Weight Management Test

Aspects of weight management

Obesity is a growing epidemic ‐ the average person gains 1.5 pounds of fat every year. The Centers for Disease Control and Prevention report that 40 percent of U.S. adults are obese, with the highest prevalence of obesity occurring in men and women older than 40. Your metabolism is directly affected by your hormone levels, dietary patterns, stress levels, and your ability to maintain physical activity, muscle mass, and optimal nutritional status.

How the biomarkers measured impact your health

Your body composition changes naturally over time because of fluctuating hormone levels associated with age. Thorne's Weight Management Test measures hormones and other biomarkers that are important regulators of body composition, including maintenance of muscle mass and changes in body fat accumulation, metabolism, and energy levels. An imbalance in one or more of these hormone levels could be inhibiting your ability to lose weight or maintain your current weight.

Reproductive Hormones: Estrogen, progesterone, and testosterone

Estrogen (estradiol)

Estradiol is the most powerful and active form of the three forms of estrogen in the body. In addition to being important for bone health, fertility, and cardiovascular healthy, estradiol plays a role in how the body regulates weight and metabolism. In women, the level of estradiol declines normally with menopause or other conditions that alter ovarian function. In men, their estrogen level usually increases when the level of testosterone begins to decline.

Progesterone

In women, the hormone progesterone is released by the ovaries during ovulation. It is also produced to a lesser extent in the adrenal glands. In men, progesterone is produced in the testes and also in the adrenal glands. A progesterone level not in the normal range can result in bloating and food cravings. A person's progesterone level is also connected to thyroid function and the body's ability to convert fat into energy.

Testosterone

Regarding body weight, testosterone plays a role in both men and women, and it does so in several unique ways that sometimes appear to be opposite to one another. In men, a higher testosterone level is associated with more muscle, less body fat, and better insulin sensitivity; i.e., better metabolic health. In women, however, a higher level of testosterone is associated with worse insulin sensitivity and increased body weight. Despite these nearly opposite roles, testosterone is an important biomarker for both weight/composition and metabolism, and an optimal level is beneficial in both women and men.

Thyroid hormone

Thyroid Stimulating Hormone (TSH)

In addition to the sex hormones, Thorne's Weight Management Test measures TSH, a primary indicator of thyroid function. TSH stimulates the production of two other thyroid hormones, T3 and T4, which are responsible for regulating the speed at which cells work ‐ everything from how fast your heart beats to how fast your intestines process food. An underactive thyroid gland can slow down your body's metabolism, which decreases energy production and contributes to weight gain.

Blood Sugar Maintenance

Thorne's Weight Management Test measures insulin and hemoglobin A1C (HbA1c), two biomarkers of carbohydrate tolerance and blood sugar management.

Insulin

When you consume sugar, the hormone insulin is released from your pancreas to remove that sugar from the bloodstream and into your cells to be used for energy. However, any extra sugar not used for energy is stored and converted into body fat. Type 2 diabetes occurs as a result of insulin resistance ‐ the inability of the body to either use insulin effectively or to make enough insulin ‐ both of which results in elevated blood glucose levels. Being overweight can increase your risk of becoming insulin resistant or having an elevated level of blood sugar. And on the flipside, a high insulin level can contribute to you being overweight.

Hemoglobin A1C (HbA1c)

HbA1c is a measure of your overall blood sugar control and is used as a primary marker of risk for diabetes. The HbA1c test measures your average blood sugar over the past 3-month period by measuring the amount of hemoglobin in your blood that has glucose attached to it. Having a higher-than-average blood sugar level over this 3-month period will result in an elevated HbA1c level. Having an elevated HbA1c level increases your risk for insulin resistance, diabetes, and cardiovascular disease.

Vitamin D

Vitamin D has always been known for its capacity to support calcium absorption and bone health. More recently, an understanding of vitamin D's wider role in the body has emerged, which includes healthy immune function, maintaining a normal inflammatory response, supporting muscle structure and function, and supporting weight management. A low vitamin D level is associated with higher body fat and increased incidence of obesity. This is due in part to the fact that with more body fat, vitamin D ‐ a fat-soluble vitamin ‐ is taken up and stored in fat rather than circulating in the body where it can do its job. However, some studies also suggest that a low vitamin D level plays a role in the development of obesity and related health complications. Some data even indicates that in overweight individuals with low levels of vitamin D, supplemental vitamin D can help achieve a healthy weight.

Adrenal Hormones

Cortisol

Cortisol is a hormone secreted by the adrenal glands. Cortisol has wide-ranging effects on regulating metabolism, immune function, and the body's response to stress. An abnormal level of cortisol can have an adverse effect on appetite and body weight ‐ resulting in increased appetite and sugar cravings. Cortisol is often called "the stress hormone" because your body releases more of it when you are experiencing stress, are ill, or have a low blood sugar level. The level of cortisol fluctuates naturally during the day, with the highest level usually being in the morning to help you wake up, to enhance your energy and appetite, and to moderate your normal response to physical and emotional stress during the day. When your cortisol rhythm is altered, however, a wide variety of adverse health effects can be experienced, including mood changes, energy changes, altered immune function, and weight change.

Dehydroepiandrosterone (DHEA)

DHEA is also produced in the adrenal glands, as well as in small amounts in the ovaries and testes. As a precursor hormone, DHEA is converted to testosterone and estrogen in other tissues. DHEA balances the effect of cortisol on metabolism and can be especially important for age-related weight maintenance. The body's production of DHEA is in direct competition with its production of cortisol, because both DHEA and cortisol utilize the same hormone precursor known as pregnenolone. Typically, stressors such as traumatic events, illness, or other life-related events significantly decrease the level of DHEA, while increasing the level of cortisol.

The Science

• Liedtke S, Schmidt M, Vrieling A, et al. Postmenopausal sex hormones in relation to body fat distribution. Obesity (Silver Spring) 2012;20(5):1088-1095.

• Mellemkjaer L, Christensen J, Frederiksen K, et al. Associations of body composition measures and endogenous sex-steroid hormones among postmenopausal women. Open Obes J 2011;3:51-55.

• Goss A, Darnell B, Brown M, et al. Longitudinal associations of the endocrine environment on fat partitioning in postmenopausal women. Obesity (Silver Spring) 2012;20(5):939-944.

• Finkelstein J, Yu E, Burnett-Bowie S. Gonadal steroids and body composition, strength, and sexual function in men. N Engl J Med 2013;369(25):2457.

• Slemenda C, Longcope C, Zhou L, et al. Sex steroids and bone mass in older men. Positive associations with serum estrogens and negative associations with androgens. J Clin Invest 1997;100(7):1755-1759.

• Haffner S, Karhapää P, Mykkänen L, Laakso M. Insulin resistance, body fat distribution, and sex hormones in men. Diabetes 1994;43(2):212-219.

• Cohen P. Aromatase, adiposity, aging, and disease. The hypogonadal-metabolic-atherogenic-disease and aging connection. Med Hypotheses 2001;56(6):702-708.

• Blanchette S, Marceau P, Biron S, et al. Circulating progesterone and obesity in men. Horm Metab Res 2006;38(5):330-335.

• Zumoff B. Hormonal abnormalities in obesity. Acta Med Scand 1987;222(S723):153-160.

• Vermeulen A, Goemaere S, Kaufman J. Testosterone, body composition and aging. J Endocrinol invest 1999;22(5 Suppl):110-116.

• Gummesson A, Nyman E, Knutsson M, Karpefors M. Effect of weight reduction on glycated haemoglobin in weight loss trials in patients with type 2 diabetes. Diabetes Obes Metab 2017;19(9):1295-1305.

• Vigna L, et al. Vitamin D supplementation promotes weight loss and waist circumference reduction in overweight/obese adults with hypovitaminosis D. Presented at: European Congress on Obesity. May 6-9, 2015; Prague.