When this happens, I ask them to get comprehensive blood work done, most notably their thyroid and testosterone levels.Every so often I'll run into a client that regardless of how hard we push things (decreasing carbs, increasing cardio, etc.) their results are very sub-optimal. It's not for lack of effort - they don't cheat on the diet, they do all the cardio, and follow my instructions exactly. They just don't see the results they should.
In practically every instance that I have asked them to do this, the levels come back as lower than normal, to the point of needing medication to correct (thyroid medication, testosterone replacement therapy, etc.).
This is what I mean when I say that you must optimize three things - diet, training, and hormones, to be your best. You can't just do one or two of them - you have to have all three.
You can have the best plan in the world, but if your hormones are out of whack, you'll be spinning your wheels forever.
So if you've been working hard at your diet and cardio (and following a smart plan - that obviously plays a huge role as well) and not seeing the results you should, you may want to talk to your doctor about getting some blood work done.
Note: Thyroid levels are common on pretty much any standard blood panel, but testosterone and other sex hormones are not, so make sure you request those in addition to the other stuff.
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