Of refeeds and diet breaks
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I'm trucking along, though more maintenance than deficit. Have had a cold for the past week, so that's my excuse
(aka, have been a slug, so super low TDEE). Over yesterday because I made feijoa* crumble and demolished the whole lot, oops! Guess I should stick to just eating those suckers raw.
*https://en.wikipedia.org/wiki/Acca_sellowiana - produces lots of fruit within a very short window of time, I'm picking up around 3kg every couple of days. My digestive system is starting to complain a little about the excessive intake (there's ~7g of fibre per 100g)...7 -
Nony_Mouse wrote: »laurenbastug wrote: »Sorry if this has been brought up before, but I plan on taking a 2 week diet break. Because of this, I don't really have the time to slowly increase cals over time - is there a benefit or detriment to going straight from cutting cals to maintenance cals - aside from the obvious joy of more foods lol
You don't slowly increase cals with a diet break, it's straight from deficit to maintenance, so you're good to go
awesome thanks!! 1 -
Wow, over 200 pages now! This has been like watching a child grow into a really smart adult!
*** Public Service Announcement***
Since this thread has gotten so long, I would like to take a moment to suggest that anyone interested in this topic make some time to listen/watch/read the podcasts and videos and articles listed in the first several pages of the thread. While the idea of a generic "diet break" is thrown around a lot in mainstream weight loss and fitness media, this thread is about a specific type of diet break as laid out in all these resources.
This is not a criticism of any of the posters, I just know that if I just wandered across this thread now, I would skim and assume it is about the typical - just take a couple of weeks off and don't worry about your diet - diet break, and that's not what this is :drinker:
Also, I believe you will literally have a higher IQ for having absorbed even some of those resources
It really has grown. And it's barely 6 months old. AP testing will be a requirement lol.
And I would agree with the sentiment that many people might wander in and assume the same. The original post on page 1 is the backbone for everything that follows, which includes the podcast. And as always #context is heavily emphasized.
Increased frequency of refeeds and diet breaks in this context are all strategically planned, but personally tailored, for the purposes of fat loss and hormonal regulation in the already lean dieter.6 -
Well I'm 5 days in on my maintenance time and it's tougher than I thought it would be. I appreciate it showing me that maintenance will still be work. First couple of days I was under, and then it was like why not eat all that since you have the calories, then oh crap I went over and no longer have a buffet. It's a mindset change as well as needing to remember the good habits and portions of when trying to lose weight. I'm gonna stick with it for a couple more days and try and be more mindful and make better decisions.8
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Idontcareyoupick wrote: »Well I'm 5 days in on my maintenance time and it's tougher than I thought it would be. I appreciate it showing me that maintenance will still be work. First couple of days I was under, and then it was like why not eat all that since you have the calories, then oh crap I went over and no longer have a buffet. It's a mindset change as well as needing to remember the good habits and portions of when trying to lose weight. I'm gonna stick with it for a couple more days and try and be more mindful and make better decisions.
To rebalance hormones you really need to stick with it for at least 10 days, preferably 14.
Definitely a mindset change, and remembering to stick with those good habits you've learned whilst eating at a deficit. This is why we generally advocate continuing to log, unless you're very confident in estimating portions and not losing track of what's gone in your mouth. It is very very easy to fall back into old habits.8 -
Nony_Mouse wrote: »Idontcareyoupick wrote: »Well I'm 5 days in on my maintenance time and it's tougher than I thought it would be. I appreciate it showing me that maintenance will still be work. First couple of days I was under, and then it was like why not eat all that since you have the calories, then oh crap I went over and no longer have a buffet. It's a mindset change as well as needing to remember the good habits and portions of when trying to lose weight. I'm gonna stick with it for a couple more days and try and be more mindful and make better decisions.
To rebalance hormones you really need to stick with it for at least 10 days, preferably 14.
Definitely a mindset change, and remembering to stick with those good habits you've learned whilst eating at a deficit. This is why we generally advocate continuing to log, unless you're very confident in estimating portions and not losing track of what's gone in your mouth. It is very very easy to fall back into old habits.
I've been logging, just not as strict before to see what fits. I'll do the 14, just wanted to update in here and share my mental struggles Thanks. Hope to do better these next couple of days. 8 -
Idontcareyoupick wrote: »Well I'm 5 days in on my maintenance time and it's tougher than I thought it would be. I appreciate it showing me that maintenance will still be work. First couple of days I was under, and then it was like why not eat all that since you have the calories, then oh crap I went over and no longer have a buffet. It's a mindset change as well as needing to remember the good habits and portions of when trying to lose weight. I'm gonna stick with it for a couple more days and try and be more mindful and make better decisions.
The way I've been doing maintenance is just eating my usual menu and adding maybe one extra serving here and there, or leaving it as is on a day that I would enjoy a cocktail or a couple of glasses of wine, e.g. But my maintenance calorie level is low enough that it's not a big leap.
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Just popping in to say that I have been maintaining my weight (170lbs) for the last 8 weeks or so (a holiday has happened as well in that time) due to injury (pulled my lower right back really badly doing one armed rows, but I think it was pulled initially doing a heavy 70kg bench press) and illness (weird cold-like virus that has stuck around for around 3 weeks now, blah!). So no heavy deadlifting or back exercises for me for 6 weeks and just been feeling weak and light-headed with the viral thing. Maintenance cals are around 2580...
So flexible dieting still working and on track and proud that my mind is on track also with the calories (know how much to eat now for losing, maintaining and to gain)...not logging so tightly on here, but watching and learning. Might get to goal later, but I would rather there be comfort than any discomfort physically and mentally.
Thanks for this thread and keeping it alive everyone! Here is to spring and summer, mood lifting now the sun is out more in the UK!9 -
collectingblues wrote: »Nony_Mouse wrote: »I've finally read nearly all of this thread. But I need people to dumb things down for me.
@Nony_Mouse Why are you now doing "moderately low carb"? I must admit I cringe at the thought of one of my heroes going the low carb cult route, but knowing you, you will have a good reason.
I've always eaten lowish carb (around 100-120) at a deficit, not because I think there's any magic in it, just because it's easier for me to create and sustain a deficit that way. Even at maintenance 150g a day would be the norm for me most of the time. I'm all about the protein, and the things I eat tend to be higher fat (I'm looking at you, avocado and halloumi, oh and dark choc pb in my shakes!), so by the time those two things are in there's not a lot of room left for carbs, and they're the thing I care least about. Nothing cultish about it, just basic maths. I just don't shout it from the rooftops that I'm technically low carb (if you subscribe to that meaning lower than 150g), because it's just the way I eat. Dropped that a little lower than normal the past few days simply to shift some of the unholy amount of water weight I was lugging around. Purely psychological, I know it isn't fat weight.
So there you go, I've always been moderately low carb, you just didn't know it
I've been doing the same thing, Nony. The dietitian had me doing a moderate low carb during the pre-race taper, to try to curb that taper weight gain and keep my brain from freaking out. I actually enjoyed it, and found it easier to do when I was focusing on protein more, so it seems to have stuck.
*slowly raises hand* I'm also low to moderate carb right now, just because that's how the macros land when I focus on protein. I would actually prefer to be higher carb since I'm ramping up my cycling and running, but I seem to be unconsciously reaching for the protein, fat and fiber trifecta.
Me, too. I've been really good at managing my macros for the last couple of months for roughly a 1/3 for each. My exercise has been crap for the last few weeks (though still getting steps) because of the 15 hour work days. But I keeping on track with what I can. I keep lots of food in my office, so even when there are emergency meetings, I can still manage my nutrition--at least the macros.
I have to say I feel you on the work hours cutting into activity time
I retired last May (sing hallelujah!) but for the 14 previous years I had a 4 hour daily commute and my activity was practically nothing outside of weekends. I'm impressed you're keeping up with your steps (I think you have a more or less sedentary job in mental health counselling?) Yeah, I ended up keeping a bunch of portioned out food in my office, because toward the end there I was hitting the snack machine for potato chips and snickers bars almost on the hour.
I do technically have a sedentary job. I'm closing in on one year of at least 10,000 steps every day, but the big things was the Step Bet I joined. I refuse to lose money over something which should be under my control (or so I think). My goals were quite a bit over 10,000/day (15,000/day four days a week and 18,000/day two days a week). I'd do some yoga on my own after to stretch and relax a bit. And use my pranamat.
I work on a large college campus and going from meeting to meeting really does help me with my steps.
The main threat has been gone for a week and is at home with their parents. Mom still thinks the student's diet might be part of the problem (it's not) and I am concerned for the mental health support the student might be getting at home. They should be in an in-patient or intensive outpatient treatment. They're not.
And of course, this situation happened at another school right in the middle of when we were responding to our student. Our student was hospitalized for mental health issues 4 times in about 5 weeks.
We've done everything we can possibly do and I still worry it's not enough.
And today I should get my fitness life back. It's spring break here and things are a little slower (knock on wood). Yoga tonight!
I'm not sure how bad a diet needs to be to warrant a psychiatric threat, barring pure starvation or any extreme diet methods. There are studies that suggest a balanced or improved diet, used in conjunction with therapy, aid in mental health improvement, but an underlying disorder needs to be addressed by a healthcare professional as you stated.
Oh yeah—agreed! Mom is from a culture that doesn’t really believe in treatment the way we do in the US for mental health issues, even ones as serious as these (note I used the plural).
Sure, the student could always improve their nutrition (which could help them be in better condition for treatment to work), almost all my students could (and so could I—to be perfectly honest), but eating more veggies and getting some additional fiber isn’t going to fix what’s wrong with them. Mom is thinking it’s the cure because she didn’t have exposure to mental health issues where she was from.
OK, time for more yoga!
Ah, that makes sense. Culturally speaking, the stigma surrounding mental health often causes a lot more problems due to the lack of treatment or recognition that treatment is necessary. It’s a mark of shame leading to being a sociocultural pariah if your family is known to have something wrong. Pure lack of understanding is usually the root cause.
Some of family believes there’s a cure for anxiety and depression by simply toughing it out and “getting over it.” Social awkwardness is rewarded with titles of being a good and quiet child that doesn’t speak out unless spoken to, while any objections are punished with physical and mental abuse.
In my case, if food was encouraging those types of behaviors because it deviated from traditional meals, then it was a cause of being influenced by growing up in the US and disowning their native culture.
While it might not be the same line of thought, I can understand why the Mom might believe what she does. It sure as hell doesn’t take it right, but there’s at least some existing context that can be used to try and approach her from a different perspective.
I’m 167 posts behind ... Unfortunately, she and the student are beyond my influence. I’m hoping for the best in that her beliefs support her providing the best nutrition for them, just not at the expense of other treatment. It’s beyond my control and I need to minimize the worry. There are plenty of others about whom I need to be concerned. 2 -
I just had the realisation that my projected maintenance calories for my UGW (still around 15–20 pounds from now) is the same as what I'm currently eating, so it looks like at some point I'm simply going to stop losing and that's how I'll know I'm 'done'. It's not even that low of a BMI - I'm talking about 120–125 pounds at 5'3" (middle of normal range, but I have a small frame; wrist measurement under 5.5", East Asian heritage). Being a short, old, sedentary woman blows sometimes.
I'm wondering if this realisation has any potential ramifications that I should be thinking about now, like 'take a diet break now while you still even have a deficit', as well as what this might mean, if anything, as far as metabolic or hormonal stuff in the long term. Like, that whole discussion on whether to gradually up one's calories to find maintenance level or jump immediately up to them is never going to be a thing for me. Yeesh.
If you're quite close to your goal weight, remember that extending the deficit is going to be less productive for hormonal regulation. That said, you can take more frequent maintenance days/diet break periods as an approach to give you a break from the chronic deficit.
During your goal weight maintenance, since that is perceivably the hardest concept for most dieters, you are allowed some flexibility in your diet. Not everyday is going to be the same, so hunger won't always be the same either. Some days may have a deficit, while others might have a surplus. The average intake should be roughly your calculated maintenance and scale weight will fluctuate around a range in either direction. Whether you want/need to actively track during that time is up to you, but it wouldn't hurt to have a rough idea as a baseline.
I haven't delved into ethnic demographic metabolism very much (other than potential risk factors for certain races), but it does play some part in our personal genetic ability to handle more or less substrates.
Thanks. I'm 10 pounds out from my 'stop and reassess' goal of 130 but in all likelihood will keep going until I naturally slide into maintenance at 120–125 due to the aforementioned frame size considerations. Apparently, for example, 130 and 5'3" would put me only around the very top of healthy BMI according to the Chinese government's table (140 in the US, for reference). And though I'm not Chinese as such there's a certain logic in someone with my genetic background taking note of that set of national averages. Also, when I was at uni 20-something years ago I settled at 125 for quite some time after the freshman 15 so I think of it as a sort of 'happy weight'.
I'll be doing a proper diet break in the second half of April because I've got a holiday planned that will involve a lot of eating and drinking with people I haven't seen in ages, then I guess the slow march to 'no longer losing' will continue. Knowing I'm already eating at my maintenance level for my goal weight means I can already answer the question of whether or not I'll track calories at maintenance with an emphatic yes, I'll be tracking forever, because I could easily overeat my allotment by 700 calories a day if I didn't make a point of reining it in.
Sounds like a well enough plan. Lifelong tracking may need to be done in many cases. I share that aspect considering my mention of being formerly obese. If I'm not at least aware of what I'm eating, I will overeat. Though, I do have periods of relaxed and rigid tracking when situations or events call for it.
Definitely on the “Life-Long Tracker” train. It’s what’s best for me and it keeps me here with all you lovely and knowledgeable people! 3 -
bmeadows380 wrote: »The typical bodybuilding style of getting rid of bloat after a high carb/sodium day is to flush with a lot of water, increase potassium via Lite Salt or potassium chloride for seasoning food, reduce sodium/carbs, and a lot of LISS.
Not that anyone needs to do that, but it's a thing. Bodybuilders and physique athletes, and by extension physique chasers, have a horrible binge/purge cycle, speaking from experience.
Worst case scenario is that it may take up to 2 weeks for your scale weight to return to baseline, if that's your current metric of measurement. Every 1 day of eating blown way out of proportion (full on binge) = ~1 week to return to baseline, so for 2 days of complete overfeeding, it could potentially take 2 weeks.
The optimal and ideal realistic approach would be to just consider Easter as a refeed, go back to your normal routine and just allow yourself to be as consistent as possible from here on out. Daily weigh-ins take a mental toll, and menstruation plays a part in that.
ugh. I'm guessing its going to take that two weeks. I was down another pound from yesterday this morning, but still above last week's weigh in. I did blow it both Saturday and Sunday, so there's the 2 weeks lol
I would consider Easter just a refeed weekend except that I'm trying to figure out where my maintenance level is. I raised my calorie limit to the 1800 on the 19th, and saw about 1.5 lb drop on the 22nd, which was Thursday. But I also had tightened up my recording, so I know part of that loss was water. I waited another week, hoping to see if I was still tracking at ~1 lb/wk loss rate, but then TOM came along that weekend, so I showed a much larger drop on the 29th than I expected - 4.8 lbs loss. I know this was due to TOM being on the waning side and most of that was water weight loss. So, I kept at the 1800 for another week, hoping to see if the 1 lb/wk trend continued or if I was above or below it - except I blew it on Easter weekend both days, and now I'm still trending 1 lb above last weeks weigh in and am still pushing water weigh off, so this week's weigh in is a bust.
I guess I'll keep at the 1800 calorie limit until next Thursday and see what I get then and compare it to last weeks weigh in as I'm not even bothering to record today's weight. Of course, if I just go another week beyond that, I'll have my 1 month trend line to compare to, but I was hoping to be finishing up diet break at maintenance and getting back into deficit by the 1st of May. I'm trying to see which of the calculated values for maintenance I'm closest to so when I do back into deficit, I can be at a number that is closer to the weight loss/week I want to see and yet still eat as much as I can.
It sounds like you’re doing everything right, except the whole beating yourself up for the two days of overeating. You’ve done such amazing work and two days isn’t going to screw it up permanently. I know it’s frustrating, been there, still there some days.
There’s a solid plan in place and you’re being very intentional. Give the numbers more time to fall into place. And please stop being so hard on yourself.
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collectingblues wrote: »Waist-height ratio is definitely a better metric for me than waist-hip -- I'm a classic apple, but even at my current "this is not my normal" state, it still puts me at the "bodybuilder" level (at least according to the chart on Wikipedia). My pre-things-went-bad state had me at the "female swimmer" level, which makes sense, considering my workout levels.
But my waist-hip ratio is appalling... largely because I am such a classic apple, with tiny hips.
Sigh. Some days I think I’m tube-shaped. Right as the Pilsbury crescent roll dough is exploding out of it. 2 -
collectingblues wrote: »Waist-height ratio is definitely a better metric for me than waist-hip -- I'm a classic apple, but even at my current "this is not my normal" state, it still puts me at the "bodybuilder" level (at least according to the chart on Wikipedia). My pre-things-went-bad state had me at the "female swimmer" level, which makes sense, considering my workout levels.
But my waist-hip ratio is appalling... largely because I am such a classic apple, with
I could never figure out where my "natural" waistline is and got numbers all over the place every time I measured.
OMG, me too! I do suck at measuring in the same spot each time. I’m a smart person but this task, much like finding my car in a new parking lot (I’m the only person who spent more time walking around the parking lot at Disneyland than the park itself), is beyond my mental faculties. 2 -
GottaBurnEmAll wrote: »I have such a short waist. Well, I have a short everything. I'm only 5'1". My ratio used to be better when I was heavier, because my hips have majorly fallen off, but my waist has always been small. I always was an hourlgass/pear, now I'm more an inverted triangle with boobs. I have a 26 inch waist and 34.5 inch hips. I have to enter 35 into the calculators, though. So my ratio is .74
At least you still have boobs!
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It looks like some of my post was cut off... so here goes the rest (hopefully)...
I find myself getting really flustered when these missteps happen and it makes me want to eat a lot more.
So, it seems like now would be a good time for a diet break, maybe until I see the OS and find out exactly what's going on with the knee?
Is setting calories to maintenance the best thing to do?
How long should a diet break last?
Thanks in advance!
I’m also going to suggest an exercise break, or at least modifying your routine to minimize the stabbing knee pain. That’s a clue your body doesn’t want to do what you’re making it do. Making the injury worse will take it longer to heal at a minimum and could cause permanent damage.
Signed,
Person Who Refused to Modify Her Routine to Let Minor Shoulder Injury Heal and Was Then Sidelined From Most Activities for 5 Months2 -
@anubis609 - you gotten Lyle's book on injury recovery?
at only $10, I'm almost enough curious to review my recovery from injury that was worse than his injury and see if I did good or bad.
Actually, on reflection considering I didn't think about food much - probably bad.
Maybe the $10 isn't worth it until I get hurt again. ;-)
Funny enough, to what @Maxxitt said, a lot of people seemed to have injured themselves shortly after purchasing it. It's like the curse of Zordon.
OK, crossing that one off my Christmas list lest I kill Santa (or myself)!
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MegaMooseEsq wrote: »Well, I have a bit of a confession for the refeed thread crew: I’ve been pretty vocal on the forums about my success losing weight while calorie cycling/refeeding/banking calories. The point that I haven’t always been specific on was that this whole way of eating has basically been my way to compensate for too-frequent binge drinking and the subsequent drunk munchies. Increased alcohol use was a big part of my weight gain in the first place, and controlling it has been a big part of my success losing.
Since I might consume 800-1000 calories in alcohol on a high calorie day, I’ve felt like a bit of a fraud responding to threads about banking or cycling calories, although I do like reassuring people that you don’t have to stick to a strict daily goal to be successful. So with that embarrassing background out of the way, I’m happy to report that refeed days are a lot of fun even without lots of booze!
As of late last month, my husband and I quit smoking, which has also meant no more nights out drinking. I’m still hitting my glass of red wine most evenings and have had a couple of beers over the last few weeks, but only rarely more than one drink in a sitting. So instead of just hoping I can keep my weekly calories down enough to balance my semi-uncontrolled overeating, I actually have to plan where those extra carbs are going to come from. It’s pretty cool! Plus, I’ve been seeing consistent weight drops the day after a high-calorie/carb day, which never happened before presumably because of booze bloat.
Anyhow, I’ve been less active on the boards recently due to work, but I’ve been thinking about this a lot the last couple of weeks and wanted to share. Hope everyone is doing great and enjoying whatever phase of eating they happen to be in right now.
Personally, I don’t think of it as fraudulent at all. We always talk about CICO, emphasizing it doesn’t matter where the calories come from. That’s just the point you’ve illustrated. I don’t see how the calorie cycling/banking means something different if the calories are used for alcohol as opposed to cake or French fries.
And I can totally empathize about being gone from the boards for work! ((((Hug))))
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It sounds like you’re doing everything right, except the whole beating yourself up for the two days of overeating. You’ve done such amazing work and two days isn’t going to screw it up permanently. I know it’s frustrating, been there, still there some days.
There’s a solid plan in place and you’re being very intentional. Give the numbers more time to fall into place. And please stop being so hard on yourself.
Thank you! Though the not beating myself up thing is an ongoing work in progress that I'm not really very good at sidelining.......Its apparently my favorite hobby *shrugs* This is why even though I'm introverted, I really do need to have periods with people to pull me out of my head. Too much time alone with my thoughts is not good for me and almost always leads to a downward mental spiral because no one is harder on me than I am myself!
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I survived the weekend only to return with either a cold/flu or my body's trying to purge the partying. Tracking food was manageable, but the alcohol... it might be easier to calculate what I didn't drink.
On the plus side, this was the most non-exercise activity I've done in several months.13 -
Look at what a diet break is doing for my TDEE. Wow. Just wow.
(Orange numbers are the end of the 14 day diet break. I probably should have started it sooner--it was 4 months after my previous diet break.)
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very encouraging and interesting, nice healthy change up.
How are you estimating TDEE for others to duplicate this?3 -
very encouraging and interesting, nice healthy change up.
How are you estimating TDEE for others to duplicate this?
Kind of similar to @AnnPT77's Method 3 in How to Find Your Maintenance Calorie Level (https://community.myfitnesspal.com/en/discussion/10638211/how-to-find-your-maintenance-calorie-level/p1). Specifically, I have a spreadsheet set up where I track my daily MFP net calories. I then average the 30 previous days (first value). Then, I take my average daily calorie deficit as calculated by my weight trend app and my actual weight loss (or gain) for the previous month and add it to (or subtract it from, if I was in a surplus) the first value. I then use the spreadsheet's chart functionality to make a nice graph. Hope that makes sense.
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Hi all, just wanted to update. Finished my maintenance weeks yesterday. It was a good time for it and it was nice to see that I could eat more calories and not go completely off track. Dropping my calories back down today. Weirdly, I have more calories for same rate of loss than before I took the break. Anyway this was helpful and hope that going back into a deficit is not very difficult. Thanks for the comments and helps.7
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Another update. So it turns out, I am neither a special snowflake, nor crazy.
After more time of "Why isn't this thyroid mess working? And how on earth am I still gaining weight?" I called last week and got an appointment at Cleveland Clinic, with one of their top thyroid physicians -- they were able to get me in within just four business days. He looked at my data regarding dosing, and TSH, and calories, and promptly agreed that indeed, calorie restriction *can* affect TSH, as my labs were demonstrating, and that by only treating off of TSH, my old docs were chasing the wrong number, and in the end, actually undermedicating me. (And, the new labs he ordered came back this morning -- as we predicted, TSH is still suppressed, but my T4 is completely normal, and the T3 is only *barely* normal -- it's literally .1 above the bottom of the range, and is not considered optimal.) He informed me to tell my current docs not to touch anything related to thyroid, and that he'll manage it entirely. He wrote a script for nine months worth of the new meds, and said it's not even worth testing the TSH for another six months, since it can fluctuate by season anyway, and messing with it too often, as was demonstrated here, won't actually do any good.
He pointed out that a lot of the things that other providers were attributing to the eating disorder -- and some of the things that *I* was attributing just to absolutely losing my mind -- were/are classic hypothyroid symptoms. So the hope is that if we can get this straightened out, those will also resolve.
So we're now up to the dose where I was when I last felt well, which should be a pretty good match to my "optimal" dose based on where my last TSH was completely normal -- and thus, once things actually settle out, allow me to lose this extra water weight, and get back down to the weight that I prefer. He agreed that that weight would be fine, and if I can see that I can be that weight, and be the size that I was, without things going crazy out of control, I can accept that, too.12 -
collectingblues wrote: »Another update. So it turns out, I am neither a special snowflake, nor crazy.
After more time of "Why isn't this thyroid mess working? And how on earth am I still gaining weight?" I called last week and got appointment at Cleveland Clinic, with one of their top thyroid physicians -- they were able to get me in within just four business days. He looked at my data regarding dosing, and TSH, and calories, and promptly agreed that indeed, calorie restriction *can* affect TSH, as my labs were demonstrating, and that by only treating off of TSH, my old docs were chasing the wrong number, and in the end, actually undermedicating me. (And, the new labs he ordered came back this morning -- as we predicted, TSH is still suppressed, but my T4 is completely normal, and the T3 is only *barely* normal -- it's literally .1 above the bottom of the range, and is not considered optimal.) He informed me to tell my current docs not to touch anything related to thyroid, and that he'll manage it entirely. He wrote a script for nine months worth of the new meds, and said it's not even worth testing the TSH for another six months, since it can fluctuate by season anyway, and messing with it too often, as was demonstrated here, won't actually do any good.
He pointed out that a lot of the things that other providers were attributing to the eating disorder -- and some of the things that *I* was attributing just to absolutely losing my mind -- were/are classic hypothyroid symptoms. So the hope is that if we can get this straightened out, those will also resolve.
So we're now up to the dose where I was when I last felt well, which should be a pretty good match to my "optimal" dose based on where my last TSH was completely normal -- and thus, once things actually settle out, allow me to lose this extra water weight, and get back down to the weight that I prefer. He agreed that that weight would be fine, and if I can see that I can be that weight, and be the size that I was, without things going crazy out of control, I can accept that, too.
Can I ask what your levels have been? We've been dropping my meds because my TSH levels keep dropping below range (they're under .1) and I've always felt fine and am not sure that these aren't just fluctuations. I have an appointment coming up in a few weeks and am getting bloodwork today if this migraine clears up.5 -
GottaBurnEmAll wrote: »collectingblues wrote: »Another update. So it turns out, I am neither a special snowflake, nor crazy.
After more time of "Why isn't this thyroid mess working? And how on earth am I still gaining weight?" I called last week and got appointment at Cleveland Clinic, with one of their top thyroid physicians -- they were able to get me in within just four business days. He looked at my data regarding dosing, and TSH, and calories, and promptly agreed that indeed, calorie restriction *can* affect TSH, as my labs were demonstrating, and that by only treating off of TSH, my old docs were chasing the wrong number, and in the end, actually undermedicating me. (And, the new labs he ordered came back this morning -- as we predicted, TSH is still suppressed, but my T4 is completely normal, and the T3 is only *barely* normal -- it's literally .1 above the bottom of the range, and is not considered optimal.) He informed me to tell my current docs not to touch anything related to thyroid, and that he'll manage it entirely. He wrote a script for nine months worth of the new meds, and said it's not even worth testing the TSH for another six months, since it can fluctuate by season anyway, and messing with it too often, as was demonstrated here, won't actually do any good.
He pointed out that a lot of the things that other providers were attributing to the eating disorder -- and some of the things that *I* was attributing just to absolutely losing my mind -- were/are classic hypothyroid symptoms. So the hope is that if we can get this straightened out, those will also resolve.
So we're now up to the dose where I was when I last felt well, which should be a pretty good match to my "optimal" dose based on where my last TSH was completely normal -- and thus, once things actually settle out, allow me to lose this extra water weight, and get back down to the weight that I prefer. He agreed that that weight would be fine, and if I can see that I can be that weight, and be the size that I was, without things going crazy out of control, I can accept that, too.
Can I ask what your levels have been? We've been dropping my meds because my TSH levels keep dropping below range (they're under .1) and I've always felt fine and am not sure that these aren't just fluctuations. I have an appointment coming up in a few weeks and am getting bloodwork today if this migraine clears up.
So, it varies -- hence part of the problem.
My TSH tend to be very suppressed when I'm running a deficit of 15 percent or more -- ranging from .015 in March, to .091 in June 2016. On the other end of the spectrum, I was 4.13 in November 2017 when I was eating at maintenance, and 2.913 in May 2017 after my then-endo had dropped my dosing. I felt *awful* at the non-suppressed values, which is part of why he's saying that OK, clearly being suppressed isn't a problem for me.
This physician (I feel like I can't call him New Endo, since I'll still see someone locally for diabetes management) said he's fine with it hovering around .1 or slightly below, but that he's also not going to worry if it's as low as it was, as long as the T3 and T4 are within range. He's more concerned about symptoms, and treating to those instead of trying to chase a lab value.5 -
collectingblues wrote: »GottaBurnEmAll wrote: »collectingblues wrote: »Another update. So it turns out, I am neither a special snowflake, nor crazy.
After more time of "Why isn't this thyroid mess working? And how on earth am I still gaining weight?" I called last week and got appointment at Cleveland Clinic, with one of their top thyroid physicians -- they were able to get me in within just four business days. He looked at my data regarding dosing, and TSH, and calories, and promptly agreed that indeed, calorie restriction *can* affect TSH, as my labs were demonstrating, and that by only treating off of TSH, my old docs were chasing the wrong number, and in the end, actually undermedicating me. (And, the new labs he ordered came back this morning -- as we predicted, TSH is still suppressed, but my T4 is completely normal, and the T3 is only *barely* normal -- it's literally .1 above the bottom of the range, and is not considered optimal.) He informed me to tell my current docs not to touch anything related to thyroid, and that he'll manage it entirely. He wrote a script for nine months worth of the new meds, and said it's not even worth testing the TSH for another six months, since it can fluctuate by season anyway, and messing with it too often, as was demonstrated here, won't actually do any good.
He pointed out that a lot of the things that other providers were attributing to the eating disorder -- and some of the things that *I* was attributing just to absolutely losing my mind -- were/are classic hypothyroid symptoms. So the hope is that if we can get this straightened out, those will also resolve.
So we're now up to the dose where I was when I last felt well, which should be a pretty good match to my "optimal" dose based on where my last TSH was completely normal -- and thus, once things actually settle out, allow me to lose this extra water weight, and get back down to the weight that I prefer. He agreed that that weight would be fine, and if I can see that I can be that weight, and be the size that I was, without things going crazy out of control, I can accept that, too.
Can I ask what your levels have been? We've been dropping my meds because my TSH levels keep dropping below range (they're under .1) and I've always felt fine and am not sure that these aren't just fluctuations. I have an appointment coming up in a few weeks and am getting bloodwork today if this migraine clears up.
So, it varies -- hence part of the problem.
My TSH tend to be very suppressed when I'm running a deficit of 15 percent or more -- ranging from .015 in March, to .091 in June 2016. On the other end of the spectrum, I was 4.13 in November 2017 when I was eating at maintenance, and 2.913 in May 2017 after my then-endo had dropped my dosing.
This physician (I feel like I can't call him New Endo, since I'll still see someone locally for diabetes management) said he's fine with it hovering around .1 or slightly below, but that he's also not going to worry if it's as low as it was, as long as the T3 and T4 are within range. He's more concerned about symptoms, and treating to those instead of trying to chase a lab value.
See, I've had it lower than it is now, but they're all under .1, and she's concerned by that. I have felt fine and not hyperthyroid on any dosage, and in fact I might be a little hypo in that my skin is dry and I'm more prone to feeling cold.
I'm going to ask her to run a full panel next time if she wants to try to lower my dose any more. I am running a decent deficit and that might be suppressing my TSH, you have me thinking.
The problem is the scale's not moving, but that could be me and having a stupid stall-whoosh weight loss pattern, which I'm prone to having. If I can keep myself from binging, I might hold out to see it happen.5 -
GottaBurnEmAll wrote: »collectingblues wrote: »GottaBurnEmAll wrote: »collectingblues wrote: »Another update. So it turns out, I am neither a special snowflake, nor crazy.
After more time of "Why isn't this thyroid mess working? And how on earth am I still gaining weight?" I called last week and got appointment at Cleveland Clinic, with one of their top thyroid physicians -- they were able to get me in within just four business days. He looked at my data regarding dosing, and TSH, and calories, and promptly agreed that indeed, calorie restriction *can* affect TSH, as my labs were demonstrating, and that by only treating off of TSH, my old docs were chasing the wrong number, and in the end, actually undermedicating me. (And, the new labs he ordered came back this morning -- as we predicted, TSH is still suppressed, but my T4 is completely normal, and the T3 is only *barely* normal -- it's literally .1 above the bottom of the range, and is not considered optimal.) He informed me to tell my current docs not to touch anything related to thyroid, and that he'll manage it entirely. He wrote a script for nine months worth of the new meds, and said it's not even worth testing the TSH for another six months, since it can fluctuate by season anyway, and messing with it too often, as was demonstrated here, won't actually do any good.
He pointed out that a lot of the things that other providers were attributing to the eating disorder -- and some of the things that *I* was attributing just to absolutely losing my mind -- were/are classic hypothyroid symptoms. So the hope is that if we can get this straightened out, those will also resolve.
So we're now up to the dose where I was when I last felt well, which should be a pretty good match to my "optimal" dose based on where my last TSH was completely normal -- and thus, once things actually settle out, allow me to lose this extra water weight, and get back down to the weight that I prefer. He agreed that that weight would be fine, and if I can see that I can be that weight, and be the size that I was, without things going crazy out of control, I can accept that, too.
Can I ask what your levels have been? We've been dropping my meds because my TSH levels keep dropping below range (they're under .1) and I've always felt fine and am not sure that these aren't just fluctuations. I have an appointment coming up in a few weeks and am getting bloodwork today if this migraine clears up.
So, it varies -- hence part of the problem.
My TSH tend to be very suppressed when I'm running a deficit of 15 percent or more -- ranging from .015 in March, to .091 in June 2016. On the other end of the spectrum, I was 4.13 in November 2017 when I was eating at maintenance, and 2.913 in May 2017 after my then-endo had dropped my dosing.
This physician (I feel like I can't call him New Endo, since I'll still see someone locally for diabetes management) said he's fine with it hovering around .1 or slightly below, but that he's also not going to worry if it's as low as it was, as long as the T3 and T4 are within range. He's more concerned about symptoms, and treating to those instead of trying to chase a lab value.
See, I've had it lower than it is now, but they're all under .1, and she's concerned by that. I have felt fine and not hyperthyroid on any dosage, and in fact I might be a little hypo in that my skin is dry and I'm more prone to feeling cold.
I'm going to ask her to run a full panel next time if she wants to try to lower my dose any more. I am running a decent deficit and that might be suppressing my TSH, you have me thinking.
The problem is the scale's not moving, but that could be me and having a stupid stall-whoosh weight loss pattern, which I'm prone to having. If I can keep myself from binging, I might hold out to see it happen.
I was so relieved when I asked him what I was supposed to do if my local providers wanted to drop the dose again. He told me that *he* was writing it for a 90-day supply (and then three refills on it), and that I should tell them I have someone else managing it -- and, that afterall, they could tell me anything they want, but I don't have to do it, and he'll make sure I've got the right meds.10 -
TSH is highly variable depending on what YOU are used to, particularly during adolescence. Even though people may have a high level, this may feel normal to them. This is the inherent issue with hormones - there is no perfect zone for everyone.
I went 30 years and likely hyperthyroid, but never diagnosed. Following a total thyroidectomy a TSH over 2.0 and I'm wrecked. All my appetite triggers are off and I just want to eat and sleep all day. Note that for most total thyroidectomy/cancer patients the goal is to keep TSH under 0.2 to minimize risk of cancer recurrence.
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