"Why can’t I lose weight? My diet is good and I exercise!"

You may be desperately trying to lose weight. You may be following all the usual advice: Your diet is good; You're exercising regularly; You're even doing a stress reduction technique regularly to keep stress at bay.

Still no weight loss -- or worse, the pounds keep piling on!

An under-active thyroid, also known as hypothyroidism, is a common cause of weight gain and inability to achieve weight loss during menopause.

Menopausal women are actually the group at highest risk of developing an under-active thyroid condition. 26% of menopausal women have an under-active thyroid condition.

What is hypothyroidism?

Hypothyroidism is a condition in which there is insufficient thyroid hormone levels to efficiently manage the metabolism. Thyroid hormones regulate your metabolism.

There is one system in your body that affects most of the other systems of your body - your metabolic system. Metabolism is the process the body uses to convert food into energy. Most of us think of metabolism as the rate at which we burn calories, but that’s only part of the story. Your metabolism feeds the other systems of your body with the energy, oxygen and nutrients they need to function effectively.

A decrease in metabolism leads to a decrease in the flow of blood through your body. Your blood carries energy, oxygen and nutrients to all of the cells and organs of your body. As your metabolism decreases, so does the supply of blood throughout your body. This diminishes the efficiency of all of the systems of your body.

It may be helpful to think of your metabolism as the “boiler room” of your body. As such, thyroid hormones affect nearly every cell, tissue, and organ in the body.

How hypothyroidism prevents weight loss during menopause

When your thyroid hormone levels are low, your metabolism slows down, which affects your weight in two ways:

1. Your body doesn't use all the calories from the food you eat for energy. It stores the calories not used for energy as fat on your body (as a future source of energy). Thus you gain weight.
2. Your body doesn't burn the fat on your body that it previously stored when you exercise. Thus you don't lose weight.

Furthermore, hypothyroidism causes insulin resistance. Insulin resistance is a condition where the cells of your body become insensitive to insulin. Insulin is the key that unlocks body cells to allow glucose inside. Glucose provides your cells with energy. Your body makes glucose from the food that you eat. When your cells won’t "open" for glucose, the glucose gets stored as fat. Insulin resistance also prevents fat loss and weight loss during menopause. Regular exercise will not burn fat and you will not lose weight.

Hypothyroidism and insulin resistance also increase physical and emotional stress levels. When you are under stress, your body produces cortisol, also known as the stress hormone. Protracted stress results in high levels of cortisol in your body. High levels of cortisol in your body causes your body to store more fat. It also prevents your body from burning fat. In the presence of high levels of cortisol, regular exercise will not burn fat and you will not lose weight.

How can you tell if you have an underactive thyroid?

The following checklist has been compiled from details provided by the Merck Manual, the American Association of Clinical Endocrinologists, and the Thyroid Foundation of America. It will help you to determine if you have an under-active thyroid.

____ I am gaining weight inappropriately

____ I’m unable to lose weight with diet/exercise

____ I am constipated, sometimes severely

____ I have hypothermia/low body temperature (I feel cold when others feel hot, I need extra sweaters, etc.)

____ I feel fatigued, exhausted

____ Feeling run down, sluggish, lethargic

____ My hair is coarse and dry, breaking, brittle, falling out

____ My skin is coarse, dry, scaly, and thick

____ I have a hoarse or gravely voice

____ I have puffiness and swelling around the eyes and face

____ I have pains, aches in joints, hands and feet

____ I have developed carpal-tunnel syndrome, or it’s getting worse

____ I am having irregular menstrual cycles (longer, or heavier, or more frequent)

____ I am having trouble conceiving a baby

____ I feel depressed

____ I feel restless

____ My moods change easily

____ I have feelings of worthlessness

____ I have difficulty concentrating

____ I have more feelings of sadness

____ I seem to be losing interest in normal daily activities

____ I’m more forgetful lately

I have also noted these additional symptoms which are reported more frequently in people with hypothyroidism:

____ My hair is falling out

____ I can’t seem to remember things

____ I have no sex drive

____ I am getting more frequent infections, that last longer

____ I’m snoring more lately

____ I have/may have sleep apnea

____ I feel shortness of breath and tightness in the chest

____ I feel the need to yawn to get oxygen

____ My eyes feel gritty and dry

____ My eyes feel sensitive to light

____ My eyes get jumpy/tics in eyes, which makes me dizzy/vertigo and have headaches

____ I have strange feelings in neck or throat

____ I have tinnitus (ringing in ears)

____ I get recurrent sinus infections

____ I have vertigo

____ I feel some lightheadedness

____ I have severe menstrual cramps

What should you do if you think you may have an under-active thyroid?

If this checklist leads you to believe that you may have an under-active thyroid, ask your doctor for a TSH (Thyroid Stimulating Hormone) test. If the test confirms that you have an under-active thyroid, your doctor may prescribe thyroid hormone replacement therapy to increase the levels of your thyroid hormones.

As the underlying cause of hypothyroidism in menopausal women is too little progesterone in your body relative to estrogen during menopause, the imbalance between estrogen and progesterone should also be addressed to achieve weight loss during menopause. If your doctor attempts to treat your hypothyroid condition just by increasing the levels of your thyroid hormones, it may not cure the condition because the imbalance between estrogen and progesterone will continuously disturb the levels of thyroid hormones in your body. Your doctor may also consider hormone replacement therapy to address this imbalance.

This post is reproduced with the permission of Menopause Matters.