"Higher Metabolism, Temperature And Pulse And Lower TSH Associated With Higher Mortality"

[Strongbad]

Yet the oldest verified living person is not Okinawan, how do you explain that?

Just because there's one guy who happens to be the oldest documented living person outside Japan doesn't mean everything else is irrelevant. There are plenty of centenarians in Okinawa, Japan and east-southeast Asia in general. I have plenty of centenarian relatives myself.

I've been in Tokyo before for a few weeks and I saw so many elderlies being active kicking it hard and chasing the subway trains to go to work. In US, most elderlies with similar age group would have been in nursing home bedridden all day.

The older they get, the lesser they eat and the simpler the type of food they eat. And they are cold, real cold. Not even close to 98.6 degrees. That's what I noticed from my relatives. And no, they don't drink OJ, milk, coffee, cheese and eat lots of sugar. Honestly, none of the centenarian I've known personally and through documentation eat like that.

We can talk all the theories and research studies in the world for years, but the truth is that the real world is not as simple as isolated, pinpointed research studies and hypothesis. There are lots of things at play such as genetics, living environment, lifestyle, overall diet, the regional location, stress level, relationship with friends and families. These things are interconnected, not just thyroid.

 

[Queequeg]

Well I've said this before and I'll say it again: The longest living population on the planet is the Okinawan people. My Gf's routes are in Okinawa and I'm very familiar with their diet. The traditional diet is low calorie and mildly ketogenic. Their metabolisms run generally slow, heart rate slow, and tend to have colder hands and feet than your average westerner. Their stress is very low. I have also said on many occasions, for every study you find supporting one thing, you can usually find a study that contradicts it. So then your left scratching your head with the only evidence of real world situations, and sorry to say folks, the reality is (and the Okinawan people prove it), low calorie with a slowed down metabolism supports longevity. On the flip side, steroids rapidly increase metabolism by increasing Testosterone. As people should know, steroid users tend to die quicker; this shouldn't even be debateable.

Great points. I know this is heresy, but I don't think that they eat a lot of dairy as well.

 

[Queequeg]

Thyroid Status, Disability and Cognitive Function, and Survival in Old Age
Thyroid Status and Renal Function in Older Persons in the General Population

I don’t really understand your post; especially why you linked to those two studies. This first study doesn’t exactly support your argument as it shows that higher TSH is associated with increased longevity and higher FT4 is associated with higher mortality.

“Increasing levels of thyrotropin were associated with a lower mortality rate that remained after adjustments were made for baseline disability and health status. The hazard ratio (HR) for mortality per SD increase of 2.71 mIU/L of thyrotropin was 0.77 (95% confidence interval [CI], 0.63-0.94; P = .009). The HR for mortality per SD increase of 0.21 ng/dL (2.67 pmol/L) of free thyroxine increased 1.16-fold (95% CI, 1.04-1.30; P = .009). In the general population of the oldest old, elderly individuals with abnormally high levels of thyrotropin do not experience adverse effects and may have a prolonged life span.

The second study is on sick elderly admitted to the hospital. Not exactly a great method for screening a study sample. What they found is that overt thyroid dysfunction leads to health problems. I think we all agree with that observation.

After 4 years 61% of the people with low and normal TSH were still alive vs. 76% of those with high TSH. The ratio of men was 65% higher in the groups with low and normal TSH. The mortility did not differ between low (< 0.3) and normal TSH. Survivors had a higher T3/T4 ratio than non-survivors. Low T3 was associated with increased mortality, disability, lower cognitive function and depression. A small percentage took T4 and/or antithyroid drugs, other drugs are not reported. The cause of death is reported as "CVD" or "other". At age 88 blood samples were taken again, and some individuals who have been hyperthyroid at the first examination were hypo at the second or vice versa, 95% were considered to have normal thyroid function vs. 85% at baseline.

Again not sure what your are trying to say. Is this from the full text of the Leiden study? Can you provide a link?

 

[Agent207]

The craze for pursuing a higher metabolic rate and temps for all using supplements and strategies of every kind is something I never really understood, in the absence of contextualized evidence for it.

Being hypo is definitely not good. Otherwise, tsh <2 and trying to move towards hyper... what for?? Non-sense. Its another one to add to the "try to be in the under 5gr pufa a day", while restricting functional foods.

We can talk all the theories and research studies in the world for years, but the truth is that the real world is not as simple as isolated, pinpointed research studies and hypothesis. There are lots of things at play such as genetics, living environment, lifestyle, overall diet, the regional location, stress level, relationship with friends and families. These things are interconnected, not just thyroid.

This.

 

[nikolabeacon]

First we need to clear up some basics here. I asked a question once about inter-relationship beetwen hormones( metabolism) and environment(availability of foods, location,way of living, climate, daily activities). Arent hormones( and metabolism) a body response to an environmental stimulants and response for balancing a stability of a system.? Cells and Organism needs stability or homeostasis with the current environmental stimulants..Every sudden change or frequent changes are stresors (especially if constantly forced ) for the metabolism if they are not coherent with current relatively stable environmental factors(location ,activity) .Even an increased temp and pulse. What is consciouss body response i terms of hormones and metabolism overal for example in a stresfull location vs free and rich one. Body secrete some hormones for a reason...for adaptation, of to escape some dangers and save us and establish stability as quick as possible. So if we look traditional diets one things in common for them is stability of metabolism( same foods and meal frequency and activities) and its coherence with environmental factors. So they dont have so much sudden forced changes and thus their imbalaces from homeostasis and then stress hormones are lower. Probably stable secure life with richness of food and environment will lead to a metabolism whose needs will strive to be in coherence with a rich environment. ( higher temp, faster) or reverse for bad stresfull environment and life style. Adrenaline should force us to escape dangers and bad environment and change things which require more strain for body. So conclusion is : forcing high temp and pulse , against current stresfull disfunctional environment which is shaping our hormone profile and metabolism is a stressor . It puts constant and frequents sudden strains and changes which are stresors. There is no coherence .High temp and pulse are nice only when they are a result from abundance of good and quality food and environmental factors. How people in colder climate developed? Because adrenaline forced them to establish functional less stresfull environment for their organism or because they somehow managed to get their thyroid, progn and proge in high range.

 

[Drareg]

Well I've said this before and I'll say it again: The longest living population on the planet is the Okinawan people. My Gf's routes are in Okinawa and I'm very familiar with their diet. The traditional diet is low calorie and mildly ketogenic. Their metabolisms run generally slow, heart rate slow, and tend to have colder hands and feet than your average westerner. Their stress is very low. I have also said on many occasions, for every study you find supporting one thing, you can usually find a study that contradicts it. So then your left scratching your head with the only evidence of real world situations, and sorry to say folks, the reality is (and the Okinawan people prove it), low calorie with a slowed down metabolism supports longevity. On the flip side, steroids rapidly increase metabolism by increasing Testosterone. As people should know, steroid users tend to die quicker; this shouldn't even be debateable.

No sorry to you, you dont reflect reality at all. You have romantic popular notions of the okinawans.
If we ignore the questions of fraud in centenarians claims in these areas,I have posted studies on this before on the forum,we then look at current okinawan male longevity which is 78. Longevity is decline there.
Declining longevity advantage and low birthweight in Okinawa. - PubMed - NCBI

Monaco has the highest life expectancy of all at 89.5 ,they eat like the French, the place is full of cheese shops with every type of cheese you can imagine,they eat cheese,lots of it.
Next is Singapore then Japan.
Singapore diet is vast,varied and tastes great,it's not boiled sweet potatoes all day and the lifestyle is active and evolving,not rigid.


The okinawan men life expectancy is 78,in Iceland life expectancy of men is currently at 81.5 years old. In Iceland they eat a lot of dairy and high protein.
Please explain.

 

[Drareg]

Just because there's one guy who happens to be the oldest documented living person outside Japan doesn't mean everything else is irrelevant. There are plenty of centenarians in Okinawa, Japan and east-southeast Asia in general. I have plenty of centenarian relatives myself.

I've been in Tokyo before for a few weeks and I saw so many elderlies being active kicking it hard and chasing the subway trains to go to work. In US, most elderlies with similar age group would have been in nursing home bedridden all day.

The older they get, the lesser they eat and the simpler the type of food they eat. And they are cold, real cold. Not even close to 98.6 degrees. That's what I noticed from my relatives. And no, they don't drink OJ, milk, coffee, cheese and eat lots of sugar. Honestly, none of the centenarian I've known personally and through documentation eat like that.

We can talk all the theories and research studies in the world for years, but the truth is that the real world is not as simple as isolated, pinpointed research studies and hypothesis. There are lots of things at play such as genetics, living environment, lifestyle, overall diet, the regional location, stress level, relationship with friends and families. These things are interconnected, not just thyroid.

The below quote is probably why they are dying,progressive freezing.

"The older they get, the lesser they eat and the simpler the type of food they eat. And they are cold, real cold. Not even close to 98.6 degrees. That's what I noticed from my relatives. And no, they don't drink OJ, milk, coffee, cheese and eat lots of sugar. Honestly, none of the centenarian I've known personally and through documentation eat like that."

The okinawan centenarians issue is open to question,Peat mentioned it before,there is a lot of fraud around centenarians in particular Japan to claim pension benefits,Peat pointed out the researchers just asking the okinawans their date of birth in many cases without evidence to back it up.

 

[Strongbad]

@Drareg , everybody is dying as they age. It's normal. People are dying when reaching 100s just as people are dying when reaching 30s and 40s. We call that c'est la vie.

Just as there are people who are dying with sickness in 100s, there are people who are still healthy and fit in their 100s:



I also said that there are elder Japanese who are still active and working and chasing subway trains to go to work. They're are not "dying", freezing the way you described it.

Have you been to Japan at all? There's a huge difference between reading stats about Japan online than being in Japan in person and see them for yourself. Plenty of healthy elderlies there still working hard.

And you make this debate sound like religion A vs religion B. We're only discussing about health, man. Chill out. No need to be hostile. I got no beef with you.

 

[HDD]

HD: Ok. How about, if the temperature doesn’t reach 98.6, or the pulse never gets over 70 (in the mid-afternoon) ?

RP: Well, people have their chronic adaptation, and some people can stay very well at these average numbers. But, on average, people have the greatest ability to resist stress and recuperate from injury if their temperature is a little above average, and their pulse rate is a little above average. So, your health can be very good for most of your life, but you will have more resilience if your metabolic rate is higher.
HD: I remember you saying that if you don’t reach 98.6 , it means your immune system doesn’t run at its maximum capacity ?

RP: Probably. And usually you can see some evidence in your blood test, that there’s unnecessarily high TSH, or other pituitary hormones, indicating that you’re driving your endocrine system and immune system unnecessarily hard. When things are running very smoothly on the cellular level, your endocrine and immune systems don’t have to do very much. The tissue cells take care of things all by themselves.
-------------------

HD: You’ve always said that TSH in its own right is a chaperone for other inflammatory molecules. In a normal healthy person, it’s a good idea to try to get the TSH as close to zero as possible. Does TSH have any benefits, apart from stimulating the production, or release, of thyroid hormone ?

RP: My newsletter on osteoporosis a couple of years ago, went over the arguments they’re using to say that it prevents osteoporosis. I think that the references that I give in there show that basically it’s just increasing the load of inflammation.

Hashimoto’s, Antibodies, Temperature and Pulse KMUD, 2013

 

[Giraffe]

I don’t really understand your post; especially why you linked to those two studies. This first study doesn’t exactly support your argument as it shows that higher TSH is associated with increased longevity and higher FT4 is associated with higher mortality.

The second study is on sick elderly admitted to the hospital. Not exactly a great method for screening a study sample. What they found is that overt thyroid dysfunction leads to health problems. I think we all agree with that observation.

Again not sure what your are trying to say. Is this from the full text of the Leiden study? Can you provide a link?

@Drareg wondered about the strange wording in the abstract (part of the Leiden study) linked here. It seems that the full text is not available online. I linked the fulltext of two other papers that are part of the Leiden study as well and discuss the very same data (and some more). In my post above I just gave a brief summary of the information.

Drareg was spot on with questioning the wording in the abstract: "64 deaths per 1000 per year vs. 114 deaths per 1000 per year" makes the mortality in the hyperthyroid and euthyroid group appear higher than it was.

One weakness of the study was that they tested the subjects only once at baseline and again three years later:

Twentyone of the 30 participants with subclinical hypothyroidism at baseline were reassessed at age 88 years. None had developed overt hypothyroidism, 8 continued to have subclinical hypothyroidism, 11 had normal thyroid function, and 2 participants had overt hyperthyroidism at age 88 years.

So 13 out of 30 considered subclinical hypothyroid at baseline had a TSH in the euthyroid or hyperthyroid range at second evaluation. (5 had died, 8 were still subclinical hypo, 4 had not been retested.)

Among those considered as euthyroid (judged by TSH) surely were people that in fact were hypothyroid, but had a lower TSH thanks to an acute infection, for example. If we (hypothetically) counted 5% of the deaths among the "euthyroid" towards the hypothyroid group, the result would be that there was no association between TSH and mortality.
....

Low T3 is predictive for mortality. Period. TSH is inflammatory, but a single high or low reading doesn't mean much, as so many factors influence TSH. -- If a high TSH was so great for longevity, why did so few of the oldest old have a high TSH?

 

[Queequeg]

@Drareg wondered about the strange wording in the abstract (part of the Leiden study) linked here. It seems that the full text is not available online. I linked the fulltext of two other papers that are part of the Leiden study as well and discuss the very same data (and some more). In my post above I just gave a brief summary of the information.

Drareg was spot on with questioning the wording in the abstract: "64 deaths per 1000 per year vs. 114 deaths per 1000 per year" makes the mortality in the hyperthyroid and euthyroid group appear higher than it was.

One weakness of the study was that they tested the subjects only once at baseline and again three years later:


So 13 out of 30 considered subclinical hypothyroid at baseline had a TSH in the euthyroid or hyperthyroid range at second evaluation. (5 had died, 8 were still subclinical hypo, 4 had not been retested.)

Among those considered as euthyroid (judged by TSH) surely were people that in fact were hypothyroid, but had a lower TSH thanks to an acute infection, for example. If we (hypothetically) counted 5% of the deaths among the "euthyroid" towards the hypothyroid group, the result would be that there was no association between TSH and mortality.
....

Low T3 is predictive for mortality. Period. TSH is inflammatory, but a single high or low reading doesn't mean much, as so many factors influence TSH. -- If a high TSH was so great for longevity, why did so few of the oldest old have a high TSH?

I wouldn't characterize Drareg as being spot on here or in any of his other posts. Like before this criticism comes from a misunderstanding of the research and how the information is presented. The study is just presenting its mortality findings in two different but very standard ways. There is no attempt to mislead as they give both sets of numbers. As an example, for the high TSH group, they give the mean annual mortality rate of 64 deaths per 1000 per year. They then express this same finding as a mortality density rate of 16 deaths in 264 person years of follow up. If you run out the percentages, they are the same value, just expressed differently. The mortality density rate is often used to convey additional information on how quickly the subjects may have died in the observation period.

As for the other paper, they acknowledge that low T3 was associated with poor health. This is not unexpected but they also showed that this did not effect their findings on TSH or Free t4.
Thyroid Status, Disability and Cognitive Function, and Survival in Old Age
“To study whether levels of free thyroxine(T4) and free triiodothyronine(T3) were independent predictors of mortality, the risks of mortality of free triiodothyronine and free thyroxine were estimated simultaneously, with adjustments for baseline disability and health status. In this model, the increased mortality associated with increasing baseline level of free thyroxine was independent of the level of free triiodothyronine.”

“The finding that the increased mortality risk for higher free thyroxine was independent of the level of free triiodothyronine indicates that the association between free thyroxine and mortality was not explained by an underlying low triiodothyronine syndrome.”

 

[Giraffe]

I wouldn't characterize Drareg as being spot on here or in any of his other posts. Like before this criticism comes from a misunderstanding of the research and how the information is presented. The study is just presenting its mortality findings in two different but very standard ways. There is no attempt to mislead as they give both sets of numbers. As an example, for the high TSH group, they give the mean annual mortality rate of 64 deaths per 1000 per year. They then express this same finding as a mortality density rate of 16 deaths in 264 person years of follow up. If you run out the percentages, they are the same value, just expressed differently. The mortality density rate is often used to convey additional information on how quickly the subjects may have died in the observation period.

"Like before this criticism comes from misunderstanding of the research and how the information is presented"

Please stick to discussing the topic.
.....

On the topic:

" The majority with normal or low TSH levels had 193 deaths in 1698 person-years of FU."
"In the 491 subjects with normal TSH or low TSH (<0.3 mIU/L), the mean annual mortality rate was derived at 114 per 1000 per year."

193/1698 = x/1000 --> x = 114 death / 1000 person-years.

Both figures are based on the timeline, and this is questionable in a small population (16 death in four years among the people with high TSH).

As for the other paper, they acknowledge that low T3 was associated with poor health. This is not unexpected but they also showed that this did not effect their findings on TSH or Free t4.
Thyroid Status, Disability and Cognitive Function, and Survival in Old Age
“To study whether levels of free thyroxine(T4) and free triiodothyronine(T3) were independent predictors of mortality, the risks of mortality of free triiodothyronine and free thyroxine were estimated simultaneously, with adjustments for baseline disability and health status. In this model, the increased mortality associated with increasing baseline level of free thyroxine was independent of the level of free triiodothyronine.”

“The finding that the increased mortality risk for higher free thyroxine was independent of the level of free triiodothyronine indicates that the association between free thyroxine and mortality was not explained by an underlying low triiodothyronine syndrome.”

They found that low T3 was associated with increased mortality, disability, cognitive decline and depression. They found that high T4 was associated with increased mortality. They write that in sick people the conversion of T4 to T3 is suboptimal due to "disease-related factors". Then they go on adjusting for baseline health status and disability, and simultaneously calculating the effect of T3 and T4; and they discuss it away that T3 has anything to do with the outcome. They conclude that " current clinical practice of treating these elderly persons may have limited clinical benefit." -- So let's stop screening the oldest old for thyroid dysfunction! -- Current clinical practice is to treat the TSH instead of the patient. Why don't they question the practice of T4 monotherapy?

I think that their findings regarding the TSH are meaningless. See my post above.

 

[Queequeg]

" The majority with normal or low TSH levels had 193 deaths in 1698 person-years of FU."
"In the 491 subjects with normal TSH or low TSH (<0.3 mIU/L), the mean annual mortality rate was derived at 114 per 1000 per year."

193/1698 = x/1000 --> x = 114 death / 1000 person-years.

Both figures are based on the timeline, and this is questionable in a small population (16 death in four years among the people with high TSH).

You are changing the basis of your criticism of the paper. Your’s and Dareg’s original comments were:

Drareg said

"High TSH rates had 16 deaths out of 264 , The majority with normal or low TSH levels had 193 deaths in 1698 person-years of FU". Strange way to put it ,the timeline of deaths have needs to be seen here.

Giraffe Said

Drareg was spot on with questioning the wording in the abstract: "64 deaths per 1000 per year vs. 114 deaths per 1000 per year" makes the mortality in the hyperthyroid and euthyroid group appear higher than it was.

Again, I don't think that there is anything “strange” with their wording nor are they are trying to make anything “appear higher than it was.” Like I said, the mortality density rate, is a standard measurement used to express mortality. His criticism of the research comes from this misunderstanding.

Also I don't understand what you are trying to say with the new criticism. There is nothing small about the sample population. It is well over the size needed for statistical relevance.

They found that low T3 was associated with increased mortality, disability, cognitive decline and depression. They found that high T4 was associated with increased mortality. They write that in sick people the conversion of T4 to T3 is suboptimal due to "disease-related factors". Then they go on adjusting for baseline health status and disability, and simultaneously calculating the effect of T3 and T4; and they discuss it away that T3 has anything to do with the outcome. They conclude that " current clinical practice of treating these elderly persons may have limited clinical benefit." -- So let's stop screening the oldest old for thyroid dysfunction! -- Current clinical practice is to treat the TSH instead of the patient. Why don't they question the practice of T4 monotherapy?
I think that their findings regarding the TSH are meaningless. See my post above.

That is not my reading of the study. They were able to statistically separate the effects of low T3 from high T4 and found that high T4 had an independently negative effect on health. Nothing magic here.
"“The finding that the increased mortality risk for higher free thyroxine(T4) was independent of the level of free triiodothyronine (T3) indicates that the association between free thyroxine and mortality was not explained by an underlying low triiodothyronine syndrome.”

 

[Giraffe]

You are changing the basis of your criticism of the paper. Your’s and Dareg’s original comments were:

Again, I don't think that there is anything “strange” with their wording nor are they are trying to make anything “appear higher than it was.” Like I said, the mortality density rate, is a standard measurement used to express mortality.

Usually authors of a clinical trial like this would write "193 out of 491 (39%) have died during the follow-up period." If you wanted to, you could express it as "98 death per 1000 persons per years". The authors of the study however expressed their values as time-to-event. This is ridiculous given how small the sample of hypos is (16 out 67). With more than half of the population being still alive, it is more than questionable anyway.

That is not my reading of the study. They were able to statistically separate the effects of low T3 from high T4 and found that high T4 had an independently negative effect on health. Nothing magic here.

"“The finding that the increased mortality risk for higher free thyroxine(T4) was independent of the level of free triiodothyronine (T3) indicates that the association between free thyroxine and mortality was not explained by an underlying low triiodothyronine syndrome.”

You are just repeating yourself here. Let's agree to disagree.

 

[Queequeg]

Let's agree to disagree.

agreed

 

[Diokine]

I've had a lot of thoughts on this subject and an analogy came to me that I liked.

Imagine we have a large community of bears. These bears live happily in the woods, in relative abundance during spring time. Sure, some fights broke out here and there, and the bears also got injured sometimes building their bear-houses. But they recovered quickly, enjoyed a happy bear life, and got lots done. There was little stress. These bears had a high metabolism, what most would consider "optimal." High pulse, warm hands and feet, happiness, etc.

But winter was coming. Good food became harder to come by, there was less and less sunshine, and lots of fights happening. A lot of bears started to get stressed out. Unfortunately for some of these bears, they looked at their cell phones too much and ate things that made them sick all the time. They were constantly stressed - running on adrenaline and cortisol, and their brains couldn't turn down the throttle so to speak. When it came time to really hunker down and hibernate, these bears couldn't handle the lack of food and light, their muzzles turned grey and they died at much higher rates. So it went, for year after year, with different shades of bear metabolics.

So I think if you ran a study on these bears, over a long period of time, you'd say that the bears that weren't able to hibernate had a chance of dying at a much higher rate. And you'd be completely right. But could you infer the idea that high-TSH bears have an overall chance of living longer? I think you definitely could. Getting down to the bottom line, that's what we're really arguing here. Does having lower metabolism increase your chance of survival? In times of famine and stress, you have to concede the answer is definitely yes. The body does this on purpose, lowering the metabolic rate during times of sickness and great stress.

Many people, I'm sure many of which were included in the studies, we're under a lot of stress. They were starved from lack of proper nutrition and poisoned from heavy metals and other toxic elements. All adding to the stress. And so if we roll the previous idea, that having a lower metabolism brings a higher chance of survival, into this frame of thought - does a lower metabolic rate offer protection against stress? In some cases, absolutely. In fact that is the primitive role of serotonin and other metabolic modulators - to conserve energy. There comes a point, though, that it must be decided whether or not to expend the energy to gather more resources. That decision rides upon an extremely delicate balance, all governed by the brain. Stress requires energy to mitigate, but depending on the brain and the organisms perception of it's environment, it may decide to conserve energy and wait for better times or it may decide to keep energy consumption high and explore.

We are rewarded for reducing stress - eating food, having sex, making the right decisions, etc. So this delicate balance is hinged upon the pull of the reward of less stress, and the push towards conservation. Unfortunately for us, our environments are extremely difficult to navigate emotionally without a good frame of reference. We also eat poison food that tastes fantastic, we bombard our brains with very high frequency information and require it to make decisions under stress - things are way out of whack. And so a lot of our brain don't get the necessary feedback to regulate the metabolism correctly - we are functionally starving but surrounded by stimulating food. A terrible mess to be in, no doubt.

So for me, the conclusion I get from these studies is this - When the brain is unable to correctly regulate the metabolism due to the environment and other stressors, you will have a higher chance of dying. If you look at someone who is very old, their metabolism has slowed considerably. If they are able to organize their metabolism to encourage conservation rather than consumption of energy, they will live longer.

 

[mgrabs]

so if free t3 & 4 are optimal… but tsh is around 3-4 is that not good? Or shows
Longevity