Teach my personal trainer about endocrine disorders!
August 5, 2013 8:47 PM Subscribe
Where can I find explanations of insulin resistance and Hashimoto's disease that I can give to my personal trainer (who does not have a background in biochemistry)?
I've recently been diagnosed with insulin resistance and Hashimoto's disease. I'm seeing my GP and an endocrinologist but maintaining a good diet, getting plenty of exercise, and getting my weight down are going to be important factors in getting my health to where I want it to be. Prior to the diagnosis I'd been going to a good gym that specialises in personal training. Over the last six months my fitness has increased exponentially, but my weight has remained constant. I've explained the diagnoses to my personal trainer, but it turns out that she's never heard of either of these conditions and has always thought that weight loss was about diet and exercise/ calories in and out.
I need a layperson's explanation of these two conditions that I can give to my personal trainer so she understands what I have (which might help us to train more effectively). I'm a scientist and am comfortable with the principles of biochemistry - I'm having difficulty finding something that would be a quick and easy (but informative) read for someone with no background in biochemistry. I also don't want to hand her a giant stack of papers - that just seems impolite!
In summary: where can I find concise explanations of insulin resistance and hashimoto's for a personal trainer with no background knowledge of biochemical principles?
I've recently been diagnosed with insulin resistance and Hashimoto's disease. I'm seeing my GP and an endocrinologist but maintaining a good diet, getting plenty of exercise, and getting my weight down are going to be important factors in getting my health to where I want it to be. Prior to the diagnosis I'd been going to a good gym that specialises in personal training. Over the last six months my fitness has increased exponentially, but my weight has remained constant. I've explained the diagnoses to my personal trainer, but it turns out that she's never heard of either of these conditions and has always thought that weight loss was about diet and exercise/ calories in and out.
I need a layperson's explanation of these two conditions that I can give to my personal trainer so she understands what I have (which might help us to train more effectively). I'm a scientist and am comfortable with the principles of biochemistry - I'm having difficulty finding something that would be a quick and easy (but informative) read for someone with no background in biochemistry. I also don't want to hand her a giant stack of papers - that just seems impolite!
In summary: where can I find concise explanations of insulin resistance and hashimoto's for a personal trainer with no background knowledge of biochemical principles?
This hits home for me, so I hope you don't mind if I talk about it on a very personal level. I hope it's helpful, but it probably isn't, so I apologize for that.
From your question you state that you have agreed with your medical team that a major factor in your continual health would be counteracting a genetic predisposition to insulin resistance and a complex variant of a mostly hypothyroid condition.
I recognize your tendency to intellectualize issues in your life since I struggle with the same thing on a daily basis, but perhaps it is worth considering that your personal trainer's job is not really affected by your diagnosis. I agree, it would be nice if basic endocrine and autoimmune conditions were part of general education.... but biochemistry and endocrine pathophysiology are largely irrelevant to their management of your training, since they don't need to administer insulin and wouldn't be qualified to treat, say, thyroid storm, not that there's any likelihood of that occurring.
Unless they are also serving as your nutritionist/registered dietician, your need to focus on complex carbohydrates, proteins, and healthy fats due to your susceptibility to hyperglycemia is also not really pertinent to their day to day.
If you're undergoing regular visits with an endocrinologist, and assuming your current energy levels are an accurate reflection of your TSH/T3/T4 levels, there shouldn't be any affect on your ability to exercise at a normal rate.
If that isn't the case, then it's a problem that needs to be addressed with your endocrinologist rather than your personal trainer, especially if you're taking any medications for insulin resistance that are giving you troublesome side effects.
All your personal trainer really needs to know, I bet they already have a good handle on. You've decided you need to build lean muscle mass and slim down your adipose reserve, like 99% of their clientele. Maybe this isn't what's going on with you, so allow me to project. I frequently feel the need to offer an excuse for a perceived lack of my gym progress, but body shame and guilt are common reactions that feed into a cycle of depression and despair, and they're misplaced outlets for that energy. When you begin to feel that way, abort it and try to focus on doing something productive that you can feel good about.
What you're doing is commendable, your continued progress is an exemplary testament to your iron will, and it's literally your personal trainer's priority number one to help rather than to judge you. You're doing better than the vast majority of people with those conditions by continuing to show up at the gym and doing your best. If you feel like your personal trainer is pushing you too hard and you want them to ease up, unless you're at risk of injury, they're doing their job properly.
In short, you should feel perfectly at ease stating briefly that you have several complex health conditions that makes it difficult for you to lose weight. If that feels too hand-wavy for you, you could say that your body has decided to attack your thyroid gland, which can make it hard to exercise and focus when it's under-treated, and that you are on the verge of developing diabetes (If you want to add the disclaimer that it's a largely genetic predisposition rather than a moral failing on your part, add to taste) and the significant variations in your blood sugar related to that are very unpleasant and frequently make you very tired, especially when you over-indulge or skip a day of exercise. But my opinion is that I don't think you should need to say any of that. If you've received the impression that your personal trainer isn't able to emphasize with clients who aren't triathletes, or isn't addressing your needs successfully, then you need a new one.
Lastly, if you happen to be anything like me, whenever you feel the shame spiral begin upon entering the gym, just try to remember that everyone there is fighting their demons, whether consciously or not, that you're all on the same team, and that in a nation with an lifetime prevalence of obesity that will likely pass 1 out of every 2 adults, you're doing extremely well to be addressing your issues by just showing up, and continuing to make the effort to exercise consistently. Best of luck.
posted by hobo gitano de queretaro at 12:17 AM on August 6, 2013 [3 favorites]
From your question you state that you have agreed with your medical team that a major factor in your continual health would be counteracting a genetic predisposition to insulin resistance and a complex variant of a mostly hypothyroid condition.
I recognize your tendency to intellectualize issues in your life since I struggle with the same thing on a daily basis, but perhaps it is worth considering that your personal trainer's job is not really affected by your diagnosis. I agree, it would be nice if basic endocrine and autoimmune conditions were part of general education.... but biochemistry and endocrine pathophysiology are largely irrelevant to their management of your training, since they don't need to administer insulin and wouldn't be qualified to treat, say, thyroid storm, not that there's any likelihood of that occurring.
Unless they are also serving as your nutritionist/registered dietician, your need to focus on complex carbohydrates, proteins, and healthy fats due to your susceptibility to hyperglycemia is also not really pertinent to their day to day.
If you're undergoing regular visits with an endocrinologist, and assuming your current energy levels are an accurate reflection of your TSH/T3/T4 levels, there shouldn't be any affect on your ability to exercise at a normal rate.
If that isn't the case, then it's a problem that needs to be addressed with your endocrinologist rather than your personal trainer, especially if you're taking any medications for insulin resistance that are giving you troublesome side effects.
All your personal trainer really needs to know, I bet they already have a good handle on. You've decided you need to build lean muscle mass and slim down your adipose reserve, like 99% of their clientele. Maybe this isn't what's going on with you, so allow me to project. I frequently feel the need to offer an excuse for a perceived lack of my gym progress, but body shame and guilt are common reactions that feed into a cycle of depression and despair, and they're misplaced outlets for that energy. When you begin to feel that way, abort it and try to focus on doing something productive that you can feel good about.
What you're doing is commendable, your continued progress is an exemplary testament to your iron will, and it's literally your personal trainer's priority number one to help rather than to judge you. You're doing better than the vast majority of people with those conditions by continuing to show up at the gym and doing your best. If you feel like your personal trainer is pushing you too hard and you want them to ease up, unless you're at risk of injury, they're doing their job properly.
In short, you should feel perfectly at ease stating briefly that you have several complex health conditions that makes it difficult for you to lose weight. If that feels too hand-wavy for you, you could say that your body has decided to attack your thyroid gland, which can make it hard to exercise and focus when it's under-treated, and that you are on the verge of developing diabetes (If you want to add the disclaimer that it's a largely genetic predisposition rather than a moral failing on your part, add to taste) and the significant variations in your blood sugar related to that are very unpleasant and frequently make you very tired, especially when you over-indulge or skip a day of exercise. But my opinion is that I don't think you should need to say any of that. If you've received the impression that your personal trainer isn't able to emphasize with clients who aren't triathletes, or isn't addressing your needs successfully, then you need a new one.
Lastly, if you happen to be anything like me, whenever you feel the shame spiral begin upon entering the gym, just try to remember that everyone there is fighting their demons, whether consciously or not, that you're all on the same team, and that in a nation with an lifetime prevalence of obesity that will likely pass 1 out of every 2 adults, you're doing extremely well to be addressing your issues by just showing up, and continuing to make the effort to exercise consistently. Best of luck.
posted by hobo gitano de queretaro at 12:17 AM on August 6, 2013 [3 favorites]
I had my thyroid taken out so I can comment on the thyroid portion. As long as your levels are right exercising shouldn't be different. If you have low energy you would have to talk to your endocrinologist . I have read from other people with no thyroid that low carb diets work very well for people with low and no thyroids . I haven't asked my doctor about it though. That's an endocrinologist question though.
Anyway your trainer shouldn't really have to do anything different in relation to your thyroid and exercise.
posted by majortom1981 at 4:46 AM on August 6, 2013 [1 favorite]
Anyway your trainer shouldn't really have to do anything different in relation to your thyroid and exercise.
posted by majortom1981 at 4:46 AM on August 6, 2013 [1 favorite]
Response by poster: Just a quick clarification:
1) My trainer has specifically said that she's interested in knowing more.
2) Any impact on training would be directed towards understanding plateaus.
I am meeting with an endocrinologist this week and am looking into seeing a dietitian. Mainly I'd just like advice on resources to help my personal trainer understand why we haven't seen weight results yet (which had confused both of us until now).
posted by Alice Russel-Wallace at 5:57 AM on August 6, 2013
1) My trainer has specifically said that she's interested in knowing more.
2) Any impact on training would be directed towards understanding plateaus.
I am meeting with an endocrinologist this week and am looking into seeing a dietitian. Mainly I'd just like advice on resources to help my personal trainer understand why we haven't seen weight results yet (which had confused both of us until now).
posted by Alice Russel-Wallace at 5:57 AM on August 6, 2013
Mary Shomon's written extensively about Hashimoto's disease; here's a brief article describing the intersection of Hashimoto's, insulin resistance, and weight loss.
posted by Iris Gambol at 1:10 PM on August 6, 2013 [1 favorite]
posted by Iris Gambol at 1:10 PM on August 6, 2013 [1 favorite]
An experienced exercise physiologist has the information you and your personal trainer need to shift your sessions' focus from fitness and weight loss to the role of exercise in the management of Hashimoto's and insulin resistance. Take a couple of educational sessions. Take your personal trainer along. (It could be a career move for her.)
Without doubt, both the endocrinologist and the dietitian will recommend exercise. Ask them if they can recommend someone ... maybe get a referral. The exercise physiologist will have some researched specifics. (Some) weight loss may ensue.
posted by de at 10:01 PM on August 7, 2013
Without doubt, both the endocrinologist and the dietitian will recommend exercise. Ask them if they can recommend someone ... maybe get a referral. The exercise physiologist will have some researched specifics. (Some) weight loss may ensue.
posted by de at 10:01 PM on August 7, 2013
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Here (for Hashimoto's disease) and here (for metabolic syndrome, which is probably more relvant than insulin resistance alone).
(By the way, both of these topics are properly filed under endocrinology and not biochemistry).
posted by scblackman at 9:25 PM on August 5, 2013