Help With Edema

[Peatri Dish]

Hi,
I've been at this for a little over a year. I keep my diet pretty simple - milk, OJ, coffee, liver, oysters, strained yogurt, sugar, grass fed beef, and the handy, dandy carrot. Occasionally I have some potato and sometimes I eat a baked good with a bit of flour, but otherwise mostly no starch.
Thanksgiving it was pie and sweet potato and some bread but that's unusual.
I am on 50mcg cynomel broken into about 10 doses and two weeks ago I added cynoplus(1/8) (my temps range from 98.1 to 99)
I take several drops of Thorne vitamin k2, 2500IU vitamin d in the morning and
B1 100mg, coffee or caffeine 200mg, pure encapsulations b complex, 400iu vitamin e, and 325 mg aspirin three times a day
at night I take 1000mg of both taurine and glycine, 5000mcg biotin, 50 mg diphenhydramine and 500mg of niacinamide
I also take aceta Diazol (acetazolamide) 125mg three times a day. At first this seemed like a miracle wonder drug, as I peed out about 10 lbs. but I still have a lot of water weight that won't budge.
I have reduced my fluid to one quart of OJ and one quart of milk and maybe on cup of coffee a day but this still seems to be too much.
Today I through out the milk and cut the OJ in half and doubled my strained yogurt. Not really enjoying this...really thirsty!
Any ideas?

 

[tara]

I don't usually get bad edema, so I can't speak from experience, but here are some thoughts anyway.

I would think if you are thirsty it makes sense to drink. I know some people need to drink less for a while, but I get problems if I drink less than ~2l. With supps and temps routinely above 98 deg F you don't seem to be running hypothyroid.

Are you salting your food much? If you run your diet through cronometer, what does it say about calcium, magnesium, sodium, potassium, phosphorus?

Where is the edema? How long has it been there? Do you feel well otherwise? I think edema can sometimes happen when people start to eat more carbs after low carb, or adequate food after undereating. I think you came to this from low carb? If it's in the context of recovering from significant undereating, according to Gwyneth (I've not heard this from Peat) it usually eases up after a few months of reliably eating enough, but limiting food intake can keep it going longer. I haven't been through this process, and it may seem like a leap of faith to trust it, but that is what Gwyneth reports. Not sure if this applies to you.

I don't know enough about the effects/side-effects of those drugs, so I don't know if could be affecting the picture.

 

[Peatri Dish]

I am about 14 months away from low carb. I liked it precisely because it helped me manage my edema. That 4 g of water for every gram of glcogen bit made it easier for me to manage my extra fluids. I have had this problem a long time but didn't realize that's what it was. I have cankles whether I weigh 130 or 170! Ha ha ha!
The fluid gathers in the lower half of my body. Especially legs and ankles. It gathers more on the left hand side than the right.
I use salt in my foods. I probably get about two teaspoons a day. Maybe I will try to inch that up. I understand what you mean about drinking to craving but that practice has caused me to swell quite a bit. It also makes me cold if I drink as much as I'd like.

 

[Blossom]

Do you use Progest-e Peatri Dish? Progest-e can often help with edema.

 

[Peatri Dish]

Yes I do! About 10 days off and two and one half weeks on - four drops every three hours or so.
The stuff is the bomb, huh?

 

[treelady]

It sounds like you are doing everything right. If you are thirsty though I would not withhold liquids. It's not like you are drinking lots of water and if you cut out the milk you are loosing lots of protein. Here are some of the things I am doing for edema(legs, ankles). I've made progress but am looking for more ideas as well:
- Aspirin - baby size 4x/day
- E 400mg 4x/day - I know it's alot but my body wants it
- Protein - trying for 80g /day (mostly dairy)
- Baking soda in water seems to help my leg swelling but I don't tolerate it well.
- CO2 is supposed to help. I have a bag by the computer, just have to remember to use it...
- Glycine powder (I can't tolerate gelatin). I am currently experimenting with adding it to all drinks.
- Extra thyroid
- Magnesium, calcium, potassium
- Niacinamide - 100mg 3-4x/day
- pregnenolone
- Progest-E
- PUFA avoidance as much as possible
- Salt. I need lots.
- Trying to keep Tryptophan low
- Tumeric
- B vitas
- B1 increases CO2, reduces lactate. I'm not suggesting you try this but my body needs 400mg 4x/day

I take alot of other stuff but I think I used up enough space here. I am usually best in the morning when I wake up and worse in the evening.

 

[Blossom]

YES Peatri Dish!
@ treelady- Great suggestions.
I've noticed when I increase my salt/sodium intake it takes a day or two to adjust to the higher amount so I will have some temporary swelling but once adjusted the salt helps keep edema in check (for me).

 

[Peatri Dish]

Treelady & blossom: How much salt are you using?
I am also taking 50mg of pregnanalone three times a day.
I am taking Swanson extra strength. It's OK. I miss the BAC which I can't seem to find anymore,but Swanson is dirt cheap.
I could try more B1. I will see if I can find any studies about that.
Thanks for the suggestions!
I will let you know what's working TreeLady.

 

[treelady]

Salt - I don't measure it, I muscle test it. And when my body wants it I dampen my finger and put it in some salt I have for that purpose. Then I take a couple fingerfulls. I do that several times a day or if something is bothering that I think salt might help. And I shake extra salt in most things I eat. I would say definitely if you crave salt you need it. If I feel like I want salty nuts or potato chips, I take some salt and the craving goes away.

B1 - Again I muscle test it before taking it so I feel safe with the large dose. I take it with other B vitamins. I read a deficiency is rare but I also read that alpha lipoic acid can contribute to a B1 deficiency and I take that. Also read Carbonated beverages, coffee and tea, may lead to thiamin deficiency. It is possible the seizure drug I had been taking lowered my B1 levels. I wasn't taking them, but diuretics can reduce B1 too. I was taking 100mg B1 4x/day for my blood sugar. I recently upped it for a while. ...Just experimenting - Could be barking up the wrong tree. Haidut mentioned a large dosage here http://www.raypeatforum.com/forum/viewtopic.php?t=681&start=20

Thank you Peatri Dish, I would like to know what works and any new discoveries you find.

 

[sunmountain]

I started peeing after starting DHEA 5mg. It's helped with the edema, but there's still water in me. So today I started diamox (brand Iopar) and will see how that goes.

 

[north]

I just re-read this: http://raypeat.com/articles/articles/ed ... enia.shtml
Which i think can be useful for you. A good read.

Aldosterone causes leakiness and and fluid can leak outside blood vessels. Salt lowers aldosterone. Progesterone antagonises aldosterone.

This is also pretty interesting:
"In the adrenal glands, renewing cells stream from the capsule on the surface of the gland toward the center of the gland. The first cells to be produced in a regenerating gland are those that produce aldosterone, the next in the stream are the cortisol producing cells, and the last to be formed are the cells that produce the sex hormones, the androgens including DHEA, and progesterone. In aging, after the age of thirty, the renewal slows, but the dissolution of the sex hormone zone continues, so the proportion shifts, increasing the ratio of the aldosterone and cortisol producing cells to the layer that produces the protective androgens and progesterone (Parker, et al., 1997)."

I also find that circadian rhythm and sleep has major(!) impact on this, and good sleep probably shifts the ratio of stress to steroid very favorably. If i sleep at 10pm instead of 12-1am, its like a 5 fold important in everything.

So if you are stressed out for a while you will probably produce more aldosterone than progesterone/androgens from the adrenal gland, and lowering the "need" for adrenals during a longer period might shift this.
Ie, dietvise, a lot of carbs, good proteins, calcium and salt.

Salt is underestimated, i need toonnnnssss!
Aim for like 15g a day at least. Especially with all that fluid.

Also, personally I do much better with potato in my diet instead of only tons of OJ and milk, all that liquid messes anybody up who doesn't have an extremely good thyroid function and if the climate isn't very hot.

 

[Peatri Dish]

Thanks, North!
I've been doing this for a little over a year. At first I was really heaping on the potatoes coming from low carb and also always having restricted starches. So, I implicated them on the weight gain. But, more and more, I'm thinking its fluid. Just by the fact that the left leg is bigger than the right, for example.
It's funny that bit about the adrenals - I'm always telling people about that. It just makes perfect sense doesn't it? As people get older they get disinterested in sex, fat around the middle and all sorts of problems. It makes intuitive sense, in addition to the science backing it.
So, I'll start with more salt but keep an open mind about potatoes.
As far as sleep - I'm quite spoiled in that area. I get plenty! The only issue is that I work four ten hour days so I have to get up early. But even those days I get 8-10 hours. Ah! The joys of being an empty nester!
Thanks for your help!

 

[Peatri Dish]

Treelady: thanks! I was just searching Haiduts posts for the B1 thing. It's hard to remember it all. Since the acetazolamide has diuretic effect, it might help to increase B1.
I probably need to up the salt, too. I Often put it on my fingertip as well. Not so keen on salty OJ or milk. I will keep you posted.

 

[Raypmom]

Treelady: thanks! I was just searching Haiduts posts for the B1 thing. It's hard to remember it all. Since the acetazolamide has diuretic effect, it might help to increase B1.
I probably need to up the salt, too. I Often put it on my fingertip as well. Not so keen on salty OJ or milk. I will keep you posted.

Have you tried zero starch ?

I have this problem, but I think mine is a little different. Only in the face area T zone, puffy eye brows flat nose bridge area. I use to get puffy all over, but cutting all starch has helped with that type of edema. No swelling, and feel lighter. I remember even having 1/2 cup of rice or any starch especially grains would cause me to have swelling in legs and ankles. But for some reason now I am having fluid build up in some areas of my face, this is related to my thyroid issues I'm guessing.

 

[aguilaroja]

...I also take aceta Diazol (acetazolamide) 125mg three times a day. At first this seemed like a miracle wonder drug, as I peed out about 10 lbs. but I still have a lot of water weight that won't budge.
I have reduced my fluid ...
Today I through out the milk and cut the OJ in half and doubled my strained yogurt. Not really enjoying this...really thirsty!

Yes, Dr. Peat has discussed CO2 effects of acetazolamide/diamox. It is a diuretic. The use reported here is considerable. It is expected that their would be water loss initially, and that it would come to equilibrium. Diuretic response is not a particular indicator of restored metabolism.

Combining a diuretic with fluid restriction can quickly become dangerous. It is not a prudent long-term strategy for relieving water weight. If necessary, it would best be done with experienced supervision and monitoring of blood pressure and pulse response.

Please be very clear on what edema is, its nature, and its context. It's good that you are exploring different supportive maneuvers. If you have clearly "pitting edema" that has not been evaluated, have experienced health care guidance would be wise. It is always helpful to look through symptoms and aim for feeling well, together with tissue findings. The concept of water weight does not much clarify where and how fluid accumulates, and what factors influence this.

Many kinds of decline can lead to thick, soggy, or puffy tissue response. The impairment from, say, congested heart function, cortisol excess, lymph blockage, or many other possibilities might all be approached somewhat differently. Fluid restriction and diamox may not be a main thing.

There are some forum readers who are somewhat eager to restrict fluid as a strategy. My experience, and myreading of Dr. Peat, is to emphasize take in adequate salt while avoiding excess ("forced") water consumption. If soggy/swollen/puffy tissue effects remain, careful tuning of restorative metabolism is primary.

http://raypeat.com/articles/articles/water.shtml

"When people force themselves to drink a certain amount of water every day, even when they don't feel thirsty, they are activating complex adaptive processes unnecessarily. Thirst is the best guide to the amount of fluid needed.

When extra water consumption is combined with a low salt diet--as physicians have so often recommended--a healthy person can adapt easily, but for a hypothyroid person it can have disastrous effects."
--
"Hypothyroidism is typically associated with increased prolactin secretion. Hypothyroid people typically retain water, while losing salt, so the hypothyroid state is analogous to the salmon that has returned to the river, and to the mice that drink too much salt-free water.
The typical hypothyroid person loses salt rapidly in the urine (and probably in the sweat, too, though that is usually diagnosed as cystic fibrosis), and retains water, diluting the urine less than normal. The reduced production of carbon dioxide, with increased susceptibility to producing lactate and ammonium, causes the cells to be more alkaline than normal, increasing their affinity for water. The rise of estrogen that usually accompanies hypothyroidism also increases intracellular pH, loss of sodium, and over-hydration of the blood."

 

[Peatri Dish]

I have gone several weeks zero starch - except in supplements - but that hasn't done much.
If I get puffy face it's usually estrogen related.

 

[Peatri Dish]

Thanks, Aquilaroja. No, it's not pitting edema. I have seen a doctor for it and she just said that I was getting older and that it was part of aging.
I have taken the acetazolamide since the summer. I took a month off due to supply issues. I knew I retained water but I was stunned at how much went with the acetazolamide. My metabolism has definitely improved. I used to wake up weighing the exact amount that I did when I went to sleep. My husband would have evaporated six pounds! He thought it was funny, but I sensed it was something more sinister.
I am seriously thinking of stopping the acetazolamide - that's why I am in a hurry to resolve the water weight. I don't want to stay on this medication too long. I don't want to go off it only to be carrying around an extra 10 or 15 lbs again.
I have read the three main articles around this problem: "When energy fails..." "Salt" and "Water" over and over. I'm sure it is something simple.
Thanks for the words of caution. You are right. Sparing fluids along with a diuretic is stupid. Sometimes I start to tweak things and I lose sight of the big picture. I'm glad I asked for help!

 

[natedawggh]

Hi,
I have reduced my fluid to one quart of OJ and one quart of milk and maybe on cup of coffee a day but this still seems to be too much.
Today I through out the milk and cut the OJ in half and doubled my strained yogurt. Not really enjoying this...really thirsty!
Any ideas?

Just as cutting calcium won't solve high tissue calcium levels, cutting fluids doesn't really do anything to alleviate water retention. Don't over-drink, but cutting, if unpleasant isn't going to help because you'll just absorb whatever liquid you take anyway.

As stated above its a problem of hypothyroidism, as you know, but really its a problem of minerals. Our hypothyroid conditions cause a waisting of many elements, salt is always recommended but one of the others people don't mention is Chloride, which is especially important because if the body is losing salt its also losing chloride, and you need chloride for water balance and stomach acid and B12 absorption.

Since Magnesium is the most important mineral to take, use Magnesium Chloride. From what I've heard it results in higher levels of both elements better than other forms of the supplement, and continue keeping salt levels high as well.

The sub-category of this too is CO2 levels... the diamox you're taking is only a mild diuretic, but it is helpful in keeping CO2 levels raised which will power the water management process. Make sure you have enough carbs to generate CO2 with the diamox, otherwise it won't really have anything to do.

 

[Peatri Dish]

Thanks, Natedawgh. I appreciate all the feedback I'm getting. I think, in spite of the great strides I've made in the last year, I need an overhaul. I've been treating the water weight as an isolated issue - which is entirely "un-Peat!" I am looking more closely at everything now.

 

[messtafarian]

Hey there --

First of all I think it's too much pregnenolone. I am not sure of your age but even if you were having basic failure due to aging, that's about twice as much P as recommended. I take 30mg once a day and cycle off for a week every month or so. Hormone imbalance is one cause of edema.

Another cause of edema is inflammation. I am not sure exactly how this works but if you are allergic or do not tolerate something it will cause you to swell. I just had a bad infection and got swollen all over -- my eyes and fingers are still puffy.

Basically though, at this point if you are "doing everything" I would not add anything to your regimen. I would start taking things away instead. One of the major causes of edema, even in hypothyroidism, is an inability to digest starches and a tendency to have reactive gut bacteria that goes crazy for starch ( yeast is one). Even though you say it hasn't worked for you what I suggest is going to ZERO STARCH for at least a month. Peat would suggest this also -- he offers "safe starches" but he'd also pretty quickly be supportive of no starches at all.

If your gut is compromised, it is just not going to like starch. The endotoxic molecules are going to escape in your bloodstream and cause inflammation. Your gut bacteria is going to be dysbiotic and it will behave nutty ways and give you all kinds of symptoms.

If I were you I would commit to a no starch diet for three months. There is a real possibility that if you just do that everything will calm down and heal and your edema won't come back; and then you can add them again.

I know it's hard. I love love love starch and Im really bummed out when I have to stop eating it. But that is my humble suggestion.