25 year old female with cold urticaria for 2 years, feel unsure what to do anymore

summergirl

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Hi all,
My name is Sarah, I am a 25 year old female. I have been lurking on this forum for 2 years and it is so sad that I finally was able to join the forum about a week ago, and that same day I discovered that Ray Peat passed away.

I apologize for how long this is probably going to be. I will try to make it as brief as I can. I developed cold urticaria around December of 2020. I was on a hike in the winter and I got itchy bumps all over my legs and hands. I thought it must have been something I ate, but then it happened every single time any part of me got cold, ever since then. My face, hands, arms, legs, stomach, anything that is exposed to cold temperatures for more than a few minutes will turn red and develop hives a few minutes into rewarming. Now I can't swim in cold water, etc. because I could develop anaphylaxis (which I thankfully have never had before).

I took accutane in 2019-2020, and got off of accutane in July. By August I discovered Ray Peat, and started loosely "peating" by the fall. I was increasing carbs, reintroducing dairy after 7 years of avoiding it, decreasing PUFAs. A few months later, in Dec 2020, my reactions to the cold started.

I did not see my PCP for my cold urticaria until the spring of 2021 and I did not see an allergist until spring of 2022. The allergist suspected that I developed cold urticaria because of a mycoplasma pneumonia infection, though I did not remember ever being sick. He tested me for mycoplasma pneumonia IgG and IgM and my titers were high so I was positive for that, even though the time of the testing was almost 2 years after developing the reaction to cold. The allergist said he doesn't know how long I will react to the cold, and he recommended me to take zyrtec 4 times per day and famotidine 2x per day but I have not done that. He also recommended xolair injections which I considered for a while and then decided not to pursue.

Some factors in my life that I believe are relevant:
- I had a physical/emotional trauma from my father my whole childhood
- I have had significant anxiety probably mostly related to that trauma, ever since I was about 5
- I had lyme disease 3 times as a teenager, and ehrlichiosis once, all from tick bites.
- I was bullied a lot in school because I had bad acne since I was 12 and I was socially anxious and awkward, this caused a lot of additional stress
- I got the covid vaccine against my will when my work mandated it to keep my job in healthcare, though I had already had cold urticaria for 6 months by that point
- I was diagnosed with PCOS when I was 19, which I know is related to thyroid function, stress, and estrogen, and all those issues can cause urticaria issues
- I have known estrogen dominance from DUTCH testing in 2019, and I did a repeat dutch test in 2021 after 1 year of "peating" and all of my levels improved (stress hormones went down a LOT, testosterone excess went down, progesterone went up)
- I still had estrogen dominance in my 2021 DUTCH test.
- For birth control I do fertility awareness method, and I do ovulate every month since 2020 and I get my period every 32-35 days which is a huge improvement as I used to rarely ovulate and my period would skip every few months.
- I know that stress hormones like cortisol are immune suppressants. They were off the charts in my 2019 DUTCH test. When I finally lowered my stress levels significantly by eating more pro-metabolically, I wonder if that allowed my autoimmune condition (cold urticaria) to show itself.

I can attach screen shots of my DUTCH tests from 2019 and 2021 if that would be helpful.

When I gave in and took accutane for 9 months in 2019-2020, it was because my acne was severe. At the time of starting accutane I was doing low carb, high fat and intermittent fasting. I was eating tons of nuts and seeds and nut butters instead of carbs, taking fish oil, avoiding fruit and almost all carbs, which I don't do any of that now. My hair was falling out, my face was puffy, my acne was horrible, and I was in denial that all the "healthy" fats could cause that, so I kept telling myself my symptoms were just because I didn't take my carbs low enough for PCOS, and I was convinced for about 2 years that low carb, close to keto, and intermittent fasting was best for insulin resistance which was the "root cause" of PCOS, but I now know insulin resistance is just a symptom of a bigger metabolic problem.

I had thyroid testing done in spring of 2022 because I was convinced my cold U and my PCOS must be related to my thyroid. My results came back "normal" i will add those numbers here:

TSH. 1.06 uIU/ML0.400 - 4.100 uIU/ML
Free Thyroxin1.0 NG/DL0.80 - 1.90 NG/DL
Free T3 3.3 PG/ML2.2 - 4.2 PG/ML
Thyroid Peroxidase Antibody10 IU/ML<35 IU/ML
Thyroglobulin Antibody<15 IU/mL0 - 115 IU/mL

Long story short if anyone has any advice for me, what to try, what to eat, what to test, please let me know. My PCP, allergist, and endocrinologist, have nothing to offer me except telling me to take antihistamines and avoid cold. I do take hydroxyzine daily only at night and it helps with sleep and anxiety as well as the itchiness of the reactions.
Other supplements I take:
Inositol 1 tsp 2x per day
vitamin D3 5,000 IU a few times per week
vitamin K2 a few times per week
vitamin E every day with dinner
beef liver capsules
magnesium glycinate every night

I try to not let my stress and anxiety overwhelm me. I spend a lot of time in nature (though it's harder now in the winter because it's cold).
I spend time with my boyfriend and people that love me. I try to stay hopeful that my body can heal itself and wants to heal itself. I try to tell myself I am resilient and young and I will be ok.
 
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Hi Sarah, I am so sorry about your health struggles. It must be so frustrating dealing with it all. I cannot speak for your urticaria but your thyroid results look similar to mine before I had my thyroid treated. I had nice low TSH just like yours so my doctor never considered I had hypothyroidism. Your free thyroxine is particularly low, even though it is within range. (My total thyroxine was hovering around low too, never had free thyroxine tested before medication) You must understand these ranges are not ranges for healthy people, just the majority of the people that the lab itself tests. Many people suffer from poor thyroid function these days. The free thyroxine and free T3 should both be in the upper 25% of the range to feel your best. Your free t3 could be higher as well, mine is currently at 3.8 and I am just starting to feel normal.

"My hair was falling out, my face was puffy, my acne was horrible" These could be low thyroid problem symptoms, I had these myself.
"I was convinced my cold U and my PCOS must be related to my thyroid" It very well may be. It took years and lots of suffering for doctors to finally address my issues. You have to take charge of your own health--as I see you have done and are doing!

Also, when one is suffering from hypothyroidism, one's body tends to over-produce the stress hormones cortisol and adrenaline to make up for a lack of proper thyroid hormone levels. This makes for a very stressful time.

Should you decide to get some thyroid hormone medication remember that you must go slowly, you may feel slightly worse for a few days or so. For me, after a week give or take-I suddenly felt calmer than I have in years and was not over-reacting to everything in my life. I upped my dose every couple months when I would get too sleepy during the day.

A lot more health problems than I can mention were resolved when I started thyroid medication, I noticed that my all of my hormones were affected. I am not saying you need medication, but you need a change. Maybe you just need to rid your body of excess estrogen. Maybe thyroid support minerals like selenium etc. Do not over do it, especially iodine. It can make problems worse.

Maybe this chart found on this website could help you understand where your lab ranges should fall, so you don't have to take my word for it:


 

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summergirl

summergirl

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Hi Sarah, I am so sorry about your health struggles. It must be so frustrating dealing with it all. I cannot speak for your urticaria but your thyroid results look similar to mine before I had my thyroid treated. I had nice low TSH just like yours so my doctor never considered I had hypothyroidism. Your free thyroxine is particularly low, even though it is within range. (My total thyroxine was hovering around low too, never had free thyroxine tested before medication) You must understand these ranges are not ranges for healthy people, just the majority of the people that the lab itself tests. Many people suffer from poor thyroid function these days. The free thyroxine and free T3 should both be in the upper 25% of the range to feel your best. Your free t3 could be higher as well, mine is currently at 3.8 and I am just starting to feel normal.

"My hair was falling out, my face was puffy, my acne was horrible" These could be low thyroid problem symptoms, I had these myself.
"I was convinced my cold U and my PCOS must be related to my thyroid" It very well may be. It took years and lots of suffering for doctors to finally address my issues. You have to take charge of your own health--as I see you have done and are doing!

Also, when one is suffering from hypothyroidism, one's body tends to over-produce the stress hormones cortisol and adrenaline to make up for a lack of proper thyroid hormone levels. This makes for a very stressful time.

Should you decide to get some thyroid hormone medication remember that you must go slowly, you may feel slightly worse for a few days or so. For me, after a week give or take-I suddenly felt calmer than I have in years and was not over-reacting to everything in my life. I upped my dose every couple months when I would get too sleepy during the day.

A lot more health problems than I can mention were resolved when I started thyroid medication, I noticed that my all of my hormones were affected. I am not saying you need medication, but you need a change. Maybe you just need to rid your body of excess estrogen. Maybe thyroid support minerals like selenium etc. Do not over do it, especially iodine. It can make problems worse.

Maybe this chart found on this website could help you understand where your lab ranges should fall, so you don't have to take my word for it:



Thank you so much for taking the time to read my long post! I have considered taking thyroid but with my tendency toward anxiety I am so afraid of making it worse. I am still unsure about how to purchase, how to dose it, and if I told my doctor or endocrinologist about those endeavors none of them would support me.

I have been trying so hard to improve my thyroid with diet/supplements/stress reduction alone. Now I am finally able to look back and acknowledge my whole adolescent life of having freezing hands and feet, constant anxiety, bouts of depression, hair loss, acne, horrible pet/dust allergies, etc, is probably all related to stress and low thyroid function.

Thankfully now my hands and feet stay warm as long as I eat every 3-4 hours. My hair has grown back like crazy, my acne is gone, my anxiety is a lot better now but I still feel fragile to some extent.

I will consider taking thyroid at some point if I feel that I am stuck for a long time. There are some case studies out there showing that taking thyroid hormone got rid of patients chronic hives, even cold hives. That is what prompted me to test my thyroid hormones.

Also I take "thorne basic nutrients 2/day" but I only take 1 per day, because I think the full dose is excessive.
It has no iron and it has selenium, zinc, copper, b vitamins etc
 

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You may find that thyroid hormone can calm your anxiety, if it is caused by cortisol or adrenaline. My thyroid levels looked just like yours on a normal day for me, I had them tested many times over a couple years or so...and I felt like crap (tired, couldn't exercise-or recover from it, hair thinning, face puffiness, female issues), most of the time. I would have bouts of over-hyper energy, but I came to realize that was just when my thyroid was working more normally, (I would have my blood tested and when I thought I was hyperthyroid that day and it always came back at just under top of the range...perfect) and the excess of stress hormones would amplify in the presence of suddenly normal thyroid hormone levels. The stress hormones do not immediately lower once thyroid is back to good levels and that makes one feel anxious, hyper, agitated and all that.

I get that "fragile" feeling. I hope you find what works--and refuse to suffer as well.

You could show your doctors the chart I showed you and tell them you want to work toward these optimal levels to see how that makes you feel. They may agree to let you test it out, perhaps just the smallest dose. Most doctors are pretty ignorant about thyroid levels from what I have experienced. If your primary doc doesn't go for it, try your endo, someone just might give in. They are prescribed. And who knows, maybe your thyroid will heal and all hormones will balance and you can wean off of it. You may be surprised how much it helps other things in your body. Oh, you can try going gluten free because that's a big problem with thyroid. It always made my thyroid better when I cut it out of my diet.
 

Lilac

Member
Joined
May 6, 2014
Messages
636
I have a female friend who suffered from this. I don't know every detail of her problem, so I'm just throwing this out there, as my Peat-slanted thoughts.

She had this "allergy to cold," as it was explained to me. I saw her collapse at the beach after she was in cold water.

She was quite thin (and under-ate to maintain this) and had been a premie. She also suffered from arrhythmia--racing heartbeat at times. Maybe in her 30s she underwent cardiac ablation, which I understand took care of the cold allergy and the arrhythmia.

I suspect she was hypothyroid. I also wonder about the house she grew up in. In was an old house below street level, as it was built before the surrounding neighborhood. Factories existed in this area, so I have speculated that the yard was toxic. Every person in this house--mother, father. and each of five children had a different health problem, and some of them were young when the ailment occurred.
 
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summergirl

summergirl

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You may find that thyroid hormone can calm your anxiety, if it is caused by cortisol or adrenaline. My thyroid levels looked just like yours on a normal day for me, I had them tested many times over a couple years or so...and I felt like crap (tired, couldn't exercise-or recover from it, hair thinning, face puffiness, female issues), most of the time. I would have bouts of over-hyper energy, but I came to realize that was just when my thyroid was working more normally, (I would have my blood tested and when I thought I was hyperthyroid that day and it always came back at just under top of the range...perfect) and the excess of stress hormones would amplify in the presence of suddenly normal thyroid hormone levels. The stress hormones do not immediately lower once thyroid is back to good levels and that makes one feel anxious, hyper, agitated and all that.

I get that "fragile" feeling. I hope you find what works--and refuse to suffer as well.

You could show your doctors the chart I showed you and tell them you want to work toward these optimal levels to see how that makes you feel. They may agree to let you test it out, perhaps just the smallest dose. Most doctors are pretty ignorant about thyroid levels from what I have experienced. If your primary doc doesn't go for it, try your endo, someone just might give in. They are prescribed. And who knows, maybe your thyroid will heal and all hormones will balance and you can wean off of it. You may be surprised how much it helps other things in your body. Oh, you can try going gluten free because that's a big problem with thyroid. It always made my thyroid better when I cut it out of my diet.

You may find that thyroid hormone can calm your anxiety, if it is caused by cortisol or adrenaline. My thyroid levels looked just like yours on a normal day for me, I had them tested many times over a couple years or so...and I felt like crap (tired, couldn't exercise-or recover from it, hair thinning, face puffiness, female issues), most of the time. I would have bouts of over-hyper energy, but I came to realize that was just when my thyroid was working more normally, (I would have my blood tested and when I thought I was hyperthyroid that day and it always came back at just under top of the range...perfect) and the excess of stress hormones would amplify in the presence of suddenly normal thyroid hormone levels. The stress hormones do not immediately lower once thyroid is back to good levels and that makes one feel anxious, hyper, agitated and all that.

I get that "fragile" feeling. I hope you find what works--and refuse to suffer as well.

You could show your doctors the chart I showed you and tell them you want to work toward these optimal levels to see how that makes you feel. They may agree to let you test it out, perhaps just the smallest dose. Most doctors are pretty ignorant about thyroid levels from what I have experienced. If your primary doc doesn't go for it, try your endo, someone just might give in. They are prescribed. And who knows, maybe your thyroid will heal and all hormones will balance and you can wean off of it. You may be surprised how much it helps other things in your body. Oh, you can try going gluten free because that's a big problem with thyroid. It always made my thyroid better when I cut it out of my diet.
I might be mistaken but I’m not sure if doctors have access to the full spectrum that you need when you are hypothyroid. Don’t they just give you thyroxine and not T3?

The issue is I am normal weight, I am fairly fit looking, so I appear healthy. Doctors have tested my thyroid for years as I honestly suspected issues for one reason or another since I was like 14, but it has come back “normal” time and time again. My TSH is usually somewhere between 0.8-1.0. I know chronic stress can suppress TSH levels. Also my endocrinologist said that only quacks test for reverse T3 and there was no evidence for that, and she said there is no evidence I have thyroid disease so I don’t need medication.

my point I’m trying to get at is, I have been dismissed a LOT in my life especially with thyroid/ hormone issues because I appear healthy, and I don’t have good insurance at the moment. But I will consider looking further into taking thyroid.

Also I have tried going gluten free for a few months at a time but I haven’t seen any reduction in hives or changes in my digestion unfortunately.
 
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I might be mistaken but I’m not sure if doctors have access to the full spectrum that you need when you are hypothyroid. Don’t they just give you thyroxine and not T3?
full spectrum of what exactly? of labs? medicine? They can give you T4(thyroxine) and T3 (triiodothyronine). I take T4 only, i convert it to T3 well, i'm not terribly old or unhealthy otherwise.
The issue is I am normal weight, I am fairly fit looking, so I appear healthy. Doctors have tested my thyroid for years as I honestly suspected issues for one reason or another since I was like 14, but it has come back “normal” time and time again. My TSH is usually somewhere between 0.8-1.0. I know chronic stress can suppress TSH levels. Also my endocrinologist said that only quacks test for reverse T3 and there was no evidence for that, and she said there is no evidence I have thyroid disease so I don’t need medication.

You can be thyroid sick without gaining weight. When I ate normally (healthy) and went to bed on time, I was fit and thin for all of my life...then my husband's ways got a hold of me (restaurant food, pufas!! I never ate fried food hardly at all before this) and not going to bed at a good hour made me really sick because my thyroid was already in a fragile state. My body had finally had enough and my thyroid couldn't hold on any longer and I started to gain weight like never before in my life. My thyroid was showing signs of problems for many years before this--the tiredness, hair thinning.

When I was in my twenties I was quite thin and I did suffer a lot with tiredness...I attribute that to having babies, but my thyroid problems were starting to show up in an occasional neck pain. Now I know that pain was my thyroid...I had thyroiditis a lot apparently.

I guess I am saying this is something you have to watch out for. I never had my reverse t3 tested, doesn't seem useful for me because my medication works, as in it turns into T3, so nothing to worry about. Your t3 is also quite a bit higher in proportion than t4, just like I was before. My TSH is always low, when I was the most hypothyroid it was 1.5, (lowest was 0.5), so free t4 and free t3 are useful for me. My TSH is undetectable now, and my free t4/t3 are getting into the upper 25% range. I do not have any over-medicated symptoms, which is what doctors are soooooo freaked out about when giving this medication. They absolutely would rather under-medicate you than go anywhere near a little too much.

my point I’m trying to get at is, I have been dismissed a LOT in my life especially with thyroid/ hormone issues and I don’t have good insurance at the moment. But I will consider looking further into taking thyroid.

Also I have tried going gluten free for a few months at a time but I haven’t seen any reduction in hives or changes in my digestion unfortunately.

In hindsight, I think maybe I needed a low dose of thyroid hormone since I started having problems having these weird random bursts of adrenaline in my young 30's. (that symptom tells me that cortisol and adrenaline were trying to compensate for lack of thyroid sometimes) That may have started after I tried Lugol's iodine and got a bad reaction (totally wired and couldn't sleep a wink all night). What is certain that my thyroid was slowly but surely getting more and more out of control and if someone would have taken these labs of freet3/freet4 maybe we would have noticed that I could use a little help. Maybe my thyroid would have healed and wouldn't have blown up into something that had to be removed. But doctors never look at thyroid problems like that. You will have to get sicker before you get better. I am spending time trying to help people see what I couldn't. It seems so common.
 

redsun

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Hi all,
My name is Sarah, I am a 25 year old female. I have been lurking on this forum for 2 years and it is so sad that I finally was able to join the forum about a week ago, and that same day I discovered that Ray Peat passed away.

I apologize for how long this is probably going to be. I will try to make it as brief as I can. I developed cold urticaria around December of 2020. I was on a hike in the winter and I got itchy bumps all over my legs and hands. I thought it must have been something I ate, but then it happened every single time any part of me got cold, ever since then. My face, hands, arms, legs, stomach, anything that is exposed to cold temperatures for more than a few minutes will turn red and develop hives a few minutes into rewarming. Now I can't swim in cold water, etc. because I could develop anaphylaxis (which I thankfully have never had before).

I took accutane in 2019-2020, and got off of accutane in July. By August I discovered Ray Peat, and started loosely "peating" by the fall. I was increasing carbs, reintroducing dairy after 7 years of avoiding it, decreasing PUFAs. A few months later, in Dec 2020, my reactions to the cold started.

I did not see my PCP for my cold urticaria until the spring of 2021 and I did not see an allergist until spring of 2022. The allergist suspected that I developed cold urticaria because of a mycoplasma pneumonia infection, though I did not remember ever being sick. He tested me for mycoplasma pneumonia IgG and IgM and my titers were high so I was positive for that, even though the time of the testing was almost 2 years after developing the reaction to cold. The allergist said he doesn't know how long I will react to the cold, and he recommended me to take zyrtec 4 times per day and famotidine 2x per day but I have not done that. He also recommended xolair injections which I considered for a while and then decided not to pursue.

Some factors in my life that I believe are relevant:
- I had a physical/emotional trauma from my father my whole childhood
- I have had significant anxiety probably mostly related to that trauma, ever since I was about 5
- I had lyme disease 3 times as a teenager, and ehrlichiosis once, all from tick bites.
- I was bullied a lot in school because I had bad acne since I was 12 and I was socially anxious and awkward, this caused a lot of additional stress
- I got the covid vaccine against my will when my work mandated it to keep my job in healthcare, though I had already had cold urticaria for 6 months by that point
- I was diagnosed with PCOS when I was 19, which I know is related to thyroid function, stress, and estrogen, and all those issues can cause urticaria issues
- I have known estrogen dominance from DUTCH testing in 2019, and I did a repeat dutch test in 2021 after 1 year of "peating" and all of my levels improved (stress hormones went down a LOT, testosterone excess went down, progesterone went up)
- I still had estrogen dominance in my 2021 DUTCH test.
- For birth control I do fertility awareness method, and I do ovulate every month since 2020 and I get my period every 32-35 days which is a huge improvement as I used to rarely ovulate and my period would skip every few months.
- I know that stress hormones like cortisol are immune suppressants. They were off the charts in my 2019 DUTCH test. When I finally lowered my stress levels significantly by eating more pro-metabolically, I wonder if that allowed my autoimmune condition (cold urticaria) to show itself.

I can attach screen shots of my DUTCH tests from 2019 and 2021 if that would be helpful.

When I gave in and took accutane for 9 months in 2019-2020, it was because my acne was severe. At the time of starting accutane I was doing low carb, high fat and intermittent fasting. I was eating tons of nuts and seeds and nut butters instead of carbs, taking fish oil, avoiding fruit and almost all carbs, which I don't do any of that now. My hair was falling out, my face was puffy, my acne was horrible, and I was in denial that all the "healthy" fats could cause that, so I kept telling myself my symptoms were just because I didn't take my carbs low enough for PCOS, and I was convinced for about 2 years that low carb, close to keto, and intermittent fasting was best for insulin resistance which was the "root cause" of PCOS, but I now know insulin resistance is just a symptom of a bigger metabolic problem.

I had thyroid testing done in spring of 2022 because I was convinced my cold U and my PCOS must be related to my thyroid. My results came back "normal" i will add those numbers here:

TSH. 1.06 uIU/ML0.400 - 4.100 uIU/ML
Free Thyroxin1.0 NG/DL0.80 - 1.90 NG/DL
Free T3 3.3 PG/ML2.2 - 4.2 PG/ML
Thyroid Peroxidase Antibody10 IU/ML<35 IU/ML
Thyroglobulin Antibody<15 IU/mL0 - 115 IU/mL

Long story short if anyone has any advice for me, what to try, what to eat, what to test, please let me know. My PCP, allergist, and endocrinologist, have nothing to offer me except telling me to take antihistamines and avoid cold. I do take hydroxyzine daily only at night and it helps with sleep and anxiety as well as the itchiness of the reactions.
Other supplements I take:
Inositol 1 tsp 2x per day
vitamin D3 5,000 IU a few times per week
vitamin K2 a few times per week
vitamin E every day with dinner
beef liver capsules
magnesium glycinate every night

I try to not let my stress and anxiety overwhelm me. I spend a lot of time in nature (though it's harder now in the winter because it's cold).
I spend time with my boyfriend and people that love me. I try to stay hopeful that my body can heal itself and wants to heal itself. I try to tell myself I am resilient and young and I will be ok.
You can try TMG (also known as Betaine Anhydrous). There are some good brands on Amazon such as life extension. I would suggest copper if blood tests show you need it otherwise most people get enough from diet especially if you consume beef liver capsules. I would also recommend eating choline rich foods, specifically eggs and red meat (for zinc which is helpful for allergic reactions) to further support methylation.

Your thyroid labs are good. You likely just need methylation support.
 
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I stared at labs exactly like that for years, had doctors tell me there is nothing wrong with my thyroid, meanwhile I got sicker and sicker until I started to have a mass in my neck was too much for a doctor to ignore (and that still took years). My labs were always "good" even when I was choking on my thyroid, pinging off the walls, having hot flashes that lasted all day (they thought I was menopausal at 35 :roll:), having adrenaline rushes out of nowhere, getting every bug that was within 20 miles of me, my face puffing up more and more often, my vision was randomly blurring some days, and and I was unable to stop gaining weight no matter what I ate. Plus other more personal symptoms I don't care to list.

As soon as I got started on thyroid medication, I couldn't believe how many things started to feel better and I was angry I didn't get properly treated years before...because of "good" labs such as hers. Sometimes vitamins would help a little, but nothing compared to *optimum* level of thyroid hormone.
 
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summergirl

summergirl

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You can try TMG (also known as Betaine Anhydrous). There are some good brands on Amazon such as life extension. I would suggest copper if blood tests show you need it otherwise most people get enough from diet especially if you consume beef liver capsules. I would also recommend eating choline rich foods, specifically eggs and red meat (for zinc which is helpful for allergic reactions) to further support methylation.

Your thyroid labs are good. You likely just need methylation support.
I do know I’m heterozygous for the MTHFR mutation. Is that the type of issue you think the TMG would be helping with? How do you propose that would help with the cold urticaria?

My Dutch test also indicated I was deficient in vitamin B6. So that’s when I started the multivitamin that I posted in the comments. Also, in 2019 before I started taking accutane my AST and ALT were really high and that’s when I was doing low carb, fasting, and high PUFA. I know my liver must be struggling to detox my excess estrogen. My AST and ALT are down to low normal levels now though
 

redsun

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Messages
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I do know I’m heterozygous for the MTHFR mutation. Is that the type of issue you think the TMG would be helping with? How do you propose that would help with the cold urticaria?

My Dutch test also indicated I was deficient in vitamin B6. So that’s when I started the multivitamin that I posted in the comments. Also, in 2019 before I started taking accutane my AST and ALT were really high and that’s when I was doing low carb, fasting, and high PUFA. I know my liver must be struggling to detox my excess estrogen. My AST and ALT are down to low normal levels now though
Urticaria is when something triggers a massive release of histamine in the skin. Histamine is deactivated by methylation. TMG increases recycling of homocysteine to methionine (and then to SAM-e) which can then be used to deactivate histamine in the skin. It should improve the condition.
 
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summergirl

summergirl

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Urticaria is when something triggers a massive release of histamine in the skin. Histamine is deactivated by methylation. TMG increases recycling of homocysteine to methionine (and then to SAM-e) which can then be used to deactivate histamine in the skin. It should improve the condition.
What do you think about taking SAM-e ? Or is it better to take TMG and let your body make the SAM-e
 

EvanHinkle

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May 2, 2021
Messages
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Hi all,
My name is Sarah, I am a 25 year old female. I have been lurking on this forum for 2 years and it is so sad that I finally was able to join the forum about a week ago, and that same day I discovered that Ray Peat passed away.

I apologize for how long this is probably going to be. I will try to make it as brief as I can. I developed cold urticaria around December of 2020. I was on a hike in the winter and I got itchy bumps all over my legs and hands. I thought it must have been something I ate, but then it happened every single time any part of me got cold, ever since then. My face, hands, arms, legs, stomach, anything that is exposed to cold temperatures for more than a few minutes will turn red and develop hives a few minutes into rewarming. Now I can't swim in cold water, etc. because I could develop anaphylaxis (which I thankfully have never had before).

I took accutane in 2019-2020, and got off of accutane in July. By August I discovered Ray Peat, and started loosely "peating" by the fall. I was increasing carbs, reintroducing dairy after 7 years of avoiding it, decreasing PUFAs. A few months later, in Dec 2020, my reactions to the cold started.

I did not see my PCP for my cold urticaria until the spring of 2021 and I did not see an allergist until spring of 2022. The allergist suspected that I developed cold urticaria because of a mycoplasma pneumonia infection, though I did not remember ever being sick. He tested me for mycoplasma pneumonia IgG and IgM and my titers were high so I was positive for that, even though the time of the testing was almost 2 years after developing the reaction to cold. The allergist said he doesn't know how long I will react to the cold, and he recommended me to take zyrtec 4 times per day and famotidine 2x per day but I have not done that. He also recommended xolair injections which I considered for a while and then decided not to pursue.

Some factors in my life that I believe are relevant:
- I had a physical/emotional trauma from my father my whole childhood
- I have had significant anxiety probably mostly related to that trauma, ever since I was about 5
- I had lyme disease 3 times as a teenager, and ehrlichiosis once, all from tick bites.
- I was bullied a lot in school because I had bad acne since I was 12 and I was socially anxious and awkward, this caused a lot of additional stress
- I got the covid vaccine against my will when my work mandated it to keep my job in healthcare, though I had already had cold urticaria for 6 months by that point
- I was diagnosed with PCOS when I was 19, which I know is related to thyroid function, stress, and estrogen, and all those issues can cause urticaria issues
- I have known estrogen dominance from DUTCH testing in 2019, and I did a repeat dutch test in 2021 after 1 year of "peating" and all of my levels improved (stress hormones went down a LOT, testosterone excess went down, progesterone went up)
- I still had estrogen dominance in my 2021 DUTCH test.
- For birth control I do fertility awareness method, and I do ovulate every month since 2020 and I get my period every 32-35 days which is a huge improvement as I used to rarely ovulate and my period would skip every few months.
- I know that stress hormones like cortisol are immune suppressants. They were off the charts in my 2019 DUTCH test. When I finally lowered my stress levels significantly by eating more pro-metabolically, I wonder if that allowed my autoimmune condition (cold urticaria) to show itself.

I can attach screen shots of my DUTCH tests from 2019 and 2021 if that would be helpful.

When I gave in and took accutane for 9 months in 2019-2020, it was because my acne was severe. At the time of starting accutane I was doing low carb, high fat and intermittent fasting. I was eating tons of nuts and seeds and nut butters instead of carbs, taking fish oil, avoiding fruit and almost all carbs, which I don't do any of that now. My hair was falling out, my face was puffy, my acne was horrible, and I was in denial that all the "healthy" fats could cause that, so I kept telling myself my symptoms were just because I didn't take my carbs low enough for PCOS, and I was convinced for about 2 years that low carb, close to keto, and intermittent fasting was best for insulin resistance which was the "root cause" of PCOS, but I now know insulin resistance is just a symptom of a bigger metabolic problem.

I had thyroid testing done in spring of 2022 because I was convinced my cold U and my PCOS must be related to my thyroid. My results came back "normal" i will add those numbers here:

TSH. 1.06 uIU/ML0.400 - 4.100 uIU/ML
Free Thyroxin1.0 NG/DL0.80 - 1.90 NG/DL
Free T3 3.3 PG/ML2.2 - 4.2 PG/ML
Thyroid Peroxidase Antibody10 IU/ML<35 IU/ML
Thyroglobulin Antibody<15 IU/mL0 - 115 IU/mL

Long story short if anyone has any advice for me, what to try, what to eat, what to test, please let me know. My PCP, allergist, and endocrinologist, have nothing to offer me except telling me to take antihistamines and avoid cold. I do take hydroxyzine daily only at night and it helps with sleep and anxiety as well as the itchiness of the reactions.
Other supplements I take:
Inositol 1 tsp 2x per day
vitamin D3 5,000 IU a few times per week
vitamin K2 a few times per week
vitamin E every day with dinner
beef liver capsules
magnesium glycinate every night

I try to not let my stress and anxiety overwhelm me. I spend a lot of time in nature (though it's harder now in the winter because it's cold).
I spend time with my boyfriend and people that love me. I try to stay hopeful that my body can heal itself and wants to heal itself. I try to tell myself I am resilient and young and I will be ok.
Try activated charcoal. Two tablespoons in 8oz of water three times a day for 3-5 days. Then try it once a day end of day for about a week. It’s cheap and simple, and will tell you whether you have endotoxin overload.

Then you can proceed from there to treat bacterial/endotoxin issue at its root.
 

mostlylurking

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Joined
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Messages
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Location
Texas
I developed cold urticaria
Have you looked into a possible connection between the urticaria and dysautonomia? It seems to me that the two could be related. Dysautonomia = dysfunction of the autonomic nervous system; there's a very strong tie-in with thiamine deficiency/functional blockage and thiamine supplementation is considered to be the key to recovery.

I did a search for the two and found this: Edema & Cold Urticaria
quote:
"I know we've recently had a few members with teen daughters who struggle with swelling & cold urticaria. I recently stumbled across an abstract that may point towards possible treatment that been proven VERY effective so far.

Idiopathic edema, a condition associated with pelvic pain and other symptoms in women, as a remedial cause of chronic cold induced urticaria - PubMed

Clin Exp Obstet Gynecol. 2010;37(3):235-6.

Idiopathic edema, a condition associated with pelvic pain and other symptoms in women, as a remedial cause of chronic cold induced urticaria.

Check JH, Cohen R, Check D.

The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA. [email protected]

Abstract

PURPOSE: To determine if the treatment of cold induced urticaria refractory to conventional antihistamine-type therapy would respond to treatment with sympathomimetic amines.

METHODS: Dextroamphetamine sulfate (15 mg) extended release capsules were prescribed to be taken daily in the morning.

RESULTS: The cold-induced urticaria completely disappeared and antihistamine therapy was discontinued.

CONCLUSIONS: Treatment of chronic refractory cold-induced urticaria effectively responds to treatment with sympathomimetic amines similar to other cases of chronic refractory urticaria that are not merely cold induced. Manifestation of idiopathic orthostatic edema, a condition predominantly of women, should always be considered in the differential diagnosis of baffling medical conditions.

PMID: 21077535 [PubMed - in process]"

Long story short if anyone has any advice for me, what to try, what to eat, what to test, please let me know.
Have you ever taken fluoroquinolone antibiotics (Cipro/Ciprofloxacin, Levaquin/Levofloxacin, Avelox/Moxifloxacin and Floxin/Ofloxacin)? Do you remember what you took for the Lyme Disease? This class of antibiotics is known to cause long term issues.
I do take hydroxyzine daily only at night and it helps with sleep and anxiety
Are you aware of the issues with this drug? Drug Induced Nutrient Depletion : Hydroxyzine potential health problems: "Insomnia, depression, growth hormone deficiency, blood sugar changes, decreased protection against cancer and aging"
I try to not let my stress and anxiety overwhelm me.
Are stress and anxiety included in your list of illness symptoms? Or do you think that these are simply a result of being concerned about your situation? Or have you thought about this? The drug, Hydroxzine is supposed to increase insomnia and depression; perhaps it is adding to your problems?
 
OP
summergirl

summergirl

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Messages
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Location
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Have you looked into a possible connection between the urticaria and dysautonomia? It seems to me that the two could be related. Dysautonomia = dysfunction of the autonomic nervous system; there's a very strong tie-in with thiamine deficiency/functional blockage and thiamine supplementation is considered to be the key to recovery.

I have not looked into the link between urticaria and dysautonomia but I do take a multivitamin that has thiamine hcl 25 mg every day.
I did a search for the two and found this: Edema & Cold Urticaria
quote:
"I know we've recently had a few members with teen daughters who struggle with swelling & cold urticaria. I recently stumbled across an abstract that may point towards possible treatment that been proven VERY effective so far.

Idiopathic edema, a condition associated with pelvic pain and other symptoms in women, as a remedial cause of chronic cold induced urticaria - PubMed

Clin Exp Obstet Gynecol. 2010;37(3):235-6.

Idiopathic edema, a condition associated with pelvic pain and other symptoms in women, as a remedial cause of chronic cold induced urticaria.

Check JH, Cohen R, Check D.

The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA. [email protected]

Abstract

PURPOSE: To determine if the treatment of cold induced urticaria refractory to conventional antihistamine-type therapy would respond to treatment with sympathomimetic amines.

METHODS: Dextroamphetamine sulfate (15 mg) extended release capsules were prescribed to be taken daily in the morning.

RESULTS: The cold-induced urticaria completely disappeared and antihistamine therapy was discontinued.

CONCLUSIONS: Treatment of chronic refractory cold-induced urticaria effectively responds to treatment with sympathomimetic amines similar to other cases of chronic refractory urticaria that are not merely cold induced. Manifestation of idiopathic orthostatic edema, a condition predominantly of women, should always be considered in the differential diagnosis of baffling medical conditions.

PMID: 21077535 [PubMed - in process]"


Have you ever taken fluoroquinolone antibiotics (Cipro/Ciprofloxacin, Levaquin/Levofloxacin, Avelox/Moxifloxacin and Floxin/Ofloxacin)? Do you remember what you took for the Lyme Disease? This class of antibiotics is known to cause long term issues.
I have never taken any of those antibiotics. I have only taken doxycycline every single time for Lyme disease, ehrlichiosis, etc.

This study says that dextromethorphan was their treatment. So cough medicine? I don’t have edema or pelvic pain, just cold urticaria. I don’t know if that would apply to me but it’s worth looking into.
Are you aware of the issues with this drug? Drug Induced Nutrient Depletion : Hydroxyzine potential health problems: "Insomnia, depression, growth hormone deficiency, blood sugar changes, decreased protection against cancer and aging"

Are stress and anxiety included in your list of illness symptoms? Or do you think that these are simply a result of being concerned about your situation? Or have you thought about this? The drug, Hydroxzine is supposed to increase insomnia and depression; perhaps it is adding to your problems?
I developed chronic anxiety from a young age due to abuse etc. I have always been a worrier for many different reasons. I was very jumpy, easily put into fight or flight, couldn’t handle caffeine. Of course having health issues and then anxiety about that is another stress.

I Never struggled with insomnia in my life until I was like 9 months into peating and then I got the covid vaccine against my will. Within a day or 2 after the first shot I felt like I had a thyroid storm or brain inflammation..?. My heart was constantly racing, I was in constant fight or flight and felt like I couldn’t breathe. my metabolism went super high and I was burning through calories like crazy. I lost 10-15 lbs in a month without trying at all. I couldn’t sleep, I could barely eat, I quit my job that I got the vaccine for. So I went to my doctor desperate for help. She prescribed me hydroxyzine. I didn’t take it for another 2 months where I continued to lose a pound or 2 per week, couldn’t sleep through the night, waking up every hour. I then gave in and tried the hydroxyzine before bed. I’ve taken it every night since then and i have been able to sleep through the night ever since then. I also have much lower anxiety levels throughout the day, and I gained the weight back that I lost that stressful time. I do plan on getting off of hydroxyzine eventually because it’s not recommended during pregnancy but I really want to get my health in order as much as I can before I get pregnant.
 
Last edited:
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summergirl

summergirl

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Messages
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Location
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I have not looked into the link between urticaria and dysautonomia but I do take a multivitamin that has thiamine hcl 25 mg every day.

I have never taken any of those antibiotics. I have only taken doxycycline every single time for Lyme disease, ehrlichiosis, etc.

This study says that dextromethorphan was their treatment. So cough medicine? I don’t have edema or pelvic pain, just cold urticaria. I don’t know if that would apply to me but it’s worth looking into.

I developed chronic anxiety from a young age due to abuse etc. I have always been a worrier for many different reasons. I was very jumpy, easily put into fight or flight, couldn’t handle caffeine. Of course having health issues and then anxiety about that is another stress.

I Never struggled with insomnia in my life until I was like 9 months into peating and then I got the covid vaccine against my will. Within a day or 2 after the first shot I felt like I had a thyroid storm or brain inflammation..?. My heart was constantly racing, I was in constant fight or flight and felt like I couldn’t breathe. my metabolism went super high and I was burning through calories like crazy. I lost 10-15 lbs in a month without trying at all. I couldn’t sleep, I could barely eat, I quit my job that I got the vaccine for. So I went to my doctor desperate for help. She prescribed me hydroxyzine. I didn’t take it for another 2 months where I continued to lose a pound or 2 per week, couldn’t sleep through the night, waking up every hour. I then gave in and tried the hydroxyzine before bed. I’ve taken it every night since then and i have been able to sleep through the night ever since then. I also have much lower anxiety levels throughout the day, and I gained the weight back that I lost that stressful time. I do plan on getting off of hydroxyzine eventually because it’s not recommended during pregnancy but I really want to get my health in order as much as I can before I get pregnant.
I forgot to add by the time I got the covid vax I was already having cold hives for 6 months. I am not sure if my development of basically a panic disorder and insomnia immediately post vax was all psychological due to being so uncomfortable with getting the vaccine, or if there was something physiologically going on with me because of the vaccine.

I also forgot to add that I have a feeling that anxiety plays a role in my reactions because if I’m really anxious about something and then I get cold, my reaction is worse.

My cycle also affects my cold urticaria, when my estrogen and everything drops when I get my period my cold u almost goes away. Then as I approach ovulation and the luteal phase where my estrogen is high, my reactions are much more frequent and significant.
 

mostlylurking

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Joined
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Messages
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Location
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I have not looked into the link between urticaria and dysautonomia but I do take a multivitamin that has thiamine hcl 25 mg every day.
If you have dysautonomia issues, I think it would be helpful if you would do some reading about it and also about thiamine. I've lived through many years of dysautonomia problems; high dose thiamine hcl was the key to my recovery. Here's a link to hormonesmatter.com. There's a search feature (top left). Dr. Derrick Lonsdale posts articles to this site that are very good. Suggested search words: Dysautonomia; Dr. Derrick Lonsdale; anxiety. Here's a good one:

25mg of thiamine hcl won't be of much if any benefit because it has poor absorption via the intestine. This is why high doses of thiamine hcl are needed. After researching and experimenting with thiamine hcl I learned that my optimum dose is 2 grams/day (divided into two doses). There are other types of thiamine available; Dr. Lonsdale, Dr. Chandler Marrs, and Elliot Overton all prefer TTFD thiamine. However, good glutathione status is needed for it to work and I was deficient in glutathione so I couldn't tolerate it which is why I stuck with thiamine hcl, high dose.
have never taken any of those antibiotics. I have only taken doxycycline every single time for Lyme disease, ehrlichiosis, etc.
Well, that's good.
This study says that dextromethorphan was their treatment. So cough medicine? I don’t have edema or pelvic pain, just cold urticaria. I don’t know if that would apply to me but it’s worth looking into.
I really don't know anything about this treatment; I just stumbled upon the information and thought I'd pass it along to you. I've become pretty suspicious of all pharmaceutical drugs because of personal experiences. By definition and because of patent laws, pharmaceutical drugs are all toxic in one way or another and they do not exist in nature.
I developed chronic anxiety from a young age due to abuse etc. I have always been a worrier for many different reasons. I was very jumpy, easily put into fight or flight, couldn’t handle caffeine. Of course having health issues and then anxiety about that is another stress.
It's important to understand that there's emotional stress and there's physical (internal) body stress. While emotional stress can increase the body's physical stress these are not the same thing. For example, if your estrogen is high, you will experience high physical stress. If you supplement with progesterone and it pushes the estrogen out of the cells and into circulation you will experience increased physical stress but then when the liver detoxes the estrogen in circulation you will experience much lower physical stress. The physical stress of high estrogen will make a person more high strung and more likely to feel emotional stress. Other physical stressors can also make a person feel emotional stress more strongly. Heavy metal exposure can cause this problem. When a whole family is experiencing stress problems it may be that something in their environment is toxic and poisoning them.

My own family of origin included a clinically depressed mother, an absent father, and both of my siblings suffered from mental disease (paranoid schizophrenia). I wasn't doing great either. All three children had multiple mercury amalgams placed in childhood and I suspect the copper plumbing pipes with the lead soldered joints played a part in creating the bedlam too. My parents stayed in that house until they died. My mother died of brain cancer at the age of 76; my father (AWOL during my childhood) developed Alzheimer's and died of it some years later.

I Never struggled with insomnia in my life until I was like 9 months into peating and then I got the covid vaccine against my will. Within a day or 2 after the first shot I felt like I had a thyroid storm or brain inflammation..?
The covid vaccine is very problematic. It can cause brain inflammation. So can the other vaccines.
also
also
My heart was constantly racing, I was in constant fight or flight and felt like I couldn’t breathe. my metabolism went super high and I was burning through calories like crazy. I lost 10-15 lbs in a month without trying at all. I couldn’t sleep, I could barely eat,
Your metabolism went haywire. In order to have good oxidative metabolism, several things are required, the two major ones are thyroid hormone and thiamine.
also this Ray Peat search engine; results for "oxidative metabolism" (scroll down to the ice cream cone & the coconuts).
Start with this one:
So I went to my doctor desperate for help. She prescribed me hydroxyzine. I didn’t take it for another 2 months where I continued to lose a pound or 2 per week, couldn’t sleep through the night, waking up every hour. I then gave in and tried the hydroxyzine before bed. I’ve taken it every night since then and i have been able to sleep through the night ever since then. I also have much lower anxiety levels throughout the day, and I gained the weight back that I lost that stressful time. I do plan on getting off of hydroxyzine eventually because it’s not recommended during pregnancy but I really want to get my health in order as much as I can before I get pregnant.
Your doctor is only trained to despense pharmaceutical drugs; she has very limited knowledge in things like oxidative metabolism and orthomolecular medicine. Unfortunately, this is a universal problem with the modern medical industrial complex.

Metabolic energy is needed for sleep. Good oxidative metabolism is key to correcting health issues because it provides the body the energy it needs to heal itself.
 

mostlylurking

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Joined
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Messages
3,078
Location
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I also forgot to add that I have a feeling that anxiety plays a role in my reactions because if I’m really anxious about something and then I get cold, my reaction is worse.

My cycle also affects my cold urticaria, when my estrogen and everything drops when I get my period my cold u almost goes away. Then as I approach ovulation and the luteal phase where my estrogen is high, my reactions are much more frequent and significant.
Sounds like you have a problem with high estrogen. You might benefit from some progesterone and also avoiding polyunsaturated fats like the poisons that they are. Search for Progest-E; it's available on line without a prescription.

I found the following Ray Peat audio shows enormously helpful.
also Ray Peat on the thyroid:
and

Also, about thyroid: Did you ask me about my thyroid med? I'll assume "yes". I take prescription NP Thyroid made by Acella, 135mg/day. My dose was 180mg/day but it had to be lowered when I started taking high dose thiamine in 2020. The thyroid gland needs thiamine to do its job of making thyroid hormones. Too much supplemental thyroid will block thiamine function which results in hypothyroid symptoms like low body temperature, lethargy, weight gain and massive confusion in patient and doctors alike. The two supplements need to be balanced with each other. Fortunately for me, my 87 year old endocrinologist knew about the issue and finessed my dose down a little.
 
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