Thyroid Weirdness and Low Carbing
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KnitOrMiss
Posts: 10,104 Member
So, a post came up in another thread, http://community.myfitnesspal.com/en/discussion/10403529/help-starting-lchf#latest
GaleHawkins
drcate.com/going-low-carb-too-fast-may-trigger-thyroid-troubles-and-hormone-imbalance/
This could be the cause of some Keto Flu symptoms perhaps? T3 and reverse T3 are subjects I am trying to gain a deeper understanding about.
Personally, I was just diagnosed with rT3 issues in the past couple weeks, after having been treated for hypothyroidism for the last several years. In another thread (I think about Biotin and hair loss), @darlswife posted about having been added to a T3 medication, too. So this situation has obviously got some ground in this forum.
I'm copying and pasting the remaining posts, so that the discussion can continue here rather than hijacking the aforementioned thread.
RalfLott
GaleHawkins wrote: »
drcate.com/going-low-carb-too-fast-may-trigger-thyroid-troubles-and-hormone-imbalance/
This could be the cause of some Keto Flu symptoms perhaps? T3 and reverse T3 are subjects I am trying to gain a deeper understanding about.
@GaleHawkins - Keep us posted, eh? Nice to have you back.
FitToLead
Fantastic article. A few years ago I was hiking in the Himalayas, seemingly perfectly healthy, on extremely low carbs - and everyone was amazed at how I ate - no rice, no junk, no alcohol, no sugar sweets - when hiking way above the snow line up to 10 hours a day. 1 Year later I contracted meningitis and ... long story .. and it took a few years to figure out that the lingering lethargy, pain and cognitive impairments were not due to permanent damage from meningitis, but a whacked around thryoid. Interestingly, at the time, they thought thyroid was affected by the meningitis, but a few times since that I've gone very low carb the same thyroid symptoms get extremely bad - quickly - and don't get better like keto flu usually does. Who knows chicken or egg, but at this stage, I have not dropped carbs too low. I will see how next few weeks go.
RalfLott
Here's the nub of it:
If you have gone low carb successfully, you have accomplished a major change in your metabolism, one that involves turning on scores of enzymes your body has not needed or used for a long time, decades in some cases. Not everyone can accomplish this overhaul in time. Those who can often continue low carb for life with great success. But those who cannot accomplish all the necessary changes flip the hibernation switch, increase production of rT3 and thyronamines, which causes crushing fatigue and may lead to intense carb cravings in order to turn off the hibernation switch again.
For these people, an easy way to avoid flipping the hibernation switch and reduce carb cravings may be to simply make a more gradual reduction in carbs rather than an abrupt one.
Atkins, who advocates an abrupt switch to less than 20 gm per day, seems to have been aware of this problem and in fact in his writing he warns people they may experience fatigue in the first few days or weeks after going very low carb. Unfortunately, for some people, the fatigue never improves and they give up on low-carbing all together.
Incidentally, none of my patients reported feeling worse when they went low carb. I suspected it had something to do with the fact that I introduced them to low carbing one meal at a time beginning with breakfast. I made this recommendation simply because I didn’t have time to go over everything with them in one visit. I only had time to give them ideas for one meal, and had them start by cutting carbs from breakfast because that is the time of day we are most able to switch our dormant fat-burn enzymes from off to on.
KnitOrMiss
@GaleHawkins Thanks for posting this. I was just this week/last week diagnosed with a bad RT3 ratio and ongoing hypothyroidism not responding as well to increased T4 meds as expected. The hypo was diagnosed PRIOR to going low carb, but officially after a dramatic weight loss following my divorce. I'm going to dig into this, too, specifically because my pharmacist mentioned that she now has liver damage from being on the T3 medication my Endo added to my treatment regimen (took first dose this AM), but she also takes NDT...so I'm trying to determine if the risks are related to the T3 med or the combination... So much information!! I'm going to dig into this article.
KnitOrMiss
Hmm... Now I'm more confused than ever. This article references rT3 symptoms without other thyroid issues. I have both. My doctor has in fact increased my T4 medication (my TSH was terrible 6-9 months ago - like the worst it's ever been) 2 times since I've been low carb - and has now added a T3 medicine (lowest possible dose) to see if it helps my rT3 stuff... I'm going to extract this into a Thyroid Thread, so as not to permanently hijack here!
GaleHawkins
drcate.com/going-low-carb-too-fast-may-trigger-thyroid-troubles-and-hormone-imbalance/
This could be the cause of some Keto Flu symptoms perhaps? T3 and reverse T3 are subjects I am trying to gain a deeper understanding about.
Personally, I was just diagnosed with rT3 issues in the past couple weeks, after having been treated for hypothyroidism for the last several years. In another thread (I think about Biotin and hair loss), @darlswife posted about having been added to a T3 medication, too. So this situation has obviously got some ground in this forum.
I'm copying and pasting the remaining posts, so that the discussion can continue here rather than hijacking the aforementioned thread.
RalfLott
GaleHawkins wrote: »
drcate.com/going-low-carb-too-fast-may-trigger-thyroid-troubles-and-hormone-imbalance/
This could be the cause of some Keto Flu symptoms perhaps? T3 and reverse T3 are subjects I am trying to gain a deeper understanding about.
@GaleHawkins - Keep us posted, eh? Nice to have you back.
FitToLead
Fantastic article. A few years ago I was hiking in the Himalayas, seemingly perfectly healthy, on extremely low carbs - and everyone was amazed at how I ate - no rice, no junk, no alcohol, no sugar sweets - when hiking way above the snow line up to 10 hours a day. 1 Year later I contracted meningitis and ... long story .. and it took a few years to figure out that the lingering lethargy, pain and cognitive impairments were not due to permanent damage from meningitis, but a whacked around thryoid. Interestingly, at the time, they thought thyroid was affected by the meningitis, but a few times since that I've gone very low carb the same thyroid symptoms get extremely bad - quickly - and don't get better like keto flu usually does. Who knows chicken or egg, but at this stage, I have not dropped carbs too low. I will see how next few weeks go.
RalfLott
Here's the nub of it:
If you have gone low carb successfully, you have accomplished a major change in your metabolism, one that involves turning on scores of enzymes your body has not needed or used for a long time, decades in some cases. Not everyone can accomplish this overhaul in time. Those who can often continue low carb for life with great success. But those who cannot accomplish all the necessary changes flip the hibernation switch, increase production of rT3 and thyronamines, which causes crushing fatigue and may lead to intense carb cravings in order to turn off the hibernation switch again.
For these people, an easy way to avoid flipping the hibernation switch and reduce carb cravings may be to simply make a more gradual reduction in carbs rather than an abrupt one.
Atkins, who advocates an abrupt switch to less than 20 gm per day, seems to have been aware of this problem and in fact in his writing he warns people they may experience fatigue in the first few days or weeks after going very low carb. Unfortunately, for some people, the fatigue never improves and they give up on low-carbing all together.
Incidentally, none of my patients reported feeling worse when they went low carb. I suspected it had something to do with the fact that I introduced them to low carbing one meal at a time beginning with breakfast. I made this recommendation simply because I didn’t have time to go over everything with them in one visit. I only had time to give them ideas for one meal, and had them start by cutting carbs from breakfast because that is the time of day we are most able to switch our dormant fat-burn enzymes from off to on.
KnitOrMiss
@GaleHawkins Thanks for posting this. I was just this week/last week diagnosed with a bad RT3 ratio and ongoing hypothyroidism not responding as well to increased T4 meds as expected. The hypo was diagnosed PRIOR to going low carb, but officially after a dramatic weight loss following my divorce. I'm going to dig into this, too, specifically because my pharmacist mentioned that she now has liver damage from being on the T3 medication my Endo added to my treatment regimen (took first dose this AM), but she also takes NDT...so I'm trying to determine if the risks are related to the T3 med or the combination... So much information!! I'm going to dig into this article.
KnitOrMiss
Hmm... Now I'm more confused than ever. This article references rT3 symptoms without other thyroid issues. I have both. My doctor has in fact increased my T4 medication (my TSH was terrible 6-9 months ago - like the worst it's ever been) 2 times since I've been low carb - and has now added a T3 medicine (lowest possible dose) to see if it helps my rT3 stuff... I'm going to extract this into a Thyroid Thread, so as not to permanently hijack here!
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buuuump for anyone interested.
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We'll add another bumpity bump. 0
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Update, I guess. I've been on the T3 medicine in addition to the T4 medicine about 3 weeks now. I get a drop after about 3 hours after I take the T3, as it's an immediate use thing. If this continues, I might look into a continuous release, but my understanding is that even compounded, there aren't really any good ones on the market.
I have added back in my Iodine supplement just a few days ago. I feel better at some points, worse at some points, so I'm really hoping to get back to level.
Good thing is overall I seem more level in all the other categories.
Possibly related things I've done in the last 60 days - add a probiotic. Not sure whether I should stick with the one I have or switch... Added Diatomaceous Earth (thanks, @dietbepsi for the suggestion!) - and between these two, with treatment for low stomach acid, my stomach issues have started leveling out, too.
I just typed in my supplement list for giggles, and goodness, I really am a walking pharmacy.
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