Developing Chronic Knee Pain

[lampofred]

I'm only in my early 20s, what could be the cause?

I eat mostly: milk, OJ, coke, gelatin, coffee, occasionally: eggs, pizza with no PUFA, burgers with no PUFA, Italian/Indian food made with primarily cheese/saturated fat, infrequently: beans, veggies, shrimp. I usually get at least 80+ grams of animal protein each day and my PUFA intake is pretty low.

I probably should eat more liver and shellfish for the vitamins and trace minerals but I don't do well with copper-rich foods (beef liver), chicken liver is exceedingly high in iron, and plus I'm worried about heavy metal contamination in oysters.

Thankfully my hair has reached the point that it can sustain itself without supplements (I know, it's vain... but I have to be honest, that's why I came to Peat in the first place), so I don't really take supplements regularly anymore except Vitamin D & K, methylene blue and thyroid. I take the occasional B complex when I need a mental boost, occasional vitamin E if I've eaten out, occasional Progest-E if I need to relax. I realize I said I don't really take supplements anymore but nevermind, that was a pretty long list of supplements...

My temps are pretty steady in the low-mid 98s (I know 98.6 is better, but my digestion isn't great enough to handle so much food yet), my heart rate is probably a bit higher than it should be because of excess adrenaline, but overall I don't think my metabolism is in bad shape...

Don't know if this is relevant but I am single and drink very little alcohol.

Are there any vitamin deficiencies or anything I should focus on to fix this steadily growing knee pain?

Apparently knee pain is related to poor kidneys, which is related to low dopamine, which ties back to my poor focus...

It probably ties back into excess estrogen/too little progesterone, but not really sure what else I can do to lower estrogen...

 

[Luckytype]

You may be looking too much into the peat tunnel for this.

Knee pain can very easily be attributed to poor/dormant activation of muscular things that surround the knee. Naturally dormant because they sometimes require specfic things in specific populations to be neurologically active. Along the use or lose idea. This happens alot in naturally not muscular groups that may be growing, as in age.

Whats your day look like as far as activity and sitting/standing etc?

 

[marsaday]

What thyroid medication are you on ? What bloods do you have for thyroid before medication and while on it ?

 

[lampofred]

You may be looking too much into the peat tunnel for this.

Knee pain can very easily be attributed to poor/dormant activation of muscular things that surround the knee. Naturally dormant because they sometimes require specfic things in specific populations to be neurologically active. Along the use or lose idea. This happens alot in naturally not muscular groups that may be growing, as in age.

Whats your day look like as far as activity and sitting/standing etc?

I'm sedentary now but for most of my life I was an avid bike-rider & squatter. Maybe I overdeveloped my quads relative to my hamstrings and I'm facing the consequences now?

 

[lampofred]

What thyroid medication are you on ? What bloods do you have for thyroid before medication and while on it ?

Cynoplus, about 1.5 grains a day. Well my TSH was already reasonable (1) and my cholesterol was low (123) prior to starting regular thyroid, but my temps were not at 98.6 and I don't have energy unless I take thyroid. So my TSH was being suppressed by cortisol, not actual thyroid hormone.

I don't have any blood work after starting thyroid.

I emailed Peat and he said low TSH is not a problem, although low cholesterol is. The knee pain could definitely be caused by low cholesterol, but I'm not able to understand why my cholesterol is so low.

It seems like there a lot of people with low cholesterol these days, especially males around my age group.

 

[marsaday]

Thyroid or T3 shunts cholesterol to be made into the many hormones it makes. so excess thyroid might lead to low levels of cholesterol. Low thyroid patients typically have high cholesterol and it used to be the way to help work out if a patient needed some thyroid hormone.

So for someone how may not need thyroid or is taking to much this may be an issue.

Can you tell me how much T4 and T3 is in 1 grain please as i am not familiar with this product.

also can you explain how cortisol suppresses TSH as i am not familiar with this

 

[lampofred]

Thyroid or T3 shunts cholesterol to be made into the many hormones it makes. so excess thyroid might lead to low levels of cholesterol. Low thyroid patients typically have high cholesterol and it used to be the way to help work out if a patient needed some thyroid hormone.

So for someone how may not need thyroid or is taking to much this may be an issue.

Can you tell me how much T4 and T3 is in 1 grain please as i am not familiar with this product.

also can you explain how cortisol suppresses TSH as i am not familiar with this

An healthy person produces 3-4 grains per day (Not 100% but I think 1 cynoplus tablet is 4 grains, 120 mcg of T4 and 30 mcg of T3), so I don't think 1.5 grains is too much, especially since I have low temps without it and since that's how much it takes for me to hit 98.6.

So most likely, my cholesterol is low due to low production (due to stress from too much excitatory neurotransmission I'm guessing) instead of high conversion into hormones.

Dr. Peat talks about how stress suppresses TSH in this article: Preventing and treating cancer with progesterone.

"The stress-induced suppression of TSH and other pituitary hormones is reminiscent of the protective inhibition that occurs in individual nerve fibers during dangerously intense stress, and might involve such a “parabiotic” process in the nerves of the hypothalamus or other brain region. The relative disappearance of the pituitary hormones when the organism is in very good condition (for example, the suppression of ACTH and cortisol by sugar or pregnenolone) is parallel to the high energy quiescence of individual nerve fibers."

When your body just can't handle the stress of excess of stimulation, it lowers TSH as a protective mechanism.

 

[marsaday]

Ok, i have read a bit more about TSH and can see how this pieces together.

My take is that you are on far to much thyroid medication.

By using such a strong tablet you have no way of knowing what small thyroid doses do for you. Even if you started on 1/2 grain this is still 60 T4 and 15 T3. A huge starting dose.

So many people the world over start on big doses of thyroid meds. T4 isn't so bad but the T3 is a killer. People think a small starting dose of T3 is 6.25mcg. I can tell you this is a huge dose and have the experience of trying many doses out. Dr Blanchard in the USA (now deceased) has some really good books on thyroid treatment. His view and the way he treated patients was to use very small T3 doses with T4. He wanted to use 0.1mcg (one tenth of a mcg), but couldn't get this size made up. So his starting dose was only 1mcg and he thought this was often to big for some people. I have posted about him today on another thread for someone.

Smaller doses of thyroid meds are very powerful because they will not suppress your own feedback loops. So many people jump past this point and they think they need more and more thyroid meds when really they need to go right back and add a little. In your case with a TSH of 1 you should have been looking to start with T4 only and add in 25mcg max. Maybe on alternate days so using 12.5mcg per day. I am amazed you didn't have any FT4 or FT3 results as well before starting on thyroid meds.

Thyroid and cortisol work together. So cortisol goes high when thyroid drops off. Cortisol is a poor substitute energy system for thyroid, but it will step in and help. So with higher cortisol in the system due to a stress response it may be a good idea to see how a little T4 helps to dampen down this response. Targeting it at bedtime will be a good idea as well.

You need to get some bloods done. What is your SHBG like ? It could be sky high due to the thyroid meds and so wrapping up testosterone. this may be leading to the knee pain.

I have responded to this post because i have just been experiencing the same pain, but in both knees and my elbows. Its been going on for a while now. Say 4 months. I have posted on here about it. Well i think i have got my answer. Too MUCH thyroid !!!!

I have been on thyroid meds since 2008 now. However i self treated and i realise i started way to high and have been on too much ever since. About 4 years ago i realised i was on to much (150 T4 and 50 T3) and so dropped back. For the last few years i have been pretty steady on 125 T4 only (maybe the odd 3mcg T3 thrown in).

Well last autumn i tried an increase and i felt worse, so i took that as a sign i needed less again. So dropped down to 112.5 T4. Ever since then i have had these pains.

You need more T4 i hear people cry, and this is what i thought so i went up again, but i was much worse. So i just decided to stop for a day and have started again on 50mcg T4 only per day. I am feeling a lot better. IT is 9 days in and i am not showing signs i am to low on T4. So it is still a work in progress, but at the moment all is positive.

What i feel may have happened is to do with the feedback loops that work in the body and how they interact with a given level of external hormone consumed. When we suppress the loops the body is reliant on the external hormone given and you can be ok with this. But if the body is not happy with this situation it will tell you. Other things will go wrong. For me a useful indicator was my BP going up (and the pains with hindsight). For you it could be the cholesterol and the knee pain.

Reducing down for me probably caused my own production to ramp up and so there may have been an element of self created RT3 taking place. Now i am on a much lower T4 level i think i am near the COMPLIMENTARY value of the T4, so it is adding to my system rather than confusing it and so raising the RT3 levels.

Another thing i have recently added in is pregnenalone at 25mcg per day. I think this is helping a lot, but in time i will be looking at removing this for a period to see how i am on less T4 only. The pregnenalone is doing something as well, so it is hard to work out what is doing what. I do know from previous experience pregnenalone was good initially for a few days, but then it shut my system down. I now realise this was due to have to much thyroid in my system,

 

[Luckytype]

I'm sedentary now but for most of my life I was an avid bike-rider & squatter. Maybe I overdeveloped my quads relative to my hamstrings and I'm facing the consequences now?

The sitting and biking is a big flag here.

I would bet your VMO(the inner lower head of your quad down by the knee) is not active enough to counter the force of the outer head(vastus lateralis).

Essentially, the weaker moment of the VMO is over powered by the lateral head and when your entire quad complex contracts it creates a slight very minor imperceivable moment that pulls the patella enough laterally(though the opposite situation can rarely occur) for it to track just enough that it causes excruiating pain. Once this imbalance is present even walking, when your leg swings through especially can be super painful. I bet you would find that warming up on a bike likely lessens this pain.

The patella rides essentially in a groove over the femur and any imbalance in a quadricep muscle group can lead to poor tracking. This can cause incredible knee pain in all populations including those young and old.

if your statistics are truly that good, I think you are in a great place and I do not humbly believe that it is metabolism-based. If you can spend a couple of weeks learning to re-activate that lower inner quad head I would bet five dollars that your knee pain considerably subsides.

Common examples of people that develop this poor patellar tracking are desk workers, bikers, rowers, squatters that may have an inherently strong lateralis and especially females that are going through the hip whitening phase of puberty because of the angle that it creates .

Edit: also anything posture wise or activity-wise that shortens the ITband and tensor fascia latae musculature can yank on the netting-like connective tissue that also influences the patella. It can all be rectified with diligence though

 

[Runenight201]

Eat more eggs, meat, and saturated fat.

Do rehab exercises for strengthening glutes, core, and hamstrings.

Whenever my meat and sat fat intake goes down, my knees creak. When the above intake is high, my muscles become so strong that they fire correctly to support and protect the joint.

Bacon has given me the hardest muscles that I’ve ever felt in my entire life.

 

[somuch4food]

I had knee pain frequently in my late teens and have had it on and off since then.

It was painful for me to squat or to sit for long hours with my knees bent.

I played hockey and soccer as a teen and my left knee became so weak when I was nineteen that I stopped hockey.

Going to the gym and working my knee helped and was my first solution, but if I stopped the pain would eventually come back.

Interestingly, the pain completely disappeared during pregnancy and breastfeeding which might signal something hormonal at play.

Last month, I struggled with knee pain and I associated it with my vitamin D intake that increased. Since stopping, the pain receded without any exercise and has yet to come back. I have read it has to do with calcification in the knee. Calcium gets stored in tissues around the knee and vitamin D is the driver of this process.

I probably should eat more liver and shellfish for the vitamins and trace minerals but I don't do well with copper-rich foods (beef liver), chicken liver is exceedingly high in iron, and plus I'm worried about heavy metal contamination in oysters.

Adding more stuff is not always better, it might be wiser to remove items from your routine. Once you start adding more supplements, it can be easy to end up with a complete arsenal to try to balance the effects of each one, but your body might not need everything you throw at it and might benefit from a simpler less dense (in vitamins, not calories) diet.

If you don't like the feel you get from eating a food, please stop eating it. It's a sign your body is rejecting it. It might not be tolerated or simply not prepared adequately for proper digestion.

 

[methylenewhite]

Try chiropractics. Well may be it does not sound scientific but you could have something there out of the proper place.

 

[mujuro]

Yeh I think you need to take the Peat goggles off for this one. You’re in your early 20s so it could very well be any number of functional issues — in fact, I would bet money on it. Bad gait, excessive foot eversion/inversion, weak VMO, weak vastus lateralis, weak glute med, weak glute max, short TFL, short adductors, short medial hams, tight rectus femoris, patella tracking problems and knee valgus are all on the table. It’s not unusual for me to see problems in people when they make changes to their exercise quantity, either stopping or starting. I would suspect a few issues in a chronic sitter, even without the history of cycling and squatting.

One would think that stopping exercise would allow the body to unwind into a more relaxed, unloaded state, but that’s not always the case. Start looking for good massage therapists, chiro, osteo, etc. A good

 

[biffbelvin]

I'm sedentary now but for most of my life I was an avid bike-rider & squatter. Maybe I overdeveloped my quads relative to my hamstrings and I'm facing the consequences now?

I'm only in my early 20s, what could be the cause?

I eat mostly: milk, OJ, coke, gelatin, coffee, occasionally: eggs, pizza with no PUFA, burgers with no PUFA, Italian/Indian food made with primarily cheese/saturated fat, infrequently: beans, veggies, shrimp. I usually get at least 80+ grams of animal protein each day and my PUFA intake is pretty low.

I probably should eat more liver and shellfish for the vitamins and trace minerals but I don't do well with copper-rich foods (beef liver), chicken liver is exceedingly high in iron, and plus I'm worried about heavy metal contamination in oysters.

Thankfully my hair has reached the point that it can sustain itself without supplements (I know, it's vain... but I have to be honest, that's why I came to Peat in the first place), so I don't really take supplements regularly anymore except Vitamin D & K, methylene blue and thyroid. I take the occasional B complex when I need a mental boost, occasional vitamin E if I've eaten out, occasional Progest-E if I need to relax. I realize I said I don't really take supplements anymore but nevermind, that was a pretty long list of supplements...

My temps are pretty steady in the low-mid 98s (I know 98.6 is better, but my digestion isn't great enough to handle so much food yet), my heart rate is probably a bit higher than it should be because of excess adrenaline, but overall I don't think my metabolism is in bad shape...

Don't know if this is relevant but I am single and drink very little alcohol.

Are there any vitamin deficiencies or anything I should focus on to fix this steadily growing knee pain?

Apparently knee pain is related to poor kidneys, which is related to low dopamine, which ties back to my poor focus...

It probably ties back into excess estrogen/too little progesterone, but not really sure what else I can do to lower estrogen...

I've formatted you're quotes to form a (hopefully) blunt metaphor.

You're problem has nothing to do with your diet, it's because you're sedentary (and I presume sat down a lot?). I started getting knee pain pretty bad a year or so ago, and it was regular exercise that helped as well as reducing my time spend sat down as much as possible. I found that Step-outs and Single Leg deadlifts where particularly beneficial (the latter also helped identify and improve some serious differences in ankle/hip mobility for me)

I would definitely recommend checking out more of Dr evan osar's work.

@Luckytype if you have any specific exercise recommendations I'll be all ears as it's always good to know more.

 

[somuch4food]

You're problem has nothing to do with your diet, it's because you're sedentary (and I presume sat down a lot?). I started getting knee pain pretty bad a year or so ago, and it was regular exercise that helped as well as reducing my time spend sat down as much as possible.

Everything is linked. You can't totally exclude diet. I was able to get rid of my problem two ways, but exercise provided temporary relief, it was not a cure.

 

[mujuro]

I've formatted you're quotes to form a (hopefully) blunt metaphor.

You're problem has nothing to do with your diet, it's because you're sedentary (and I presume sat down a lot?). I started getting knee pain pretty bad a year or so ago, and it was regular exercise that helped as well as reducing my time spend sat down as much as possible. I found that Step-outs and Single Leg deadlifts where particularly beneficial (the latter also helped identify and improve some serious differences in ankle/hip mobility for me)

I would definitely recommend checking out more of Dr evan osar's work.

@Luckytype if you have any specific exercise recommendations I'll be all ears as it's always good to know more.

I love Osar’s stuff. Good to see I’m not the only fan.

 

[biffbelvin]

I was recommended by someone on this forum (i can't remember unfortunately).

Discovering his work was honestly the single-most useful thing this forum has done for me.

 

[alywest]

Do you have hashimoto's? Have you had a virus lately? I caught mono recently and for about a month my knee pain was excruciating. But also, is it possible the methylene blue isn't needed anymore? I think anything that alters your serotonin can contribute to the knee issues. It's possible you needed it for a while but now you don't. I would eliminate it for a while and see what happens.

 

[lampofred]

Thanks everyone for the responses. @Luckytype Definitely will be considering restarting proper weightlifting. I have an imbalance in my muscles in that my front (chest, quads) are more developed than my back/hamstrings, and maybe this is causing me to develop an unnatural posture that is stressing my joints.

@marsaday I definitely am in danger of overdoing the thryoid because of my low cholesterol, but the pain was actually there even before I started supplementing thyroid and thyroid actually slightly makes it better.

But I think inadvertently discovered the cause when I took valerian this morning. The pain completely vanished as a result of increasing GABA. So in sense basically everyone in this thread was right... @Runenight201 mentioned increasing fat intake, fat helps to lower glutamate/increase GABA. @somuch4food mentioned calcification, low GABA/high glutamate is strongly related to calcification @alywest viral infections might be a cause of lowered glutamate to GABA conversion

But I don't really know if it's due to a virus or just long-term PUFA exposure, heavy metal exposure, radiation exposure, excess stimulation from the internet all coming together to accelerate aging and lead to excess glutamate/low GABA

Starting to ramble on a tangent, but I feel like there's really no practical way to increase GABA... The only way Peat mentions is PUFA depletion but it's starting to seem too theoretical to be possible... Who can eat less than a gram of PUFA per day for decades?? Even Peat who has been restricting rigidly strictly for decades has only managed to slow down the increasing excitatory dominance of age, but he hasn't actually reversed it. Or massive amounts of breath/CO2 retention, which would have the same effect, but you would have to basically stop participating in society to be able to do it for the hours on end needed to actually reverse things...

 

[Luckytype]

Thanks everyone for the responses. @Luckytype Definitely will be considering restarting proper weightlifting. I have an imbalance in my muscles in that my front (chest, quads) are more developed than my back/hamstrings, and maybe this is causing me to develop an unnatural posture that is stressing my joints.

@marsaday I definitely am in danger of overdoing the thryoid because of my low cholesterol, but the pain was actually there even before I started supplementing thyroid and thyroid actually slightly makes it better.

But I think inadvertently discovered the cause when I took valerian this morning. The pain completely vanished as a result of increasing GABA. So in sense basically everyone in this thread was right... @Runenight201 mentioned increasing fat intake, fat helps to lower glutamate/increase GABA. @somuch4food mentioned calcification, low GABA/high glutamate is strongly related to calcification @alywest viral infections might be a cause of lowered glutamate to GABA conversion

But I don't really know if it's due to a virus or just long-term PUFA exposure, heavy metal exposure, radiation exposure, excess stimulation from the internet all coming together to accelerate aging and lead to excess glutamate/low GABA

Starting to ramble on a tangent, but I feel like there's really no practical way to increase GABA... The only way Peat mentions is PUFA depletion but it's starting to seem too theoretical to be possible... Who can eat less than a gram of PUFA per day for decades?? Even Peat who has been restricting rigidly strictly for decades has only managed to slow down the increasing excitatory dominance of age, but he hasn't actually reversed it. Or massive amounts of breath/CO2 retention, which would have the same effect, but you would have to basically stop participating in society to be able to do it for the hours on end needed to actually reverse things...

Do you have the ability to begin to activate your lower inner quad before the rest of the muscle belly begins to fire?