Help appreciated re blood work

[emma]

Hi,

I have been lurking on this site for the past 6 months, trying to understand what Ray Peat's ideas are all about.
Of course, I still have a long way to go in terms of really understanding but I do think I get the basics thanks to this forum. The posts have been extremely helpful in putting things in context.

Recently, I have been considering supplementing with thyroid. I was able to get a full physical which includes basic thyroid hormone levels and I can only understand them so far. I think I may have some symptoms of hypothyroidism but not sure and I would really appreciate your help in interpreting the results.

Basic info about myself
Female/35 yo/130lbs/5'4"/Used to be extremely active (running everyday & playing tennis on weekends)
A couple of months ago, had shingles for the first time in my life and also had acute sinusitis a couple of weeks ago. Basically, my immune seems to have deteriorated significantly. And despite all the exercise and controlling my diet, I have been able to lose my belly fat.

Triiodothyronine (T3) 0.88 ng/ml (Reference Range 0.80-2.0)
Free T4 1.31 ng/dl (Reference Range 0.89-1.79)
TSH 2.24 mlU/L (Reference Range 0.17-4.80)

Total cholesterol 212 mg/dL
Triglyceride 118 mg/dL

Albumin 4.37 g/dL
A/G ratio 1.8
AST(SGOT) 25 U/L
ALT(SGPT) 28 U/L
Creatinine 0.71 mg/dL

Estradiol(E2) 5.66 pg/ml (Reference Range 65-180)
FSH 4.53 iU/L

I seem to have low T3 but I don't know if it's so low that I would be considered hypothyroid. TSH level seems to be debatable. My liver seems to be fine and my estrogen levels seem to be on the very low side. Taken together, I don't know what to think.

I just ordered Cytomel and Cynoplus and would appreciate any recommendation as to the dosage.

Thank you in advance.
Emma

 

[Mittir]

TSH level varies through out the day. I am guessing you measured your TSH in the morning
with fasting Cholesterol. I always measure it in the morning ( non-fasting)
so i can gauge if TSH is going up or down.

RP has mentioned that he has never seen a comfortably healthy person with TSH over 2.
I had TSH around 3 for several years and i did not feel significantly better until i added
thyroid. Ideally TSH should be close to zero.

Ideally T3 should be at the upper end of normal and T4 at the lower end of normal
This shows higher rate of conversion from T4 to active hormone T3.
T3 level largely depends on glucose supply and changes rapidly.
I am wondering if your T3 level was lowered by fasting.
If you are following a low carb diet that can cause low T3.

I had T3 around 90 for some a while and i did not feel good.
I have seen one study that found average for healthy people was around 135.
I feel lot better when my T3 is above 120. Your T4 is in the middle of the range, which is good.

Your albumin is quite good and Estrogen level can be low in blood but high in tissues.
Blood level does not say much.

Your cholesterol level is quite good, RP thinks one should have total cholesterol
at least 160 preferably 200 before starting thyroid supplement.
You also need to increase your ability to store glycogen ( stored form of glucose)
before taking thyroid. It is best to start with very low dose, may be half a grain
equivalent,which is about 5 mcg T3 and 20 mcg T4. You can increase dose after 2-3 weeks.
People used to get half a grain of thyroid from foods, chicken stew, fish head etc.
It is better to take it in divided dose. Even 1-2 mcg of T3 can give noticeable improvement.
You can measure pulse and temp after breakfast and through out the day to get
a good idea about your metabolism.

RP recommends raw carrot salad and he noticed this salad in few days
normalized hormonal imbalance in many people. Good digestion is very important
for thyroid function. Eating easily digestible food and avoiding gut irritants can
greatly improve thyroid and over all health.

 

[tara]

emma

In addition to Mittir's good thoughts, I'll put a plug in for making sure you are getting adequate nutrition before starting thyroid supplementation, and if you decide to use the cynoplus, to start low and only increase after 3 weeks, because the T4 component has a long half life and can take 2-3 weeks to reach a stable level in the system with a steady supplement.

Cronometer can give you a rough idea of what nutrients you are getting out of your food.
If you want thoughts on this, you can post about what and how much you are eating, if you feel like it.

 

[emma]

Thank you both so much for your responses. I can put the test results in perspective.

One correction regarding my height, I'm 5'2". I am more familiar with the metric system :)

I have been following Peat way of eating for about a couples months (with the exception of last 2 weeks when I was on a trip). Which is to say that my diet consists of the following:

White rice & potatoes (with coconut oil) - main staple
Milk (non-fat or 1%)
Cheese (Gouda, skimmed string cheese)
Orange Juice
Fruits - Orange, apple, grapes, pineapple, dried dates, dried pineapple, and dried mangoes.
Bone broths
Beef
Shrimp
Turnips (kimchi)
Occasionally, chicken, pork, and brown rice.

I usually try to stay at about 1800 cal and walk about 30 min. to an hour per day. My protein intake is about 60-90g and I know I should

I used to take aspirin (500mg a day), niacinamide 250 (split the dosage), and 2-3 cups of coffee. Need to get back on that horse since I stopped taking them due to antibiotics that I was taking for my sinusitis.

I also supplement with K2, Vitamin E 400iu (Unique E), Vitamin D3, thiamine 100mg.

I gained about 10lbs in about a month after getting shingles because I started eating a lot more food to get my immune system back up and stopped working out due to doctor's orders.

Now I would like to lose the 10lbs and the last 5lbs that I had before. But most of all, I really just want not to be fatigued and feel depressed most of the time.

Reading thru many of the posts here, I think I am on the right track.
But I do wonder sometimes if thyroid supplementation is what's missing. Hence, the order.

Any thoughts or advice are appreciated.

 

[tara]

My view, not shared by everyone here, is that restricting calories can sometimes be part of what is keeping thyroid function low. Belly fat can be an adaptive response to energy deficit too - the body figuring the best way to defend itself from the next famine is to store up some reserve fuel, insulate the vital organs, and slow down the metabolism a bit so it doesn't have to catabolise other organs too fast. The thymus, which is key in immunity, can be one of the early victims of low sugar supply. Your doctor may well have been right that stopping the running for a bit would give your immune system a better chance at handling the shingles.

If this is the case here (which I guess it could be, but can't be sure), I think supplementing thyroid at the same time as trying to restrict diet to only 1800 cals may risk more stress. Whether you increase food first or only later in response to improved metabolism, I'd be hoping that you eventually get it up by a few hundred cals. And not by constant extreme exercise, which can also suppress T4 to T3 conversion.
I'd be depressed and fatigued on that little food too.

If you put the quantities of those foods into cronometer, you can check roughly whether you are getting more calcium than phosphorus, and enough magnesium, potassium etc from your food. If you are, adding or replacing a bit of your rice with more milk and or fruit may improve the balance.

I hope you have got over the shingles - I gather it can be a real trial. But if not, I think some people find trying to limit foods high in the amino acid arginine can sometimes be helpful, and B-vitamins (can't remember which specifically for shingles).

 

[Mittir]

I am bit unclear on the timeline, did you start peating before or after shingles?
Suddenly Changing diet can be problematic, it takes few weeks for body to get adjusted
to new foods and if you are having problem digesting some of the new foods like milk
then that can cause problem. Anything that irritates gut weaken immune system.
RP has mentioned that sinusitis is usually associated with gut issues.
It could be irritants in supplements, commercial supplements often have
allergenic compounds. Safer approach is to slowly introduce new foods
and supplements and see how body reacts to it. Key is to eat easily digestible foods
that's free of gut irritants. If you had high PUFA intake in past
then it might take some time to regain metabolism.

 

[emma]

Mittir,

I started Peating very loosely around January this year. I had the shingles around the end of March.
I can't exactly remember when but I may have started stricter Peating around the time I had the shingles.

However, I can't attribute the shingles solely to my diet because I was under extreme work-related stress. I think it was the day after I worked till 3AM (and went back to work at 8:30AM) that the symptoms started showing up.

Thankfully, I was able to prevent it from getting worse. It may be due to the fact that I am relatively young and with a little bit of help, my immune system can get better.

I have been generally healthy all my life but my body started giving out last year. I think the main reasons are overworking and I was heavily dieting and working out everyday without rest days.

So I am now trying to find a way to boost my immune system, not be fatigued, and lose weight.

I thank you for your insight, Mittir, but I do have a question. In the quote below, are you saying that my cholesterol level is quite for starting thyroid supplement? Or that a cholesterol level around (or over) 200 is quite good? Can you expound on this further?

Your cholesterol level is quite good, RP thinks one should have total cholesterol
at least 160 preferably 200 before starting thyroid supplement.

People used to get half a grain of thyroid from foods, chicken stew, fish head etc.
It is better to take it in divided dose. Even 1-2 mcg of T3 can give noticeable improvement.

I just made fish head broth. Hopefully that will tie me over until I get my cytomel/cynoplus. :)

RP recommends raw carrot salad and he noticed this salad in few days
normalized hormonal imbalance in many people. Good digestion is very important
for thyroid function. Eating easily digestible food and avoiding gut irritants can
greatly improve thyroid and over all health.

I have been eating raw carrot salad for a while (and AC from time to time) and I took antibiotics for about 11 days couple of weeks ago because of my sinusitis. So I think my gut should be in pretty good Peating shape.

 

[emma]

Tara,

Thanks for your recommendation regarding shingles.

With respect to restricting calories, I don't disagree with you. Ultimately, I would like to be able to not restrict calories and retain my health and weight at the same time. But at the moment I feel apprehensive about raising my calories too much because of the recent weight gain and the fact that after being on antibiotics for sometime, I seem to be gaining even more.

I googled antibiotics and weight gain and apparently, there are studies that support the claim that antibiotics can cause weight gain.

I read from somewhere in the forum that Peat is not opposed to taking antibiotics for gut sterilization. Any insight as to the weight gain from taking antibiotics considering this?

Have you found a way to keep your immunity and lose weight while not restricting calories? I would love to hear your success story.

 

[Mittir]

Cholesterol is a major protective substance on it's own and increased cholesterol
can increase production of anti-stress hormones like progesterone, pregnenolone, DHEA etc.
If you follow the older guideline for cholesterol it is between 160 and 200+age= 235
Since, you are thinking about taking thyroid it is good to have cholesterol at high end of normal.

Your shingles and sinusitis both happened after changing your diet.
Whenever you are adding new foods or supplement to your diet you have
to pay attention how your body reacts to it. Pectin in OJ can be problematic for many.
Milk can be detrimental to people who can't digest it properly. It is better to slowly
increase milk intake to let body adjusted to it. I had a lot of bad reaction to new foods
and supplements. It is good not to add lots of new foods and supplement at the same time.

If all these problems are happening due to some problematic food or supplement then
it is quite difficult to fix it with thyroid and other supplement.

Lack of sleep and stress increases stress hormones like cortisol and adrenaline and
it weakens digestion and permeability of gut wall. This results in increased endotoxin entry.

 

[tara]

Tara,

Thanks for your recommendation regarding shingles.

With respect to restricting calories, I don't disagree with you. Ultimately, I would like to be able to not restrict calories and retain my health and weight at the same time. But at the moment I feel apprehensive about raising my calories too much because of the recent weight gain and the fact that after being on antibiotics for sometime, I seem to be gaining even more.

I googled antibiotics and weight gain and apparently, there are studies that support the claim that antibiotics can cause weight gain.

I read from somewhere in the forum that Peat is not opposed to taking antibiotics for gut sterilization. Any insight as to the weight gain from taking antibiotics considering this?

Have you found a way to keep your immunity and lose weight while not restricting calories? I would love to hear your success story.

Hi Emma,
No, I don't have a weight-loss from Peating story. I gained weight last year by deciding to consistently eat to appetite and to avoid acute hunger stress, which has been a key stress-trigger for me for a long time. I have been weight-stable this year continuing to eat to appetite. I figured it was worth a try to see if eating more would help. I had some old injuries recover, my sleep is pretty reliably good now, I have more mental alertness in some ways, I spend a lot less time feeling anxious and stressed, or trying not to fall asleep at work, I've had only a couple of trivially short colds this year (I put htis down partly to improved breathing habits, too) etc, so I think I it has been an overall improvement in my health, but I still have my key health issue unresolved. I have no current intention of deliberately eating less to get thinner again. It remains to be seen whether my weight will stay where it is, or increase, or eventually head back down again of it's own accord.

Peat has been fairly favourable about some kinds of antibiotics (eg tetracyclines), more than others - I can't remember the details, but there are threads. Yes, he has said that some people benefit from reducing the amount of gut bacteria, because it can reduce the endotoxin load on the system. I don't know about the weight gain component.