LCHF after Rai 131 and severe hypoglycaemia
ElizabethAN2017
Posts: 565 Member
Hi, I'm hoping to start LCHF. I had rai 131 to ablate my thyroid, so I have no functioning thyroid any more, and now just take synthroid. Since that time, I developed severe hypoglycaemia and I was advised by the dietician the only option was to eat a combo of carbs and protein every 2-3 hours to control my blood sugars (so I wouldn't crash). Since implementing what the dietician suggested, I gained 89 lbs (lost about 34 so far with a great deal of struggle). I feel the worst in my life eating so many carbs. Can someone suggest how I can control my hypoglycaemia but without having to eat so many carbs? Physically I have found I feel much better when I eat more protein and limited carbs; but I haven't tried it in the long run. I was also curious as to whether vegetarians can do LCHF... Thanks so much for letting me join the group. ~ Elizabeth Maryam
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Hypoglycemia generally happens when the body is still responsive to insulin, but the insulin over-reacts and stores too much of the glucose from a meal.
Carbs and protein both reduce to sugar when used for fuel. It takes 2-3 hours for your glucose and insulin to go through a cycle and you're back down to fasting levels (or go hypo in the dysfunctional case). Hence, the 2-3 hour recommendation.
The conventional recommendations are a bunch of bull for actually controlling such conditions, really, and it's actually the protein+fat combo that buffers the glucose hit from carbs, not protein on its own. Think about the usual "eat peanut butter with the apple" recommendation -- have you ever actually looked at the label for peanut butter? It's not a "protein" (ie - gets most of its calories from protein), it's a fat!
The best way to handle the hypoglycemia? Don't eat so many carbohydrates, especially starches and sugars. Base your meals around non-starchy vegetables and high-quality protein. For a vegetarian, that's generally eggs, tofu (though I'm not a fan of soy, though natto would be a good option if you can handle it), and beans/lentils. Some do seitan (wheat gluten), too, though that's another I don't personally advocate.
Also, don't be afraid of fat. If you eat eggs, eat whole eggs (whites and yolks). If you do dairy, eat butter and use cream. Avocado, coconut, and tree nuts are your friend, too. I recommend keeping "vegetable" oil intake to its whole-food form (ie - avoid corn oil, soybean oil, etc) and use coconut, olive, or avocado oil, or butter for cooking and adding to dishes.
As a vegetarian, your carbohydrate intake will be higher than omnivorous and carnivorous low carbers, but it's very much doable in the 50-100g range. The key is to make sure that your carbohydrate sources are primarily non-starchy and fibrous (prefer veggies over fruit, beans over grains, etc).
Finally, it might be good to revisit your reasons for being vegetarian. You don't have to explain them here, but just consider what your goals are for eating that way and how it aligns with your health needs. Some people can do vegetarian without issue, while others need to be more careful to be healthy, and others have found their health to suffer, no matter how much they want to be vegetarian. It might be necessary to tweak your way of eating to find a balance between your physiological needs and your ethical values (such as including bivalves a couple of times a week, or sourcing animal products from sustainable, humane sources).0 -
Thank you for responding. I have found that I seem better (feeling wise and with regards to the brain fog) when I sometimes just grab some peanut butter or other protein and fat ... so I think you are right on that account. I am going to try to get away from the carbs as I find they mess me up more than anything.
With regards to vegetarianism, I am not a vegetarian but am somewhat looking at it as an alternative as money has been tight recently to buy proper meat and poultry products. So I was curious how beans, lentils, etc would fit into the LCHF diet. In not a fan of soy either and have been advised to stay away from it due to having to reply solely on synthroid (soy affects the absorption of the synthroid, reportedly).
Thanks again for your response. I am going to apply your feedback to my decision making process as I try to move to a LCHF diet.
Sincerely,
Elizabeth Maryam0 -
Be careful. There are people who are not able to use fatty acids effectively for energy. I don't know why you get hypoglycemia, and that might be something to discuss with your doctor, or a specialist, since your dietician's advice hasn't worked out so well. You should be able to control your weight by logging your calories and not eating more than you need. There are a lot of moderate carb options, not only LCHF.
https://en.wikipedia.org/wiki/Fatty-acid_metabolism_disorder0 -
lithezebra wrote: »Be careful. There are people who are not able to use fatty acids effectively for energy. I don't know why you get hypoglycemia, and that might be something to discuss with your doctor, or a specialist, since your dietician's advice hasn't worked out so well. You should be able to control your weight by logging your calories and not eating more than you need. There are a lot of moderate carb options, not only LCHF.
https://en.wikipedia.org/wiki/Fatty-acid_metabolism_disorder
Thank you for your response. With the dieticians advice, I believe it was just the general advice she gives to all people with hypoglycemia. I know for myself, the calorie counting is not working as I can eat less than 800 calories over a number of days (and also work out and NOT eat back any of the calories burned) and actually gain weight (and I don't mean water weight ... I mean weight that stays because this is how I gained the weight I ended up gaining in the first place); but I find that this is when my carbs are higher. Because of personal health issues, my body does not seem to process the carbs properly... and because of my weight gain and struggle to get it off (despite weighing everything and following all of the standard advice), my dr suggested I look into a LCHF diet. My doctor is going to refer me back to a specialist if things do not work well with the LCHF way of eating. I also know that with average and higher carbs, it affects my mental health... and I find I feel and think better when my carbs are on the lower end of things.
For the hypoglycemia, it basically started after I had the radioactive iodine to ablate my thyroid. Since that time I have had a terrible time trying to manage my blood sugars from crashing. I've been to the endocrinologists and they just generally say to eat carbs and protein every 2-3 hours to control it.... but for my overall well being, this is not working for me, and the history has proven this.
I look forward to starting LCHF and seeing how things go.
Thanks again for responding
~ Elizabeth Maryam0 -
@MaryamCh2013 - going to multiple doctors and getting the same answer that doesn't work has got to be frustrating. Do you think that the endocrinologists have your replacement hormone working well? I'm moderately hypothyroid, and was heavier before I got medication, but you're completely dependent on medication, so if it isn't right, it could be a serious problem.0
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I have reactive hypoglycemia but it is pretty mild. I have found that since I went very LCHF (<20g of carbs per day) that the problem is almost gone. Because I eat so few carbs and only moderate protein, my glucose does not spike upwatds or drop downwards quickly. I use ketones (fats) for fuel more than glucose so my blood glucose levels are quite steady now.
I also have an underactive thyroid. I agree that the right meds for you can really make a difference. I tried Synthroid for almost a year but it did not help with my symptoms. Switching to a natural desiccated thyroid made a big difference to how I felt. For some, adding T3, or a NDT can really help.0 -
I have reactive hypoglycemia but it is pretty mild. I have found that since I went very LCHF (<20g of carbs per day) that the problem is almost gone. Because I eat so few carbs and only moderate protein, my glucose does not spike upwatds or drop downwards quickly. I use ketones (fats) for fuel more than glucose so my blood glucose levels are quite steady now.
I also have an underactive thyroid. I agree that the right meds for you can really make a difference. I tried Synthroid for almost a year but it did not help with my symptoms. Switching to a natural desiccated thyroid made a big difference to how I felt. For some, adding T3, or a NDT can really help.
Totally agree with the bolded here. I have a friend who lost her thyroid to cancer probably 25 years go, and she struggled until she found a doctor who was willing put her on Cytomel (a T3) and Armour Thyroid (desiccated). The difference for her was night and day, really.
I'd suggest that if you haven't already, you check out the book and website Stop The Thyroid Madness. It is a treasure trove of useful information that can help you sort out exactly what to talk to your doc about (and how to approach it to get the best result!)0 -
lithezebra wrote: »@MaryamCh2013 - going to multiple doctors and getting the same answer that doesn't work has got to be frustrating. Do you think that the endocrinologists have your replacement hormone working well? I'm moderately hypothyroid, and was heavier before I got medication, but you're completely dependent on medication, so if it isn't right, it could be a serious problem.
I haven't seen the encrinologist since I had the Rai treatment; but my family dr (who is excellent) has consulted with them all along. Yes, you are correct in saying it is extremely frustrating. My dr is keeping me at almost hyperthyroid, and I am feeling better but my body just doesn't seem to still work correctly. There are other factors that can play a part, so, we are trying to gradually rule things out. I've always been a size 2,3,4 apx most of my life and then about 4/5 years ago everything went out of whack and I put on this weight. Just trying to find what works for me now ... Thanks 0 -
I have reactive hypoglycemia but it is pretty mild. I have found that since I went very LCHF (<20g of carbs per day) that the problem is almost gone. Because I eat so few carbs and only moderate protein, my glucose does not spike upwatds or drop downwards quickly. I use ketones (fats) for fuel more than glucose so my blood glucose levels are quite steady now.
I also have an underactive thyroid. I agree that the right meds for you can really make a difference. I tried Synthroid for almost a year but it did not help with my symptoms. Switching to a natural desiccated thyroid made a big difference to how I felt. For some, adding T3, or a NDT can really help.
My doctor and I spoke about going LC and this is something I am seriously going to try. Once I have it established, my dr wants me to give it an honest try for one month. If after that time I am still having problems losing (or have to almost starve myself to lose), she is going to investigate further. ie. do hormone testing, etc.
My dr has been open to trying other meds (versus using synthroid); but she has found that her other patients have not had success with it. (And my dr is one of the good honest dr's, so I know she is being real with me). She is willing to try it; but I am scared of the transition and possible lack of success and what would happen to me during this time. I get very down when I am hypothyroid and I also have somewhat a similar response with eating a lot of carbs ... so I'm trying to be careful of my own mental health. I also have some other health issues (one a congenital heart problem that I was born with, and as thyroid function affects the heart my dr and I are cautious about any changes). Thanks 0 -
I have reactive hypoglycemia but it is pretty mild. I have found that since I went very LCHF (<20g of carbs per day) that the problem is almost gone. Because I eat so few carbs and only moderate protein, my glucose does not spike upwatds or drop downwards quickly. I use ketones (fats) for fuel more than glucose so my blood glucose levels are quite steady now.
I also have an underactive thyroid. I agree that the right meds for you can really make a difference. I tried Synthroid for almost a year but it did not help with my symptoms. Switching to a natural desiccated thyroid made a big difference to how I felt. For some, adding T3, or a NDT can really help.
Totally agree with the bolded here. I have a friend who lost her thyroid to cancer probably 25 years go, and she struggled until she found a doctor who was willing put her on Cytomel (a T3) and Armour Thyroid (desiccated). The difference for her was night and day, really.
I'd suggest that if you haven't already, you check out the book and website Stop The Thyroid Madness. It is a treasure trove of useful information that can help you sort out exactly what to talk to your doc about (and how to approach it to get the best result!)
I'm glad your friend feels much better. I am not sure what the best answer is for supplementing my thyroid function. My dr is open to it; but it is the transition that scares me and the possible lack of success and the time frame to get back to where I was. It is something I will mention to the dr when I see her next week; but I would like to consider the LC option first to see how it makes a difference for me. (If I change everything at once we won't know what is contributing to the change).
I do have a book by Mary Shomon, called The Thyroid Diet. In it she talks about three different diet approaches... one of which is a carb-sensitive diet, which seems to fit my situation. So this is why I am wanting to implement a LC diet.
I would like to consider adding the T3; but my dr said that my synthroid would have to be reduced when it would be implemented and, in my head, it was like alarm bells saying "no way"... because I don't want to feel lousy. I am curious to know what your friend takes and how long it took to get a response to the change.
Thanks
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I will ask her for you, @MaryamCh2013 and let you know what she says.0
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MaryamCh2013 wrote: »I have reactive hypoglycemia but it is pretty mild. I have found that since I went very LCHF (<20g of carbs per day) that the problem is almost gone. Because I eat so few carbs and only moderate protein, my glucose does not spike upwatds or drop downwards quickly. I use ketones (fats) for fuel more than glucose so my blood glucose levels are quite steady now.
I also have an underactive thyroid. I agree that the right meds for you can really make a difference. I tried Synthroid for almost a year but it did not help with my symptoms. Switching to a natural desiccated thyroid made a big difference to how I felt. For some, adding T3, or a NDT can really help.
My doctor and I spoke about going LC and this is something I am seriously going to try. Once I have it established, my dr wants me to give it an honest try for one month. If after that time I am still having problems losing (or have to almost starve myself to lose), she is going to investigate further. ie. do hormone testing, etc.
My dr has been open to trying other meds (versus using synthroid); but she has found that her other patients have not had success with it. (And my dr is one of the good honest dr's, so I know she is being real with me). She is willing to try it; but I am scared of the transition and possible lack of success and what would happen to me during this time. I get very down when I am hypothyroid and I also have somewhat a similar response with eating a lot of carbs ... so I'm trying to be careful of my own mental health. I also have some other health issues (one a congenital heart problem that I was born with, and as thyroid function affects the heart my dr and I are cautious about any changes). Thanks
I would make sure you look at a few tests when deciding dosage. From what I understand, TSH should be near a 1 (if on Synthroid but if on NDT all bets are off), and free T4 and free T3 should be in the 50-75% range of the normal reference range... And go by symptoms.
Whe I was on synthroid (180mg?) we managed to get my TSH to a 2 something but my FT4 and FT3 were at the bottom of the normal range. I still felt the same as when I took nothing. The doctor refused to change anything because TSH was now normal.
When I went to NDT (150mg) my TSH dropped to 0.01, which looks scary, but my FT4 and FT3 are just above the halfway mark in the normal ranges, and I feel good.That's just my n=1. Thyroid issues are tricky.
BTW I haven't vhanged my meds since losing 40 lbs or going LCHF. It might be a tad high but I still feel fine.
... and I hear you on the carbs thing... they're a natural depressent, I swear. LOL
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MaryamCh2013 wrote: »I have reactive hypoglycemia but it is pretty mild. I have found that since I went very LCHF (<20g of carbs per day) that the problem is almost gone. Because I eat so few carbs and only moderate protein, my glucose does not spike upwatds or drop downwards quickly. I use ketones (fats) for fuel more than glucose so my blood glucose levels are quite steady now.
I also have an underactive thyroid. I agree that the right meds for you can really make a difference. I tried Synthroid for almost a year but it did not help with my symptoms. Switching to a natural desiccated thyroid made a big difference to how I felt. For some, adding T3, or a NDT can really help.
My doctor and I spoke about going LC and this is something I am seriously going to try. Once I have it established, my dr wants me to give it an honest try for one month. If after that time I am still having problems losing (or have to almost starve myself to lose), she is going to investigate further. ie. do hormone testing, etc.
My dr has been open to trying other meds (versus using synthroid); but she has found that her other patients have not had success with it. (And my dr is one of the good honest dr's, so I know she is being real with me). She is willing to try it; but I am scared of the transition and possible lack of success and what would happen to me during this time. I get very down when I am hypothyroid and I also have somewhat a similar response with eating a lot of carbs ... so I'm trying to be careful of my own mental health. I also have some other health issues (one a congenital heart problem that I was born with, and as thyroid function affects the heart my dr and I are cautious about any changes). Thanks
I would make sure you look at a few tests when deciding dosage. From what I understand, TSH should be near a 1 (if on Synthroid but if on NDT all bets are off), and free T4 and free T3 should be in the 50-75% range of the normal reference range... And go by symptoms.
Whe I was on synthroid (180mg?) we managed to get my TSH to a 2 something but my FT4 and FT3 were at the bottom of the normal range. I still felt the same as when I took nothing. The doctor refused to change anything because TSH was now normal.
When I went to NDT (150mg) my TSH dropped to 0.01, which looks scary, but my FT4 and FT3 are just above the halfway mark in the normal ranges, and I feel good.That's just my n=1. Thyroid issues are tricky.
BTW I haven't vhanged my meds since losing 40 lbs or going LCHF. It might be a tad high but I still feel fine.
... and I hear you on the carbs thing... they're a natural depressent, I swear. LOL
What's annoying where I live is that "if" your TSH is normal, they won't even test your T3 or T4, even if the dr requisitions it. And, if your TSH is normal, you have to wait a year from that time before you can be tested again.
I feel good compared to what I used to feel; BUT, I feel lousy compared to when I had my own thyroid for most of my life.
The only reason my dr is considering looking at things is because I have gained so much weight in a short time and am having such a hard time taking it off. I wish they would test my T3 and T4 but they won't, even with the drs signature ...
I'm glad you have your meds figured out 0 -
Ack!!!! You must not be in the U.S., or must have an issue with your insurance if they won't test T3 and T4. I had them tested even though my TSH was normal. It isn't that expensive at the lab I go to in California, and would definitely be worth paying for out of pocket. If having the tests done privately is an option, I would look into it.0
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lithezebra wrote: »Ack!!!! You must not be in the U.S., or must have an issue with your insurance if they won't test T3 and T4. I had them tested even though my TSH was normal. It isn't that expensive at the lab I go to in California, and would definitely be worth paying for out of pocket. If having the tests done privately is an option, I would look into it.
I'm in NewBrunswick, Canada. Healthcare is a provincial issue in Canada and they (NB) won't cover a lot of the basic things that other provinces do ... I'm already paying out of pocket for many things already, although I think if I was going to have a lab do testing, I would likely have to send the samples to the US.0 -
MaryamCh2013 wrote: »lithezebra wrote: »Ack!!!! You must not be in the U.S., or must have an issue with your insurance if they won't test T3 and T4. I had them tested even though my TSH was normal. It isn't that expensive at the lab I go to in California, and would definitely be worth paying for out of pocket. If having the tests done privately is an option, I would look into it.
I'm in NewBrunswick, Canada. Healthcare is a provincial issue in Canada and they (NB) won't cover a lot of the basic things that other provinces do ... I'm already paying out of pocket for many things already, although I think if I was going to have a lab do testing, I would likely have to send the samples to the US.
I would do some comparison shopping. Quest lab is usually my least expensive option, but I live in an area with few options. My insurance sucks, (again, few insurance options where I live), and I've paid for a lot of necessary tests out of pocket, because of my high deductible.0 -
lithezebra wrote: »MaryamCh2013 wrote: »lithezebra wrote: »Ack!!!! You must not be in the U.S., or must have an issue with your insurance if they won't test T3 and T4. I had them tested even though my TSH was normal. It isn't that expensive at the lab I go to in California, and would definitely be worth paying for out of pocket. If having the tests done privately is an option, I would look into it.
I'm in NewBrunswick, Canada. Healthcare is a provincial issue in Canada and they (NB) won't cover a lot of the basic things that other provinces do ... I'm already paying out of pocket for many things already, although I think if I was going to have a lab do testing, I would likely have to send the samples to the US.
I would do some comparison shopping. Quest lab is usually my least expensive option, but I live in an area with few options. My insurance sucks, (again, few insurance options where I live), and I've paid for a lot of necessary tests out of pocket, because of my high deductible.
Thanks 0 -
lithezebra wrote: »MaryamCh2013 wrote: »lithezebra wrote: »Ack!!!! You must not be in the U.S., or must have an issue with your insurance if they won't test T3 and T4. I had them tested even though my TSH was normal. It isn't that expensive at the lab I go to in California, and would definitely be worth paying for out of pocket. If having the tests done privately is an option, I would look into it.
I'm in NewBrunswick, Canada. Healthcare is a provincial issue in Canada and they (NB) won't cover a lot of the basic things that other provinces do ... I'm already paying out of pocket for many things already, although I think if I was going to have a lab do testing, I would likely have to send the samples to the US.
I would do some comparison shopping. Quest lab is usually my least expensive option, but I live in an area with few options. My insurance sucks, (again, few insurance options where I live), and I've paid for a lot of necessary tests out of pocket, because of my high deductible.
I don't know if they service Canadian clients, but there is a laboratory service called Direct Labs where you can requisition your own labs if you need to - at a steep discount, too. I used them all the time when I didn't have insurance at all. http://www.directlabs.com. Depending on how close you are to the US border that might be an option.0 -
lithezebra wrote: »MaryamCh2013 wrote: »lithezebra wrote: »Ack!!!! You must not be in the U.S., or must have an issue with your insurance if they won't test T3 and T4. I had them tested even though my TSH was normal. It isn't that expensive at the lab I go to in California, and would definitely be worth paying for out of pocket. If having the tests done privately is an option, I would look into it.
I'm in NewBrunswick, Canada. Healthcare is a provincial issue in Canada and they (NB) won't cover a lot of the basic things that other provinces do ... I'm already paying out of pocket for many things already, although I think if I was going to have a lab do testing, I would likely have to send the samples to the US.
I would do some comparison shopping. Quest lab is usually my least expensive option, but I live in an area with few options. My insurance sucks, (again, few insurance options where I live), and I've paid for a lot of necessary tests out of pocket, because of my high deductible.
I don't know if they service Canadian clients, but there is a laboratory service called Direct Labs where you can requisition your own labs if you need to - at a steep discount, too. I used them all the time when I didn't have insurance at all. http://www.directlabs.com. Depending on how close you are to the US border that might be an option.
Thank you 0
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