guidance on metabolism

Hi Anna, thanks for your question. Are you aware of what's causing the raised prolactin levels, as there are a number of causes and some of these could be causing the fluid retention, the increased appetite and the difficulty in losing weight. One cause is hypothyroidism and if this is the case then losing weight will be more difficult but possible with the right protocol i.e. certain nutrients to support the thyroid and it is also important to ensure you are eating enough calories to prevent your metabolism slowing further. In order to work out your BMR (Basal Metabolic Rate - the calories you need to function) you can use an online BMR calculator. You then need to account for your exercise level (the BMR calculator will tell you how to do this) and then you can minus this total by 500 to 1000 calories in order to lose weight. It is advised that you never eat less than 1200 calories a day. The other thing you mention is you really love bread and there is evidence to show that prolactin levels can be raised by gluten (collection of proteins found in wheat, rye, barley, triticale), particularly if you are coeliac. If you haven't been tested already I would ask your doctor to test you for coeliac disease (an autoimmune disorder where you have an adverse reaction to gluten). Even if it comes back negative you may still have a problem with gluten. This can sometimes be the case if you crave gluten containing products so you may benefit from doing a 14 day gluten exclusion, where you remove all gluten from your diet for 14 days and then reintroduce it three times on day 15. If you start to lose weight, your prolactin levels come down or you generally feel better during this 14 days and then things get worse when you reintroduce it this can be a sign that you have a problem with gluten and I usually advise that you remove it altogether. I would advise that you have further investigations done to determine the cause of the raised prolactin and then it will be easier to decide on a way forward. Good luck.

Hi Anna, thanks for your question. I agree with Elizabeth that having raised prolactin levels may be contributing to your fluid retention, increased appetite and difficulty in losing weight, therefore trying to find out and address the underlying cause is a priority.

In terms of dietary and lifestyle suggestions to try to help you to increase your metabolism: firstly incorporating more activity and/or exercise into your daily routine (with the approval of your doctor)
For example - setting yourself a goal of walking a number of steps per day and tracking your progress using your mobile or a sports watch, making time for some exercise (starting with a low intensity and duaration) such as swimming or cycling, and including an exercise session using weights (perhaps seek the help of a personal trainer to do this safely).
Secondly try making small changes to your eating habits -
For example - When considering your meal, divide the plate so that it’s: one quarter (palm-size portion) protein such as lean meat, fish, seafood, eggs, beans, peas or pulses, one quarter (palm-size portion) slow-releasing carbohydrates such as oats, brown rice, root vegetables, or sweet potatoes, and half (two palm-size portions) non-starchy vegetables such as leafy greens.
Cut down or avoid simple sugars (in fizzy drinks, sweets and chocolate and alcohol) to help keep your sugar cravings at bay, balance your blood sugar levels and to help you to lose weight. Reducing your portion sizes and eating little and often (every 3-4 hours) will also help with this.
Lastly, Keep well hydrated. Hunger can be confused with thirst. If you find that you’re constantly hungry, try having a drink and waiting ten minutes to see if you are still hungry before eating. Try sipping water or herbal teas between meals to stay well hydrated.

Hi Anna,

Thanks for your question.

As Elizabeth and Joanne have advised it is important that you seek to find out if there is an underlying cause for your raised levels of prolactin and at the very least rule out potential causes. This will provide a clearer picture for you to move ahead.

To support weight management I would echo the above suggestions provided by Joanne in relation to diet and exercise.

Building in relaxation time is also important as well as aiming for 7 - 9 hrs of sleep each night to support health and wellbeing. If you are getting less sleep than the required amount the stress hormone cortisol may be increased. Excess cortisol production is linked to promoting fat storage specifically around the middle.

Limiting fruits to 1 portion a day and opting for low sugar options including berries may help to avoid blood sugar spikes. Fruit is rich in antioxidants with many associated health benefits and also contains fibre, however as it still contains sugar and may be best eaten alongside a source of protein such as nuts/seeds or yogurt.

Aim to balance snacks/meals with a source of protein, slow release carbohydrate and good fats to support blood sugar balance. Aim to eat the rainbow including many different vegetables on a daily/weekly basis with each meal.

Best Wishes

Sharon