Do I Need To Give In And Take Thyroid Supplement?

[Mad]

This is my 1st post and have a range of questions so wasn't sure where to post this in the forum.
I'm 23yo female, diagnosed hypothyroid Dec 2016. TSH Dec 2016 was 6.1, Jan 2017 was 5.6, March 2017 is 6.8. For reference, TSH in 2014 was measured at 2.9. Upon my diagnosis in December, doctor wanted to put me on Synthroid. I freaked out, went to the internet, and began "peating" by altering diet and exercise. Dr agreed to wait a couple of months to address it again. I was so sure that my TSH would be much improved at this last blood work - but it's only much worse! Pretty discouraged.
Some background: when I started reading about low thyroid, I really felt like mine was caused by over exercising and low carb/low calorie. I have been big into sports my whole life and once I reached high school, running track and cross country were my main things. Late high school and into college age, I got obsessive about running and trying to lose even more weight (was always already thin, muscular build). I'd run 10 miles in a day and try to eat 400 calories. It was crazy, thankfully I've totally recovered from that. But my "recovery" still consisted of mostly low carbing and still logging tons of miles each week - I was just getting a lot more calories and not obsessive about it all. So when diagnosed in December, I totally stopped running - something I've been doing nearly every day for 10 years! I started trying to eat as much good, peaty calories as possible to re-feed and heal myself. Have gained 5-10 lbs probably, don't weigh myself much. I was so sure this would affect my TSH immediately, and now that it's worse, I don't know what could have went wrong....any wisdom for me?
I have an appt with my doctor (who has been very critical of me not jumping in to synthroid immediately) in 2 weeks. I am considering taking thyroid supplement since my method "failed". Should I insist on a t3/t4 combo such as cytomel instead of synthroid? I've read so much about this that my head spins, so can anyone narrow it down to a good source or two with advice from Ray on how to dose correctly? Does anyone think I don't need the supplement at all since I'm young? I just never saw myself on thyroid medicine at 23!
Other issues I'm experiencing (I'll try to keep concise :) ):
- acne is the main symptom that I am concerned with. I have seen great improvements since peating; I think Vit A/aspirin have helped, as well as Progest E (topically and internally). The only acne that persists is cystic acne around chin/mouth that comes and goes with each cycle. So by that measure, I thought my thyroid would have improved, as well.
- I have been having some terrible breathing/heart racing/sleeping issues. I think it might be the Progest E? The most prominent thing that happens is just as I'm drifting off to sleep, I get an adrenaline rush and heart starts pounding rapidly. This cycle continues for hours until I finally fall asleep in wee hours of the morning, wake up at 6 for work and do it all the next night. It is miserable. I am so tired and basically fall right to sleep, but then the heart starts racing and I know I'll be awake for several hours. Breathing becomes uncomfortable, I've had vertigo, chest pains, head feels like a balloon with all the pressure. While I'm tossing in bed I'll start sweating. Also lately I sometimes have this weird giddy feeling/feeling like I might start laughing if I take a deep breath.
Sorry for the novel - lots to get off my chest.
Oh one more thing I've been so confused about: I have read so much about estrogen dominance. But in Oct 2016 I had done a month-long saliva hormone panel and results were that progesterone is low-normal, estrogen was very low - like almost no estrogen. Just something I wanted to throw out there.

 

[aguilaroja]

I'm 23yo female, diagnosed hypothyroid Dec 2016. TSH Dec 2016 was 6.1, Jan 2017 was 5.6, March 2017 is 6.8. For reference, TSH in 2014 was measured at 2.9. Upon my diagnosis in December, doctor wanted to put me on Synthroid.
....Late high school and into college age, I got obsessive about running and trying to lose even more weight (was always already thin, muscular build). I'd run 10 miles in a day and try to eat 400 calories. It was crazy, thankfully I've totally recovered from that. But my "recovery" still consisted of mostly low carbing and still logging tons of miles each week...
when diagnosed in December, I totally stopped running - something I've been doing nearly every day for 10 years! I started trying to eat as much good, peaty calories as possible to re-feed and heal myself. Have gained 5-10 lbs probably...
I am considering taking thyroid supplement since my method "failed". Should I insist on a t3/t4 combo such as cytomel instead of synthroid? ...
Other issues I'm experiencing (I'll try to keep concise :) ):
- acne is the main symptom that I am concerned with. I have seen great improvements since peating; I think Vit A/aspirin have helped, as well as Progest E (topically and internally). The only acne that persists is cystic acne around chin/mouth that comes and goes with each cycle....
- I have been having some terrible breathing/heart racing/sleeping issues. I think it might be the Progest E? The most prominent thing that happens is just as I'm drifting off to sleep, I get an adrenaline rush and heart starts pounding rapidly. This cycle continues for hours until I finally fall asleep in wee hours of the morning, wake up at 6 for work and do it all the next night....

There is a lot to unwind here.

I am going to be brief, since WADR some new members post a story and are not regular participants.

First, it is great you’ve taken steps to restore things and are getting some results.

Second, if not being done, please search the forum or Dr. Peat’s writings for tips on low thyroid/low metabolism symptom inventory and measure daily pulse/temperature. These will help track the direction and rate of improvement. Blood tests alone are not the final word. The goal is thriving life.

Third, it is possible that the Progest E is making thyroid funcion more efficient at night, at least briefly. That may result in the more full heart beating, and wakefulness. Revved up metabolism, rather than adrenaline excess can also lead to these things.

It does not happen that often, since natural progesterone also has sedating effects. Sometimes, when thyroid function is quite low then any boost-like from progesterone, magnesium, or other things-can start the engine. If you are using Progest-E orally or to the lips & gums, switch to applying it ONLY to the skin. You cold also adjust the Progest-E amount downward in the short term.

Naturally, you can also use things like sweet or salty bedtime snacks to encourage lower night time adrenalin.

Fourth, exhaustive exercise plus long under-nutrition is a recipe for low metabolism. I have been there, personally.
Contrary to some medical dogma, boosting metabolism short term with supplementary thyroid does not necessarily mean a lifetime of prescription medicine.

Fifth, at the next medical visit, insist on your doctor checking a 25-hydroxy vitamin D level, if you are in the northern hemisphere. Winter is just ending and even an outdoor person has difficulty getting skin “intake” in the cold season. Low vitamin D (with high PTH) can drive a low metabolism even lower in the winter.

Darkness is a biological stressor. It is fairly common for metabolism to be lower in the winter. Added supports to work more slowly in winter.

Sixth, I think long term for those who need thyroid supplement, a combination of T3 & T4 is best. Dr. Peat AFAIK still prefers the synthetic, bio-identical supplements. Some forums members appear to prefer NDT. But practically speaking, getting physician cooperation to prescribe both T4& T3 is not always easy.

If the doctor insists on T4 only (aka Synthoid aka Levoxyl aka levothyroxine), I think it’s okay to start with a small amount of the T4 only. You can always add T3 or switch to a combination, if preferable. Pending a cooperative physician, that sometimes requires initiative.

Some on the forum insist on working entirely through lifestyle & diet. My main concern is that people get safe supports to feel really well, then tune supports for the long term.

 

[tara]

Mad

Glad you are making changes to the undereating - overexercising habits that have probably got you into this state.

A few more thoughts to add to aguilaroja's good ideas.

If you are very run down from 10 years of this, I would expect it to take more than a couple of months to reverse it.
I don't know whether you would be best to supplement thyroid at this stage or not, but if you do, I'd encourage slow titration, watching the signs, and making sure to get enough nutrition, including enough carbs, to support it. I think supplementing thyroid while undereating has the potential to deepen nutritional deficiencies and stress. Progesterone without enough food probably can't do its best either.

You may have already come across this, but I found the information on this site interesting - whether or not the eating disorder label fits, some of the ideas around how energy deficiency and recovery work may be relevant: Patients and General Public. I found it particularly interesting reading what 'normal' calories are for young women (eg around 3000) - and as an athlete, your needs would have been higher than average.
Consider seeing if you can find a local dr who is familiar with recovery from anorexia athletica or related issues (whether or not you fit all the criteria, some if could well apply). Make sure whatever dr you see knows the energy deficiency (overtraining/undereating) history you are trying to recover from.

Peat tends to favour sugars over starches, but some here find that more starchy foods (eg spuds) are helpful - see what works for you.

If you have night time mouth-breathing habits, you could try either tape or chinstrap to keep it shut. For me this made a big difference, till I retrained nasal breathing. Open mouth can be one factor that contributes to hyperventilation which tends to be self-reinforcing, and can get to feeling quite stressed and breathless.

If it's hard to get enough sunlight, consider getting extra red light (there are threads on this).

 

[sele]

to the forum @Mad .

I'd run 10 miles in a day and try to eat 400 calories.

How long did you do this?

So when diagnosed in December, I totally stopped running - something I've been doing nearly every day for 10 years! I started trying to eat as much good, peaty calories as possible to re-feed and heal myself. Have gained 5-10 lbs probably, don't weigh myself much. I was so sure this would affect my TSH immediately, and now that it's worse, I don't know what could have went wrong....any wisdom for me?

Do not expect the journey to be short on this yellow brick road.
You cannot expect to recover something that took you years to destroy.
My guess is your inflammation is through the roof.

I am considering taking thyroid supplement since my method "failed". Should I insist on a t3/t4 combo such as cytomel instead of synthroid?

Synthroid (T4) is a no-no.
Combo or T3 is fine.
I would wait a little longer before jumping on the thyroid wagon.

I have been having some terrible breathing/heart racing/sleeping issues. I think it might be the Progest E? The most prominent thing that happens is just as I'm drifting off to sleep, I get an adrenaline rush and heart starts pounding rapidly. This cycle continues for hours until I finally fall asleep in wee hours of the morning, wake up at 6 for work and do it all the next night. It is miserable. I am so tired and basically fall right to sleep, but then the heart starts racing and I know I'll be awake for several hours. Breathing becomes uncomfortable, I've had vertigo, chest pains, head feels like a balloon with all the pressure. While I'm tossing in bed I'll start sweating.

Classic high cortisol/adrenaline signs.
Your liver is running out of glycogen.
What do you eat before going to bed?

 

[Tarmander]

Glad you are making changes to the overeating - underexercising

I think you meant to swap these? Lol sorry I found it a bit funny, sounded healthy to me!

 

[tara]

I think you meant to swap these? Lol sorry I found it a bit funny, sounded healthy to me!

Lol. Thanks Tarmander! Fixed now.

 

[Mad]

If you are very run down from 10 years of this, I would expect it to take more than a couple of months to reverse it.
I don't know whether you would be best to supplement thyroid at this stage or not, but if you do, I'd encourage slow titration, watching the signs, and making sure to get enough nutrition, including enough carbs, to support it. I think supplementing thyroid while undereating has the potential to deepen nutritional deficiencies and stress. Progesterone without enough food probably can't do its best either.

That's how I feel, too, and I'd like to give myself more time to continue to heal this way. Basically my doctor is pushing me into this and I feel like I can't refuse his prescription since instead of baby steps forward with my most recent lab, my TSH reflects steps backwards. The under eating is not a problem anymore - I do understand that i suffered from an eating disorder for a long time, but I also know my mind has recovered and I'm not scared of food anymore. Especially since beginning Peat principles, I have really tried to eat until I want to pop! - which honestly isn't all that much food...I think when I was running I could eat and eat and eat, but now that I don't do the endurance exercise, I get full pretty quickly.

Peat tends to favour sugars over starches, but some here find that more starchy foods (eg spuds) are helpful - see what works for you.

I favor sugar, as well! :) I have been getting most of my carbs from OJ, ice cream, and coke but I also have been eating a potato for dinner as much as possible, maybe 3 times a week - baked potato can get old quickly for me, though I do enjoy it. I could use some ideas for variation in my diet. But I do feel good after eating potato.

If you have night time mouth-breathing habits, you could try either tape or chinstrap to keep it shut. For me this made a big difference, till I retrained nasal breathing. Open mouth can be one factor that contributes to hyperventilation which tends to be self-reinforcing, and can get to feeling quite stressed and breathless.

I guess I need to look into this since I have read so much about it on this forum. I have been trying to focus on breathing through the nose without physical restraint for the mouth, and focusing on belly breathing. I was having problem getting deep breath for a while, but now my issue seems to be that without fail, my heart starts racing as soon as I start falling asleep. I'm took my progest e much earlier tonight so I'll see if that affects it.
I definitely also need to look into sunlight/red light. I work in an office so I'm inside basically all day!

How long did you do this?

To this extreme, maybe 2-3 years at my worst with the eating disorder behavior. Of course I couldn't get by with that exact scenario
everyday - that's why my disorder cycled between overexercising and starvation to overexercising and binging. I had a very unhealthy relationship with food. I thought it was my enemy.

Synthroid (T4) is a no-no.
Combo or T3 is fine.
I would wait a little longer before jumping on the thyroid wagon.

I think I may go to my appt in a couple of weeks, be persistent in what I believe, and if he will give me a t3/t4 combo prescription, I will at least pick it up and have it on hand for if ever I am ready to try it.

What do you eat before going to bed?

I'm hungry pretty much right after work so I eat dinner around 5-6pm and don't eat anything else before bed.
A couple of nights the heart racing has been so bad I end up here on the forum searching for answers! And have found suggestions to have some milk, salt, and/or OJ. The past two times my heart was racing I got up immediately and drank small amount of milk and OJ. One time the heart racing stopped. One time it did not.

 

[tara]

The under eating is not a problem anymore - I do understand that i suffered from an eating disorder for a long time, but I also know my mind has recovered and I'm not scared of food anymore. Especially since beginning Peat principles, I have really tried to eat until I want to pop! - which honestly isn't all that much food...I think when I was running I could eat and eat and eat, but now that I don't do the endurance exercise, I get full pretty quickly.

Have you had a go at tracking your daily calories for a week, and see where it averages? It's possible that you got so used to eating very little, that even now when you feel as though you are eating a lot, and even stuffing yourself, your unaccustomed digestive system may be limiting you to less than you need to recover?

I'm hungry pretty much right after work so I eat dinner around 5-6pm and don't eat anything else before bed.

That looks like a good target to try for improving sleep: supper before bed, and snacks by the bed that you can eat if are not sleeping in the night.

Did you see this thread? Not Peat, but relevant for some of us:
https://raypeatforum.com/community/...sterone-hint-no-low-carb-no-starvation.12506/

 

[Mad]

I have been thinking I need to track my food for a few days just to see if I'm getting even close to adequate protein and sugar. I will try to start tomorrow... Any experience with a good website/app?

That looks like a good target to try for improving sleep: supper before bed, and snacks by the bed that you can eat if are not sleeping in the night.

Did you see this thread? Not Peat, but relevant for some of us:
https://raypeatforum.com/community/...sterone-hint-no-low-carb-no-starvation.12506/

https://raypeatforum.com/community/...sterone-hint-no-low-carb-no-starvation.12506/[/QUOTE]

Do you think still doing dinner around 6 and then just going for more milk and OJ before bed would be a good solution?
Right now i have breakfast around 7, lunch at 12, small snack of dark chocolate or dried fruit at 3 and dinner at 6.
Between breakfast and lunch I sip coffee all morning with lots of sugar and half-and-half. Is that enough calories to count for a mid-morning "snack"? Is the afternoon snack adequate? If not, any ideas for some travel friendly snacks to take to work? I have a fridge available and already take my big mason jars of milk and OJ :)
I will try for a bigger portion of milk and OJ tonight before bed since I already had my normal dinner.

 

[sele]

I'm hungry pretty much right after work so I eat dinner around 5-6pm and don't eat anything else before bed.
A couple of nights the heart racing has been so bad I end up here on the forum searching for answers! And have found suggestions to have some milk, salt, and/or OJ. The past two times my heart was racing I got up immediately and drank small amount of milk and OJ. One time the heart racing stopped. One time it did not.

Try having 4oz salted OJ before bed.
Or better yet maybe some salted caramel ice cream.
Don't wait for adrenaline. It's hard to stop once it arrives.
Think fructose/sucrose, better liver, lower stress, lower TSH.
Btw, more salt through out the day will lower adrenaline.
What does your dinner look like?

 

[Mito]

I have been thinking I need to track my food for a few days just to see if I'm getting even close to adequate protein and sugar. I will try to start tomorrow... Any experience with a good website/app?

MyFitnessPal is a free app that's easy to use and has a huge food database. Good for tracking macros (fat/carbs/protein). Cronometer is a $3 dollar app that is better than MyFitnessPal for tracking micronutrients but it's food database is much smaller.

 

[Mad]

What does your dinner look like?

Usually either loaded baked potato with milk (either OJ, ice cream, or coke for sugar) or muscle meat with OJ with gelatin in it, or eggs with milk and OJ. Maybe sushi on weekends or boiled shrimp. I find it harder to eat a lot for dinner than I do for the other meals.

 

[Mad]

MyFitnessPal is a free app that's easy to use and has a huge food database. Good for tracking macros (fat/carbs/protein). Cronometer is a $3 dollar app that is better than MyFitnessPal for tracking micronutrients but it's food database is much smaller.

Cool thanks, I'll give my fitness pal a try tomorrow.

 

[sele]

Usually either loaded baked potato with milk (either OJ, ice cream, or coke for sugar) or muscle meat with OJ with gelatin in it, or eggs with milk and OJ. Maybe sushi on weekends or boiled shrimp. I find it harder to eat a lot for dinner than I do for the other meals.

In the past I've tried stuffing myself to no avail.
High stress hormones do not allow you to store glucose for energy.
B vitamins help with hypoglycemia.
Are you taking any meds/supps other than Progest E?

 

[tara]

Do you think still doing dinner around 6 and then just going for more milk and OJ before bed would be a good solution?

Maybe, but it does seem to be a bit personal - experiment. It doesn't seem to do it for me, but I'm not handling milk well. If it doesn't work, you could try more calorie dense variants, eg add a bit of cheese, add sugar to the milk, try a bit of jelly - gelatin is helpful for some. Maybe have something salty, as aguilaroja said. Or see if starchy foods work better for you (not Peat's advice). Some people find that too much liquid/too low calorie-density holds them back (but don't drink less if you are actually thirsty).

I suspect that I make better use of carbs that I eat during the morning and around midday than evening, and
I've got a better chance at sleeping through the night and waking refreshed if I eat a more solid breakfast, morning tea and lunch, though I still eat a lightish dinner and supper too.

If not, any ideas for some travel friendly snacks to take to work?

I'm lucky, I have access to microwave too. So often potatoes, veges, meat for lunch.
For cold portable snacks, sometimes chopped fruit with rice and a tiny bit of butter of coconut oil. Boiled eggs or cold meat for portable protein. Fruit juice jelly carries well. Fruit. I sometimes resort to bread, but not sure whether it's a good a idea.
If milk agreed with me I'd make custards, jellied chocolate milk. For a while I was making cheesecake.

(For reference, I'm no expert, just read a bit. My situation is not the same as yours. I have not experienced extreme prolonged exercise of severe undereating, but I think some level of undereating and some shorter patches of pushing myself physically a bit much may have contributed to my issues. I've had patches of poor sleep, and the heart-racing hard-to-calm breathing at night in the past, now seldom. I'm older than you early 50s.)

 

[Mad]

In the past I've tried stuffing myself to no avail.
High stress hormones do not allow you to store glucose for energy.
B vitamins help with hypoglycemia.
Are you taking any meds/supps other than Progest E?

Interesting - I've been more concerned with getting my protein, but you think I should focus more on carbs/sugar?
Even though I love the OJ, coke, and ice cream, there's only so much of that I can take. I try for fresh fruit but it's just easier for me to get juices down. And besides that, oatmeal in the morning and potatoes for some dinners are the only other sources of carbs I usually get. Maybe aiming for more carbs during those morning and evening snacks would be a good goal for me.

Do you take B vitamins just in supplement form or get them from any particular food source?

Other than Progest E, I take one 81mg aspirin tablet and one 25,000IU Thorne Vit A tablet 3-4 days/week. I feel like that combo has been what has helped my skin the most, plus the topical Progest E.
I have also been taking Vitex during the second half of my cycle because that's what i was using for progesterone boosting before I found Progest E a couple of months ago. I plan to stop the Vitex once this menstrual cycle ends and focus on a Progest E maintenance dose since I've been dosing higher the first two cycles.

Side note: Good news - last night I took my second dose of Progest E around 5:30pm instead of right before bed, and also ate a larger snack before bed. No heart racing!! I was able to fall asleep pretty quickly which was amazing! I really hope this can continue instead of just being a placebo effect.

 

[Mad]

Oh and I also have been using Ease magnesium spray every day.

I'm lucky, I have access to microwave too. So often potatoes, veges, meat for lunch.
For cold portable snacks, sometimes chopped fruit with rice and a tiny bit of butter of coconut oil. Boiled eggs or cold meat for portable protein. Fruit juice jelly carries well. Fruit. I sometimes resort to bread, but not sure whether it's a good a idea.
If milk agreed with me I'd make custards, jellied chocolate milk. For a while I was making cheesecake.

These are good ideas, sounds like if I kept cooked rice on hand more or boiled eggs that these could be good options. Also a larger variety of fruit juices sound good to me. Basically I've just been really lazy with my food prep and cooking since I started peating...I used to cook all the time but I felt like my options have been so slimmed that I lost inspiration to cook so I've been sticking to what I know lately. If I could find some good quality, pre-made portable options for snacks in the grocery store, that would be best for me while I'm stuck in this uninspired cooking rut

 

[sele]

Side note: Good news - last night I took my second dose of Progest E around 5:30pm instead of right before bed, and also ate a larger snack before bed. No heart racing!! I was able to fall asleep pretty quickly which was amazing! I really hope this can continue instead of just being a placebo effect.

Some progress is always better than no progress. :)

Interesting - I've been more concerned with getting my protein, but you think I should focus more on carbs/sugar?
Even though I love the OJ, coke, and ice cream, there's only so much of that I can take. I try for fresh fruit but it's just easier for me to get juices down. And besides that, oatmeal in the morning and potatoes for some dinners are the only other sources of carbs I usually get. Maybe aiming for more carbs during those morning and evening snacks would be a good goal for me.

Your brain runs on sugar.
Always add sugar with protein to avoid blood glucose dips.
Preferably sugar grams should be x2 that of protein.
Take all your protein by dusk. After that think deserts and sweets.
RDA for sodium amounts to 1 tsp salt for healthy people. Aim for more than that.

Do you take B vitamins just in supplement form or get them from any particular food source?

From supps. The amount in food is not enough to mend a broken health.
B1, B2, B3, B7.
www.toxinless.com

25,000IU Thorne Vit A tablet 3-4 days/week

Vitamin A in high doses can also hamper thyroid production for a already slow liver.
Possible cause of your high TSH after peating.

 

[Mad]

Vitamin A in high doses can also hamper thyroid production for a already slow liver.
Possible cause of your high TSH after peating.

I have considered this but since my skin has improved and pulse has improved too I guess I was hoping to not have to face that possibly reality since I'm scared that if i lower the Vit A, skin issues will return.
But you're right - I think I need to at least lower the Vit A slowly and see what happens. If skin worsens, would that be a direct reflection of worsening thyroid fucntion, or not necessarily?

Preferably sugar grams should be x2 that of protein.

From tracking my food so far today, looks like my sugar is over 2x protein so that's good

I may try some B vitamins, thanks

 

[EIRE24]

I have considered this but since my skin has improved and pulse has improved too I guess I was hoping to not have to face that possibly reality since I'm scared that if i lower the Vit A, skin issues will return.
But you're right - I think I need to at least lower the Vit A slowly and see what happens. If skin worsens, would that be a direct reflection of worsening thyroid fucntion, or not necessarily?



From tracking my food so far today, looks like my sugar is over 2x protein so that's good

I may try some B vitamins, thanks

Vitamin A never did anything for my skin. Did it clear yours instantly?