Why Staging your Leptin Resistance Matters
Already know a little bit about leptin resistance? Want to take your knowledge to the next level?
If so, then you will find the information in this article incredibly helpful!
Today, the topic is all about leptin resistance and staging your serum leptin level.
Why does this matter?
Because it helps you understand how difficult it will be for you to lose weight and keep it off.
I’ve found that the higher a leptin level is, in the fasted state, and the more weight you have on your body, it will be more difficult to lose weight.
This makes sense, right?
Those people who have 70+ pounds to lose will have a more difficult time getting back to normal compared to those who only have 20-30 pounds to lose.
And the reason for this has to do with your SERUM LEPTIN LEVEL.
In my opinion, leptin resistance exists in some form in almost ALL obese patients.
Many people will argue that insulin is the primary driver of weight gain for most people but I would disagree.
If that were true then we would see people who start the keto diet ALWAYS lose weight, but we don’t.
We have to explain away the fact that there are many people who don’t lose weight on very low-carb diets despite having insulin resistance.
The rest of the obesity story, in my opinion, can be explained by looking at leptin.
Leptin, without a doubt, is considered the master weight management hormone.
Without proper regulation of leptin, it will be impossible to lose weight.
The good news is that this leptin level is easily testable and can be ordered by any doctor.
With that in mind, let’s talk about how to stage your leptin resistance (and how it influences your TREATMENT).
3 Stages of Leptin Resistance
These stages of leptin resistance are diagnosed based on your SERUM LEPTIN LEVEL.
You can test your serum leptin level very easily by asking your doctor.
When you do, just make sure that you get it tested in the FASTED state.
I typically recommend checking your fasting leptin level after you’ve been fasting for about 12 hours and usually first thing in the morning around 8 am.
This is also a good time to check both your cortisol and thyroid function as well.
This can give you valuable insight into the OTHER hormone systems in your body, so don’t neglect them! You never want to look at just one hormone in isolation.
Once you have your serum leptin level you can then compare your results to the ranges provided below.
I’ve created these ranges based on testing hundreds of patients with leptin resistance and treating them at various levels.
These stages of leptin resistance matter because they tell you how likely or how easy it will be to lose weight (also, how aggressive you need to be with your therapies!).
Mild Leptin Resistance
You most likely have mild leptin resistance if your serum leptin level is between 10 and 19 ng/ml.
Any leptin level greater than 10 ng/ml in the fasted state and in the setting of obesity (meaning you are overweight) indicates leptin resistance.
Mild leptin resistance, in this range, means that you have the earliest form of leptin resistance.
If you fit into this category then that is great news.
It means that you will probably not have a very difficult time losing weight and it also means that you do not have extreme leptin resistance.
If your leptin level is between 10-19 then you can most likely get by with treatments that include diet, exercise, and leptin supplements.
If you are new to leptin resistance then you will want to spend some time looking at how having leptin resistance changes how you should be eating.
In addition to diet and exercise, you can use the following supplements:
- GAGs (1 capsule per day) – GAGs have been shown in studies to help lower leptin levels.
- High-dose fish oil (1-2 capsules per day) – I like to combine fish oil with other anti-inflammatory ingredients for an added boost.
- L-glutamine (up to 5 grams per day)
These supplements can and should be used at ANY level of leptin resistance because they will augment and enhance the benefits of diet and exercise.
They also directly help to lower leptin levels.
Moderate Leptin Resistance
Moderate leptin resistance is defined as having a serum leptin level between 20 and 29 ng/ml.
If you have moderate leptin resistance it will definitely be more difficult for you to lose weight compared to those with mild leptin resistance.
People with moderate leptin resistance are often people who have a history of using yo-yo diets throughout their life, those who maybe have struggled with mild weight gain throughout their life, and those who have other hormone imbalances such as high cortisol or hypothyroidism.
Moderate leptin resistance is obviously more difficult to treat compared to mild leptin resistance which means you will need to be more aggressive in your treatments.
To treat moderate leptin resistance you will want to do the following:
- Use diet/exercise (as above)
- Use ALL leptin resistance supplements (as above)
- Use 1-2 prescription leptin resistance medications
The only new therapy you will need to add here is the use of certain medications.
You don’t necessarily HAVE to add these medications, though.
You can always try the more natural approach (diet, exercise, supplements, and so on) and see how well you do.
Just realize that if you go this route that it will take longer for you to lose weight (it may take 6-12 months of HARD work).
Severe Leptin Resistance
Severe leptin resistance is present if your serum fasting leptin is greater than 30 ng/ml.
This is obviously a HUGE range as you might find that your leptin level is as high as 70-90 ng/ml.
The highest leptin level I’ve seen to date is in the 90s (ng/ml) but I’m sure there are some people who may be even higher.
The key here is to realize that if your leptin level is higher than 30 (at any level) then you fit into this category of severe leptin resistance.
People with a leptin level this high are often those who have struggled with weight their entire life (they probably can’t remember a time when they weren’t overweight), they may have had an eating disorder at some point in their life, they may have hypothalamic damage from an infection or trauma, and they have used diets throughout the ENTIRE life.
The more you diet, lose weight and regain it back, the more damage you are doing to your body.
So you want to avoid this at all costs.
If you have severe leptin resistance you will obviously want to be more aggressive than those with mild to moderate leptin resistance.
I recommend the following treatments for those in this category:
- Diet/exercise/lifestyle changes – You will want to be aggressive here and make sure that you are also sleeping enough and managing your stress.
- Leptin supplements – Use all of the leptin supplements listed above.
- Leptin medications (2-3 or more) – The main difference is that you will want to layer multiple weight loss medications on top of each other. There is an art to this, however, so make sure you find a doctor who knows what they are doing.
Even with these therapies, it may take 6-12 months for you to lose weight.
Be patient, though, because once you lose it the right way it should NOT come back.
You can find out more about how I use certain medications, hormones, diet, and so on to treat obesity in my weight loss guide (over 2,000 people have used this guide with great results).
One last parting thought:
These staging levels are not a perfect science.
They are based on my own experience, however, and do hold true for many patients.
But I don’t want you to think that you can’t have severe leptin resistance with a low serum leptin level, because you absolutely can.
I’ve seen patients with leptin levels of 15-17 who are INCREDIBLY leptin resistant and in whom weight loss is very very slow.
I’ve also seen patients with leptin levels in the 60-70s who look like they have crazy high leptin resistance but who are very responsive to weight loss therapies.
The moral of the story?
You can’t go by just your leptin level alone.
I do think it’s a good idea to be more aggressive if your leptin level is higher, but don’t think that it will be impossible to lose weight if your leptin level is greater than 50 ng/ml because that isn’t necessarily true.
Also, just remember that treating leptin resistance is a marathon and not a sprint.
It will take both time and patience to get back to a normal weight, so be sure to keep your expectations tamed.
But now I want to hear from you!
Are you someone suffering from leptin resistance?
Was it easy or difficult for you to lose weight?
What stage do you fit in based on your leptin level?
If you haven’t had your leptin tested, does this information make you want to get the test?
Leave your questions or comments below to keep the conversation going!
18 thoughts on “3 Stages of Leptin Resistance and How They Impact Weight Loss”
Leptin level on 1/21/2019 =39 ng/ml
Leptin level on4/22/2019= 73 ng/ml
My doc has me on xymogen Leptin manager 2times a day.
I have Hashimotos and am 3 weeks away from turning 55. Also taking T-4/T3 75/15 mcg at night & T3 5mcg 12 hours later. Normally 10 pm & 10 am. I’m on a low inflammatory diet & exercise 4 -5 days a week. Carbs raise my bp & I finally have my glucose under 100!
It sucks being 40 lbs overweight.
I’ve commented before but I’m a 30 y/o male with a 14y history of bulimia. Now with underactive thyroid which I’m taking cytomel for, not producing ADH which I’m (finally) taking desmopressin for. Leptin was less than 1 last time I checked, which was about 1 yr ago. Odd because I’ve become somewhat weight loss resistant, putting on 15 pounds in the past few years that I can’t lose despite adequate caloric intake, moderate exercise, etc. I was wondering if this suppressed leptin was some odd form of leptin resistance or have I just destroyed my pituitary? Thoughts?
I’m not sure what caused it exactly but a very low leptin is basically the same thing as having a very high leptin in terms of its impact on the body.
LOVE your stuff! So much profound info…….please try to slow down.
Glad you enjoy it 🙂 I will do my best to slow down!
Hello-Thank you for the great info, your blog provides hope and a direction that I can focus on. I have been unable to lose a pound after a year despite tracking my calories/macros, weight training, and HIIT classes. After reading your article I had tested my fasting Leptin which came back at 25 ng/ml. I started your protocol of supplements for moderate Leptin resistance including Metformin which I somehow convinced my PCP to prescribe. I have been on this protocol for 8 weeks. I don’t expect overnight results but wanted to get your thoughts on what would be a reasonable amount of time before I might see results and if I get no results what would be possible adjustments I could make?
You should see changes to your body size (measurements) within the first month and definitely some weight loss (5-10 pounds) by the second month. There’s so much more to weight loss than supplements, though, so I would recommend that you look at my weight loss program here to get an idea: https://www.restartmed.com/hormone-mastery/
Can you please be my doctor? Are you taking patients?
My doctor does not take my leptin problem seriously.
He did prescribe Saxenda for me after I begged, but I lost zero pounds. I need a comprehensive plan.
I’m not taking any new patients at this time!
I’m a 46 year old female. I just got my Leptin results back today…131.4 ng/mL. I’m currently treated for low thyroid, but those numbers are also a bit of a mess. I’m not quite sure what direction to go now. I’ve had a lifetime history of yo/yo dieting and have easily put on 30lbs in the last few months and CANNOT lose weight.
I’d love to know what 2-3 or more Leptin medications to request for severe leptin resistance. My endo has said on more than one occasion that I “might be” leptin resistant and prescribed more T3 on top of my NDT. It didn’t do a thing! I went and got my tests done on my own, only to discover after a 14.5 hr fast with blood draw at 9:30am, that my serum leptin level is 86.8 – ugh! I have always been healthy and fit up until about 8 years ago when I started gaining weight unexpectedly, only to be told that my thyroid was within normal ranges. A year ago I decided I couldn’t live with the aches and pains and weight gain, to find an endo who at least put me on Armour and T3 (for Hashimoto’s and Hypothyroid), but nothing yet for Leptin Resistance. It’s very frustrating.
You can find medications used to treat leptin resistance here: https://www.restartmed.com/leptin-resistance-medications/
Just listen to your video. You said to leave comments :
03/07/2022 49,7 mg/ml, so severe leptin resistance
But I’m around 30 pounds overweight. I have all the risk factors…
But my fasting time was less than 12 hours, more around 9 hours. Could that influence the result ?
Yes, the length that you fast will impact your leptin results. You want to make sure you fast the same amount of time in between tests for consistency and to see if your therapies are working.
I have been doing a ton of research on successful weight loss programs for hypothyroid people and discovered your research. I have tried everything from low carbs, low sugar, high protein and/or combinations of all of it to exercising up to 7 days per week. Sure, I lost 25 pounds in 9 months, but as soon as I decreased my exercise to a more normal rate of 3-4 days per week, I grained all of the weight back in a shorter amount of time. I have struggled with my weight since was 12 yrs old. Now that I’m over 50, I am tired of being fat, unhealthy, and unhappy with my mirror image. I started the conversation with my PCP today about leptin resistance and how to treat it in my fight with my weight. I had my blood drawn today for a serum leptin level. Hopefully I’ll have some answers soon. Thank you for giving patients like myself hope that there is a treatment out there for our lifelong struggle with weight.
Glad you found it helpful! I have lots of information on weight loss, leptin resistance, weight loss medications, etc. that you can find in other blog posts as well. You might also find these thyroid weight loss case studies helpful:
I was never overweight as a child sometimes a little chunky but by 8th grade I got slightly fat. Developed an eating disorder lost a bunch of weight and maintained my weight loss for the most part for years until age 31. Became very underweight. Then I gained 35 pounds in 2 months. I believe this rapid weight gain caused insulin resistance because the former low calorie dieting stopped working and all it did was make my body more weight loss resistant and slow my metabolism down. I am now 32 and according to my scale have the metabolism of a 36 year old. I am 50 pounds over my normal weight, gaining 30 more after the hospital from undereating which makes no sense. Is there any hope I can lose this weight as it seems permanently attached to my body. I am only 32 I don’t want to be borderline obese just because of one bad year…though granted it’s been my whole life I’ve kept my weight in check. Please tell me there is hope doctor.
There’s always hope! I don’t think I’ve ever seen a situation in which someone can’t lose a significant amount of weight. It may take a long time (years) and it may be hard work, and they may not reach their desired weight, but they can always lose at least some of their weight and improve their overall situation.