Also- if her thyroid numbers are marginal she should find a doc that will treat the symptoms more than follow AMA guidelines.
Most MD type docs are too conservative.
Myself- I function best when my TSH is as low as possible. Below .5 for sure- sometimes close to zero. Also consider Armour thyroid instead of synthetic. Synthetic never worked for me- my numbers did not move greatly until I switched to the good old pig.

Ditto here re: low TSH (0.3 is my magic spot) and non-GENERIC hormones (for me it was the variability in the generic dosage that contributed; that and calcium limiting uptake). Lots of foods out there that don't play well with those of us who are hypo. AP

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"How bad could it be?" - SimpleS

There is no generic Armour- only name brand AFAIK.
At least in USA.
But I have read about when Armour changed and some of the tablets seemed to be light dosage, etc.

Over the years or plates that we purchase to eat off of have gotten larger. So, what used to fill normal plates in the past now look like the plate is empty.
So, purchase new plates or just only eat off the salad plates.

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Dave Campbell | Facebook | @DaveECampbell | h2ofun@h2ofun.net

Boom Nutrition code 19F4Y3 $5 off 24 pack box | Bionic Runner | PowerCranks | Velotron | Spruzzamist

Lions don't lose sleep worrying about the sheep

Here is how I would present it to my friend:

1) RELIGIOUSLY count calories and log every item of food/drink that goes in for a week. Run it through a macro nutrient and calorie app or program of some kind. This will tell you what is and is not going in her pie hole.

2) Consider a sleep lab study to see if she is actually sleeping at night or perhaps has undiagnosed apnea. This could be HUGE.

3) Bump up her fat intake, and drop carbohydrates to 100g or less per day for 6 weeks.

4) Drop the Crossfit stuff to 2x or perhaps 3x a week tops. 6x a week is just plain stupid. It's a cult of sorts that breeds over-training. Can be awesome if done A) less frequently and B) under the watchful eye of an experienced trainer. Two things the herd mentality at most boxes works against.

5) Get a full metabolic blood panel done. There is benefit in knowing how well her hormones are cascading (being produced and shuttled around the body).

You may want to wait until after the holidays to start with the diet modifications, she could very likely be a grumpy bitch if she tries to be careful during the "eating season".

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Dave Stark
dreamcatcher@astound.net
USAC & USAT level 2 certified coach

There is no difference between the variability of generic t4 and brand name. This is simply a marketing myth perpetuated by abbot to keep Synthroid selling . The FDA guidelines that dictate brand/generic equivalence are the same that dictate lot/lot variability of the brand name. So every new batch of the brand will vary as much as the generic. The biggest issue with t4 dosing is compliance with regard to taking it in a completely constant manner daily.

I only have the small plates in my house. The large ones that came with the dishes are either in basement ready for party or donated to charity.

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The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.

Well your quite the guy......................your recommendation is do not have friends that are over weight......how is that glass house?

I don't think there's an ejection handle to pull. This is a girl friend. Not a girlfriend. She's married (assuming not to IamIronman).

Correct, my.point exactly.

This. Thermodynamics is at play. If she was actually at a 1,000k/cal/day deficit she'd lose weight quite fast. Tell her to log EVERY LAST THING she eats for a week. As an aside, many/most processed and packaged foods have way more calories than their nutrition labels indicate. IIRC, the FDA gives companies variance and third party tests have often shown actual calorie content to be 15-25% higher.

I believe the part about about walking though. If she works in a hospital and is back and forth from parking to her offices to surgery to the cafeteria... it adds up.

This 100%
MDs tend to be the worst at telling others what to do and following their own advice. Your girl needs to get her head out of her ass and be honest with herself.

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DISH is how we do it.

Yes. Everything. Including vending machine junk, soda, candy, juice, chocolate, nuts, nut butter.... not just the main meals. Bet it will add up to a lot.

it's probably a buncha cortisol from being all stressed from her crazy ass job

Maybe she's having extra meals with her husband?

Just a guess,

twomarks

I would think it's more likely over-estimating calories burned. MyFitnessPal seems to over-estimate the value of exercise. Perhaps she should use something like MyFitnessPal but not put in her exercise.

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''Sweeney - you can both crush your AG *and* cruise in dead last!! 😂 '' Murphy's Law

I find that as well.

The one thing I tell patients when I talk with them about diet (most of mine are diabetic, hypertensive, high lipid folks) is that you have to keep it manageable and convenient. My only 2 rules for them are:

1. Don't drink your calories
2. If it comes in any type of packaging then it is likely not what you should be eating (meaning eat whole foods).

While there is a lot of debate on a calorie being a calorie, some people will metabolize calories differently (i.e insulin resistant folks and carbs for example). Cutting back on the crap will help her at least feel better.

Cutting 1000 kcal a day is moronic unless she is currently eating 2800+ a day. All that leads to is a decrease in her immune function, mental health and ability to be a nice person.

Having said that, my husband has an incredibly low metabolic rate that has been tested by 3 folks with identical results (his BMR is around 1100 for someone who is 6'3" and 195 currently). The only test that came back wonky was an incredibly low Vitamin D level, so he has to supplement that. I, on the other hand, am 131 lbs and exercise as much as he does, BMR of ~1400 and eat like a Sumo wrestler. The only way he can lose weight is to dial back his carbohydate and caloric intake. I don't seem to have that issue...so it isn't always true that men can drop weight and women gain.

The smartest person in my class in med school was at least a 100 pounds over weight. I watched her polish off a two pound bag of peanut m and ms during a 90 minute lecture. Later that day she was lamenting her weight problems and I heard her plaintively say, "I don't understand why I'm so fat, I hardly eat anything."

Your friend is eating way, way more than she is telling you. She may not be consciously aware of it or maybe she isn't paying attention. I would be willing to bet that she is eating 1,000 more calories per day than she takes credit for.

Another source of calories is stuff you drink. Juices. Mocha frappucinos. Cream and sugar in your AM coffee. I wonder what she is drinking throughout the day. I get zero calories from things I drink (except beer....). The only time I drink calories is fueling for training.

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Jason
None of the secrets of success will work unless you do.

This. Too much broscience going on here!

Broscience???/ Then what is a "Functional" medicine doctor??????? As another poster said, what is that................

I was agreeing to seeing a doctor, not which specific type. I am not in the medical industry so couldn't recommend which type. Given the subject is a physician herself she can probably figure out which type to see. A triathlon forum is not the place to try to solve someone's serious health issues.

Think you meant to put one of those question marks at the end of the sentence.

Gotta agree here.....dropping calories form your liquids is a great way to easily lose hundreds (if not 1000+) calories form your daily intake. Given her work hours, it wouldn't surprise me if she is drinking a lot of coffee (with cream and sugar) etc during the day.

People don't realize how many calories they consume in liquid form. It can be pretty shocking.

When I need to lose my offseason weight, I drop nearly all my liquid calories. I have black coffee in the AM and a single glass of vino at night. Beyond that, I drink club soda, water or a Cherry Coke Zero if I want something with flavor. That, combined with some adjustment in my portion sizes and the weight comes off relatively *easily*.

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Chicago Cubs - 2016 WORLD SERIES Champions!!!!

"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams

There is no info in this thread to base any sound advice on. All we know is she thinks she is 80 pounds overweight and you think she is only 50. Either one of you could be right, or you both could have a warped ideal of what her body can actually do.

How tall is she?
How much does she weigh?
What is her body fat percentage?

Has she ever been at a weigh she considers ideal?

How much did she weigh back when she was swimming?

As for what to do, I agree that if she really does have a 1000 a day calorie deficit, she is going to have a hard time having the energy to do any type of effective exercise especially given her work environment. You can't burn the candle at both ends.

that's good to know. it was a rec from my endo ages ago, so you're right it may not hold water anymore. thx for the info.

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"How bad could it be?" - SimpleS

Your friend is

(a) not on a diet (saying you are isn't being)
(b) not exercising.
(c) Not a Doctor of Medicine, therefore not a physician.

The accepted standard for gaining a pound of weight is 3500 calories.
To maintain her weight she needs 2,000 calories a day (sedentary lifestyle).
To gain 30 lbs in 18 months she had to eat 200 calories extra a day, everyday.

If she walks between 5 and 8 miles a day that's about 130 calories a mile, so 650 to 1040 calories extra
which means she's actually eating between 850 and 1240 extra calories a day.

If she is actually exercising (with sweat involved) 45 mins four times a week she might burn a further 450 calories per session.
Which means she is now eating close to 1300 - 1700 calories a day extra on the days she exercises.
(1300 calories is about 2 Big Macs with fries)

There's no magic, it's just math.
Eat what you like, when you like, how you like, with what you like on it.
It makes no difference. But do the math, the numbers don't lie, only people do.

(fixed it)