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Mary Shomon

Leptin, Thyroid Disease, and Weight Loss: What You Need to Know

By December 27, 2007

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Weight loss is a topic that is always of interest to the majority of thyroid patients. And one area of particular interest is leptin and the latest science on appetite control. For insights into leptin and some practical tips, I interviewed Drs. Richard and Karilee Shames, experts in thyroid and autoimmune disease, and authors of two popular thyroid-related books, ThyroidPower and Fat Fuzzy and Frazzled.

Mary Shomon: Can you give us some background on the hormone leptin as relates to weight loss?

Karilee Shames: Leptin is a hormone from fat cells that, in proper amounts, inhibits food intake and increase caloric burning.

It was not long ago that practitioners in our field were told that leptin would be a major magic bullet to help with weight loss. It was thought that certain kinds of leptin deficiency were responsible for obesity, and thus managing leptin would be a quick and effective solution. Then, researchers found that obese people have, surprisingly, a higher level of leptin. Then the focus shifted to leptin resistance as the culprit, and that hasn't panned out either. Currently, what can be said is that leptin plays the role of "messenger," informing the other organs about the state of fat stores. It's not clear whether it's worth attempting to intervene on and try to directly control.

Mary Shomon: Could you briefly explain the current thinking about leptin?

Richard Shames: To put leptin in perspective, take a quick look at just one array of endocrine signaling in the brain that controls body weight. These are the hormonal signals that mediate meal initiation, types of food intake, blood sugar and insulin levels, satiety (your sense of feeling full), meal termination, and level of fat stores.

"Just thinking about food," as you say in The Thyroid Diet, results in changes in hormone levels that stimulate appetite and salivation.

Here's the science: The stomach releases the peptide ghrelin, which further acts as an appetite stimulator and meal initiation signal. These changes result in increases in peptide Y and agouti-related protein in the arcuate nucleus area, along with the decrease here of alpha-melanocyte stimulating hormone. All this now results in a decrease of melanocortin-4 receptor, accompanied by a decrease in thyrotropin-releasing hormone. These activities also lead to an increase in melanin-concentrating hormone in the lateral hypothalamic area. The result: metabolism slows down and food intake increases. in an attempt to restore the previously burned-off fat.

Mary Shomon: So what does this mean to someone who wants to eat right to reach or maintain a healthy weight?

Karilee Shames: Well, first off, it seems to us that this impressive complexity is better optimized by eating three square meals a day. All these intricate hormone interactions and feedback loops might not be well served cranking up and cranking down six or seven times within fourteen hours.

Instead, the older advice of a smaller number of meals per day may lead to smoother function and fuller recovery time for your hard-working biochemicals. Also, eating at three regular and expected times a day means that when you're not eating, you're not thinking of food or planning when next to eat. And as noted, even thinking about food can trigger some of the chemical reactions.

This seems to be of definite help to large numbers of people because it is at the in-between times that our fabulous complexity can begin to rebalance and adjust itself better. We still have the bodies and chemistry of our ancestors who most likely ate quite intermittently, with long breaks between meals.

Richard Shames, MD graduated Harvard and University of Pennsylvania, did research at the National Institutes of Health with Nobel Prize winner Marshall Nirenberg, and has been in private practice for more than twenty five years. Dr. Shames practices holistic medicine -- with a focus on thyroid and autoimmune conditions -- and has for more than two decades been engaged in the search for answers about thyroid disease. Karilee Halo Shames RN, Ph.D. , Dr. Shames' wife, is herself hypothyroid, and is a Clinical Specialist in Psychiatric Nursing and a Certified Holistic Nurse with a Ph.D.. in Holistic Studies. The Shames are authors of two thyroid-related books, ThyroidPower and Fat Fuzzy and Frazzled?


The Thyroid Diet Weight Loss Center


Shomon, Mary J. The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss, HarperCollins, 2004

Zimmermann-Belsing, T, et. al. "Circulating leptin and thyroid dysfunction," European Journal of Endocrinology, Vol 149, Issue 4, 257-271

Photo: istockphoto.com

December 28, 2007 at 3:45 am
(1) Stacey says:

I have been battling Hashimotos, Celiac and just a bunch more that we had to figure out on our own with little help from many doctors. I have read all the books and every email sent through this web site. I wish Dr. Shames and others would make it more cut and dry to understand for those without Harvard medical degrees. I have 3 little ones that are all gifted with high IQs, but I however, am not fortunate to be in that catagory and wish to have some of it explained in a much easier way for me to understand on recommendations to help me. Even Dr. Shames books were terribly confusing since I fell into most catagories and was clueless as to what vitmamins, etc. to take in order for me to benefit from anything.
Lost and Frusterated,

December 28, 2007 at 4:06 am
(2) Sue Thompson says:

I have been battleing a weight gain of 3 stone following radio active iodine which reversed my thyroid problem to underactive.Having tried every diet going including a less than 900 cals a day I was unable to lose little more than a couple of pounds.I am sure everone knows the problem apart from the medics of course who are happy if T4 is within their bands of normality then it must be down to overeating. I have consulted a private endo who three months ago following every blood test available prescribed Rimonabant available here in the UK & Europe but not the USA. Sticking to the same diet plan (slimming World) I have lost 2 stone…could this be a wonder drug for underactive thyroid patients?

December 30, 2007 at 7:34 pm
(3) Gail says:

After leaving in SanDiego, Calif. for 5 years, my thyroid was diagnosed after drinking all the tap water there with the perchlorate in it….which is an endocrine disruptor. Thereafter we drank water only from Canada and have moved to the least toxic part of America in southwest Fla…..clean air, drinkable water and clean beaches!

January 24, 2010 at 9:20 am
(4) Tracy says:

I am particularly interested in the role of leptin. I think mine plays silly buggers with me. I am hypo, overweight (yet weirdly also have IBD too, usually you lose weight with that), can’t lose weight no matter what. Also have PCOS and hyperemesis gravidarum when pregnant. Apparently there are leptin links to these. Curious as to what is going on with mine!

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