Concerning weight loss, monitoring is the technique used to determine changes of fat and water contributing to weight change. Blood pressure, pulse, and temperature are measured as well.
An Aimpedance scale@ is used. The patient stands briefly on a metal platform allowing an electrical circuit to be completed from one foot to the other. (Don't worry. No one has ever been shocked by one of these scales. The current is minuscule.)
Fat retards the slow of electrons, and salt water allows them to flow more freely, kind of like a copper wire with insulation surrounding it. This difference of electrical impedance allows the scale to differentiate between water and fat. Since the patient's height has already been inputted into the scale's computer, the machine then electrically determines weight of fat and weight of watery tissue. Comparing determinations made over a time period will supply the net changes of water and fat.
For example, you may have a weight loss of 5 lbs over a one week period. Checking the impedance figures may tell you that the entire amount of weight lost was fat. Or, perhaps the machine will show drop of 4 lbs of fat and one pound of water. Another possibility is a drop of lbs of fat and a gain of 2 lbs of water. And these are just 3 possible examples resulting in the same net weight change.
It is not unusual for a person to drop fat and gain water at the same time. Then, several days to a week later, the excess water is urinated out and the fat loss is appreciated as a weight drop on the scale. The impedance apparatus can reassure the patient who has dropped fat but retained water.
What else is monitored? Taking vital signs: blood pressure, pulse, & temperature are done at every monitoring visit. As well, patients are asked about any side effects of medication or any problems whatsoever. Telephone conferences with the doctor about problems are encouraged.
My program involves weekly monitoring for weight loss patients. Patients taking natural hormones in my program are required to do so under my guidance as well. For patients taking only thyroid replacement, I expect weekly monitoring in my office during the process of determining a stabel, mature thyroid dose, a process that typically takes 6 to 8 weeks.
Patients on a weight loss program and simultaneously taking thyroid, of course, are fully expected to monitor weekly in the office until they have reached stable, mature doses.
Dealing with one's self is often very subtle. Physician monitoring can point out some issues that may have escaped the patient busy with life. During the monitoring process, the patient is prompted to describe compliance with diet, hydration, exercise, and supplementation schedule.
Weight Loss Medication And Amino Acid Supplements
With the exception of the hCG technique (discussed in another article), all weight loss medication and amino acid supplements that actually work for weight loss, without undue side effects, do so by manipulating neurotransmitters.
So, what are neurotransmitters? They are substances that take messages from one brain cell to the next. And there are stores of them at the junctions of nerve cells.
Think of the brain as made up of various columns of cells, each column having its very own substance for sending messages. There are over 130 different neurotransmitters in the human brain, but for weight loss, we will concern ourselves with only 3 of them:
As the following discussion ensues, please continue to refer to the above summary table.
Glutamine controls cravings for alcohol, sugar, and starch. It has been used for years in alcohol treatment programs. Robert C. Atkins, MD pioneered the use of L-Glutamine for weight loss.
The simple amino acid, L-Glutamine, is itself a neurotransmitter. L-Glutamine can be found at any health foods store. It is sold as 500 mg capsules or tablets, sometimes as 1,000 mg tablets, and as powder. The dose varies considerably, with alcoholics typically requiring the smallest amount, perhaps 500 mg per day. Most of us require more than 500 mg per day to obtain an effect. Therefore, I advise using a rounded teaspoon of powder, delivering about 5,000 mg to be added to water.
There are several ways to do this. One is the quick and easy way for those of us who are relatively impatient. Just stir the powder into the water and quickly drink it down. In this way, the powder is in suspension in liquid. It's a little gritty, thus bothersome to some people. An alternate way is to vigorously shake the teaspoon of powder in a bottle of water to allow it to go into solution. This method requires a wide mouth water bottle or the use of a funnel.
The usual dosing regimen is to match timing with the daily occurrence of cravings or interest in snacking. For most people, that means taking the Glutamine in the late afternoon, say upon arrival home from work, and again in the evening after dinner so as to avoid the return of cravings just before bedtime. Keep in mind that a very bad time to eat is at bedtime!
This is not to say that you cannot use L-Glutamine at other times during the day. Some people have problems with cravings during the mid-afternoon or during the morning. Of course, they can use Glutamine at those times as well.
After being swallowed, the Glutamine is absorbed into the blood and carried to the head. There, it saturates the glutaminergic nerves, causing an exaggerated effect of satiation.
The next two neurotransmitters, Norepinephrine (NE) & Serotonin (SE), should be thought of as one large system, each providing a complementary and seemingly opposite effect to the other.
NE is the neurotransmitter of wakefulness & alertness. SE is dominant during relaxation, satisfaction, even sleepiness. As you can tell, they are two sides of the same coin.
There are little packets of extra NE near the bundles of NE nerves. During times of excitement, for example, like when slamming on the brakes to avoid a collision with an animal in the road, these little packets are caused to discharge their contents and the outpouring of NE saturates the NE nerve endings.
Under such a condition, you are absolutely not hungry. Your appetite is powerfully suppressed. Moreover, you are breaking down fat like crazy! Both NE and its cousin Epinephrine from the adrenal glands cause fat stores to start releasing their contents. And as long as you are drinking your requisite amount of water, you will rinse these fat breakdown products out through your urine.
So, to repeat, NE, when released from storage packets, causes weight loss 2 separate ways: suppression of appetite and breakdown of fat stores.
Now we are back to the drug, Phentermine, mentioned in the Preface of this article. Phentermine works by releasing NE from storage packets. So, remember that Phentermine does not cause weight loss directly, but only by release of NE.
So, here is where the main problem with the efficacy of phentermine arises. When Phentermine is used by itself for about a month to 6 weeks, it stops working. Why? Because the storage packets have become depleted of NE. Constant release of NE caused by Phentermine produces this depletion. The body simply cannot keep up production of NE fast enough.
In order to promote more efficient replenishment of NE, weight loss patients can take the simple amino acid, L-Tyrosine, an over-the-counter nutritional supplement. Tyrosine is converted into NE over a multi-step process. The amino acid, L-Cysteine, also obtainable from the health food store, taken together with the Tyrosine, makes this process more efficient.
L-Tyrosine 500 mg is taken 3 times daily. L-Cysteine 500 mg is typically taken twice daily, eliminating the early morning time slot so as to avoid Cysteine's major side effect, nausea & stomach pain. Phentermine is usually taken twice daily with the major dose at 12 hours before bedtime and the minor dose at 6 to 8 hours prior to bedtime, as depicted in the following Medication Schedule:
This is so that the weight loss properties of the system of enhancing these neurotransmitters is concentrated toward the evening, the usual time of excess calorie consumption. The trick, of course, is to time the dosing so as to walk the fence of appetite suppression on one side balanced with the ability to go to sleep at a reasonable bedtime. Typically, the mornings do not present an appetite problem, with most people becoming hungry the first time during the day at 12 hours prior to bedtime. The above demonstrated Medication Schedule shows one such regimen for a person who goes to bed at 10 p.m.
Serotonin is enhanced by taking the precursors L-Tryptophan or 5-Hydroxytryptophan (5-HTP), usually at bedtime. Tryptophan is converted into 5-HTP over a multi-step process, then 5-HTP is immediately converted into Serotonin. Thus, L-Tryptophan is consumed from a dietary source. (The famous food with high levels of Tryptophan is turkey meat.) And 5-HTP is an entirely normal product of human metabolism. So, taking pure 5-HTP delivers a natural nutrient in concentrated form. This in turn, produces enhanced blood levels of Serotonin. Serotonin typically gives a sense of satisfaction & fullness. It causes most people to be sleepy.