I am a 45 year old pre menopausal woman. I do cardio five times a week and strength train almost every day. I am training for my first triathlon this month. At the gym where I work, we have a New Leaf Metabolic Analyzer. I know my RMR and my V02 max. I train in all my zones every week. Often times, I run in the morning and bike at night or swim and run, etc. My RMR is 2300 calories, and I try to eat 2700 a day. I weigh 159 pounds, but I want to weigh 140. I am 24 percent body fat. What more can I do? Am I eating too much or not enough? I am on hormone replacement therapy for testosterone, progesterone and DHEA. I have a thyroid condition and take cytomel and levoxyl. All of my hormones are in normal ranges.
Well, this is a great example of how there is more than one piece to the healing puzzle. You are learning, as is most of society, that just exercising and eating right sometimes just does not cut it. Exercise and nutrition are of course important, but you can see that there is more to your healing puzzle than just those things. There are a lot of questions within your question, so I will do my best to answer them all.
When it comes to being a triathlete, overtraining and being in some sort of adrenal fatigue comes with the territory. In the Textbook of Functional Medicine, Thomas Sult states that overtraining can actually decrease sIgA in the gut. This is our first line of defense against foreign invaders. Without it, we decrease the strength of our immune system, creating an environment for bacteria, parasites and fungus, which creates stress to the adrenal glands and can lead to hormone imbalances and so forth.
When it comes to triathlon training, the main goal should be adaptation to your many stressors. This might entail certain types of parasympathetic exercises, eating high quality organic foods, drinking plenty of water and eliminating most of the lighter colored Gatorade drinks (replacing them with electrolyte capsules), getting regular soft tissue work, working with a professional to get proper training, etc. This will allow you to train effectively. You will have homeostasis within and homeostasis without!
You need to get out of the mindset that doing more equals weight loss. This is not the case, and you are a prime example of this. When you overtrain or can’t adapt to the many stressors in your life, your adrenal glands become overworked. You can end up in one of three stages of adrenal fatigue (Stage 2 or 3 is very common in triathletes). When our bodies are stressed, we over produce hormones (typically cortisol) from the adrenal glands in order to reduce inflammation and handle stress. The adrenal glands get these signals from the pituitary. When the adrenals have to over produce cortisol, a process called “pregnenolone steal” happens. This is when pregnenolone (precursor) is stolen from producing DHEA, testosterone, estrogen and progesterone in order to over produce cortisol. From my clinical experience and testing, this is how most women develop what is called “estrogen dominance,” (i.e., not enough progesterone to counteract the unwanted affects of estrogen).
The problem with being estrogen dominant is that estrogen inhibits T4 to T3 conversion, overloads the liver, inhibits osteoclasts and increases water retention. These are all symptoms when progesterone is not there to oppose estrogen. Estrogen is produced and stored in fat cells, so the more estrogen dominant you are, the body converts more hormonal precursors (cholesterol and pregnenolone) to cortisol than to progesterone. Estrogen dominance leads to excess weight around the midsection and gluteal cleft area. (According to Charles Poliquin, this is where there are a lot of estrogen receptors.) The more estrogen you have or the more dominant you are with estrogen, the harder it is to lose fat. Besides this, cortisol is a fat storing hormone as well. Anytime cortisol goes up, so does insulin.
My recommendation is to treat your hormonal issues from the precursors down, not the end products up. Treating with DHEA and testosterone, with low precurors, typically will not do the trick. You might feel good when on them, but once off, you will be right back to where you started. As for the progesterone, that is fine, but you need to add pregnenolone into the mix, which is its precursor. You most likely have low testosterone and DHEA levels because of pregnenolone steal. I typically recommend bio-dentical progesterone over creams that are stored in plastic bottles. Plastic bottles contain a lot of xenoestrogens as well as synthetic solvents. Plus, you can actually measure how much cream is actually being absorbed into the body.
As for the thyroid issue, there are a lot of schools of thought that believe this is actually the byproduct of an adrenal issue. You have the HPA (hypothalamus-pituitary-adrenal) and HPT (hypothalamus-pituitary-thyroid) axis. The thyroid is the master gland of metabolism, and with stress and estrogen dominance, it actually slows down to protect the body, in simplistic terms. I’ve seen few results when treating it head on. Using holistic nutrition and lifestyle principles and aggressively balancing the adrenals and progesterone levels is what I have found works best to facilitate thyroid function.
Now with all this, what do you do?
- Follow holistic nutrition and lifestyle principles (organic foods, enough water, eliminating plastics, good sleep, right types and amount of exercise and so forth).
- Read The Metabolic Typing Diet by William Wolcott.
- Find a practitioner who can help you to balance your hormones with bio-identicals head on, instead of backwards.
Remember, our bodies are 3D representations of what is going on inside. So you must get healthy to lose weight, not lose weight to get healthy. Good luck!