Returning to health

[ErinElizabeth]

Hi there!

I first heard about Peat through Matt Stone almost two years ago. At the time I poked around here a bit but at that time I was more interested establishing a healthy relationship with food and stopping the unhealthy focus on what I was eating so this forum didn't feel like a helpful fit for that, the last thing I needed was new foods to vilify and obsess over.

I have a much more balanced relationship with food now, I no longer treat ANYTHING as off limits and as a result it's gotten easier to listen to my body and respect the cravings I get (lately I have a serious hankering for cottage cheese). PUFAs haven't been a significant part of my diet for a couple years though I don't go out of my way to avoid them when I eat out so I still get some. I come from a past of low carb > "traditional foods" (WAPF) > GAPS line of restrictions, so sugar was quite thoroughly vilified and I've done stints of grain and dairy free. None of those things helped me feel better and now I'm hypothyroid with nearly no adrenal function and severely overweight (I'm 5ft 4in and 250#).

Just a month ago I got a bunch of labwork done and found out about the hypothyroid and just today I got the cortisol saliva test back finding out about the adrenal function. It was searching the internet for information about Hashimoto's and hypothyroid that I refound Peat and I've been reading his articles and lurking here nearly every day since.

In the last month I've switched from drinking some whole milk to lots of 1%, I've been drinking a LOT more juice and eating more fruit and switched from wheat to potatoes as primary starch (I DO still eat wheat products though). I tried gelatin but that didn't agree particularly well with me (lots of gas) and I haven't been able to try a different brand yet. I started haidut's Estroban. I tried Progest-E but it made me exceptionally angry and irritable so I discontinued that for now (back to normal day after stopping it).

I've got two beautiful, sweet boys, 5 and 1 1/2. I would really love to have enough energy to be the kind of playful and adventurous momma that I want to be for them. I really hope some of Peat's ideas and some inspiration from this forum can help me get there.

Thanks!

 

[ErinElizabeth]

Lab results for anyone who wants to look:

Cortisol, saliva test:
8:45am 0.08 mcg/dL
12:00pm 0.09 mcg/dL
4:15pm 0.03 mcg/dL
10:30pm <0.03 mcg/dL

Reference range:
8-10 am: 0.04 - 0.56
4-6 pm: <= 0.15
10-11 pm <= 0.09

result (reference)
Ferritin 37 (10-154ng/mL)
AST 15 (<40 U/L)
ALT 21 (<40 U/L)
Alk Phos 35 (<130 U/L)
Creatine Kinase 137 (<200 U/L)
BUN/Creatinine 25.9 (<=40)
NT-proBNP <20 (<125pg/mL)
Uric Acid 4.9 (<6 mg/dL)
Homocysteine 6.6 (<10 umol/L)
eGFR 105 (>60)
BUN 19.7 (3.0-25.0 mg/dL)
Creatinine 0.76 (0.51-0.95 mg/dL)
Albumin 4.4 (3.5-5.2g/dL)
Vit D, 25 OH 16 (30-100 ng/mL)

TSH >75 (0.27-4.2 uIU/mL)
Total T4 3.5 (4.5-11.7 ug/dL))
Free T4 0.52 (0.93-1.70 ng/dL)
Total T3 1.0 (0.8-2.0 ng/mL)
Free T3 2.8 (2.0-4.4 pg/mL)

Thyroid antibodies results have been rendered illegible by munchkin mangling but the thyroglobulin(?) antibodies were over 800 and the other one was <1

HbA1c 5.5 (<5.7%)
HOMA-IR 10 (<2)
Glucose 91 (70-99 mg/dL)
GSP 162 (<200 umol/L)
Adiponectin 8.3 (>13 ug/dL)
Insulin 44 (5-15 uU/mL)

Fibrinogen 379 (<370 mg/dL)
hs-CRP 5.7 (<1.0 mg/L)
LpPLA2 156 (<200 ng/mL)
MPO 87 (<350 pmol/L)

Total Cholesterol 246 (<200mg/dL)
Direct LDL-C 175 (<100mg/dL)
HDL-C 33 (>60mg/dL)
Triglycerides 281 (<150mg/dL)
Non-HDL-C 213 (<130mg/dL)
(there was actually a LOT more specific lipid/cholestrol stuff reported if anyone thinks it would be interesting/useful but if not I don't wanna type it all in :) )

Estradiol 39.2 (26.7-156.0 pg/mL)
Free Testosterone 6.0 (1.0-8.5 pg/mL)
Progesterone 0.4 (0.2-1.5)
Total Testosterone 26.9 (8.4 - 48.1 ng/dL)
SHBG 21.1 (24.6-122.0 nmol/L
FSH 7.5 (3.5-12.5 mIU/mL)
LH 8.9 (2.4-12.6 mIU/mL)
DHEA-S 138.6 (98.8-340 ug/dL)

 

[aguilaroja]

https://raypeatforum.com/forums/posts/98288/ Lab results for anyone who wants to look:

Cortisol, saliva test:
8:45am 0.08 mcg/dL; 12:00pm 0.09 mcg/dL; 4:15pm 0.03 mcg/dL; 10:30pm <0.03 mcg/dL
...
Albumin 4.4 (3.5-5.2g/dL)
Vit D, 25 OH 16 (30-100 ng/mL)

TSH >75 (0.27-4.2 uIU/mL)
...
Thyroid antibodies results have been rendered illegible by munchkin mangling but the thyroglobulin(?) antibodies were over 800 ...

HbA1c 5.5 (<5.7%)
HOMA-IR 10 (<2)
Glucose 91 (70-99 mg/dL)...
Insulin 44 (5-15 uU/mL)

Fibrinogen 379 (<370 mg/dL)
hs-CRP 5.7 (<1.0 mg/L)...

Total Cholesterol 246 (<200mg/dL)...

Estradiol 39.2 (26.7-156.0 pg/mL)...

There is a lot in here. But to start with some simple things (thyroid & vit D): clearly the TSH is very high, with positive thyroid antibody test.

If you have started on NDT (mentioned in your other thread), make sure that the total amount is spread throughout the day (say, four times total per day) in order to space out the T3 (triiodothyronine) component of NDT, which is short acting.

At one steady dosing of thyroid supplement, it can take around two (or several) weeks to reach approximate equilibrium. If you have a practitioner and a good working relation in place, check in with them every few weeks to discuss dosage and symptoms. Many people are told to follow up in a few months, or twice a year, once they start on thyroid supplement. It better to avoid waiting many months to adjust dosage when the hypothyroid state is severe.

If you are not already measuring daily resting pulse and temperature, and logging baseline low thyroid symptoms and their changes, please start.

The 25-hydroxy vitamin D level is low. If you are in the northern hemisphere, it is especially low, since late summer should be the highest cumulative sunlight/D-stores in the year. Certainly, if it is summer in your part of the world, get some mid-day sunlight exposure to skin.

http://www.vitamindcouncil.org/about-vi ... ody-needs/

In the short term, it may be helpful to supplement with, say, 5,000 units of Vitamin D3 daily. You mention using haidut's Estroban. That formulation includes D and also other fat soluble vitamins (E, A & K). It is up to you to decide if you would like the other vitamins in the same proportion if you increase Vitamin D, or get an additional D3 supplement.

Hopefully, there would be further thyroid (at least TSH) serum testing soon, and you could re-check Vitamin D levels after a few weeks or more of supplementing.
--
https://www.vitamindcouncil.org/vitamin ... d-disease/

“These findings suggest a possible role of vitamin D in the development of AITD and a potential crosstalk mechanism between vitamin D and estrogen in the pathogenesis of thyroid autoimmune disease,”

http://www.ncbi.nlm.nih.gov/pubmed/24320141

http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24320141/

 

[tara]

ErinE

https://raypeatforum.com/forums/posts/98273/ I've got two beautiful, sweet boys, 5 and 1 1/2. I would really love to have enough energy to be the kind of playful and adventurous momma that I want to be for them. I really hope some of Peat's ideas and some inspiration from this forum can help me get there.

I hope so too. I know what you mean.

Aguilaroja's advice above looks good to me.
Do you want to tell how much NDT you are taking, and whether you increased it gradually or all at once?

 

[answersfound]

I would dissolve the Gelatin in boiling hot water and consume after it has cooled down a bit. That worked like a charm for me when I was having issues with gelatin.

 

[ErinElizabeth]

I have supplemented D in the past and had good levels last time I was tested (somewhere in the 50's about two years ago) but that was when I was pregnant with my second and the last half of that pregnancy is when my health really started falling apart. I don't really remember why I stopped supplementing or if it was just one of many things to fall by the wayside. I think I'll stick with the suggested dose of estroban and add some supplemental D3.

I'm seeing a naturopath and while I'm not super impressed with her so far she does listen to me and isn't pushing the kitchen sink at me so I'm going to continue working with her for now, I'm in a relatively small city and she's the only naturopath that takes my insurance (actually covered as my primary care physician!) so that's a perk worth some inconvenience. In the month since I got diagnosed I've already been back in twice and I have another appointment in 3 weeks, she's easy to get in to see and isn't suggesting long waits between appointments. I think the plan is to recheck the thyroid at this upcoming appointment though I will double check before it as my understanding is that I shouldn't take the thyroid on the day of testing.

She started me on 130mg Naturethroid (2 grains). I felt awful the first day; hotflashes and headache mainly but I DID have energy. I called and she recommended cutting the dose in half. I kept on that for three days and felt better but still ran excessively hot for the ambient temperature so we cut it in half again. Finished off the first week there and was really excited about the new feeling of having ENERGY! But then my period resumed (first time since my 19 month old was born, he's still nursing and it was pretty close to the same timeframe as with my first son so that wasn't unusual). My energy went back to nonexistent, my period was really excessively heavy and long and I got really irritable and yelled a lot, none of which was standard menstrual issues before (I didn't have any cramping though which was a major issue in the past). Even after the period was over the feeling of having energy didn't come back.

With the blessing of the naturopath at two weeks into treatment I started increasing the thyroid dose edging back toward the two grain dose and never felt any difference whether I took 1/2 a grain or 2 grains, or one day forgot to take any altogether (FYI I have been taking the thyroid in one dose first thing in the morning).

I haven't taken my pulse with any regularity though I did track my temperatures during the day and they were pretty good. I have a really hard time getting a basal temp reading, forgetting to have the thermometer by the bed or forgetting to take the temp before getting up but my daytime temps since starting the thyroid are pretty consistently 98.3-98.8. The few mornings I did get basal temp readings ran 96.8- 97.4 though (and my thermometer vanished last week so I need a new one to continue).

Spreading the thyroid through the day makes sense, should it be divided evenly though or loaded higher towards the morning? I know I suggested splitting my dose with my doctor and she recommended against it as she was concerned it would interfere with sleep.

Thank you so much for taking the time to help!

 

[tara]

I'm no expert in this, just read a bit, but this seems like another illustration of the value of increasing more gradually.
The T4 has a long half life, so a high starting dose can stick around for weeks, and if you keep taking the same dose it can keep building for 2-4 weeks before it stabilises.
I think Broda Barnes used to get people to increment doses by 1/4 grain every month until a good level was reached. You may be able to go faster than that, esp. since your TSH is so high, but it may be something to bear in mind.

The T3 component has a short half-life of just a few hours, so I agree with Aguilaroja bout spreading it out through the day. If you get a lot of T3 in one go, that may give a stronger reaction, too. Not everyone responds to things the same way, but I would not necessarily expect it to interfere with sleep if you take some in the evening. I imagine the ideal would be to try to keep it fairly even through the whole day . You need adequate thyroid to sleep well too.

Peat has said that thyroid supps can temporarily increase sensitivity to adrenaline, till your system adapts, so that could also be part of your initial reaction.

I know what you mean about having trouble getting morning temps.

 

[ErinElizabeth]

https://raypeatforum.com/forums/posts/98332/ The T4 has a long half life, so a high starting dose can stick around for weeks, and if you keep taking the same dose it can keep building for 2-4 weeks before it stabilises.
I think Broda Barnes used to get people to increment doses by 1/4 grain every month until a good level was reached. You may be able to go faster than that, esp. since your TSH is so high, but it may be something to bear in mind.

The T3 component has a short half-life of just a few hours, so I agree with Aguilaroja bout spreading it out through the day. If you get a lot of T3 in one go, that may give a stronger reaction, too. Not everyone responds to things the same way, but I would not necessarily expect it to interfere with sleep if you take some in the evening. I imagine the ideal would be to try to keep it fairly even through the whole day . You need adequate thyroid to sleep well too.

Peat has said that thyroid supps can temporarily increase sensitivity to adrenaline, till your system adapts, so that could also be part of your initial reaction.

I'll start splitting my dose throughout the day and I'll slow down the rate I increase in the future.

Interesting that we need thyroid to sleep as well, really poor sleep is one of my primary complaints. Now I'm curious to see if getting some late in the day will help that.

I'm very familiar with the fact that not everyone reacts to drugs and such "normally." Coffee has always made me sleepy and in excessive doses (think espresso milkshake made with coffee ice cream, extra shots and ground beans) actually made me feel drunk just a few sips in (too bad, that thing was tasty). Nitrous oxide (laughing gas) doesn't sedate me or make me giggly, it just gives me a nasty headache. Ashwaganda taken first thing in the morning at a low dose left me spacey and out of it all day and completely unable to sleep at night. I think there's a few more but I'm tired and I think that's probably enough to say I know I'm weird and just need to find out what works for ME.

 

[ErinElizabeth]

https://raypeatforum.com/forums/posts/98328/ I would dissolve the Gelatin in boiling hot water and consume after it has cooled down a bit. That worked like a charm for me when I was having issues with gelatin.

I did hydrate it in cold water and dissolve it in hot water before consuming. It was thoroughly dissolved, though the water wasn't near boiling if that makes a difference. I made a delicious stained glass gelatin with orange juice and sweetened milk but each time I ate it I had gas for many hours afterward (painless, not smelly, but copious). And I'm certain it's neither the juice. milk or combo as I have those apart and together in similar and larger quantities with no issue.

 

[ErinElizabeth]

I forgot to mention: the vast majority of my excess weight it on my abdomen. I look about 7-8 months pregnant. While weight loss would be nice, it is a distant concern compared to restoring my energy. I would like to lose the 100+ pounds I don't need but I'll be happy if I get my energy back even if I never lose an ounce. I just thought I'd mention it in case it triggered any insights. I remember reading belly fat correlated with high cortisol but that doesn't seem accurate in my case.

 

[SQu]

Best of luck. I have a similar pattern but my kids are teenagers so I'm older. Look pregnant. Hypo thyroid only admitted to by doc and tests when all symptoms went from bad to severe. A couple of years later I can tell you it takes time to straighten out energy and symptoms but it does get better. Coffee might be making you sleepy because it increases progesterone (hope I got that right) so once settled with thyroid supplementing perhaps look into progesterone?( Edit: sorry I see you did mention. May need revisiting sometime as countering estrogen is close to top of the list of priorities. Has done much for me) like you I put health before weight loss and have found as health got better weight loss began. Stomach last! Which is fine. And yes I believe it is the cortisol.

 

[sweetpeat]

I agree with sueq about the cortisol. I think the typical pattern when thyroid function starts to fall is for adrenals and cortisol to kick in for a while to take up the slack. And they can sometimes hang in there for a long time. But eventually they too start to run out of steam. That could be what happened with you, ErinElizabeth. And now you're at the point where both thyroid and adrenals are weary.

I think you mentioned you are still breast-feeding? If that's the case, you may want to hold off on getting prolactin tested (mentioned in the other thread I think). It will most likely be pretty high as it's needed for lactation, and I'm not sure you should worry about it right now.

I know you're getting a lot of information here, but definitely take it slow. Leave off with the progest-e for now. Addressing the thyroid alone will probably help with a lot of things. Maybe wait on the other hormones until the baby is weaned? In the meantime, the carrots could help. If you don't like the carrot salad, I think just munching on raw carrots is fine.

Definitely play around with the dosage amounts and timing of the thyroid.

I hope you at least have a sunny window you can sit in a few times a day. Maybe while you're nursing the baby? :)

 

[ErinElizabeth]

Three months of NDT (I'm sitting at 1 1/2 grains daily so about 100mg) taken in two doses during the day. I tried splitting it to 3 or 4 does but only managed to take all of them maybe once per week, just never remembered all the doses. I feel SO MUCH BETTER. Late October I got notice of something that required a deep clean of the apartment on a hard deadline (two weeks) and the timing was such that my husband was going to be out of town for the last 5 days of it. A few months ago it simply wouldn't have been possible but I just did it. With two little boys "helping out" and my husband's contribution was the removal of the stuff I was purging (trash, donations, recycling etc. actually a significant and very helpful task). I did it in only one week. And I wasn't dead at the end of each day despite working my butt off at a level I haven't been able to even consider for years. I've never been a great housekeeper and was downright awful once my health tanked but it was awesome realizing that I could do it.

My cycle is not good though. It resumed shortly after starting NDT but is 6-8 weeks instead of the more appropriate 4 and is VERY HEAVY. Currently menstruating, only mild cramping but I've been very tired and I've been having spells of being really light headed a couple times each day the last few days. Some episodes only last a minute or two but some have been more like 15-20 min of feeling uncomfortably "floaty." I'm wondering if it's due to excessive blood loss or something else.

I haven't been taking my temperatures lately but my hands are usually warm (cold hands has been a fairly accurate indicator previously of low body temp) but my resting pulse has been consistently 80-85.

My hypothyroid symptoms that have improved significantly are better sleep (now wake ups are due to kids, not random "why the hell am I awake?") and energy, I feels rested on far fewer hours than I used to require to even function. Libido is all over the place, sometimes it's great and sometimes it's non-existant. My appetite and sugar cravings are significantly reduced. I have to pay attention to make sure I'm eating enough, I end up inadvertently skipping meals because I just don't feel hungry (I used to graze CONSTANTLY). My salt consumption feels kind of crazy, I'm salting food to taste and that takes a LOT of salt.

The little dude is still nursing for naps and bedtime so I want to be careful about what I introduce but I don't think I can handle many more of these excessive periods. My naturopath wanted to check my labwork around the 21st day of my cycle so I'll be scheduling that soon. What should I be sure we check/recheck?

 

[tara]

post 111978 My cycle is not good though. It resumed shortly after starting NDT but is 6-8 weeks instead of the more appropriate 4 and is VERY HEAVY. Currently menstruating, only mild cramping but I've been very tired and I've been having spells of being really light headed a couple times each day the last few days. Some episodes only last a minute or two but some have been more like 15-20 min of feeling uncomfortably "floaty." I'm wondering if it's due to excessive blood loss or something else.

I wonder if progesterone (eg progest-e) would be helpful.
Not sure of the effect on breast-fed child, so may be safer after weaning. Sounds like you've given him a good run. :)

 

[ErinElizabeth]

All right, got my labs back this morning. Some interesting changes, I'll put the new results from 12/23 in [] and leave July's for comparison:


Ferritin [not tested?] 37 (10-154ng/mL)
AST [19] 15 (<40 U/L)
ALT [21] 21 (<40 U/L)
Alk Phos [39] 35 (<130 U/L)
Creatine Kinase [98] 137 (<200 U/L)
BUN/Creatinine [25.5] 25.9 (<=40)
NT-proBNP [<20] <20 (<125pg/mL)
Uric Acid [5.3] 4.9 (<6 mg/dL)
Homocysteine [5.6] 6.6 (<10 umol/L)
eGFR [117] 105 (>60)
BUN [16.6] 19.7 (3.0-25.0 mg/dL)
Creatinine [0.65] 0.76 (0.51-0.95 mg/dL)
Albumin [4.3] 4.4 (3.5-5.2g/dL)
Vit D, 25 OH [20] 16 (30-100 ng/mL)

TSH [10.49] >75 (0.27-4.2 uIU/mL)
Total T4 [4.6] 3.5 (4.5-11.7 ug/dL))
Free T4 [0.65] 0.52 (0.93-1.70 ng/dL)
Total T3 [1.4] 1.0 (0.8-2.0 ng/mL)
Free T3 [3.4] 2.8 (2.0-4.4 pg/mL)

Thyroglobulin Antibodies [<1] <1 (<=1 IU/mL)
Thyroid Peroxidase Antibodies [375] 823 (<9 IU/mL)

HbA1c [5.7] 5.5 (<5.7%)
HOMA-IR [9.9] 10 (<2)
Glucose [97] 91 (70-99 mg/dL)
GSP [121] 162 (<200 umol/L)
Adiponectin [6.4] 8.3 (>13 ug/dL)
Insulin [41] 44 (5-15 uU/mL)

Fibrinogen [433] 379 (<370 mg/dL)
hs-CRP [6.9] 5.7 (<1.0 mg/L)
LpPLA2 [189] 156 (<200 ng/mL)
MPO [131] 87 (<350 pmol/L)

Total Cholesterol [226] 246 (<200mg/dL)
Direct LDL-C [149] 175 (<100mg/dL)
HDL-C [29] 33 (>60mg/dL)
Triglycerides [373] 281 (<150mg/dL)
Non-HDL-C [197] 213 (<130mg/dL)

Estradiol [52.7] 39.2 (26.7-156.0 pg/mL)
Free Testosterone [7.7] 6.0 (1.0-8.5 pg/mL)
Progesterone [0.5] 0.4 (1.7-27 ng/mL)
Total Testosterone [36.8] 26.9 (8.4 - 48.1 ng/dL)
SHBG [25] 21.1 (24.6-122.0 nmol/L
FSH [7.5] 7.5 (3.5-12.5 mIU/mL)
LH [11.9] 8.9 (2.4-12.6 mIU/mL)
DHEA-S [182.2] 138.6 (98.8-340 ug/dL)[/quote]


So the things that stand out to me are an awesome drop in TSH and antibodies though both are still quite high. My triglycerides are significantly higher and insulin resistance markers appear worse. Estrogen to progesterone ratio even worse despite labwork being taken in the third week of my cycle.

I'm upping my thyroid a bit and going to try out the progest-e again. This time I'm starting REALLY REALLY slowly with the progest-e. Last time I started high as I saw suggested here and by the people I bought it from but it made my really irritable and uncontrollably angry. Since I'm normally very difficult to anger that was a pretty clear sign to stop. Slow and steady seems like a good place to go this time around. Maybe it'll even help reduce my cycle from 40+ days to a more normal 30.

I want to look at K2, niacinamide, and aspirin to try to give my liver a boost. I can't stand the carrot salad but I like carrot sticks (texture thing mostly I think, shredded carrots just can't be made tasty unless they're in carrot cake) so I've been eating those almost every day.

I'm slowly but steadily eating less "unapproved" foods. Still getting some wheat a few times a week but not multiple times daily anymore. Significant sources of PUFA (like eating out or pre-pepared foods) are maybe once a week now. My diet revolves around dairy (milk and cheese) with a solid representation of fruit, juices, potatoes, meat and gelatin. As long as I'm eating/drinking fairly constantly my temps stay in the high 98's and even reach 99 after a salty potatoey meal. I'm sipping on orange juice or sweet milky coffee between meals and that seems to help a lot. If I run out (like I'm out of the house and didn't adequately prepare) my hands will quickly (maybe 30-45 min after last ingestion) get so cold my fingers hurt. A salty or sweet drink reverses it in moments.

Um, only thing left I can remember is that over the last few weeks (husband says it started before Thanksgiving) I've been feeling increasingly brain dead. The walk in a room and don't know why I'm there kinda forgetful is happening multiple times daily. I'm finding myself singing things like "where, oh where has my brain gone? oh where, oh where could it be??" as I look for something I'd had in my hands less than 5 min before (my munchkins find it hilarious, my husband would find it funnier if he wasn't so worried about me :) ).