Lipoedema is not obesity
Lipoedema is a chronic adipose tissue disorder characterised by disproportionate fat accumulation, primarily in the lower body. It is often misdiagnosed as obesity or sometimes lymphoedema. Individuals with lipoedema find that dieting and exercise do not get the same results as in those without lipoedema. The emotional toll of being told to just lose weight when the condition is largely driven by metabolic, hormonal, and connective tissue dysfunctions can lead to feelings of despair, self-doubt and even body dysmorphia. Many doctors are unfamiliar with lipoedema, dismissing concerns or misattributing symptoms to lifestyle factors, which can leave people feeling unheard and unsupported.
The Hormonal Connection.
Lipoedema has a strong hormonal component, with evidence suggesting that oestrogen plays a significant role in its development and progression. Many individuals first notice symptoms or worsening fat accumulation during times of hormonal fluctuation, like puberty, pregnancy or menopause. Excess oestrogen or poor oestrogen clearance by the liver and gut can contribute to the proliferation of fat cells, increased water retention and inflammation. When the body struggles to detoxify excess oestrogen efficiently, it can lead to oestrogen dominance, exacerbating symptoms.
Low progesterone levels can further compound this issue. Progesterone has anti-inflammatory and diuretic properties, and when levels are insufficient, individuals may experience increased swelling, fluid retention and difficulty with fat metabolism. A balance between oestrogen and progesterone is essential for metabolic health. Disruptions in this balance can contribute to the stubborn fat accumulation and pain associated with lipoedema.
Thyroid involvement.
Many individuals with lipoedema have symptoms of hypothyroidism, even if their standard thyroid lab results fall within the normal range. If your GP has told you that your thyroid is fine based solely on TSH levels, it may not be the full picture. TSH alone does not give a reliable insight into how well your body is converting T4 to the active T3 hormone or whether you have an excess of reverse T3, which can block thyroid function.
Common symptoms of poor thyroid function include fatigue, cold intolerance, dry skin, hair thinning, brain fog, constipation, and weight gain. These symptoms are often overlooked or dismissed, leaving many individuals without proper intervention. Furthermore, iodine deficiency is a significant contributor to thyroid dysfunction, yet it is rarely tested in conventional medical settings.
Iodine Deficiency and Fluoride Exposure
Fluoride exposure, commonly found in tap water, toothpaste and certain medications can further deplete iodine levels. Fluoride, along with other halogens, compete with iodine in the thyroid, reducing its availability and impairing hormone production. Iodine deficiency could contribute to the development of lipoedema as it can lead to the development of larger, fibrous fat cells.
Insulin Resistance in Lipoedema
Insulin resistance plays a significant role in lipoedema development. Elevated insulin levels promote fat storage and inflammation, exacerbating the condition. Research suggests that a low-carbohydrate, high-fat approach such as the ketogenic diet can help improve insulin sensitivity, reduce inflammation, and prevent further fat accumulation in lipoedema-affected areas. Stabilising blood sugar and supporting metabolic flexibility can be beneficial in reducing symptoms.
Food Intolerances and Inflammation in Lipoedema
Food intolerance’s can be a hidden driver of inflammation in individuals with lipoedema. When the body reacts negatively to certain foods, it can trigger an immune response that leads to systemic inflammation, worsening symptoms like swelling, pain, and fluid retention. Common intolerances, such as those to gluten and dairy can contribute to gut permeability issues (leaky gut), which in turn exacerbate inflammation and metabolic dysfunction. Chronic immune activation from food sensitivities can also impair lymphatic drainage, further worsening fluid accumulation and fat deposition in affected areas. Identifying and eliminating trigger foods through elimination diets or food sensitivity testing can help reduce inflammation, improve gut health and support overall lipoedema management.
Connective Tissue Disorders and Zinc Deficiency
Elhers-Danlos Syndrome (EDS) and other connective tissue disorders frequently co-occur with lipoedema, leading to increased skin laxity, poor lymphatic function and joint hypermobility. Zinc is a crucial nutrient for collagen synthesis and connective tissue integrity, yet many individuals with lipoedema and EDS have sub-optimal levels. Ensuring a balance of key nutrients that aid connective tissue repair can be helpful in symptom management.
Ketogenic and Mediterranean Diets for Lipoedema
The ketogenic diet has been proposed as a beneficial approach for lipoedema due to its ability to lower insulin, reduce inflammation and support mitochondrial function. Many individuals with lipoedema report symptom improvement, including reduced pain, swelling and easier weight management when following this approach. A Mediterranean-style diet, rich in healthy fats, antioxidants, and anti-inflammatory foods, can also help reduce oxidative stress and inflammation while supporting metabolic health.
Functional Nutrition Testing for Lipoedema
Functional nutrition emphasises personalised diet and supplement interventions based on each person’s biochemical individuality. Key functional tests for managing lipoedema include:
- Comprehensive Thyroid Panel: To detect sub-clinical hypothyroidism
- Insulin and Glucose Testing: HbA1c to evaluate long-term blood sugar control.
- Hormonal Testing: DUTCH test to evaluate oestrogen, progesterone, and their metabolites to identify hormonal imbalances and issues with oestrogen clearance.
- Hair Mineral Analysis: To assess zinc/copper imbalances, which can impact connective tissue integrity and hormonal function.
- Iodine Loading Test: To determine iodine status and assess whether deficiency may be contributing to thyroid dysfunction.
- Food intolerance testing: To identify which foods are contributing to inflammation
If you are interested in running any of these functional lab tests, get in touch using the contact form below.
A Functional Approach to Managing Lipoedema
Lipoedema is a complex condition influenced by metabolic dysfunctions, hormonal imbalances and connective tissue integrity. The frustration of not being able to achieve slim legs despite dedicated effort is entirely valid and the lack of recognition from healthcare professionals can be discouraging. However, understanding the underlying factors and addressing them through targeted nutritional and functional medicine approaches offers a path forward. A functional nutrition approach, focusing on detecting underlying thyroid dysfunction beyond standard TSH testing, balancing oestrogen and progesterone, improving insulin sensitivity, addressing nutrient deficiencies and supporting connective tissue health, can significantly enhance symptom management.
Personalised dietary interventions, combined with targeted supplementation and functional testing can provide a comprehensive strategy to improve outcomes for individuals with lipoedema.
If you would like support to manage lipoedema using functional testing and a bespoke nutrition and supplement plan, get in touch.
