Weight Loss

Unfortunately there is nothing trivial about weight loss. At Foreviva Medical Clinique we are completely aware of all the difficult challenges in achieving and maintain your weight. We offer medically supervised weight loss on a very personal level and are committed to helping you achieve your goal and reducing the health risks associated with excess weight.

HCG Protoccol

The HCG Protocol is not a diet ; diets are about what you can't have and what you have to do. If you go on a diet, sooner or later you are going to get off the diet..

Well-Woman Gynecological Visit

Dr. Osias is board certified in OBGYN and can perform well-woman exams as well as pap smears. Many of our patients find it tremendously convenient to have their yearly well-woman exam and other wellness exam done at Foreviva Medical Clinique.

HCG Newsletter

Many of you saw Dr. Oz's recent show on HCG and have questions. We are been getting a lot of requests for HCG so I wanted to share with you some more information about HCG. Although there are many opinions on the topic

Electro Slim Technology

Electro-Slim is an exclusive custom software program created by Madame et Monsieur that specializes in area-specific body sculpting through the use of skin contact electrodes.

Biophotonic Scanner

The recent study showing that skin carotenoids can be indicative of oxidative stress in the body is an important advance in antioxidant research and may potentially be the most important discovery with the Pharmanex BioPhotonic Scanner.

Food Allergies

In the last 3 years, there has been an evolving spectrum around Celiac Disease and Gluten Sensitivity. The acceptance of Non-Celiac Gluten Sensitivity (NCGS) in the medical community as a distinct clinical entity has gone from that of being an orphaned child crying in the world for recognition, to an accepted, unique component of the triad of gluten-related disorders.

Supervised Medical Weight Loss

Thank you for allowing us the privilege of being your coach and your guide in creating a healthier, more abundant life. We have helped thousands of men and women like you lose weight and keep it off. We are here listen. We know that together we can create a customized program that will ignite your fat burning genes and change your metabolism from that of a sleeping bear to an energetic, elegant jaguar.

As you know, diets don't work. Our program is about having more. More food to energize your body, your dreams and more fuel for a life of abundance.Food is not the enemy. It carries a message to your genes, your hormones and the chemical reactions going on in your body. Food is more than calories. It carries information that interacts with your unique biology to create the body that you see staring at you in the mirror. The messages the foods you eat give your body can be those that create health, energy, vitality and passion or the ones that createpain, fatigue, artery clogging cholesterol, fat and even cancer. You tell your body what to do by the choices you make about to put in your mouth. Your weight is not the enemy. It is only a mirror that reflects what is happening within…within your thoughts….within your metabolism…within your body. Your thoughts have the power to control your biology, your behavior and the way you experience your life. If you don't like what you see in the mirror, attacking the mirror won't change anything. It only keeps you stuck in self hatred, stuck in being stuck and looking for solutions in all the wrong places.

Losing weight requires more than information about the right diet. It requires a change in your relationship with yourself and your thoughts about your body. It requires love for yourself and gratitude for the body that you may now hate. It is through loving acceptance of yourself that you will manifest the body you want and the life of your dreams. You need a strong enough yes to say no to chocolate covered empty promises that are as filling as cotton candy. Your body is a sacred and magnificent gift through which you experience the magic of life, the blissful pleasure of chocolate as it melts gracefully on your tongue, the timeless beauty of a flower as it dances in the summer breeze, the warmth of the sun shining through your window, the tender kisses of your loved ones that maketime stand still. You are an unfolding work of perfection. You already are more than you could have ever dreamed of. The intelligence to achieve your perfect weight already exists within your body. The only decision you have to make now, and every moment of your life, is whether or not to let your beauty and magnificence to shine through. You can chose again.

You don't need to get to a certain number on your bathroom scale to be happy. You can chose happiness now. Today is a new day, filled with promise and possibilities. Celebrate your life. Say yes tothat little black dress, yes to dancing on a sandy beach, yes to living your best life now.Say yes to a leaner, younger, more passionate, more confident You!

Joelle Osias, MD

Our Medically Supervised Medical Weight Loss Program Features

  • Physician's care
  • Guidance on appetite management, and activity to lose weight.
  • Strategies to keep weight off using real food.
  • FDA approved appetite suppressants (if needed)
  • Lasting Results
At Foreviva Medical Clinique we are aware of the challenges you may have experienced in achieving andmaintaining a healthier body weight. We offer a personalized medically supervised weight loss that will help you shed those excess pounds and enjoy a better quality of life. Research now reveals that changes in body weight and shape are controlled by gene expression. We offer you genetic testing through Pathway Genomics that will allow us to accurately identify your body's needs so you can better understand your metabolism and which kinds of exercise will work best for you. Our goal is to improve your metabolism and increase your metabolism while helping to maintain your lean muscle. Some insurances will cover this test. Tofind out more, please give us a call and visit the website: www.pathwaygenomics.com.

We also offer the latest FDA approved appetite suppressants to as a bridge to help you control cravings as you adopt the lifelong habits that will empower you to succeed Today, there are two new appetite suppressants that can be a resource for you in accomplishing your goals: Beltiq and Qsymia. (Find out more by visiting the website Qsymia.com and Beltiq.com. For many, these medicationsprovide a practical and effective complement to behavior modification for long term and sustainable weight loss. We regularly monitor your progress, health and compliance. Whether your goal is to lose just a few or several hundred pounds, our comprehensive program and powerful tools will help you achieve your goals to avoid theall too familiar "yo-yo" effect.

Are you finding it difficult to lose weight even though you are watching what you eat and exercising?

If you are having a difficult time losing weight, there are a few tests that may help us unlock your body's ability to burn fat. You should be evaluated for thyroid resistance. The tests we order are free T3, Free T4, TSH, total T3, total T4, reverse T3, anti-thyroid antibodies and anti-thyroglobulin antibodies. If your thyroid function is suboptimal, losing weight can be extremely difficult. For more detailed information, please see our section on thyroid function.

Another cause of weight loss resistance is food allergies. Food allergies cause a great deal of inflammation and slow down your metabolism. The most common allergens are gluten, dairy, soy, peanuts and corn. To find out what your specific food allergies are, we offer the ALCAT test. This blood test will check for intolerance to 200 foods, 50 supplements and 50 food additives and environmental triggers. By removing the foods that you are most allergic to from your diet and restoring the function of your bowel, you will unlock your body's ability to lose weight. For more information, please check the website ALCAT.com. This test is covered by many insurance companies. Call us to find out if your insurance will cover this valuable test at www.alcat.com.

We offer pharmaceutical grade vitamins and supplements will complement your rapid weight loss program. Our vitamin and minerals in conjunction with our nutritional plan will help you increase your metabolism and the rate at which your body breaks downstored fat.

Your personalized weight loss regimen will be designed after a review of you medical history, physical exam and diagnostic test results.

Your first visit will include the following:

  • Consultation
  • Medical History
  • Physical Exam
  • Laboratory Analysis
  • Painless nutritional testing with Biophotonic Scanner
  • Blood Pressure
  • Weight and Body Mass Index
  • Appetite Suppressants (If indicated)
  • B12/BcomplexInjections
  • Weight Loss Diary
Your first visit will take approximately one hour.

Weekly visits will include the following:

  • Weight and Body Mass Index
  • Blood Pressure
  • B12/BcomplexInjections (if indicated)
  • Prescription Refills (if indicated)
  • Review and adjustment of treatment plan
Weekly visits typically take approximately 20 minutes.

Recommended Supplements

1. Fat Burner
Irvingiagabonensis. Irvingiagabonensis is a mango-like West African fruit; extracts of its seeds have been shown to reduce fat stores, and promote healthy blood lipid and fasting blood glucose levels (Egras 2011). Irvingiagabonensisextracts are thought to work by inhibiting, the development of fat cells by down-regulating a protein involved in activating fat cell growth and proliferation. Three randomized controlled trials have investigated Irvingia extracts in healthy volunteers; all have demonstrated its ability to significantly decrease body fat stores, weight, and waist circumference (Ngondi 2005, 2009; Oben 2008). When compared to placebo, healthy overweight and/or obese volunteers taking 150 mg of Irvingiagabonensis seed extract before meals for 10 weeks exhibited a significantly greater decrease in body fat percentage (6.3% versus 1.9%), body weight (28.2 pounds versus 1.5 pounds), and waist circumference (-6.37 inches versus -2.09 inches), as well as significant drops in total- and LDL-cholesterol, C-reactive protein, and fasting blood glucose (Ngondi 2009).

Sphaeranthusindicus and Mangosteen (Garciniamangostana). Mangosteen has long been used as a diabetic treatment in Southeast Asia; modern investigations suggest antioxidant and anti-inflammatory activities, especially in white adipose tissue (Devalaraja 2011). Sphaeranthusindicus (S. indicus) has been widely used in Ayurvedic medicine for a variety of ailments, and has been studied for its anti-inflammatory, blood sugar-lowering, and lipid-lowering activities in animal and cell culture models (Galani 2010). In a trial of 60 obese volunteers, 30 were randomized to receive 800 mg per day of the S. indicus and mangosteen combination for 8 weeks, while maintaining a restricted 2000 calorie per day diet and exercising (walking) for 30 minutes, 5 times a week. After 8 weeks, the group receiving the dual plant extract exhibited significant reductions in body weight (11 pounds versus 3.3 pounds for placebo), BMI (2.05 versus 0.5 for placebo), waist circumference (4.05 inches versus 2.02 for placebo), as well statistically significant reductions in total cholesterol, serum triglycerides, and serum glucose (Lau 2011).

2. Green Tea
Green Tea (90mg) in combination with caffeine (50mg) helps to increase your metabolism. When taken before meals, green tea helps to block fat absorption. Studies have shown found that 300mg twice a day of their Green Tea Phytosome formula in combination with a sensible diet (1800 calories for men and 1200 calories for women.) resulted in a 30lb weight loss in 90 days. This all natural formula can be an exciting part of your weight loss regimen. Try it today. Green Tea also helps to block fat aborption, when taken before meals) and increases your fat burning potential. Try our Green Tea Fat Burning Formula today.

3. Multi-Vitamins
A good multivitamin is an important part of your weight loss program. We recommend Lifepak essentials from Pharmenex. This pharmaceutical grade supplement will provide the micronutrients and vitamins you need to help shift your metabolism from fat storing to fat burning.

4. Berberine
This important plant extract helps to decrease your fat storing signals. Fat storing is under the control of a hormone that many of you have already heard about called insulin. Studies demonstrate that berberine has important benefits for glucose metabolism, maintenance of healthy lipid levels, insulin sensitivity, cardiac support, weight management, gastrointestinal health, oncology support, immune modulation, and cognitive support.*

  • Berberine is a powerful antimicrobial, and can benefit those with intestinal, yeast, or fungal infections*
  • Berberine has been shown to reduce hepatic fat content (fatty liver disease)*
  • Berberine helps to restore intestinal function*
  • Berberine has been shown to stabilize LDL cholesterol and blood sugar levels*
  • Berberine has a long history of safe use*
There has been a considerable body of technical research supporting the use of Berberine for:

Metabolic Support:In one pilot study and two placebo-controlled trials of subjects exhibiting signs of metabolic syndrome,Berberine (500 mg two to three times daily) helped maintain healthy cholesterol and triglyceride levels. Waist-to-hip ratio was decreased in women with polycystic ovary syndrome and insulin resistance.

Glucose Metabolism : Several two- to three-month studies demonstrateberberine at doses of 500 mg two or three times daily resulted in maintenance of healthy blood sugar levels, measured by fasting glucose, post-prandial glucose, and HbA1c

5. Acacia Fibre :
This is a healthy fiber that comes from acacia trees in sub-Saharan Africa. This fiber has many medicinal applications and helps eliminate many bowel symptoms. It helps promote a sense of fullness and regular bowel movements. This fiber is virtually tasteless and blends well into a shake or soup. The recommended daily allowance of fiber intake is 35g a day. With 3 tablespoons of acacia fiber a day, you will already be half way towards getting the fiber you need to stay regular and keep your metabolism working hard for you. Acacia fiber can be purchased directly from our office. For your convenience you can order your acacia fibre online 24 hours a day.

6. Omega 3 Fatty acids
Omega 3 fatty acids rich in EPA and DHA have beneficial effects on the body's ability to convert food to heat (thermogenesis). They block fat storing and enhance fat burning. Omega 3 fatty acids help decrease inflammation and restores your metabolic symphony so that you can effectively convert the food you eat to fuel for your muscles instead of storing it as fat. A high potency Omega 3 formula is available on mymetagenics.com/foreviva.

Exercise : 7 minutes to a Leaner, Younger, confident YOU!

Unfortunately, it is very difficult to exercise your way out of a bad diet. A double cheese burger has over 500 calories and you would have to run for over an hour to burn those. Bad food turns on your fat storing genes and give you the metabolism of a hibernating bear. Is that what you want for yourself?

There is increasing evidence to show that high-intensity interval training provides a lot of the fitness benefits of prolonged endurance training but in much less time. Research also shows that those who exercise are more likely to keep the pounds that they lose off. Now you don't need a gym membership, a personal trainer or even sneakers! Only yourbody weight, a chair and a wall.

The May-June issue of the American College of Sports Medicine's Health & Fitness Journal published an article about the new and wonderful 7-minute workout. The best bit? It requires no gym equipment whatsoever! All you need is a chair, a wall, and your own body weight; do each exercise for 30 seconds with a 10 second rest in between.

Scientists have discovered that the best kind of workout is one that concentrates on the following 12 exercises. Even only a few minutes of high intensity exercise creates molecular changes in your muscles that are similar to those created after running or riding a bicycle for hours! The following 12 exercises that make up the miraculous seven-minute workout do require brief intervals of rest in between each however, in order for the workout to be effective. Ten seconds of rest between each high-intensity exercise is the optimal length of time.

Powerful, yet simple eating plan :

The key to awakening your body's fat burning engine is in your mind, in your heart and ultimately in your mouth. You deserve more than dead food that is going to unleash a storm of inflammation and cravings and leave you feeling guilty, empty and fat. You deserve food that has the nutrition your body needs to power your muscles, your life, your dreams.

Weighing yourself every day is not going to change the number staring at you on the scale. The key to a loving the number on the scale is to chose a healthier lifestyle that will awaken the your fat burning genes. It is not just about losing weight, but changing your body composition. Our program will help you achieve and maintain your weight loss goals.

Our eating plan eating plan focuses on helping eat a balanced diet that will promote lean muscle and increase your metabolism. The first step is decrease the amount of fat storing foods (refined carbohydrates and fatty foods) that you eat. These include bread, rice, pasta. It is also important to avoid liquid calories like juices and sodas. At the same time, you will increase your protein, fruit, and vegetable intake. It will be important to take in protein with each meal to ensure that the your fat burning signals stay on throughout the day. Eating protein is very important to protecting and increasing your metabolically active lean muscle mass.

Our Program's Benefits

  • This powerful, comprehensive program is designed to help you achieve a healthy, lean body
  • Helps support and maintain lean muscles
  • Helps you increase healthy metabolism through targeted supplements
  • Promotes healthy weight loss for a healthier, leaner, younger you!
  • Helps improve your mood, reduce your cravings, reclaim

Frequently Asked Questions

1.What kind of results can I expect from the program?
Our program promotes healthy and sustainable weight loss. Many of our patients lose between 10-20lbs on the first month. Although the standard bathroom scale may continue to not change as fast as you would like, it is important to remember that losing lean muscles prevents you from keeping your weight off in the long term. Many weight management programs do not always differentiate between losing fat vs.lean muscle. We monitor your progress to ensure that you are losing primarily fat and not muscle. An unhealthy and overly rapid approach to weight loss will can lead to the loss lean muscle, your metabolic engine. Our progam helps you protect your lean muscle and supports your metabolism to help you tone and reshape your body and see a healthier, slimmer, youngerYOU.

2.Are there any foods that I should avoid?
  • No diet sodas
  • High Fructose Corn Syrup
  • Synthetic sweeteners like aspartame, sucralose
  • No liquid Calories
  • No Monosodium Glutamate

Food Allergies

So You Think you Know All About Gluten...
By Dr. Tom O'Bryan, DC, CNN, DACBN

In the last 3 years, there has been an evolving spectrum around Celiac Disease and Gluten Sensitivity. The acceptance of Non-Celiac Gluten Sensitivity (NCGS) in the medical community as a distinct clinical entity has gone from that of being an orphaned child crying in the world for recognition, to an accepted, unique component of the triad of gluten-related disorders.i Differentiating among gluten-related disorders, guides clinicians in making an accurate diagnosis and recommending specific dietary, nutritional and other medical advice; however, clinical and laboratory diagnosis is complex and evolving.ii

Gluten Sensitivity (GS) is a state of heightened immunological responsiveness to ingested gluten in genetically susceptible people. It represents a spectrum of diverse manifestations, of which, the gluten sensitive enteropathy known as CD is one of many. Adverse reactions to the toxic family of gluten proteins found in wheat, barley, rye, and their derivatives may trigger a heterogeneous set of conditions, including wheat allergy (IgE), NCGS, and CD, that, combined, affect between 10–35% of the population.iv,v,vi,vii


1. Even in the presence of negative small bowel biopsy, positive Endomysial antibody (EMA) IgA predicts development of CD.

2. The prevalence of CD varies by race/ethnicity, with a marked predominance among non- Hispanic whites.

3. With more sophisticated diagnostic markers now available, the majority of CD cases are being recognized.

4. Complete histological normalization of the small-intestinal mucosa occurs in the majority of adult patients after commencing a gluten-free diet (GFD).

5. An American College of Gastroenterology Task force recommends that patients presenting with diarrhea-predominant IBS type symptoms should be serologically tested for CD.

6. What percent of individuals with NCGS suspect they may have a problem with wheat?
A. 32%
B. 76%
C. 50%
D. 12%

7. Of the following three scenarios, which is the most dangerous for increased mortality in CD?
A. Total villous atrophy
B. Positive celiac serology with negative villous atrophy
C. Increased intraepithelial lymphocytes (IEL) with negative serology and negative villous atrophy

8. In differentiating wheat sensitivity from IBS, which one of the following features is significantly more frequent in wheat sensitive (WS) patients compared to IBS patients?
A. Anemia
B. Self-reported fructose intolerance
C. Weight gain
D.Self-reported lactose intolerance

9. Compared to patients with CD, what are the characteristic features, other than self-reported wheat intolerance, of patients with wheat sensitivity?
A. Anemia and family history of CD
B. Weight loss and increased IEL count
C. Coexistent atopy and food allergy in infancy
D. Increased serum C reactive protein and erythrocyte sedimentation rate

Current therapeutic protocols for CD, NCGS and wheat allergy include dietary counseling from a trained professional, nutritional therapy addressing biomarkers of malabsorption and creating a more balanced intestinal environment.ix Currently, there are no approved pharmaceutical treatments for this silent epidemic, however a number of Phase 3 trials are underway. Promising gluten-based research is currently being done including wheat alternatives and wheat selection, enzymatic alteration of wheat, oral enzyme supplements and polymeric binders as exciting new therapies for treatment of CD.

There appears to be at least two distinct groups of NCGS individuals. There are those who are sensitive to wheat and those who have multiple food sensitivities. Furthermore, the multiple food sensitivity group had a higher prevalence of coexisting atopy or food allergy in infancy.xi It is critically important to identify whether a NCGS individual has multiple food sensitivities or exclusively has NCGS.xii This suggests the world of NCGS is greater than just one mechanism and invites the Clinician to explore its pathophysiology.


1. True
2. True
3. False
4. False
5. True
6. C
7. C
8. A
9. C

Request the complete article, complete answers and references by sending a request to info@theDr.com

Child Obesity

Electro Slim Technology

What is Electro-Slim Technology?
Beauty Through Muscle Rehabilitation & Fat Reduction

Electro-Slim is an exclusive custom software program created by Madame et Monsieur that specializes in area-specific body sculpting through the use of skin contact electrodes. The electrodes deliver waves of pulses with a repetitive variable pulse frequency to specific targeted areas to sculpt and reshape the body. These pulse waves produce rhythmic and powerful muscle contractions that result in both muscle rehabilitation and rapid fat reduction. The personalized nutritional program coupled with the passive exercise of particular muscle groups breaks down adipose tissue while simultaneously increasing blood circulation, resulting in localized tissue reduction, improved health and longevity.

Recommended treatment: One (1) hour session, 2 to 4 times per week based on your desired results. Electro-Slim Technology is a doctor recommended therapy (FDA approved equipment) with no side effects, only total health benefits. Finally, eliminate those "hard to reduce trouble spots" and create the body you always wanted with the Electro-Slim program.

Biophotonic Scanner

What is the Scanner?
"The recent study showing that skin carotenoids can be indicative of oxidative stress in the body is an important advance in antioxidant research and may potentially be the most important discovery with the Pharmanex BioPhotonic Scanner. These findings should encourage consumers to know their score and increase their consumption of more fruits and vegetables while continuing to supplement."

Your Scanner Score


Weight loss packages

click here to download pdf

Learn more about the biophotonic scanner

HCG Protoccol

The HCG Protocol is not a diet ; diets are about what you can't have and what you have to do. If you go on a diet, sooner or later you are going to get off the diet.. Our goal is to tap into your body's natural genius and eliminate the underlying causes of weight gain. The purpose of the HCG Protocol is to improve your metabolism, detoxify your body, and educate you about how different foods affect your body. Your body will then be able to use its natural intelligence to create and maintain your ideal body weight.

The HCG Protocol was first developed by Dr. Simeon in the 1950's. It is short – 39 days – and strict, yet it is simple. It is not for everyone. The HCG Protocol, however, when administered under medical supervision, is an effective and safe method of weight loss and metabolic improvement for people who otherwise cannot lose weight.

If you are interested in learning more about the HCG Protocol, and if it is a good option for you, please call our office at 650 843-0600 to schedule a consultation. To help you learn more about this treatment, take a look at some Frequently Asked Questions on the HCG Protocol below:

1.What is HCG?
HCG (Human Chorionic Gonadotropin) is a hormone that is produced in high amounts during pregnancy to allow the fetus to survive. The HCG hormone plays a vital role in providing nutrients to the growing fetus. HCG is commonly used in the treatment of women with fertility problems.

2.Is HCG safe?
HCG is FDA approved. The HCG Protocol is a safe and effective method of weight loss and metabolism improvement for those individuals who cannot otherwise lose weight. The protocol should be administered under medical supervision.

3.How does it work?
In the protocol, HCG is used once each day in combination with a strict, very low calorie diet (VLCD) of 500 to 700 calories. The HCG is believed to act as an appetite suppressant and allow the body to tap into and use stored fat as a source of energy and nutrition.

4.Is it safe for people with diabetes and other health conditions?
Yes. Under medical supervision the protocol has been shown to improve the disease process, decrease the need for medications and in some cases, even eliminated the need for medications. Diabetes, hypertension, elevated cholesterol are among some of the disease processes that this has worked for.

5.Do I need special foods for the protocol?
There are no special foods required for the HCG Protocol. You may eat the regular proteins and fruits and vegetables you normally would. All foods should be 100 percent organic.

6.What are the benefits of following this diet?
Sustained weight loss and an improvement in your metabolism over a short period of time. For patients with chronic medical conditions like hypertension and diabetes, a decreased need for medications can be another benefit.

7.How much of a commitment is the diet?
The HCG Protocol requires a 100 percent commitment from the patient during the entire 39 days of the program.

8.What type of results can I expect to see? How soon?
Patients on the HCG Protocol can expect, on average, a weight loss of a half pound a day. At the conclusion of the 39- day program, most patients experience an average weight loss of 15-20 pounds that is sustained.

9.What are some of the side effects?
Infrequently, some patients experience temporary side effects of hunger without starvation, dry skin, constipation, and very rarely reversible hair loss. During the 6 years I have been administering the HCG Protocol to my patients, I have seen any long-term side effects.

10. Can I use the over the counter liquid HCG Diet I've seen advertised?
HCG drops that can be purchased online or in retail stores are not recommended. Many of these products contain the usual ingredients found in over-the-counter weight loss supplements: caffeine, arginine, green tea, guanine, etc. However, none include the actual HCG hormone.

Your HCG diet experience at our clinic will be customized to best help you meet your weight loss goals. Eating is about more than calories…. It is an act of self love. From now on, chose to feed the beautiful, happy, sexy, confident YOU!

NOTE: This is not associated with telemarketer Kevin Trudeau. HCG is not approved by the FDA for weight loss. However, HCG has been used safely and effectively in thousands of patients. It is not for everyone and the protocol must be followed strictly as recommended.

HCG Weight Loss Program

Weight accumulation is a significant medical condition and cannot be treated by an inexperienced "Diet Counselor" in some corner diet center with a "one size fits all" kind of program.

click here to download pdf

Why are vitamin B12 shots getting so popular?

These vitamin injections are used to:
  • Increase Energy
  • Boost Metabolism and Increase Fat Burning
  • Improve Skin Texture and Tone
  • Improve Mental Cognition and Nervous System Health
  • Decrease Headaches
  • Balance Hormones and Decrease Symptoms of PMS
  • Improve Mood
  • Reduce Stress and Support Adrenal function
  • Boost Immune system
  • Boost Detoxification Pathways
B12 is a great energy boosters. It works through the red blood cells, by enabling them to carry oxygen more efficiently. B12 is also great for the skin. These are just some of the benefits – overall, it's an essential vitamin that the body must have to stay in balance. The only problem is that it is not that easily found in food – very few foods are B12 rich and these are essentially meat and eggs. This leaves especially vegans to look for sources elsewhere, in fortified foods, supplements or vitamin B12 shots. Shots are a preferred option because of their direct and immediate absorption into the bloodstream.

Lipotropic (MIC) B12injections
with added B6, B12 and B complex. These injections contain lipotropic fat burning amino acids (methionine, inositol and choline) that play and important role your fat burning and weight loss program. These amino acids help your liver process fat and excrete fat soluble toxins to help with weight loss, detoxification and balancing your hormones.

Ultra Flora IB

Did you know that your bowel bacteria are an important source of vitamin B12. Studies have shown that people who are overweight often have an imbalance in the bacteria that normally live in the gut. This can often be due to a poor diet, or more commonly, treatment with antibiotics. Abnormalities in your gut bacteria can also increase your risk of bladder infections and recurrent vaginal yeast infections. This great probiotic formula provides 60 billion friendly bacteria that help relieve abdominal discomfort, bloating, cramping, bowel irritation, and occasional urgent bowel movements.*Ultraflora is an important part of your weight loss regimen. You can purchase a bottle directly on our website: foreviva.mymetagenics.com

Raspberry Ketones
Raspberry Ketones are responsible for Raspberry's wonderful flavor. They are considered to be among the latest and most revolutionary way to lose weight. Concentrating this flavor component requires capturing the goodness of pounds of Raspberries in a single capsule. This herbal concentrate improves the effect of a very special hormone called adiponectin. Adinopectin is a hormone that helps control the amount of fat that is stored in your fat cells. Boosting your levels of adinopectin will rev up your fat burning engine naturally. Many of you learned about Raspberry ketones from Dr. Oz. This product is safe, made only with natural ingredients, and have no reported unwanted side effects . The compound has been designated as "generally safe" by the FDA for over 50 years.

Green Coffee Extract
Green coffee extract is rich in a special polyphenol called cholorogenic acid. Taken before meals, this supplement uses a powerful, approach that, when combined with a healthy diet and regular exercise, will help you achieve maximum weight loss. One study released in January 2012, found that both men and women lost a mean of 17.6 pounds—more than 10% of their body weight—after only 12 weeks of supplementation. They also experience an average 4.44% reduction in their body fat.

Well-Woman Gynecological Visit

Dr. Osias is board certified in OBGYN and can perform well-woman exams as well as pap smears. Many of our patients find it tremendously convenient to have their yearly well-woman exam and other wellness exam done at Foreviva Medical Clinique.

Menopausal Care

Menopause, is a normal stage also known as the "Change of life", when the reproductive lifecycle, and when her monthly period stops. Every woman goes through at some point in her life. Normally menopause occurs mid forties and fifties, where the ovaries stop making estrogen. A woman who has no periods for an entire year after the age of 45 is considered to be in menopause. Going through menopause may take one to two years. After menopause, a woman is no longer fertile and able to become pregnant naturally. During this time, women can experience a number of changes, to include hot flashes, fatigue and more.

The Menopause symptoms include:
  • Irregular periods
  • Hot flashes
  • Weight gain
  • Vaginal dryness
  • Loss of libido
  • Mood swings
  • Sleep Apnea
  • Trouble focusing

If you are experiencing some of the symptoms of menopause, please inquire about the ways we can help so you can look forward to making these some of the best years of your life.

At Foreviva Medical Clinique, we have in depth knowledge and experience in treating menopause. We are here to provide you with guidance and a variety of care options, including hormone replacement therapy, as you enter this new phase.

If you would like to learn more about the benefits of our menopause treatment plan, please contact us for a consultation.

Cardio Workout

Cardio workouts are indispensable to an effective training program and general good health. By definition, cardio workouts can be any exercise-jogging, running, biking, swimming, elliptical machine, stairs, even jumping rope-that raises and maintains your heart rate over a predetermined amount of time. By doing so, you strengthen your heart and lungs and lower your resting heart rate, which means that over time the same effort that produced a 10-minute mile will produce a 9-minute mile.

The personal habits of people who successfully achieve and maintain their exercise goals are as follows.

Aerobic exercise
The basis for improving fitness is to strengthen the cardiovascular (CV) system. This means that the heart muscle needs to become stronger and the vascular system more healthy. This improves the systems capability for pushing oxygen rich blood around the body with relative ease.

Exercise Guide Lines
The American College of Sports Medicine is the largest, most respected sports medicine and exercise science organization in the world.

Thyroid Hormone

Get your thyroid hormones optimized
We specialize in thyroid optimization with T4/T3 combinations and straight T3 and treat all types of hypothyroidism, including standard (primary), secondary (pituitary dysfunction), tertiary (hypothalamic), which result in normal or low TSH with sub-optimal T4 and T3 levels, low T3 syndromes, poor conversion of T4 to T3, high reverse T3 (Wilson's syndrome), thyroid receptor resistance syndromes, which results in hypothyroidism with normal thyroid blood levels, difficult thyroid cases. Patients fly in from all over the United States and the world for treatment of thyroid disorders.

Have You Been Told Your Thyroid is Normal?

New, better test is now available through our office to accurately determine your thyroid hormone levels.
Common complaint: I've been told my thyroid is normal, but I still suffer with symptoms of a low thyroid... These symptoms include:

  • Fatigue
  • Difficulty Losing Weight
  • Depression
  • Body Aches
  • Low Libido
  • Cold all the Time
  • Water Retention
  • Dry Skin, Eczema
  • No Relief from my Treatment for Chronic Fatigue Syndrome, Fibromyalgia PMS, or Menopause
  • Diffuse Hair Loss or dry hair
  • Cold extremities
  • Constipation
  • Poor memory
  • Poor concentration
  • Anxiety
  • Weakness
  • Pale skin
  • Shortness of breath
  • Palpitations
  • PMS
  • Heavy menstrual flow
  • Muscle or joint aches
  • Poor motivation

Fatigued, depressed, difficulty losing weight..?

It may be due to your hormones

Since the endocrine system is devised of glands that produce and send hormones to all areas of our body to regulate the essential functions of our body like temperature, reproduction, growth, immunity, and aging, it stands to reason that this should be the hub of vitality, longevity and well being. Many individuals are getting remarkable results from having their hormones optimized. Specialized hormonal testing can be utilized to bring the hormones into optimal ranges. Many people are finding that common problems of fatigue, depression and difficulty losing weight can be completely reversed by physicians that specialize in hormone optimization and age management medicine. Individuals often suffer for years being told that their thyroid, testosterone, estrogen, progesterone and adrenals are fine, but these doctors are finding that these levels are actually low and need to be supplemented, often with remarkable results. Standard blood tests only pick up the sickest 2.5% of the population.

Many of the common complaints that rarely get addressed by standard medicine can be remedied by hormone optimization. These include complaints such as, I can't lose weight like I use to…I don't get as much results from working out as I used to…What happened to that feeling of well-being…I feel depressed…My body aches… My skin is dry and rough…My joints hurt…I am aging faster than I would like…I sure get tired easily…I feel cold all the time…My libido is shot…My hair is thinning…I don't feel right…My nails break so easily…I get sick easily…I get frequent headaches… My muscles are sore…I seem to retain water…I'm always constipated…I don't feel like I used to…I have PMS…I have lost my motivation…I am being treated for depression but I'm still depressed… I'm not getting much relief from my treatment for chronic fatigue syndrome or fibromyalgia…I'm being treated for hypothyroidism, but I'm still tired.

Two of the biggest problems are low thyroid for women and low testosterone for men. So many women who are told over and over that their thyroid levels are fine, actually have severely low thyroids levels that are not picked up by the standard TSH and T4 testing, which is the only testing done about 90% of the time. TSH is secreted by the pituitary in the brain, telling the thyroid to secrete T4, which is not the active thyroid hormone. T4 must then be converted in the body to the active thyroid hormone T3. When T4 and T3 levels drop, the TSH should increase indicating hypothyroidism. This is the standard way to diagnose hypothyroidism. There are, however, many things that result in hypothyroidism but are not diagnosed using the standard TSH and T4 testing. This method only reveals a few of the very sickest patients, leaving the majority of patients undiagnosed. Many people, especially women, do not adequately convert T4 to the active T3, resulting in low levels of active thyroid hormone and symptoms of low thyroid with a normal TSH. Also, there is another problem in that T4 cannot only be converted to T3, but it can also be converted to reverse T3, which is inactive and blocks the thyroid receptor.

Very few practicing physicians, including endocrinologist, are aware this because it was not taught in medical school, but it contributes to low tissue levels of thyroid in a significant percentage of patients with symptoms. Again, this is missed by standard testing. This is an evolutionary enzyme that increases the T4 to reverse T3 in times of stress. This worked well for our ancestors because it improved survival in times of famine and stress by decreasing the metabolic rate (metabolism). But in our modern society, reverse T3 works against us causing fatigue, difficulty losing weight and all the other symptoms of hypothyroidism. Reverse T3 can also be increased with dieting (often responsible for the quick weight gain after losing weight) as well as with physical and emotional stress. Low thyroid not only results in undesirable symptoms, but it also increases the risk of heart disease and cancer. Consequently, bringing the thyroid to optimal levels not only makes a person feel better, but is also results in significant health benefits, as well. So many people have been going from doctor to doctor thinking their thyroid is low, only to be told it is fine over and over. When more extensive testing is done so many individuals are relieved to be shown that their thyroid is truly low or sub-optimal and that they can expect to be feeling better soon.

A recent study in the medical journal Archives of Internal Medicine found that women with low normal thyroid (sub-clinical hypothyroidism) are 70% more likely to have arthrosclerosis (hardening of the arteries) and over twice as likely (200% increase) to suffer a heart attack. This low normal thyroid that is going untreated is not only resulting in millions of women unnecessarily feeling fatigued, depressed and being unable to loss weight, along with all the other symptoms of low thyroid, but it is also resulting in heart attacks and deaths that could easily be prevented

Reverse T3 Suppresses T4 to T3 Conversion

Endocrinology 101(2):453-63
A study of extrathyroidal conversion of thyroxine (T4)to 3,3',5-triiodothyronine (T3) in vitro

Chopra IJ

Most endocrinologists believe that reverse T3 (rT3) is just and inactive metabolite with no physiologic effect, which is not the case, however. This study and subsequent others demonstrate that rT3 is a more potent inhibitor of T4 to T3 conversion than PTU (propylthio­uracil), which is a medication used to decrease thyroid function in hyperthyroidism. In fact, rT3 is 100 times more potent than PTU at reducing T4 to T3 conversion. Clearly, rT3 not just an inactive metabolite. The authors conclude, "Reverse t3 appeared to inhibit the conversion of t4 to T3 with a potency which is about 100 times more than PTU…"

Thyroid Studies

The Journal of Clinical Endocrinology & Metabolism 2005; 90(12):6403–6409 Thyroid Hormone Concentrations, Disease, Physical Function and Mortality in Elderly Men Annewieke W. van den Beld, Theo J. Visser, Richard A. Feelders, Diederick E. Grobbee, and Steven W. J. Lamberts Department of Internal

This study of 403 men investigated the association between TSH, T4, free T4, T3, TBG and reverse T3 (rT3) and parameters of physical functioning. This study demonstrates that TSH and/or T4 levels are poor indicators of tissue thyroid levels and thus, in a large percentage of patients, cannot be used to determine whether a person is euthyroid (normal thyroid levels) at the tissue level. In fact, T4 levels had a negative correlation with tissue thyroid levels (higher T4 levels were associ­ated with decreased peripheral conversion of T4, low T3 levels and high rT3). This study demonstrates that rT3 inversely correlates with physical performance scores and that the T3/rT3 ratio is currently the best indicator of tissue levels of thyroid.

This study showed that increased T4 and RT3 levels and decreased T3 levels are associated with hypothyroidism at the tissue level with diminished physicial func­tioning and the presence of a catabolic state (breakdown of the body). This study adds to the mounting evidence that giving T4 preparations such as Synthroid and Levoxyl are inadequate for restoring tissue euthyroidism and that a normal TSH cannot be relied upon as as an indication of euthyroidism, as it has a very low sensitivity and specificity for hypothyroidism. This poor sensitivity and specificity is further decreased with the presence of one or more systemic illnesses, including diabetes, heart disease, hypertension, systemic inflammation, asthma, CFS, fibro­myalgia, rheumatoid arthritis, lupus, insulin resistance, obesity, chronic stress and almost any other systemic illness.

Low T3 syndrome, with low T3 and high reverse T3, is almost always missed when using standard thyroid function tests, as the T3 level is often in the low normal range and reverse T3 is the high normal range, again making the T3/rT3 ratio the most useful marker for tissue hypothyroidism and as a marker of diminished cel­lular functioning. The authors of this study conclude, "Subjects with low T3 and high reverse T3 had the lowest PPS [PPS is a scoring system that takes into account normal activities of daily living and is a measure of physical and mental function­ing]…Furthermore, subjects with high reverse T3 concentrations had worse physical performance scores and lower grip strength. These high rT3 levels were accompanied by high FT4 levels (within the normal range)…These changes in thyroid hormone concentrations may be explained by a decrease in peripheral thyroid hormone me­tabolism… Increasing rT3 levels could then represent a catabolic state, eventually proceeding an overt low T3 syndrome."

This study demonstrates that TSH and T4 levels are poor measures of tissue thyroid levels, TSH and T4 levels should not be relied upon to determine the tissue thyroid levels and that the best estimate of the tissue thyroid effect is rT3 and the T3/rT3 ratio.

Reduced Metabolic Rate with Dieting

American Journal of Clinical Nutrition, Vol 44, 585-595
Adaptation of energy metabolism of overweight women to lowenergy intake, studied with whole-body calorimeters
Jo de Boer, AJ van Es, LC Roovers, JM van Raaij and JG Hautvast

In 14 overweight women, 24-hour energy expenditure (EE) was measured in a whole-body indirect calorimeter: before weight reduction (100% diet), after 1 weeks on a 4.2-MJ diet, after 8 weeks on 4.2-MJ diet and after weight reduction on 100% diet. Mean body weight declined from 93.3 +/- 7.4 (mean +/- SD) to 83.4 +/- 7.7 kg; 24-hour EE decreased from 10.52 +/- 0.83 MJ on the 100% diet to 9.58 +/- 0.75 MJ on the 4.2- MJ diet. After 8 weeks, 24-hour EE had decreased by 15% of the initial 24-hour EE to 8.92 +/- 0.65 MJ. After refeeding (1 week), it increased to 9.45 +/- 0.75 MJ. Calculated energy requirement before weight reduction was 10.62 +/- 0.88 MJ/day; after weight reduction, 9.39 +/- 0.79 MJ/day. The decrease was more than that predicted from the change in body weight and body composition.

This study demonstrates that there is a significantly reduced metabolic rate after dieting that does not return to normal even after a normal diet is resumed

Diet Induced Thyroid Suppression

Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-0920
High circulating Thyrotropin levels in obese women arereduced after body weight loss induced by caloric restriction
Petra Kok, Ferdinand Roelfsema, Janneke G. Langendonk, MarijkeFrölich, JacobusBurggraaf, A. Edo Meinders and Hanno Pijl

Context: Previous clinical studies concerning the impact of body weight loss on single plasma TSH concentration measurements or the TSH response to TRH in obese humans have shown variable results.

Objective: The objective of this study was to investigate the effect of weight loss induced by caloric restriction on diurnal TSH concentrations and secretion in obese humans.

Design: This was a clinical, prospective, crossover study.

Setting: The study was conducted at the Clinical Research Center of Leiden University Medical Center.

Participants: Eleven obese premenopausal women (body mass index, 33.3 ± 0.7 kg/m2) were studied.

Intervention: The study intervention was weight loss (50% reduction overweight by caloric restriction).

Main Outcome Measure(s): Twenty-four-hour plasma TSH concentrations (10-min intervals) and the 24-h TSH secretion rate, calculated by a waveform-independent decon¬volution technique (Pulse), were determined.

Results: The 24-h TSH secretion rate was significantly higher in obese women than in normal weight controls, and weight loss was accompanied by diminished TSH release (be¬fore weight loss, 43.4 ± 6.4 mU/liter•24 h; after weight loss, 34.4 ± 5.9 mU/liter•24 h; P = 0.02). Circulating free T3 levels decreased after weight loss from 4.3 ± 0.19 to 3.8 ± 0.14 pmol/liter (P = 0.04). Differences in 24-h TSH release correlated positively with the decline of circulating leptin (r2 = 0.62; P < 0.01).

Conclusions: "Elevated TSH secretion in obese women is significantly reduced by diet-induced weight loss. Among various physiological cues, leptin may be involved in this phenomenon. The decreases in TSH and free T3 may blunt energy expenditure in re¬sponse to long-term calorie restriction, thereby frustrating weight loss attempts of obese individuals."

This study demonstrates that there is a significant reduction in thyroid levels with dieting that is not detected.

Low Normal Thyroid Levels Cause Weight Gain

The Journal of Clinical Endocrinology & Metabolism 90(7):4019–4024
Small Differences in Thyroid Function May Be Important for Body Mass Index and the Occurrence of Obesity in the Population

Nils Knudsen, Peter Laurberg, Lone B. Rasmussen, Inge Bu¨ low, Hans Perrild, Lars Ovesen, and TorbenJørgensen

This study demonstrates that low normal thyroid levels are associated with an inability to lose weight and obesity.

Brief Report

The Journal of Clinical Endocrinology & Metabolism; 91(1):225–227
Thyrotropin Suppression by Metformin
Robert A. Vigersky, Amy Filmore-Nassar, and Allan R. Glass Endocrinology Service, Walter Reed Army Medical Center, Washington, DC 20307
This study noted that patients on metformin (Glucohage) had a subsequent suppression in TSH level without a change in serum thyroid levels, demonstrating that there is often associated a thyroid resistance in patients with insulin resistance that is partially improved with metformin. This study adds to the mounting evidence that due to a variety of factors, including tissue altered metabolism of thyroid and thyroid hormone resistance, standard thyroid function tests do not correlate with tissue effect of thyroid.

Aditional Studies

1. Low normal thyroid levels result in a higher risk of heart disease than if you have high cholesterol, high blood pressure, if you smoke or even have diabetes. Individuals with low normal thyroid levels are 2.5 times more likely to suffer a heart attack. This is greater than if you have high cholesterol (2.4 times risk), high blood pressure (1.6 times risk), if you smoke (2 times risk) or have diabetes (2.4 times risk). Doctors and patients are well aware of these risk factors for heart disease but fail to correct the more important low normal thyroid levels. Many patients needlessly suffer heart attacks because their physician tells them their thyroid is fine because it is in the normal range instead of optimizing to more optimal levels.

Risk Factor Age Adjusted Relative Risk
Low normal thyroid 2.5
Hypercholesterolemia 2.4
Hypertension 1.6
Smoking 2.0
Diabetes Mellitus 2.4

6. Annals of Internal Med, 2000

7. Many physicians have realized that patients can be profoundly hypothyroid and still have normal values of TSH and Free T4. In the British Medical Journal several physicians noted this by stating, "We wish to question present medical practice, which considers abnormal serum concentrations of free thyroxin and thyroid stimulation hormone-those outside the 95% reference interval-to indicate hypothyroidism but incorrectly considers "normal" free thyroxin and thyroid stimulation hormone concentrations to negate this diagnosis. It is unusual for doctors to start thyroxin replacement in clinically hypothyroid but biochemical euthyroid patients." They note that of 80 patients who were diagnosed as hypothyroid on established clinical (signs and symptoms), only 5 patients had abnormally low T4 levels and only 4 had abnormal high TSH levels. The averaged TSH concentration was below the middle of the reference range. They state that these people deserve treatment otherwise they are condemned to many years of hypothyroidism with its complications and poor quality of life.
British Medical Journal

8. In a published article in the British Medical Journal, the authors state, "For over 80 years, before the advent of TSH testing, physicians with outstanding ability have regularly treated thyroid patients with enough thyroid to clinically normalize their patients regardless of dose. The maxim of the day before TSH arrived was to give enough thyroid until the patient felt better. Medical students are still repeatedly told to treat the patient and not the lab values, but this quickly gets forgotten and disregarded when it comes to thyroid. The 80 years of experience with thyroid hormone treatment demonstrated that people would normally need 200-400 micrograms of T4, such as Synthroid, or 3 to 5 grains of desiccated thyroid. The long-term studies of over 40 years show no side effects from such doses and thyroid is probably the safest long-term drug of the Century. When TSH testing came into use in 1973, the average doses dropped to 1/3 of the doses previously used."
British Medical Journal

9. In a study published in the Journal of Endocrinology and Metabolism, clinical signs were compared to blood tests. The authors demonstrated that individuals have varying degrees of thyroid resistance in different tissues. The authors describe this as a metabolic hypothyroidism in different tissues. They state "…tissue hypothyroidism at the peripheral target organs must be different in the individual patient." The authors summarize their findings by stating that they agree with the statement in an endocrinology text book stating, "The ultimate test of whether a patient is experiencing the effects of too much or to little thyroid hormone is not the measurement of hormone concentration in the blood but the effect of thyroid hormones on the peripheral tissues"
The Journal of Clinical Endocrinology & Metabolism
Basic and clinical endocrinology, 3rd ed. London: Appleton

10. Low thyroid is associated with an increased risk of coronary artery disease, heart attack, heart enlargement, stroke, infections, and cancer.
Numerous studies

11. In a study published in the Journal of Clinical Endocrinology and Metabolism, it was shown that T4 preparations such a Levoxyl and Synthroid resulted in very minimal increase in metabolism while supplementation with T3 was shown to increase metabolism by an average of 18%. For a person consuming a 2000 calorie diet, 18% is equivalent to burning an extra 360 calories per day. Thus giving T3 would equate to approximately a 40 pound weight loss in a year. This is equivalent to approximately jogging on a treadmill for 1 hour per day. If we would simply optimize everyone's thyroid, we would no longer have the obesity crises in this country. This could easily be remedied and drastically cut he incidence of diabetes, heart disease, hypertension, stroke and cancer. Thyroid should never be given as a weight loss medication but appropriate replacement with the proper preparations often elevates a number of symptoms, often including continued weight gain.
The Journal of Clinical Endocrinology & Metabolism

12. Reverse T3 blocks T3 action and lowers metabolism
Research Experimental Medicine 13. Thyroid hormones improve blood flow to heart and prevent heart attacks

14. There is an increased risk of arrhythmias if your T3 levels are low and/or your reverse T3 levels are high. This is opposite of what most doctors think.
Journal of Cardiology

15. Flame retardants are building up in people's bodies and blocking the thyroid effect resulting in a diminished thyroid effect despite having normal thyroid levels.
Toxilogical Sciences

16. Organochlorine compounds (pesticides) are well known to alter the thyroid hormone system by decreasing serum thyroid hormone levels in several species including humans.
Environmental Health Perspectives

17. The higher the level of polychlorinated biphenyls (PCB's) in children the lower the thyroid and the higher the level of cadmium in children the lower the thyroid levels (not picked up on standard blood test)
Environmental Health Perspectives

18. "In an ambitious review of the literature from laboratory experiments, wildlife observations and human epidemiology, Françoise Brucker-Davis concludes that wildlife data clearly demonstrate thyroid disruption by synthetic chemicals."

19. "Synthetic chemicals are released into the environment by design (pesticides) or as a result of industrial activity. It is well known that natural environmental chemicals can cause goiter or thyroid imbalance. However, the effects of synthetic chemicals on thyroid function have received little attention."

Physician's Guide: Using Blood Test Findings To Safely Induce Weight Loss

By William Faloon

Weight Loss Might Not be Possible if Thyroid Hormone Levels Are Insufficient

The thyroid gland secretes hormones involved in cellular energy expenditure. When a person restricts their calorie intake (i.e. goes on a diet), there is often a decrease in metabolically active thyroid hormone that causes the body's fat-burning processes to slow down.

One reason people put on weight as they grow older is because aging impairs their ability to efficiently utilize carbohydrates and fats. One cause of impaired carbohydrate and lipid metabolism is sub-clinical thyroid deficiency. Some physicians believe that most people over 40 have a sub-clinical thyroid deficiency that contributes to their unwanted weight gain.109,110

To give you an idea of how profoundly the thyroid gland dictates body weight, consider that when the thyroid produces too much thyroid hormone, the most common clinical symptom is significant weight loss. The name for the disease caused by an overactive thyroid gland is hyperthyroidism, and in 76–83% of cases, a patient's first complaint to their physician is about how much weight they have been losing. In the 1960s and 1970s, the connection between hypothyroidism and weight gain caused some people to assume they could speed up their metabolism and lose weight by using supplemental thyroid hormones. This led to an abuse of thyroid hormone as people created an artificial state of excess thyroid hormone (a condition medically known as hyperthyroidism). Hyperthyroidism can cause weight loss as well as irregular heartbeats, sweating, and tremors. Although people taking supplemental thyroid hormones in these studies may have lost weight, they were losing lean muscle mass in addition to undesirable body fat.111

Today our understanding of the relationship between thyroid hormone and weight loss is more complete. It works like this: when calorie intake is drastically lowered, the activity of an enzyme called 5'-monodeiodinase is reduced; 5'-monodeiodinase is necessary to convert the thyroid hormone T4 into T3. When 5'-monodeiodinase level are reduced, the levels of T3 drop.112-115 T3 is the stronger form of thyroid hormone.

Decreased T3 levels can be directly replaced. Some older clinical studies testing this theory were promising. However, later studies showed that direct T3 supplementation by dieters was connected with muscle wasting.116,117 During fasting, administration of large doses of T3 caused even more severe muscle wasting.118

More recent studies suggest that using very low doses of replacement thyroid hormone during dieting, once the body has switched over from carbohydrate burning to fat burning, may not be associated with muscle breakdown.119-121

How to Prescribe Thyroid Hormones

While there are studies showing that thyroid supplementation promotes weight loss in some people, it should only be used when there is evidence of a thyroid hormone imbalance, either in the form of decreased secretion from the thyroid gland or decreased conversion of T4 to the metabolically active T3 in the peripheral tissues. It is important to remember that many people's metabolic rate decreases in response to dieting, as their body attempts to slow the metabolic rate to conserve body mass.

That means a person with normal thyroid status before dieting may become thyroid-deficient because of the reduced intake of calories. This may occur when drugs like metformin or natural products are used to suppress appetite. For optimal fat-loss effects, a person may be prescribed small doses of Cytomel® (a prescription form of T3) if their T3 levels are not in the upper one-third range of normal, or if consuming fewer calories results in a reduction of T3 levels.

There are several blood tests used to assess thyroid function. If any of these tests indicate a thyroid deficiency, consider prescribing the appropriate dose of the drug Cytomel® (T3) or Armour® desiccated thyroid to bring your patient's level into the normal range.

If a blood test shows an increase in thyroid-stimulating hormone (TSH), this means that the pituitary gland is over-secreting a hormone to stimulate thyroid function because of an apparent thyroid deficiency. The normal range for TSH can be as wide as 0.2–5.5 mIU/mL. However, if TSH levels are above 2.0, this indicates the patient may be hypothyroid and could benefit from Cytomel® or Armour® drug therapy. Remember, the higher the TSH blood level, the more likely the patient is to be thyroid-deficient. T4 (or free thyroxine) tests the biologically available hormone being secreted by the thyroid gland. If T4 is deficient, most doctors prescribe Synthroid®, which is a synthetic T4 hormone. We recommend Cytomel® (T3) or Armour® desiccated thyroid, however, instead of Synthroid® (T4) because T3 is the metabolically active form of thyroid that aids in thermogenesis (body fat burning).122 When evaluating T4 blood test results, optimal levels for males seeking to lose weight should be in a range of 8.5–10.5 mcg/dL. Females under age 60 seeking to lose weight should be in the range of 9–11 mcg/dL. Women older than 60 years should be in the range of 8.5–10.7 mcg/dL. If there is too much T4, this is a sign of hyperthyroidism that should receive immediate medical treatment.

Measuring the amount of T3 is one way of ascertaining how much metabolically active thyroid hormone is available to the tissues. The normal free T3 range is 2.3–4.2 pg/mL, but for losing weight, you might want a range of 3.4–4.2 pg/mL. If the patient's blood levels are below this, then Cytomel® drug therapy should be considered. Some patients are started with 12.5 mcg of Cytomel® twice a day. The dose can be increased if blood T3 levels do not return to a normal range or if symptoms of thyroid deficiency persist. If T3 levels are above normal, this can indicate an overdose of drugs like Synthroid® or Cytomel, or hyperthyroidism.

It should be emphasized that thyroid hormone by itself does not induce fat loss. Human clinical studies show that when thyroid hormone is given in the absence of thyroid insufficiency, muscle tissue is depleted.111,116,118 The purpose of testing a patient's thyroid hormone status is to ensure they are in the optimal range (upper one-third of the normal reference range for T3).

Weight Loss Article From Lef

Weight Loss Might Not be Possible if Thyroid Hormone Levels Are Insufficient

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Pharmanex Weight Loss Protocol 62012


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Hypothyroidism Reverse T3

Abstract. Famine causes adaptive changes in thyroid function which helped individuals survive during times of low food availability. These changes in thyroid function and metabolism have become maladaptive as the induced hypothyroidism associated with intentional weight loss restricts the success of diet attempts and encourages weight regain. In our previous paper we described the mechanisms [1] and consequences behind maladaptive hypothyroidism associated with intentional weight loss. Here we give two specific patient examples of this syndrome and how the biochemical and clinical changes were managed for the clinical benefit of our patients. More broadly, we address the need to understand that there are limitations to our ability to detect every appropriate variable in any one patient, so that we do not overestimate the value of any particular lab reading in any one patient.

Hypothyroidism, Particularly Associated with Weight Loss:

Evaluation and Treatment based on Symptoms and Thyroid Hormone Levels

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HCG Newsletter

Many of you saw Dr. Oz's recent show on HCG and have questions. We are been getting a lot of requests for HCG so I wanted to share with you some more information about HCG. Although there are many opinions on the topic, based on my experience and research, HCG does work for many patients. In addition, many conditions like pre-diabetes, high blood pressure, and high cholesterol disappear naturally.

Weight Loss Results on HCG

This patient lost 36 lbs on the HCG protoccol. She had several previous Hypocaloric diets, without any success.

This is a 27 y.o patient was treated since the age of 7, because of her childhood obesity..Before trying the HCG diet, the maximum weight loss she had been able to achieve: 12 pounds. After a7 week course of hCGshe lost 37 pounds. Please note the absence of skin sagging despite massive weight loss.

Read more at www.hcgobesity.org

HCG Newsletter

Many of you saw Dr. Oz's recent show on HCG and have questions. We are been getting a lot of requests for HCG so I wanted to share with you some more information about HCG.

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HCG Resource

Dr Emma's study slide

HCG Injections in a Randomized, Double-Blinded, Placebo-Controlled Trial Sheri L. Emma, MD

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Effects of HCG American Journal of Clinical Nutrition

Since Simeons (1, 2) introduced his method of treating obesity using human chorionic gonadotrophin (HCG), there has been continuing controversy concerning the effect of HCG on the program.

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Obesity and Weight Loss

A startling 60 – 75% of the adult population in the United States is overweight or obese (American Heart Assc. 2012). Around the world, the prevalence of obesity has nearly doubled from 1980 to 2008 (Stevens 2012).

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The American Journal of Clinical Nutrition

Chorionic Gonadotropin and Obesity?

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Foreviva Healthy Transformation Additional Recipes Shopping Tips

Additional Recipes & Shopping Tips for the FirstLine Therapy Healthy Transformation™ Weight Loss Program

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Dr. Oz HCG Diet Videos:

Educational Resources

Current and Potential Drugs for Treatment of Obesity


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Pharmacotherapy for childhood obesity: present and future prospects

Roya Sherafat-Kazemzadeh, MD, PhD1, Susan Z. Yanovski, MD1,2, and Jack A. Yanovski, MD, PhD1

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Medicinal strategies in the treatment of obesity

When prevention fails, medicinal treatment of obesity may become a necessity. Any strategic medicinal development must recognize that obesity is a chronic, stigmatized and costly disease that is increasing in prevalence.

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Testosterone for life - Morganthaler

Abraham Morgentaler, MD, FACS Testosterone Therapy for Life

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Review Holtorf Hormones and Wellness

Hormones inWellness and Disease Prevention: Common Practices, Current State of the Evidence, and Questions for the Future

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