Fatigue and Belly Fat, Continued

After my last post, Q&A: Fatigue and That Pesky Belly Fat, I received a message from the member who originally wrote in with the question. I know there are a lot of people out there just like her, a middle-aged woman struggling with her weight and her thyroid, so I thought I’d post our correspondence for you all. She answered some of my questions from the post, and gave us more details about her situation.

Dear Neely,

Thank you so much for taking the time to respond so thoroughly. If you think it’s appropriate, you are welcome to post this for others.

I was so encouraged when I started the Paleo plan because I lost 10 pounds right away. I know that things have been complicated for me. I have always been super healthy and have kept my top weight at 135. Unfortunately, not eating breakfast, Baby Ruth bars and Funyons for lunch, and taco bell and hot dogs for dinner never seemed to affect me. (I’ve never been a fan of bread or potatoes… but I love sweets) However, about 2 years ago everything messed up in short order. I hit menopause. My thyroid was messed up. I gained 25 pounds in 5 months. High cholesterol. And the last time I went to the doctor… my blood sugar was high. Now I weigh 160 when I am stable (pretty much haven’t budged for 2 years). When my thyroid is off… I get up to 170. My healthy and comfortable weight is 135… but I’d be totally happy at 140.

To respond to some of your questions: I don’t drink alcohol or caffeine. When I am strictly Paleo I only eat what is on the menu. If I feel hungry I’ll have nuts or fruit… and sometimes dry cranberries if I need something sweet. I absolutely avoid all sugar and processed food except some bacon and sausage. I stay away from dairy… even if I have a little, I end up with zits!

When I read your post the other day, I bought some sweet potatoes. I simply microwaved it and sliced about a one inch piece and sprinkled some cinnamon and about one teaspoon of chopped pecans (yum!). I had it with my lunch (Pork cilantro tacos and salsa salad) and with my afternoon snack (Orange and almond butter). I drink a lot of water. AND, this morning I walked from the parking garage to my office instead of taking the shuttle… it’s about a mile. I did not hit the wall as hard as I usually do.

One thing that I will try is to split my breakfast. I usually feel pretty stable in the morning. Eggs, meat, a few nuts and a piece of fruit hold me pretty well and I don’t feel a crash… but I’ll spit it up and see if that keeps me stable into the afternoon. I’m generally not too hungry because the protein and fat keep me satisfied… but I don’t think its enough to keep my blood sugar stable.

In the past, I have done weight watchers successfully… but if I had a few points left… Midnight Milkyway here I come. I also did the F Plan which is high fiber low protein. I’m saying this because I do think I set myself up for needing more carbs… for me, now it’s making sure that I’m choosing good carbs.

Honestly, I’ve fallen off the wagon for a couple of days because I’m so frustrated. But, I know I feel sick when I eat sweets and hungry if I don’t eat protein and fat. I’m just tired of being so good and not losing an ounce and feeling super tired. I’ll recommit and add the sweet potatoes (which I really like) and eat as much as I usually do but split up the menu so that I’m eating every two hours. And, I’ll walk to work… weather permitting.

I’ll keep you posted! I hope it helps!

And my response to her…


Thanks for writing back and answering my questions. I know what it feels like to be frustrated with being so “good” and not losing any weight – I totally understand why you’d give up for a few days. I think that changing things up a bit with new foods and different carb/protein/fat proportions will help keep you interested. And great work on walking to work! It takes a lot of grit to make yourself exercise when you’re so tired.

I have a lot of faith that you will get to your goal weight, and that you’ll have a lot of energy once again. It might just take some time. Remember that stress can cause fatigue and weight gain, so try not to be too hard on yourself if your diet isn’t “perfect”, if you don’t exercise as much as society tells you to, and if you don’t weigh exactly what you want to weigh right at this moment. Experimenting with your diet can be fun, and it helps you understand yourself and how food affects you better. If the carbs in the morning don’t work the way you want them to, try changing something else up, like the amount of protein you eat.  If all that fails, I’d really start looking into food sensitivities testing.

As far as your carbs go, I highly suggest that you eat your sweet potatoes and other hefty Paleo carb sources as soon as you wake up in the morning (along with your protein and fat, of course).  Since you’re bonking in the afternoon, it makes me think that your breakfast is not sufficient, even though you say it keeps you satisfied.  If you’re exhausted in the afternoon, something is not right. The way you feed yourself when you wake up determines the rest of the day (and sometimes for days after that).  Eat the heavy carbs in the morning and then again maybe at mid morning or lunch.  It’s a good idea to eat heavy carbs in the first half of the day, anyway, because you have all day to use them up, as opposed to eating them at night when you’re just going to store them (potentially as fat).

The only other suggestion I have is that you go to a good naturopathic doctor in your area who can test all of your thyroid markers to see if the meds you’re on are actually appropriate. Most docs only test your TSH, but there are a lot of other physiological markers that a naturopath will test and then have you take supplements and pharmaceuticals for to correct. I’m not huge on pharmaceuticals, but sometimes when there’s profound tissue damage after so many years of abuse, your thyroid and other glands just can’t produce the hormones they need to produce. Plus, there are foods that can actually be more supportive of the thyroid, and you should look into those, too.

I wish you luck, patience and success, and I hope to hear from you for an update!



  1. I could be Barb, tho I don’t feel especially fatigued. But I am having trouble dropping the weight even tho I’m following the plan carefully. I’m not even having fruit at the moment and very little (occasional) sweet potato.

    But I don’t eat first thing in the morning. I know I’m supposed to but can you explain why I should? Then I might be able to make more of an effort.


  2. Yes, this is actually worthy of a blog post, but for now, I’ll do my best to sum it up. When people aren’t hungry in the morning, it’s usually because their blood sugar is whacked out. It’s gotten so low during the night that adrenaline and cortisol have kicked in and the result is nausea (or at least a lack of hunger). Are you having trouble sleeping, too? Because that’s another symptom of the blood sugar craziness at night. The only way to fix it is to start making yourself eat in the morning. Balanced blood sugar starts with a balanced meal in the morning which helps set the scene for your day (and into the next days).

    You should want to eat then – you’ve been fasting for 6-10 hours by that point and your body needs food to start the day off right. When you start eating in the morning and then keep eating regularly through the day (do what Barb is doing – half of your breakfast, then the other half 2 hours later, then lunch, snack, dinner) you’ll start to feel different and you’ll most likely start being hungry in the mornings. It shouldn’t take more than a week or two for the hunger to kick in after you start eating in the mornings.

    You might want to start adding some carbs like Barb to see if it jump starts some weight loss, too. The clincher here is that cortisol promotes belly fat in particular, so when you have that hormone coursing through your body so often (which you likely do), it’s not so good for weight loss. Good luck and let me know if you have any other questions.!


  3. I’m supposed to wait 1hr after I take my synthroid to start eating. I know you’re not a fan of medicine but I really doing want to stop taking it at this point because of how much better I feel. (I take it the second I wake up and I eat almost 60 minutes EXACTLY after I take my pill because I’m ravenous). Is an hr too much time to wait to eat after you get up?

    1. That’s a good point, and there are a lot of people out there in your position. An hour isn’t necessarily too long to wait for everyone, but since you’re ravenous after that hour, it’s too long for you. I suggest that you talk to your endocrinologist about changing the timing of your dose. The reason you’re supposed to take it in the morning is that some people (but not all) find they are kept awake by it if they take it at night. Talk to him/her about possibly taking it in the afternoon or evening. People have had success with that, even if it takes some time for their bodies to get used to the change.

      Some people even take it in the morning with their breakfast. That means that you’d have to get your TSH level tested after a while to see if it’s being absorbed correctly, and have your doc adjust the dose if it’s not. Taking it with food can affect its ability to be absorbed. Talk to your doc about that, too. You could also wake up an hour earlier just to take your pill and then go back to sleep every morning. Not advisable for your sleep patterns, but neither is low blood sugar…

  4. A little update… yesterday was my third day of adding the sweet potato a couple times early in the day, eating every two hours, and walking 1-2 miles per day. Because my sleep is so messed up… and I started thinking that I was having sugar highs and lows at night considering some things that Neely has said. I was even prepared to take a glucos read at my usual 2:30 awakening to see if my blood sugar was high or low… and I slept through it!I actually had a pretty good night sleep for the first time in awhile. It wasn’t perfect… but a little better than usual. I had my snack (small paleo muffin and a hard boiled egg) at about 6:00 last night because my husband was running late from work. I ate dinner around 8:00 consisting of a bunch of fresh green beans and a 6 oz. steak. It makes me wonder if my blood sugar was more stable through the night because I ate more before I went to bed?! Or, was it more stable because of what I was eating and how how often I was eating it throughout the day?! Hmmm.

    I don’t step on the scale until Sunday morning… no point in torchuring myself… I’ll keep you posted on that one.


  5. Good Morning – from the Pacific NW,

    I am new to this site yet, have known about Paleo eating for several years now. I say “known” because it has been mostly a long distance relationship! I knew it was a great idea just didn’t change my eating long term. Now, at 55 years young, I am ready to make the changes needed. I was dx’d with MS in 2002 and Ulcerative Colitis in 2003. Both are in remission these past 5 years, thanks to a non-tradtional med. So, you can see that for me avoiding inflammatory foods is crucial.

    Neely, thanks so much for your sound nutirtional wisdom! This is a bit off topic yet, could you recommend a good line of cooking pans? Cast iron are a bit heavy for me to handle. Stainless steel tends to stick so badly. Is there an green alternative to no-stick cookware?

    Also, for those post-menopausal who have trouble with metabolism and slow weight loss – I have found bio-identical hormones to have given me my vitality back! I plan to be on them for the rest of my life.

    I have been tracking my food with MyFoodDiary.com yet, I would rather pay your site to help me with my shopping, etc. and not spend time logging every bite I take. Thanks for such a comprehensive resource. I’m looking forward to the coming months and a new level of vibrant health! (I’ll be signing up tomorrow when I get my paycheck. :)

    1. Congrats on making the change, Jody!! Very good news, especially for someone with your conditions. I hope the diet does wonders for you!
      To answer your question about pans, yes, I use Green Pans. They’re the most non-toxic non-stick pans I can find, and they are REALLY non-stick. I think the coating is made of sand or something – I forget. Check them out. I got mine at Whole Foods, but they’re also at our Target. Hope that helps.


  6. My daughter has recently introduced this plan to me and I find it very interesting. I was curious though how someone could avoid eggs in this plan. Although I can cook with eggs, I don’t eat eggs.

    1. @Robin – Yes, you could certainly avoid eggs by replacing them with meat in the morning or things like tapioca starch or guar gum in baked goods. Just wondering, though, do you avoid eggs because of cholesterol reasons? If so, I can show you a hundred resources to prove the claim that eggs cause heart disease (or are even remotely related) is false. Just making sure…

  7. I also have hypo-thyroid, and take my medicine at night. I have been eating Paleo for about 4 months, and sometimes do wake up with nausea. I don’t eat first thing in the morning because I go work out, and if I eat, I feel really sick. So after reading this post about not losing weight, I’m just wondering if my cortisol is messed up too? I usually eat breakfast about 10:30 when I get home from the gym. Do you think this is really sabotaging me?

  8. I don’t eat eggs because they give me horrible stomach pains. Gas, bloating and nausea. I used to eat them all the time but gradually over the last 2 years I developed these reactions. At first, having an acid beverage like diet coke seemed to prevent the symptoms, but that no longer helps. Have tried acidophilus but that offered little help. Am considering trying paleo eating. Thoughts?

  9. Hi Neely,

    I’m so glad i stumbled across your site and especially this post! This could totally be me….i’m new to the Paleo world. I just completed my 30 day challenge, and honestly, i wish i could say that i felt great and like a new woman. I will admit to having very few sugar cravings, which is huge for me because i was a complete sugar addict! I ate Splenda with everything, literally, thinking that I was doing the right thing by staying away from sugar…I now know that I was doing more harm than good! I also don’t have the bloat and terrible yucky feeling after eating. So, i do see some positive changes. However, that’s where it stops. I lost 2 pounds during the first 4 days on the program, and was so excited, yet now at day 30, i am still down only those 2 initial pounds. I HAVE NOT BUDGED! I’m 5’8″ and 179 pounds:( I’ve gained 30 pounds in the past 1 1/2 years, and cannot seem to get it off, no matter what i do. I’m so sluggish and by 1:00 pm all i can think about is laying down on my couch! I do not sleep well AT ALL at night….fall asleep hard but wake up after about 2 hours and toss and turn the rest of the night. I have to make myself eat breakfast, not hungry at all, so now I’m wondering if my blood sugar is all out of whack too! I really didn’t think this was a problem, and on the mornings I didn’t want to eat, I just told myself that I would do an intermittent fast, which I thought was good. I have been eliminating almost all carbs from my diet, thinking that that was keeping me from losing weight. I may have 1 or 2 pieces of fruit a week, have only eaten a sweet potato once in 30 days, and for 90% of my meals only eat the protein and fat because I’m always on the go with 3 children, and the protein seems to be easier to just grab and go. I’m going to try today adding some sweet potatoes or more fruit to my diet to see if the increased carbs help.

    Also, just a little medical background on me…..I have never been diagnosed with hypothyroidism because my TSH levels are at the bottom of the “normal” range, but have every symptom of if! My father has it and I have been diagnosed with nodules on my thyroid that are benign, but according to my doctor, it’s all good. I also had gestational diabetes with all 3 of my children, each progressing so where with the last one i was taking insulin shots. Have a dad and brother with type 1 diabetes, so also a family history of that. I live in a small town and really think that a naturopathetic doctor would do me wonders, but I don’t have a clue where to find one….when i google that for my state, none come up. As you know, when you start talking to doctors on this way of life, they look at you like you’ve lost your mind. I’m a nurse, and it goes against everything I’ve been taught, but I’m smart enough to know that there’s something to this plan, and I’m willing to give it a shot.

    Thanks for listening to me ramble! It’s frustrating to feel like here’s another thing that is not working! I wish i could say that the feeling better was good enough for me, but as vain as this may sound, I really want the weight loss!! My last confession before i bore you to tears….I do drink coffee every morning, with heavy whipping cream for my creamer, and a teaspoon of Splenda. I know that it’s not good for you, but I have been so impressed with myself to getting it down to one tsp….i was putting about 4 in there!!!!! i have tried to drink it plain, but just cannot choke it down, and i really do not want to give up my coffee. is this really hurting me, and would it be better to use actual sugar instead of the Splenda?

    Thanks for all you do and any suggestions would be greatly appreciated!!

    1. Hi Jessica – Thanks so much for sharing your story. It’s helpful for people to see others’ real issues with the diet. Not everyone has an amazing transformation in 30 days’ time, so this is very true to life. Here are my two cents. I know you’re proud of yourself for having cut down on the splenda, but it may be triggering something in you neurologically that’s keeping the weight on. That may be part of the problem. I’d say cut it out completely and use stevia if you have to have something sweet. However, yes, I REALLY DO think it’s VERY possible that the coffee is affecting your sleep, and therefore your weight loss goals. Poor sleep alone can hinder weight loss because when you don’t sleep, your body has more cortisol running through it, causing inflammation and fat retention, among other things. Just try giving up your coffee and all caffeine for a month and see what happens. Drink herbal teas instead. I know it’s easier said than done, but during our 30 day challenge in January I can’t tell you how many people were shocked by how much better they felt after kicking the coffee habit. Here’s a blog post on that. http://www.paleoplan.com/2011/06-28/the-cruel-calling-of-coffee/

      Now, if you quit coffee and splenda and you still aren’t losing weight after about a month off of both, then write me back and we’ll troubleshoot. You could just be eating too much food. Also, are you exercising? Okay, good luck!

  10. Thank you so much for your advice. I will cut out coffee/splenda completely for 30 days and get back to you! To answer your last questions, I use a calorie counter on my phone to track my intake, and i’m averaging 1200 calories a day, some days less/more. Yesterday was a pretty average day for me, so i’ll give you my total for the day: fat 72.91 g, carbs 51 g (this is probably WAY more than i’ve been getting because i ate a sweet potato for lunch to see if upping my carbs would help), protein 82.85 g, calories 1,191. Also, I’m SLOWLY adding in exercise (weights & some form of cardio – usually sprints) maybe 2/week. I hope by the time i update you, I will feel energized to have increased that by a good bit!!

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