%. If you are well treated, it shouldn't make as much of a difference. I too have Hashi's and am treated properly, and am having no problem losing weight. To be honest, I lst weight in the past fairly well without treatment too, but I was not successful at keeping it off.

Good luck.

I lost weight long before my thyroid levels ever entered the "normal" range. Meds (in my case, Synthroid & Cytomel) reduce the fatigue so I can be more active. But I still kept gaining until I learned to log everything I eat & drink accurately & honestly. Logging works.

I think it really depends on the person and being adequately treated. As many hypothyroid people find out it -- it can be incredibly difficult to find adequate treatment. Many seem to be undermedicated because docs focus so much on the tests and ignore clinical symptoms. And if you Hashi's in particular, many of the tests have limited applicability because they can never really tell how much your antibodies are binding up your effective thyroid hormones. And that's why clinical symptoms are soooo important.

I have Hashi's and suspected it about 10 years before I was officially diagnosed. In those earlier years, I could just cut calories back and take the weight off -- I went up and down for a while, attributing it to stress. And that was probably partially true, but I imagine a lot of it was reactions to my thyroid -- having more of an "attack" at different times.

Then when I got to my 30s, calorie cutting just wasn't working anymore. I got to the point where I was cutting significantly and not losing hardly anything. I was running over a 750 daily caloric deficit (and was like 500 calories below my BMR) and lost a whopping 2.2 lbs over 3 months (when I should have lost 18+). That was the trigger that finally led my doctor to digging into it more and ultimately seeing doc that was an expert in thyroid and metabolic issues. Along with the thyroid, I had a bunch of accessory issues -- insulin resistance, adrenal insufficiency (my DHEA was bottomed out) and severe deficiencies in both Vitamin D and magnesium. All things that my other docs NEVER checked for -- I didn't even know about the possibilities existing. My doc checked for other stuff -- liver enzymes, deficiencies in iron, iodine, selenium and a few others -- but those are actually what I had.

So, once I got all that sorted out along with the thyroid, I pretty started losing exactly as expected with the calculated deficit. And, of course I felt TONS better -- no more consistent fatigue, losing hair, being cold all the time, etc. It was like night and day. And, weight loss actually felt pretty easy compared to what I was doing before -- finally my results were aligning with my efforts. It felt soooo much easier.

I had this big discussion with my thyroid doc about this very topic recently about how things could be soooo off (I even had an RMR test with the gas mask and it said my RMR wasn't that depressed -- like 150 cals lower than expected but not 600+). So, he shared this theory he has for people with metabolic issues -- thyroid, insulin resistance, etc. Keep in mind he's never seen any studies proving this theory, but it's the only thing that makes sense to him to explain why he sees this over and over again with so many of his thyroid patients (and makes sense to me). Okay, here it goes:

So, your basic CICO equation looks like this: CI = CO + FS (fat stores) or if you shift the CO to the other side, it looks like CI - CO = FS. So if you burn more than you eat (i.e. your CO is bigger than your CI), your fat stores will go down (i.e. lose fat). But, and here's the big caveat: this assumes that your metabolism is functioning in a way where your body is able to access all of the energy in your CI for energy needed in CO. But what if that wasn't the case? What if you couldn't access some of it and your body automatically turned some of it into fat stores even though you needed more? What would be the result? Your body would have to drop you CO to compensate -- things like fatigue, lower body temp, hair growth stops, get dry skin/hair, brittle nails, etc. -- pretty much a lot of the very things you see with an underperforming thyroid. Or you'd eat even more to get the energy you need and more would be stored as fat -- resulting in that "unexplained weight gain" -- a symptom of hypothyroid.

So, to put this into an example, let's say your TDEE (or CO) should be 1700 or so per the normal CICO calculators. So, if you eat only 1400, you should have a 300 deficit and lose weight. But, let's say your body has this problem and can't fully access the 1400 for energy. Let's say your body can only access 1200 of the 1400 and the other 200 goes towards fat storage. So even though you're eating less than your CO, some is still going into fat storage (which wouldn't be the case with a normal person). Then your body compensates and drops your CO to account for the lower energy of only 1200. And how does the body do that? By lowering non-essential functions. What would those be? Things like awful fatigue, hair loss, lower body, temp, etc. And what are those? The exact symptoms of hypothyroid!! So now you have these horrible symptoms and you're not losing weight -- because that 200 is going to fat storage.

So, if you've got this going on, you just can't manipulate the CICO equation like normal people do. You can keep cutting, but you'll just feel worse and worse (and possibly develop worse issues and it can become dangerous). He said he found that most patients lost when they got into the 800-1000 calorie range, but they feel horrible, can't function like a normal person because of the fatigue, etc. and so that obviously isn't something he'd recommend. Instead, you've go to figure out why your body isn't metabolizing things correctly like a normal person -- whether that's from thyroid, insulin resistance, liver issues, etc. Then, you figure that out, you'll start responding to the normal CICO calculations.

That was exactly what I saw in my personal experience and something my doc says he sees over and over again in his practice and why he tested for all these potential accessory issues based on my symptoms. This to me makes a LOT of sense. But some CICO fundamentalists don't understand this difference and get into fights over the laws of thermodynamics. And this doesn't violate CICO at all -- in fact, it's totally in line with it. It simply means that the application is different with people with these issues because the assumptions are different about being able to metabolize all your CI for CO.

To me, this shows why people with medical issues may need to adjust strategies. Or the converse is true -- that those who aren't getting the expected results from the traditional CICO calculations, then it may be time to investigate if they have a medical/metabolic issue in play that they didn't know about. They definitely need to figure out the underlying issues and get them treated. And part of that may require diet changes -- such as eating more or less carbs --HOW they create a deficit may result in dramatically different results. This is exactly what led me to finding out about my issues. And it doesn't mean CICO is wrong or invalid, just that it can't be applied to someone with a medical issue in the same way it is to people without those issues.

Feel free to drop by the hypo boards. A lot of people there facing similar issues and a lot of knowledgeable folks. What I've seen is that it's incredibly variable for each person -- especially for those with Hashi's because it's an autoimmune disease. People half-jokingly refer to it as getting your "personal stars aligned".

I just know that if my accessory issues hadn't been found and I was only getting treated for thyroid, I'd still probably be struggling with weight issues as IR and vitamin d deficiencies can affect weight management significantly. And there are soooo many of us that struggle with docs that ignore our symptoms and tell us that's all the medication we can have because we're "within range". Finding a doc that look at symptoms in addition to blood tests was a huge win for me -- I find those that doc that have an integrative or functional approach tend to be more apt to this. Good luck and feel free to stop by the hypo group:

http://community.myfitnesspal.com/en/categories/general-diet-and-weight-loss-help