About Carol "Rosey" Rowsemitt
I’m a Family Nurse Practitioner. I originally studied chemistry, then shifted into biology, and in my 40’s changed careers to become a nurse practitioner. Due to some amazing coincidences, I ended up working with Thomas Najarian, MD, in weight management. (He has since retired. Currently, in California, Steven McAllen, MD, is my supervisory physician.)
I’ve been helping patients lose weight and keep it off for 16 years. Dr. Najarian listened to his patients. He found that many suffered low thyroid symptoms (such as: cold, tired, depressed, and undeserved plateaus of weight loss). Even though they were not low thyroid by standard lab testing, he understood they needed to be treated. He found that conventional treatment with levothyroxine didn’t help their symptoms, but giving them the active hormone, liothyronine, eliminated symptoms and allowed them to lose weight.
His patients were going into the famine response. This occurs when you’re not eating enough to maintain your body weight; famine response can cause increased appetite and decreased metabolism. (It’s thyroid hormones that regulate metabolism.) These responses would help you live through a real famine.
When I joined his practice, my history as a biologist proved to be just what was needed. I had been an ecological physiologist, studying how animals adapt to seasonal environmental changes. So, I started reading the old science about thyroid in the famine response. This work has proven to be important in how I think about thyroid. And it gets complicated, but the ways we are taught to evaluate and treat thyroid are just plain wrong for many people who are trying to lose weight. TSH is the wrong test, and levothyroxine is the wrong treatment.
Was I working with lipedema patients? Of course I was. I just didn’t know it. I knew that some of my patients carried their weight in their hips, thighs, and buttocks, but I had no idea there was a name for it. And I had no idea how hard it was to lose this weight, possibly because we were already using thyroid hormones to help these patients. Like many others in the field of weight management, I was unaware of lipedema until Dr. Karen Herbst gave at talk at an Obesity Medicine Association conference in April, 2018.
Here we are, only one year later, and I’m working feverishly in this area. I’ve now had experience with a few patients who have been on long plateaus that they don’t deserve. One who was evaluated for famine response hypothyroidism clearly fits the diagnosis; we’ve treated her thyroid using this perspective. She has since lost 40 pounds and is almost to her optimal weight. I’m looking forward to spreading these ideas for treatment to those who could benefit.
As part of the coaching team, I can assess your symptoms, help you understand the famine response, what labs should be run, and how we should be treating you if you have famine response hypothyroidism. Unless you’re in a state where I am licensed, I cannot provide treatment. But I can offer published information and guidance for you and your provider if he/she is open to looking at thyroid from a broader perspective.