Confused And Desperate

[Catecholamine]

Hi, I've been lurking for a while, and implementing some Peaty diet modifications (i.e. drinking orange juice, putting gelatin on meat, eating more coconut oil and less PUFA, and putting salt/sugar/coconut oil into my coffee). I'm male, 25 (almost 26), 5'9.5" and currently 217lb. Let's start with a little backstory.

I have a few medical conditions, namely ADHD (been diagnosed since 9). Ever since I was 16, I've had a mysterious, constant headache. It never completely stops, and very few medications can do anything about it. Doctors have basically given up on it, giving it the diagnosis NDPH, or New Daily Persistent Headache, which means they don't know what to do about it. The only thing that did work was Adderall, which I was prescribed at age 20 (actually for ADHD, but it worked for the headache too). I was about 210lb at the time of getting prescribed, and in a couple years with lifting and a conventional paleo/IF diet, I went down to 150. I slowly gained the weight back over the years, steadily fluctuating around 195 until now, when it's gone up due to my Peaty diet modifications. Also, the Adderall doesn't really work anymore for me, for neither the headache nor the ADHD. More recently, I tried taking high-dose aspirin (1-2g/day), which felt great for a couple weeks, but I think I gained a tolerance.

I realized that I've had hypothyroid symptoms all along, namely an inability to lose a significant amount of fat, dark circles under my eyes no matter how much I sleep, lethargy/brain fog/inability to concentrate, dysthymia/anhedonia, ruminative insecurity, and my exercise recovery capacity is pathetic. A few months ago, I got a "full thyroid panel" from an endocrinologist, and these were my results:

THYROXINE (T4) 6.8 ug/dL (4.5 - 12.8 ug/dL)
T3 UPTAKE 44 % (32 - 48 %)
TSH 2.40 mIU/L (0.28 - 4.10 mIU/L)
FREE THYROXINE INDEX (FTI) 7.48 ug/dL (4.50 - 13.13 ug/dL)
T3 TOTAL 115 ng/dL (87 - 178 ng/dL)
THYROID PEROXIDASE AB 40 IU/mL (0 - 35 IU/mL) [HIGH]

The endocrinologist told me that all my levels were normal and that "no treatment is necessary," which I'm pretty sure was utter bull****, given that, 1. I feel horrible in a hypothyroid way, 2. aspirin (which has a reputation on these forums as an ersatz for T3) made me feel almost normal, and 3. hypothyroidism is the ONLY thing that this headache has ever been linked to in the scientific literature.

So I decided to take matters into my own hands.

For the past 2 weeks I tried taking Thiroyd from Pimpom Products. I started at 1 grain, and raised my dose over the past 2 weeks in 0.25 grain increments to 2 grains starting today. For a little bit, I started to feel a little warmer and less ruminative, and was able to do some workouts that weren't pathetically abridged. However, in the past 3 days, I've been feeling a weird tenderness (and possibly swelling) at the base of the front of my neck, and I gained a few pounds since last week (I was about 212, now I'm 217).

My questions are:
1. What's this tenderness at the base of my neck? Does this normally happen when you start to take NDT?
2. Should I continue with Thiroyd or try something else?

 

[tara]

Hi Catecholamine,
Sorry you're having to deal with daily headaches.

I am not an expert, and I don't know the strength of the pimpom products, but if they are full strength, then starting at one grain and going up to 2 grains in 2 weeks seems fast to me.
Again, I'm not an expert, but my reading of those lab numbers would be consistent with somewhat hypothyroid function but not extreme.

Because the T4 has a long half life, it can take at least 2 weeks at a constant dose to reach a stable level in the blood.
It is possible (but not certain) that you actually took too much NDT to be sustainable, since the T4 would have been building up since you started.
Because the T3 component of the NDT has a short half life (hours), it can be good to divide doses through the day.
I think if you take a lot more/drive your metabolism up with supplements more than your body 'thinks' is safe, it has some mechanisms to bring it back down again.
The swelling at the throat does not seem good to me.

I would recommend monitoring at least body temps and maybe also pulse at some regular time of day (or maybe at more than one time of day to get more of an idea of what is going on). This is something you can do easily and cheaply at home to assess the effects of your supplementation beyond your subjective feelings.
I'm not sure what makes sense from here, but if I were starting out, I'd think start at 1/4-1/2 grain for at least 2 weeks, then increments of 1/4 grain at intervals of no less than 2 weeks while monitoring body temps. Broda Barnes reckoned that if you bring it up to a waking temp of 97.8-98.2, it's unlikely to suppress endogenous production.
How about backing off to just one grain or less (divided into at least 2 but maybe better 3-4 doses/day) for a few days and see if the odd stuff improves?

Personally, I struggle with migraines, have had TSH similar to yours, am much older than you, and have not yet solved the problem. Taking less than 1/1/2 grain thyroid supp divided 3x/day (worked up slowly over months).

I'd also recommend tracking your food for a few days with cronometer or similar to see if you are generously meeting nutritional requirements (just use them for tracking, don't believe them on all their targets). Making sure to get all the minerals and vitamins well met can be important, along with basic protein and carbs. Peat recommends more calcium than phosphorus.

I don't know about you, but I find that there are some foods that seem to particularly mess with my head if I overdo them - milk in excess and I think commercial tomato puree tends to make me foggy. I don't mean you should necessarily avoid those things - milk seems to work really well for some people. This can be really individual - different things can bother different people.

Getting regular sunlight on your skin?

How's your breathing - habitually nasal and diaghragmatic including during sleep? If not, this may yield to change with good effect.

Some regular movement (but not extreme)?

Getting to sleep at a reasonable and regular time?

Good luck