My N=1 experience with hypothyroidism
Given the recent VLC and hypothyroidism flame wars, I thought I'd throw in my personal anecdote in case it may be of some use to someone reading this.
About six months into strict low carbing I started experiencing all the classic symptoms of hypothyroidism - hairloss, feeling cold, slow heart rate, low energy, brain fog etc. It was as if someone had one day drained every last bit of energy out of me. I could barely move. I couldn't think or concentrate. I struggled to get through the working day. All this started to happen last autumn after a 40-pound weight loss. It was like the Atkins flu all over again. Hypothyroidism is an unfathomable, endless pit of depair. It's like depression, only your mood isn't actually all that depressed, it's more that your BODY is depressed and you can't do anything. You just want to crawl into cave and hibernate for a very long time.
I got my bloods done and yes, my T3 was abnormally low. T4 was normal. TSH was "normal" according to the ridiculously wide lab reference ranges which no one in the field would consider optimal anymore so in actuality it was somewhat elevated. I read some stuff on paleo blogs and became convinced that this was all caused by VLC. As I couldn't cope with the symptoms anymore, I decided, with much trepidation, to add some carbs to my diet. Unsurprisingly, I stalled and got stuck on a plateau for a couple of months. But, I felt "normal" again.
Conclusion? VLC shot my thyroid to shit.
Not so fast.
In hindsight, when I added carbs back into my diet, I did so without decreasing fat and protein intake. This is a classic mistake people make. Fitday says I was at 1,900-ish calories during that period. No wonder I stalled! No freaking wonder I felt normal again. I was no longer restricting food intake. I was no longer on a diet. I was just another person feeding my body a normal amount of food. I was at 100 g of carb at that stage. Hypoglycaemia and chronic hunger returned, I couldn't lose weight, but hey, at least my thyroid was working again! I learned one thing for sure: there is no such thing as a safe starch for some of us. It is irresponsible for glucose-tolerant naturally-thin people like Jaminet and these paleos to be advocating up to 300 g of carb a day. My glucose control begins to collapse at 100, let alone 300, and I'm not diabetic, my labs are completely normal. Safe starches may be a reality for many, but for some of us they are a one-way ticket to an early grave.
Long story short, I now believe it's the process of losing weight rather than VLC per se which causes these problems. I've been there. It's frustrating watching hordes of people making the same mistake, reading the same flawed advice. It's a scary and lonely place to be in so I understand the knee-jerk reaction. My advice would be to stay ketogenic, add more calories from fat, bring your caloric intake to maintenance levels and watch what happens. Chances are it's the caloric restriction causing the problems, not the lack of carbs. Bodies, especially female bodies, hate losing weight. Dieting is actually quite dangerous. LC makes it seem deceptively simple and easy but make no mistake, your body is going through a metabolic upheaval when you're losing a serious amount of weight. It will employ every counterregulatory mechanism at its disposal to fight you back and test your resolve. The body doesn't know what obesity is. It thinks dieting is a famine. It's a primordial thing. It doesn't give a shit about your vanity.
Of note, I found iodine and selenium supplementation useful for normalising thyroid function. Iodine should be started off modestly, say 150 mcg, and slowly titrated upwards or else bad things can happen. I later added lots of nuts to my diet which now gives me like 400% RDA of selenium a day so I stopped the supplement. The crucial thing was upping the calories, though. I'm back to 40-50 carbs a day and no longer hypothyroid, although still suffering from unpleasant side-effects of caloric restriction.
I am unconcerned about this whole "debate". This carb orgy will blow over soon, IMO. People will try eating carbs only to re-discover what compelled them to try LC in the first place: inability to lose weight or even maintain, plus health problems. Chances are if you are in the LC community, you can't tolerate glucose all that well. Truth is uncomfortable but is always preferable to lies and opportunistic pandering.
About six months into strict low carbing I started experiencing all the classic symptoms of hypothyroidism - hairloss, feeling cold, slow heart rate, low energy, brain fog etc. It was as if someone had one day drained every last bit of energy out of me. I could barely move. I couldn't think or concentrate. I struggled to get through the working day. All this started to happen last autumn after a 40-pound weight loss. It was like the Atkins flu all over again. Hypothyroidism is an unfathomable, endless pit of depair. It's like depression, only your mood isn't actually all that depressed, it's more that your BODY is depressed and you can't do anything. You just want to crawl into cave and hibernate for a very long time.
I got my bloods done and yes, my T3 was abnormally low. T4 was normal. TSH was "normal" according to the ridiculously wide lab reference ranges which no one in the field would consider optimal anymore so in actuality it was somewhat elevated. I read some stuff on paleo blogs and became convinced that this was all caused by VLC. As I couldn't cope with the symptoms anymore, I decided, with much trepidation, to add some carbs to my diet. Unsurprisingly, I stalled and got stuck on a plateau for a couple of months. But, I felt "normal" again.
Conclusion? VLC shot my thyroid to shit.
Not so fast.
In hindsight, when I added carbs back into my diet, I did so without decreasing fat and protein intake. This is a classic mistake people make. Fitday says I was at 1,900-ish calories during that period. No wonder I stalled! No freaking wonder I felt normal again. I was no longer restricting food intake. I was no longer on a diet. I was just another person feeding my body a normal amount of food. I was at 100 g of carb at that stage. Hypoglycaemia and chronic hunger returned, I couldn't lose weight, but hey, at least my thyroid was working again! I learned one thing for sure: there is no such thing as a safe starch for some of us. It is irresponsible for glucose-tolerant naturally-thin people like Jaminet and these paleos to be advocating up to 300 g of carb a day. My glucose control begins to collapse at 100, let alone 300, and I'm not diabetic, my labs are completely normal. Safe starches may be a reality for many, but for some of us they are a one-way ticket to an early grave.
Long story short, I now believe it's the process of losing weight rather than VLC per se which causes these problems. I've been there. It's frustrating watching hordes of people making the same mistake, reading the same flawed advice. It's a scary and lonely place to be in so I understand the knee-jerk reaction. My advice would be to stay ketogenic, add more calories from fat, bring your caloric intake to maintenance levels and watch what happens. Chances are it's the caloric restriction causing the problems, not the lack of carbs. Bodies, especially female bodies, hate losing weight. Dieting is actually quite dangerous. LC makes it seem deceptively simple and easy but make no mistake, your body is going through a metabolic upheaval when you're losing a serious amount of weight. It will employ every counterregulatory mechanism at its disposal to fight you back and test your resolve. The body doesn't know what obesity is. It thinks dieting is a famine. It's a primordial thing. It doesn't give a shit about your vanity.
Of note, I found iodine and selenium supplementation useful for normalising thyroid function. Iodine should be started off modestly, say 150 mcg, and slowly titrated upwards or else bad things can happen. I later added lots of nuts to my diet which now gives me like 400% RDA of selenium a day so I stopped the supplement. The crucial thing was upping the calories, though. I'm back to 40-50 carbs a day and no longer hypothyroid, although still suffering from unpleasant side-effects of caloric restriction.
I am unconcerned about this whole "debate". This carb orgy will blow over soon, IMO. People will try eating carbs only to re-discover what compelled them to try LC in the first place: inability to lose weight or even maintain, plus health problems. Chances are if you are in the LC community, you can't tolerate glucose all that well. Truth is uncomfortable but is always preferable to lies and opportunistic pandering.
30 comments:
- Tess, thanks for sharing that. 1954 predates the discovery of antidepressants. I wonder what your mom was taking.
Hypothyroidism is a silent epidemic in the West. Nobody eats fish, seafood or seaweed anymore. I think it probably underlies a lot of depression diagnoses in women especially. Current mainstream medical view of hypothyroidism is too focused on the lab numbers which can sometimes be "normal", yet the patient is still experiencing subjective symptoms. Medicine of course hates subjective symptoms.
I tend to agree with the Jaminets in that one should be aiming for a TSH of 1 or below. I noticed whenever my TSH measured at around 2.5 and upwards (still deemed "normal" according to dumb doctors), I felt extremely shitty. Whenever it's around 1, I'm fine.
Thyroid function is so important. I think a lot of general malaise people are experiencing could be ameliorated with some careful supplementation. Usually they send people like that away with a script for an SSRI because they don't have the time or interest to dig deeper.
- Sidereal, I'm glad you solved the dilemma. Thanks for posting about this.Reply
Your experience reminds me of Emma Davies' (I'm not sure I have her name right.)
She called her diet to solve the hypothyroid problem, the porker diet. Here are the search results for "porker" at her blog:
http://autoimmunethyroid.wordpress.com/?s=porker
I, too, find iodine helpful. I've been taking it for several years. I also take PicMins mineral complex.
All the best to you. :)
- I had thought that there was something up with the VLC version of LC, too. I had trouble when going from 100 grams carb to the Dr. Ezrin program. But, looking back on things, I am wondering if it was do to being in late-fall/winter. This winter I did much better after starting vitamin D. But then things really started to improve after I started selenium and iodine. Unfortunately, the new supplements were also confounded with spring.Reply
- EB, that's interesting, I had the exact same experience. I was initially losing weight on 100 g of carb. When I slowed down, I decided to go VLC last autumn. I lost a lot of weight very suddenly. That's when my thyroid apparently crapped out, at the same time as cold weather started. So many things were going on at once it's hard to disentangle what caused what but what I do know is that I'm fine when I'm not losing weight, i.e., when I'm in caloric balance even if I'm VLC. This, to me, would appear to provide evidence against the VLC causes hypothyroidism hypothesis.
- Last year, I had moved to a long-term plateau doing LC, which then turned into a gain in the fall. That's why I started in with the D. The problem with getting your thyroid out of whack, even just a little, is that it messes up all the other experiments you might plan. This was the point I was trying to make about the homeostasis argument Ned Kock was making, but he pretty much thought I was nuts, and now ignores my posts. Too bad, cause there is a good deal of data there.
100% agreement. MTE.Reply
I too experienced these "hypothyroid" symptoms. Nothing but plain old metabolic conservation from shock of shocks weight loss, low insulin, negative energy balance in the fat tissue, etc. If I am eating low carb but feasting on ad lib cals I have normal energy and am very warm.
Low carb gets the blame because it is an effective weight loss strategy allowing for higher intakes. Ironic.
I also agree, the ones who NEED low carb will be back. This is something the glucose tolerant cannot seem to understand. Using glucose for energy when your body sucks at it is simply a miserable way to live.
- Woo, perhaps we shouldn't be calling it hypothyroidism, it's misleading. It's low T3 in the context of a functional adaptation of the body to severe weight loss, a general slowdown of the metabolism.
I too feel very warm and healthy if I eat say a nice ribeye with butter and a nice salad on the side. No carbs required to make me feel good. :p
- Yoghurt for Iodine if you suspect your deficient?Reply
I dont know what the Dairy is like in the U.S. but over here in the UK it is reasonably good quality, I get my yoghurt from here, but tbh even the brands sold in supermarkets and not at all bad.
My issue is pretty much only with Starch, ( bread,wheat,potato, rice ) aslong as those things are out of my diet I can eat Ad Libitum and not experience weight gain.
- Kindke, I eat yoghurt daily. I'm in Ireland, dairy here is excellent.
Yes, I find starch very fattening too. Many people appear to be able to eat ad libitum on a LC diet and not gain weight. I suspect this is the natural state of the body which never suffered metabolic damage from obesity etc. Unfortunately some of us don't seem to be able to eat to satiety even on LC. Lots of anecdotal evidence out there of people who are successfully managing their obesity on LC but can't eat as much as they want.
- I am very interested in Dr. Kruse's cold therapy. If he is correct that it "wakes" up the thyroid, and has wonderful implications if true. He says it doesn't work if you aren't leptin sensitive. He also says that people shouldn't do it until they do the leptin reset, and that any calorie-reducing diet will just "shut down the thyroid". But I don't understand why he insists that low carb doesn't shut things down, too, especially at the initial stages for people who are LResistant. Not that I want him to be wrong. I would love for him to be correct, but my experience has shown that it is not that straightforward.Reply
- Regarding Kruse:Reply
I think every diet slows down the thyroid, LC is no exception. I'm sceptical about a lot of things he says. I think he's a great guy and his heart is certainly in the right place, but after the initial excitement of discovering his blog, I found way too many contradictions or outright unsubstantiated speculation presented as FACT. Plus there's the whole pseudo-religious rambling about leptin and inflammation and this weird cultish vibe on the blog as if it contained all the secrets of the universe.
I don't think garden-variety obesity has anything to do with leptin resistance or inflammation or even the brain. All this stuff is probably at best downstream of what's happening at the adipocyte / in the mitochondria. At the end of the day Kruse is telling people to go on a LC diet. Practically speaking, this is no different from what Taubes or Eades are telling people. No need to wrap it up in this leptin and inflammation woo. I get it, everyone has to have a niche.
Occam's Razor: Is it more likely that Kruse injured his knee because the inflammation ate it or due to the mechanical stress on the joint from being 300 lbs or whatever he was? When one goes LC, is it not more likely / parsimonious that insulin signalling at the adipocyte is the key factor in fat loss, not this other stuff about master hormones and circadian rhythms and bullshit?
For the record, I have herniated discs in my lower spine at age 25 not because of evil cytokines but because I spent my entire life overweight and even obese for a few years. Lugging around 230 lbs even for a few years will do strange things to your body. - Sidereal, mmm, Ireland. :) Will you say "hello" to the view for me? Lucky you!Reply
If you're a tea drinker, could we talk tea? :)
Oh, to be able to eat any-old-thing on VLC. Nope, track the carbs, weigh the meat, limit that scrumptious cheese, yoghurt and cream. Not too many parsnips, just a wee bite now and then. And low fiber for happier digestion and elimination. Not exactly an eat-all-I-want version of very low carb. Getting older and hormones? Genetic gifts? ;) Results of having weighed more a few years ago? Who knows.... My version of low carb is track and weigh, and pay attention.
Someone posted at Woo's blog a while back, that even if we have to keep track as much as the low fat, low cal folks, at least we smile more. 'Tis true.
Sidereal, I wish you a really lovely afternoon. :) - Barry's Gold, yep. I don't like Lyons and I haven't tried Bewleys. People here only leave the bag in for a minute or two at most. Tea is drunk like water here - constantly - so you can imagine it can't be made too strong. LOLReply
Your reactions to tea sound familiar. The last cup of coffee I've had was 8 years ago or so. I still remember it because I ended up spending the night in the ER with severe palpitations. I can't drink alcohol either. Wine especially gives me arrhythmia. Spirits are fine but wine kills me. My beloved cider Bulmers is something I can't drink anymore due to carb content and heart rhythm abnormalities.
I'm on 1,200-1,300 kcal VLC at the moment trying to get rid of those last 20 lbs. I'm fine even on 100 carbs a day if I'm not trying to lose weight. Sweet spot for losing without ketosis-induced increases in cortisol, noradrenaline and adrenaline seems to be 40-50, anything below that and I freak out. I'm sitting here freaking out for the last two hours, completely wired. I took 400 mg of magnesium citrate and even some valerian root. No effect. I might have to take a beta blocker if the crazy continues. I doubt I'll sleep tonight.
How I wish I could just lose the remaining weight quickly so I wouldn't have to subject my body to this. Contrary to a lot of folks in the community, I don't think ketosis is a particularly desirable / optimal state to be in for prolonged periods. Enhanced stress for prolonged periods can hardly be a good thing. Maybe it's just me with my exquisitely sensitive HPA axis. I never felt good in deep ketosis. I find mildly ketogenic best 60-70% fat, adequate protein + minimum glucose required to run glucose-dependent processes without the need for gluconeogenesis. Why subject the liver to unnecessary stress? For me deep ketosis is a weight-loss maneouvre, not necessarily something I consider healthy or optimal.
Just my humble opinion.
i think the conventional point of view of "this thyroid situation" is screwed up. the current epidemic of hypothyroidism would be significantly ameliorated if the fluoride and bromines were reduced in our surroundings. those still suffering would be significantly helped by an enlightened use of nutrition. at least iodophobia is becoming discredited....
i was diagnosed hypothyroid as an infant, but from my studies, i've come to suspect that my mother was taking something for depression (in 1954) when she got pregnant, then nutritional deficiencies got in their damage (white bread and corn oil margarine, and too little meat, anyone?) i've done a HUGE amount of reading and diet-tweaking, and now i'm doing well on a bathroom-counter-full of supplements and a little dessicated raw thyroid -- whereas 35 years ago i was taking 3 grains of Euthroid a day.