Hypo Posing As Hyper?

veritas

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Aug 31, 2016
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I was diagnosed as “hyperthyroid” 2 years ago, and again a couple of months ago. After discovering Dr. Peat and these forums very recently, I’m questioning whether I am hyperthyroid, or really hypothyroid with classic hyper symptoms like insomnia, adrenaline/tachycardia, and the associated adrenal and blood sugar issues.

How should I go about figuring out if I am hypo or hyper?

From my most recent lab tests (hoping someone can help me out interpreting these, not sure if all are needed for this question but here goes):

Thyroglobulin Antibodies - 5.4mg/dL (4.0 - 6.4)
Thyroid Peroxidase Antibodies - 351 IU/mL (<9)

Hemoglobin A1C - 5.7% of total Hgb (<5.7) (“Consistent with increased risk of diabetes (prediabetes)”)

Insulin (fasting) - 5.1 uIU/mL (2.0-19.6)

T3, Free - 7.2 pg/mL (2.3 - 4.2)
T4, Free, Non-Dialysis - 2.5 ng/dL (0.8 - 1.8)
TSH - < 0.01 mIU/L (0.40 - 4.50)

Chemistry:

Glucose (fasting) - 102 MG/DL (65-99)

Low cortisol overall, and my nighttime cortisol is <0.34.

I have a (very) large amount of additional test results and data (blood, adrenal, food allergies, etc.), if anything else is relevant/needed.

Background info in case it’s relevant:

I am 5’8’’, female, 34 years old, and I usually weigh between 155-165 lbs, this goes up and down seemingly endlessly. I always weigh myself first thing in the morning. My appetite changes frequently. I tend to gain 3-5 lbs in the days leading up to my period, then lose the following week.

I have a history of long term use (10 years, stopped around 2007) of the bc pill, as well as OTC sleep aids (10 years as well, stopped two years ago).

Tachycardia was pronounced two years ago which led to a cardiologist’s visit, nothing "wrong" with my heart but she informally diagnosed me on the spot with hyperthyroidism, I saw two endocrinologists after that who did blood work and diagnosed me with hyper as well and strongly recommended the medication/radioactive iodine/and surgical route (I avoided all of those, but take Atenolol 25mg broken in half, one in morning, one in evening, for perhaps 2 weeks at a time, then wean myself off carefully, gauge myself, and go back on if needed - not sure if this is the absolute best protocol, but so far I have no markedly ill effects).

Resting heart rate lately has been around 85, but depends... on what, I'm not sure. A year ago it was 100-130 sitting still doing nothing. Hotter temperatures worsen the increased heart rate, and overall I feel physically awful in hotter temperatures, agitated, fatigued. Winter is a bit more comfortable.

Important symptoms seem, for me, to be: weight gain (two years ago at the time of my diagnosis I was 180), rapid/increased heart rate immediately with even simple exertion, fatigue on and off throughout the day, headaches (possibly just poor ergonomics, neck tension), and insomnia. It takes me a long while to get to sleep, some nights it is just impossible, other nights easier, possibly a dietary connection there that I am missing. I wake up 2-3 times per night every single night, with rapid heart beat, craving sweets/extremely hungry. Dr. Peat's salt/sugar combo has been helping, as well as ice cream before bed.

Other things: I have combination oily/normal skin but no signs of aging, no wrinkles/pigmentation/dry spots, and no acne. Hair is dry and seems to go through periods of light thinning (I abuse my hair, though). Lips are always dry, but not cracked at corners. Brittle, thin nails. Pressure often behind the eyes but no bulging. No pronounced mood disturbances, a little weepy in the hours before my period. Been supplementing with Niacinamide 500mg, twice a day, which seems to have a very subtle and pleasant sedating effect on my mood. I get irritable if I don't eat frequently, but when I don't eat frequently I lose my appetite, which starts a bad cycle particularly in mornings and around tight work schedule. I am a coffee person - 2, 3 large cups a day at least. I cut out sugar in my coffee for the last year, but have added it back in the last few days (which has been wonderful).

I used to have crippling menstrual cramps and long periods, 6+ days, when I was a teenager. Now, some cramping on and off, and 2-day periods that come back 2 days later for a few hours and disappear. My very “pear” body shape seems to scream high estrogen, plus long history of taking the pill. After stopping the OTC sleep aids 2 years ago, I switched to 5-8mg nightly melatonin and primrose oil, and just stopped that a few days ago after reading about their involvement with estrogen, and oddly I feel like “everything” in my entire body has improved slightly even in this short span of time. Plus a raw carrot every day, and coconut oil.

I tried Prometrium (progesterone) 2 months ago, for two nights. I took them 2 days before my period (no ill effects while taking them, except a woozy feeling, and I slept somewhat better), but am not sure if that was the correct thing to do. My period was delayed for almost 2 weeks. After a week or so I became extremely ill on and off for a week or two, incapacitated, heart pounding, headache, nausea, then mostly fine the next day, then back to being very sick, up and down. Made the connection finally after much digging and confusion to the progesterone, and perhaps taking it incorrectly, and/or its increasing estrogen in my body - I really have no idea, still trying to figure out what exactly went wrong (or right). This is not central to my question in this particular thread, but any advice on progesterone is greatly, greatly appreciated as my gut tells me that progesterone would be a good thing, but I am concerned as to how precisely to take it and what to expect. I ordered Dr. Peat's Vitamin E + progesterone supplement, should get to me today, and am trying to understand exactly how I need to take it because I'm scared of feeling as unbelievably sick as I did with the Prometrium. Though I have read that it will "get worse before it gets better" in terms of estrogen dominance. I thought, "Well, I'll just take a drop of it every few days or so," and then I came across something this morning that warned to not take too little or else you'll feel worse - you have to take a certain higher dose, consistently. Again, suggestions for this process are very welcome.

My temperature this morning before I got out of bed was 97.4. Sitting still, currently, my heart rate is 77. I had 3 boiled eggs for breakfast plus orange juice about 30-45 minutes ago, sitting still in a temperate room, and my temperature is now 98.1.

Does this all mean I am in fact hypo, with some symptoms simply “masking” as hyper? Thank you in advance for any guidance. Two years in and I am still trying to wrap my head around all of this. I seem to learn something new and/or conflicting every single day and the information never seems to end.

*Edit: I forgot to mention that anxiety is a daily issue, generally in the form of work-related performance anxiety, occasional panic attacks, and classic introversion/need for ample amounts of alone time to feel "okay." I don't have what I think would be seen as social anxiety or "mental"/psychological anxiety (negative thoughts, etc. - not much of that), but there is definitely an anxiety component to my physiological state, probably just from the accelerated heart rate and heat intolerance. Not sure, but thought I'd mention it as a "symptom."

* Edit: In the last year, I have also had a lot of (holistic) dentistry done to correct years of avoiding a previous dentist and just generally having lots of dental issues for unknown reasons. In the last 8 months I have had several crowns, a couple of root canals, and an extraction. No amalgam ever.
 
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tara

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Mar 29, 2014
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:welcome veritas
I don't know much about hyperthyroid states, and I don't know anything about interpreting thyroid pyroxidase antibodies, but I have a couple of questions, in case you want to add more.

I can see why people have diagnosed you as hyperthyroid with those lab numbers - the TSH is low and the T3 and T4 are both high.
Don't suppose you have at any stage had total T3 and total T4 measured? I think Peat has said they are more meaningful measures than the 'free' forms.
And I can see why you are dubious about the diagnosis, given your body temps (97.4, 98.1) are not high and current heartrate is currently in the normal range.
So it's not obvious to me whether it's likely to be a reliable diagnosis or not.

What happens if you leave out the coffee? Symptoms, or just craving?

Thyroid Peroxidase Antibodies - 351 IU/mL (<9)

Any idea how much (calories) you eat in a typical/average day? Are you burning off many thousands of calories a day, or more normal amounts (eg ~2500ish)? Thirsty and drinking a lot?
Want to mention what you are typically eating, or post a screen shot from cronometer or similar to give an idea of nutrition - macro and micronutrients?

How's your breathing? Relaxed, nasal, diaphragmatic? Or stressed, mouth, chest?

I don't know whether the progest-e will be helpful or not. Do you have a goiter? If so, that's the only situation I'm aware of where starting progesterone supps couold cause a strong reaction (potentially a brief period of hyperthyroid as hormone is released from goiter) , but if you do try it, applying it to the gums absorbs quite fast, so you can get an idea of whether it is helpful or not quite quickly. 3 drops x 5 is one way to start - and some women back down to lower doses after a while - eg 3 drops 1-3 times a day. And it will probably not hang around in the system as long as transdermal applications, so you can stop using it if it seems problematic, and have those effects pass fairly soon. If you don't want to mess with your menstrual cycle, you can take it for 12-14 days between ovulation and menstruation. If it's really helpful, and you don't want to stop, you can take it all month.

Raw cabbage juice may have some anti-thyroid effect.

Take care
 

tara

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Mar 29, 2014
Messages
10,368
If you have been running with excessive thyroid hormones, that would likely require quite a bit higher nutrition - all the micronutrients as well as protein and carbs - than the average person . That cold be one possible contributor to week teeth and nails? Are you getting plenty of calcium, magnesium, fat-soluble vitamins?
 

bluewren

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Nov 21, 2013
Messages
164
@veritas
Yours is a very interesting and thoughtful post, and I hope you get more good responses like Tara's.
I too can understand a diagnosis of hyperthyroidism being made by your Drs.

Could you record your temps and pulse for a week, at different times of the day, and before and after meals? This may show some kind of pattern and give a better indication of your BMR.

All the best to you on your healing journey. I'll be watching this thread with interest.
 

jaguar43

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Joined
Oct 10, 2012
Messages
1,310
I was diagnosed as “hyperthyroid” 2 years ago, and again a couple of months ago. After discovering Dr. Peat and these forums very recently, I’m questioning whether I am hyperthyroid, or really hypothyroid with classic hyper symptoms like insomnia, adrenaline/tachycardia, and the associated adrenal and blood sugar issues.

How should I go about figuring out if I am hypo or hyper?

From my most recent lab tests (hoping someone can help me out interpreting these, not sure if all are needed for this question but here goes):

Thyroglobulin Antibodies - 5.4mg/dL (4.0 - 6.4)
Thyroid Peroxidase Antibodies - 351 IU/mL (<9)

Hemoglobin A1C - 5.7% of total Hgb (<5.7) (“Consistent with increased risk of diabetes (prediabetes)”)

Insulin (fasting) - 5.1 uIU/mL (2.0-19.6)

T3, Free - 7.2 pg/mL (2.3 - 4.2)
T4, Free, Non-Dialysis - 2.5 ng/dL (0.8 - 1.8)
TSH - < 0.01 mIU/L (0.40 - 4.50)

Chemistry:

Glucose (fasting) - 102 MG/DL (65-99)

Low cortisol overall, and my nighttime cortisol is <0.34.

I have a (very) large amount of additional test results and data (blood, adrenal, food allergies, etc.), if anything else is relevant/needed.

Background info in case it’s relevant:

I am 5’8’’, female, 34 years old, and I usually weigh between 155-165 lbs, this goes up and down seemingly endlessly. I always weigh myself first thing in the morning. My appetite changes frequently. I tend to gain 3-5 lbs in the days leading up to my period, then lose the following week.

I have a history of long term use (10 years, stopped around 2007) of the bc pill, as well as OTC sleep aids (10 years as well, stopped two years ago).

Tachycardia was pronounced two years ago which led to a cardiologist’s visit, nothing "wrong" with my heart but she informally diagnosed me on the spot with hyperthyroidism, I saw two endocrinologists after that who did blood work and diagnosed me with hyper as well and strongly recommended the medication/radioactive iodine/and surgical route (I avoided all of those, but take Atenolol 25mg broken in half, one in morning, one in evening, for perhaps 2 weeks at a time, then wean myself off carefully, gauge myself, and go back on if needed - not sure if this is the absolute best protocol, but so far I have no markedly ill effects).

Resting heart rate lately has been around 85, but depends... on what, I'm not sure. A year ago it was 100-130 sitting still doing nothing. Hotter temperatures worsen the increased heart rate, and overall I feel physically awful in hotter temperatures, agitated, fatigued. Winter is a bit more comfortable.

Important symptoms seem, for me, to be: weight gain (two years ago at the time of my diagnosis I was 180), rapid/increased heart rate immediately with even simple exertion, fatigue on and off throughout the day, headaches (possibly just poor ergonomics, neck tension), and insomnia. It takes me a long while to get to sleep, some nights it is just impossible, other nights easier, possibly a dietary connection there that I am missing. I wake up 2-3 times per night every single night, with rapid heart beat, craving sweets/extremely hungry. Dr. Peat's salt/sugar combo has been helping, as well as ice cream before bed.

Other things: I have combination oily/normal skin but no signs of aging, no wrinkles/pigmentation/dry spots, and no acne. Hair is dry and seems to go through periods of light thinning (I abuse my hair, though). Lips are always dry, but not cracked at corners. Brittle, thin nails. Pressure often behind the eyes but no bulging. No pronounced mood disturbances, a little weepy in the hours before my period. Been supplementing with Niacinamide 500mg, twice a day, which seems to have a very subtle and pleasant sedating effect on my mood. I get irritable if I don't eat frequently, but when I don't eat frequently I lose my appetite, which starts a bad cycle particularly in mornings and around tight work schedule. I am a coffee person - 2, 3 large cups a day at least. I cut out sugar in my coffee for the last year, but have added it back in the last few days (which has been wonderful).

I used to have crippling menstrual cramps and long periods, 6+ days, when I was a teenager. Now, some cramping on and off, and 2-day periods that come back 2 days later for a few hours and disappear. My very “pear” body shape seems to scream high estrogen, plus long history of taking the pill. After stopping the OTC sleep aids 2 years ago, I switched to 5-8mg nightly melatonin and primrose oil, and just stopped that a few days ago after reading about their involvement with estrogen, and oddly I feel like “everything” in my entire body has improved slightly even in this short span of time. Plus a raw carrot every day, and coconut oil.

I tried Prometrium (progesterone) 2 months ago, for two nights. I took them 2 days before my period (no ill effects while taking them, except a woozy feeling, and I slept somewhat better), but am not sure if that was the correct thing to do. My period was delayed for almost 2 weeks. After a week or so I became extremely ill on and off for a week or two, incapacitated, heart pounding, headache, nausea, then mostly fine the next day, then back to being very sick, up and down. Made the connection finally after much digging and confusion to the progesterone, and perhaps taking it incorrectly, and/or its increasing estrogen in my body - I really have no idea, still trying to figure out what exactly went wrong (or right). This is not central to my question in this particular thread, but any advice on progesterone is greatly, greatly appreciated as my gut tells me that progesterone would be a good thing, but I am concerned as to how precisely to take it and what to expect. I ordered Dr. Peat's Vitamin E + progesterone supplement, should get to me today, and am trying to understand exactly how I need to take it because I'm scared of feeling as unbelievably sick as I did with the Prometrium. Though I have read that it will "get worse before it gets better" in terms of estrogen dominance. I thought, "Well, I'll just take a drop of it every few days or so," and then I came across something this morning that warned to not take too little or else you'll feel worse - you have to take a certain higher dose, consistently. Again, suggestions for this process are very welcome.

My temperature this morning before I got out of bed was 97.4. Sitting still, currently, my heart rate is 77. I had 3 boiled eggs for breakfast plus orange juice about 30-45 minutes ago, sitting still in a temperate room, and my temperature is now 98.1.

Does this all mean I am in fact hypo, with some symptoms simply “masking” as hyper? Thank you in advance for any guidance. Two years in and I am still trying to wrap my head around all of this. I seem to learn something new and/or conflicting every single day and the information never seems to end.

*Edit: I forgot to mention that anxiety is a daily issue, generally in the form of work-related performance anxiety, occasional panic attacks, and classic introversion/need for ample amounts of alone time to feel "okay." I don't have what I think would be seen as social anxiety or "mental"/psychological anxiety (negative thoughts, etc. - not much of that), but there is definitely an anxiety component to my physiological state, probably just from the accelerated heart rate and heat intolerance. Not sure, but thought I'd mention it as a "symptom."

* Edit: In the last year, I have also had a lot of (holistic) dentistry done to correct years of avoiding a previous dentist and just generally having lots of dental issues for unknown reasons. In the last 8 months I have had several crowns, a couple of root canals, and an extraction. No amalgam ever.

When you got your blood tested were you on Promethium or any other supplements/medications ? Ray Peat has written that different medications or hormones like adrenaline can lower your TSH. Your situation reminds me of a quote from one of Ray Peat's articles.

If a person is eating only about 1800 calories per day, and has a steady and normal body weight, any “hyperthyroidism” is strictly metaphysical, or as they say, “clinical.” - Ray Peat

Preventing and treating cancer with progesterone.


I think using progesterone is a good starting point for the present moment. It's possible that the long term use of the pill could have create a resistance to hormones like progesterone and thyroid, so it's important to see how you feel when taking it. It's also possible that it could have create a high adrenaline state of affairs which could have lower your TSH which could read certain thyroid hormones off the charts. My honest opinion is that the free t3 and free t4 are not reliable. When I first had a thyroid panel done. My free t3 and t4 were in the normal ranges, but the serum t3 and serum t4 were flag for being low.

If you are having weight gain issues then I would advise you to reconsider the "hyperthyroidism" as nothing but metaphysics at the moment.
 

Mittir

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Joined
Feb 20, 2013
Messages
2,033
Ray Peat explained how a hypothyroid person becomes hyperthyroid for a short
period of time in the following interview
Audio and Transcript : The Thyroid (East West Healing Blog Talk Radio, 2011)

Another helpful interview is this one with herb doctors : Hashimoto’s, Antibodies, Temperature and Pulse KMUD, 2013

High estrogen blocks secretion of thyroid hormone from the gland and also blocks
conversion of T4 to T3 in liver. This causes thyroid glands to store large amount of
thyroid hormone when estrogen is lowered for some reason, body releases stored
hormone and this causes hyperthyroid state. This phase should last few weeks.
How often did you measure your thyroid hormones? Did your doctor only
measured thyroid hormones when you were in hyperthyroid state?
RP also recommends not to take progesterone when thyroid is enlarged.
Progesterone opposes estrogen and can cause thyroid to released stored hormone
that will lead to short phase of hyperthyroidism.

I think diet is the most important part of resolving thyroid issue.
 
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OP
veritas

veritas

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Aug 31, 2016
Messages
40
Don't suppose you have at any stage had total T3 and total T4 measured? I think Peat has said they are more meaningful measures than the 'free' forms.

Tara, thank you for the welcome.

I’ve misplaced my initial lab results from 2 years ago somehow, can’t find them anywhere, will keep looking. My TSH from then was 0.005, but I don’t have the T3 or T4 measurements at the moment. When I find them, I’ll post them.

And I can see why you are dubious about the diagnosis, given your body temps (97.4, 98.1) are not high and current heartrate is currently in the normal range.
So it's not obvious to me whether it's likely to be a reliable diagnosis or not.

Temp/hr info from yesterday and today: I had a light dinner (shredded one-carrot salad with ACV and some refined coconut oil, bit of mozzarella, a few pickled beets, plain cabbage soup) last night at around 9pm. 30-45 mins later, resting heart rate was 89, body temp was 98.1. After a hot bath with Epsom salts, my temp was 98.3 (around 11pm). This morning before getting out of bed, my temp was 97.3, heart rate was 85.

I didn't eat too much yesterday, probably around 1400-1500 calories, and I gained at least a pound. I don't care about the weight gain in and of itself, but my very inconsistent and fluctuating weight doesn't seem to make any sense to me from a dietary standpoint and really makes me wonder about my hyperthyroid diagnosis. The weight gain seems all hypo. And/or hormonal.

Interestingly, there will be times when weight falls off of me with no effort at all. The last time this happened was from about January-March of this year. I lost 20-25 lbs without changing my diet, and with no increase in basic exercise. My other symptoms during this time didn't change. Just the weight. Then it came back quickly some time after March.

What happens if you leave out the coffee? Symptoms, or just craving?

If I leave out the coffee, I'm tired and sluggish, an out-of-it feeling all day that is uncomfortable, can't focus. Leaving it out doesn't make me irritable per se, except that it's a comfort/habit thing, and I love the taste. So I'll be cranky because I "want" it.

Any idea how much (calories) you eat in a typical/average day? Are you burning off many thousands of calories a day, or more normal amounts (eg ~2500ish)?

I tracked my food intake for part of June, so here is that data if it's helpful, with varying degrees of exercise (just walking):

June - 2016
Thursday, June 30 1,232 (calories)
Wednesday, Jun 29 1,684
Tuesday, Jun 28 1,567
Monday, Jun 27 1,525
Sunday, Jun 26 1,348
Saturday, Jun 25 521 (skipped some data here)
Friday, Jun 24 1,536
Thursday, Jun 23 1,544
Wednesday, Jun 22 1,328
Tuesday, Jun 21 1,620
Monday, Jun 20 1,977
Sunday, Jun 19 2,206
Saturday, Jun 18 1,165
Friday, Jun 17 1,163

An average day, for June anyway, would be 2-3 cups of coffee every morning with half and half and no sugar; for breakfast usually either a banana, Greek yogurt with ground flax seed dumped on it, or an Evol Scramble Cup, sometimes oatmeal; for lunch or dinner I was eating lots of vegetables like homemade stir fry, frozen kale and beets, asparagus with butter. Sometimes avocado, white rice, peanut butter and honey, spinach pasta, Brazil nuts, walnuts, dates, tortilla chips, millet & brown rice Ramen miso, dark chocolate, red wine (cab), steamed broccoli and cauliflower, garbanzo beans, handmade flax seed granola… whatever I felt/thought erroneously or not fell on the healthful side, but also were things that I enjoyed eating.

Around June I saw an integrative health doctor who, after running several dietary and adrenal tests, advised me to eliminate sugar, dairy (I am not lactose intolerant, in fact I love milk and could drink a gallon of it every day, and am not allergic to it either, but he advised against it due to its sugar content), and whey from my diet as much as possible. So I did my best, mostly succeeded (lots of gluten-free everything, I missed milk, substituted with almond milk), wound up gaining a few pounds and my sleep did not improve. Mood seemed more even-keel in a slightly sedated way from Niacinamide 500-1500mg/day, another thing he recommended.

My diet has shifted around a bit in the last couple of years since my diagnosis. Whatever “new thing” I come across that doesn’t seem unhealthy or restrictive, I will at least look into, but not necessarily do, or I might do a lot of my own reading and research and incorporate part. I tried “The Plan” by Lyn-Genet Recitas first, that was tough and I didn’t feel any better than before. My tachycardia and hand tremor were at their worst during that time, but my job at that time was also stressing me out to the max. I was walking miles every day around the city (for about a year), often carrying a purse and heavy laptop bag, not overeating or eating poorly whatsoever, and was still at my heaviest weight (180 lbs). I tried Soylent, that was silly. Lots of juicing, probably in the wrong ways (bananas and milk, raw spinach, etc.). Then lots of Factor75 deliveries. Then just meticulous shopping for whatever said organic, non-GMO, BPA-free, and now gluten-free on the label. Whole foods and simple foods, but every few weeks that would all fly out the window and I’d have a lot of chocolate and ice cream, fat and sugar cravings like mad. There is a lack of fruit in my diet for various reasons, things I read, like not eating fruit with meals, and the timing was never right so I just avoided fruit mostly altogether (except for bananas) for the last couple of years. Then in June/July/August avoiding dairy, sugar, whey. Not much left to eat! After discovering Dr. Peat and his view on PUFAs last week, I realized that I’d been eating a lot of polyunsaturated fats and am now cutting that out as much as possible, and incorporating sugar and dairy back into my diet (what a relief). Also a bit of seafood now, which I did rarely before, and things like liver pate and bone broth. Bone broth will sometimes give me brain fog for some reason.

Thirsty and drinking a lot?

Thirsty - at night, yes, very, but only if I haven’t had at least 48 oz of water throughout the day along with my few cups of coffee. Otherwise not too thirsty.

How's your breathing? Relaxed, nasal, diaphragmatic? Or stressed, mouth, chest?

My breathing is stressed, and I’ve noticed this for years. It’s all in my chest and it’s shallow or staggered. In June I bought an Emwave and learned to recognize thoughts that stress me out that I wasn’t previously aware of (work, mostly). I have tried meditation frequently, and it feels great during the time that I’m doing it, but the effects don’t linger for long even though it does remind me to be cognizant of breath. “The New Rules of Posture” by Mary Bond is a good teaching aid for breathing, and other books/articles I’ve come across, but I still feel like I don’t know how to breathe correctly.

Do you have a goiter? If so, that's the only situation I'm aware of where starting progesterone supps couold cause a strong reaction (potentially a brief period of hyperthyroid as hormone is released from goiter) , but if you do try it, applying it to the gums absorbs quite fast, so you can get an idea of whether it is helpful or not quite quickly.

I do have a slight goiter, doctors notice it quickly but it is minimal.

I start ovulation tomorrow according to this tracking app I’ve been using for a few years. I received the Progest E in the mail yesterday. Please let me know if this seems like a good/safe/effective idea - I’ll rub 1 drop into my gums tomorrow night to test, and see how I feel. If I feel fine or if I sleep more soundly, I’ll do 3 drops on my gums the following night, and will repeat (3 drops a night) until the first day of my period, then stop.

Is that enough? Do you think only 3 drops/night will cause more problems potentially, estrogen- and goiter-wise, than more drops per night?

Do you or does anyone know typically how long it takes before the potential “feeling worse” begins after taking progesterone? There was a week or so delay between the time that I took the Prometrium capsules, and the onset of my terrible symptoms (nausea, panic attacks and constant anxiety, whole body aches, flu-like feeling, lightheadedness, couldn’t move… this would last for hours. Next day I’d feel somewhat okay, a day or so later all of the symptoms would come back, this repeated for two weeks finally tapering off after that).
 
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OP
veritas

veritas

Member
Joined
Aug 31, 2016
Messages
40
Ray Peat explained how a hypothyroid person becomes hyperthyroid for a short
period of time in the following interview
Audio and Transcript : The Thyroid (East West Healing Blog Talk Radio, 2011)

Wow, this was really interesting to read. Lots of in-depth info there. Going to need to read it over a few more times. Thank you for posting.

Another helpful interview is this one with herb doctors : Hashimoto’s, Antibodies, Temperature and Pulse KMUD, 2013

Will get to that one later today. Thank you.

How often did you measure your thyroid hormones?

Two or three times.

Two (more like two and a half) years ago, when I first received my hyper diagnosis, I had no idea what the thyroid even was, or did. I was more focused on a potential heart issue and the discomfort of the tachycardia (hence the initial visit to a cardiologist). Funny, after the cardiologist informally diagnosed me with hyperthyroidism on my first visit, she casually wrote down the name of a surgeon and told me that I would most likely need to have my thyroid removed, like it was no big deal, so I naively walked out thinking I'd book an appointment and it would really be no big deal. I started to research. I then saw two different endocrinologists, who were both miserable to deal with. I didn't keep track well enough of every piece of paperwork, blood test, visit date, letter, etc., that I had during the first few months, because of how new everything was to me. It wasn't until several months in that learned how much I really didn't know. I now have absolutely everything in one place, but some of my early test results are misplaced, and I've forgotten specifics from two-ish years ago.

Did your doctor only
measured thyroid hormones when you were in hyperthyroid state?

I believe so, yes.

RP also recommends not to take progesterone when thyroid is enlarged.
Progesterone opposes estrogen and can cause thyroid to released stored hormone
that will lead to short phase of hyperthyroidism.

I do have a slight goiter, and that combined with my previous experience with Prometrium leads me to believe that I will have a repeat performance if I take progesterone again. I am willing to take that risk if taking the progesterone (Progest E) means that I'll just feel worse before I feel better - as long as I do actually feel better, even if it's a month later, or two months later. I don't mind the waiting, but I need to be certain that I won't be harming my body in the very long term or permanently. It's been hard to find solid information about how to proceed. Do I take a different supplement or medication before taking the progesterone, to completely shrink the goiter, or to do something else I'm unaware of to "prepare" my body for progesterone? Is this necessary if the goiter is so small, like mine? Do I go the gentler route and eat a raw carrot every day, follow an anti-estrogen diet, and will that eventually ease my body into a state where it would be well enough to take the progesterone? Is the "small amounts of progesterone will cause estrogen receptors to proliferate and you'll feel horrible permanently" thought scientifically valid?

I think diet is the most important part of resolving thyroid issue.

I believe so, too. It's been a long road trying to understand how each and every food, and food combination, interacts with my specific chemistry. And now, I'm wondering whether my different ways of eating over the last two years have done more harm than good at times (like eating lots of supposedly thyroid-suppressing foods, etc.) because I'm questioning whether my hyperthyroid diagnosis is really hyper - or hypo. I want to answer that question first, and then change or augment my diet accordingly. But I agree that diet seems to be the thing, here. Thank you for your response.
 

Giraffe

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@veritas, please check the link below. There is a list of possible causes for thyroid hormones not working. (I am not suggesting you supplement thyroid hormones. You have more than enough. )

New to Peat: How to get started? - Ray Peat Forum Wiki
 
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veritas

veritas

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@veritas, please check the link below. There is a list of possible causes for thyroid hormones not working. (I am not suggesting you supplement thyroid hormones. You have more than enough. )

New to Peat: How to get started? - Ray Peat Forum Wiki

Thank you. What do you mean by thyroid hormones, specifically? Are you referring to progesterone, or supplements containing thyroid?
 

Giraffe

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Thank you. What do you mean by thyroid hormones, specifically? Are you referring to progesterone, or supplements containing thyroid?
You have high thyroid hormones (T3 and T4 ), but symptoms of hypothyroidism. So something is interfering with your thyroid hormones. It is very likely that this is diet related. If I were you, I would first work on my diet before trying progesterone.
 
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veritas

veritas

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You have high thyroid hormones (T3 and T4 ), but symptoms of hypothyroidism. So something is interfering with your thyroid hormones. It is very likely that this is diet related. If I were you, I would first work on my diet before trying progesterone.

Thank you. So you're referring specifically to this area:

The body does not react to thyroid hormone? Possible causes:
  • Cholesterol is too low. One of the basic functions of thyroid is to turn cholesterol into progesterone, pregnenolone and DHEA. Total cholesterol should be at least 160, preferably 200, before starting a thyroid supplement.
  • Not enough protein (RP often recommends recommends 80-100 g. One of the studies he referenced showed that protein intake below 1 g/kg bodyweight increases PTH).
  • Magnesium deficiency - Thyroid makes your cells able to use magnesium and so take it up, but a big organ like your skeletal muscles and bones can take up so much from your blood that your brain and heart and such have trouble getting the magnesium they need to respond to the thyroid, and then you get an exaggerated stress and adrenalin reaction. Salt lowers adrenaline, improves magnesium retention and increases metabolism.
  • Deficiency in vitamins: vitamin A, B vitamins...
  • Interference from iron or carotene.
PUFA in tissue
Takes four years for a complete turnover to take place.

That is helpful, thanks for pointing me there.

I am unsure of my cholesterol levels, but I can get that tested. If anyone has any recommendations for further tests that would be helpful in getting to the root of whether I am hyper or hypo beyond TSH/T3/T4, please let me know. From my most recent tests, if relevant (trying to rule things out or in, from the list above):

Magnesium, RBC 5.4 mg/dL (4.0 - 6.4)

Vitamin D,25-OH,Total,IA 27 ng/mL (30 - 100)

Calcium 9.7 MG/DL (8.6 - 10.2)

Carbon Dioxide 26 mmol/L (19 - 30)

Sodium 140 mmol/L (135 - 146)

Protein, Total 7.1 G/DL (6.1 - 8.1)

Vitamin B12, Serum 388 pg/mL (200 - 1100)

Adrenal Stress Profile results:

Cortisol - Morning (6 - 8 AM) / Result: 10.6 / Reference Range: 13.0 - 24.0 / Units: nM/L
Cortisol - Noon (12 - 1 PM) / Result: 4.8 / Reference Range: 5.0 - 8.0 / Units: nM/L
Cortisol - Afternoon ( 4 - 5 PM) / Result: 7.1 / Reference Range: 4.0 - 7.0 / Units: nM/L
Cortisol - Nighttime (10 PM - 12 AM) / Result: <0.34 / Reference Range: 1.0 - 3.0 / Units: nM/L
Cortisol Sum / Result: 22.8 / Reference Range: 23.0 - 42.0 / Units: nM/L
DHEA-S Average / Result: 2.74 / Reference Range: 2.0 - 10.0 / Units: ng/mL
Cortisol/DHEA-S Ratio / Result: 8.34 / Reference Range: 5.0 - 6.0 / Units: Ratio

"This profile is used to evaluate the adrenal glands and hormone balance. In the event of adrenal exhaustion, underlying causes must be determined through additional lab testing and investigation into environmental and lifestyle factors, while also supporting the adrenals with nutritional protocols and lifestyle modifications.

When the body is under chronic stress, pregnenolone, the precursor to all other steroidal hormones, is diverted to produce cortisol (known as pregnenelone steal or cortisol escape). This is to the detriment of all other steroidal hormones (such as DHEA and its metabolites, including progesterone, testosterone, and the estrogens). As pregnenolone is diverted to cortisol, DHEA depletion begins. The result is an elevated cortisol to DHEA ratio. A normal ratio is approximately 5:1 to 6:1."

My gut feeling is that I have an estrogen problem, based on my 10~ year history taking the pill, which I believe may have disrupted my hormones. There must be dietary factors as you say, like my vitamin D deficiency, as well as environmental/stress factors. I'm searching for reasons to take or not to take progesterone, or even pregnenolone which I read briefly about yesterday, and dietary recommendations to follow based on my data and experiences - I am lost. Dr. Peat touts the benefits of progesterone and I can see why. Is eating a raw carrot a day going to stabilize my progesterone levels, or should I work on preparing myself somehow further to take progesterone efficiently in the future? And if so, how? Any comments or suggestions on how to interpret my lab results above in comparison to the Wiki's information would be very appreciated. In the meantime, thank you @Giraffe and I will keep reading.
 
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tara

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I didn't eat too much yesterday, probably around 1400-1500 calories, and I gained at least a pound.
I tracked my food intake for part of June, so here is that data if it's helpful, with varying degrees of exercise (just walking):
The weight I gain in one or two days is not very meaningful in my experience - my weight can go up and down by 2-3 kg more than once over a week or even a day, presumable mostly water. A general trend over a month is more meaningful.
If the calories above are typical for you, it looks as though you are chronically undereating. No wonder you have been hungry a lot - I'm glad your appetite is working well enough to tell you it needs more. If you maintain or gain weight on so little, then I'm with jag - more metaphysical hyperthyroid than real. Eating so little is unlikely to be able to sustain long term health. You are not the only one here in that situation.
Getting out of it not always easy, but my guess is that you have a better chance of improving health if you start regularly eating reasonable amounts of food (eg 2500 cals). This might result in weight gain. You might want to gradually work your way up, or just go for it.
There are different opinions here on this - I'm informed partly by youreatopia Recovery From Undereating - Youreatopia. But Peat has also said in an interview that maintaining on 1500 cals indicates a pretty low metabolism.

An average day, for June anyway, would be 2-3 cups of coffee every morning with half and half and no sugar; for breakfast usually either a banana, Greek yogurt with ground flax seed dumped on it, or an Evol Scramble Cup, sometimes oatmeal; for lunch or dinner I was eating lots of vegetables like homemade stir fry, frozen kale and beets, asparagus with butter. Sometimes avocado, white rice, peanut butter and honey, spinach pasta, Brazil nuts, walnuts, dates, tortilla chips, millet & brown rice Ramen miso, dark chocolate, red wine (cab), steamed broccoli and cauliflower, garbanzo beans, handmade flax seed granola… whatever I felt/thought erroneously or not fell on the healthful side, but also were things that I enjoyed eating.
Possibly a bit low in carbs to handle 3 cups of coffee?
You've read by now some of what Peat has said about PUFAs and seed oils - so you've seen that he's not big on promoting flax seed and nuts. (Fats, functions and malfunctions., Suitable Fats, Unsuitable Fats: Issues in Nutrition, ...)

Around June I saw an integrative health doctor who, after running several dietary and adrenal tests, advised me to eliminate sugar, dairy (I am not lactose intolerant, in fact I love milk and could drink a gallon of it every day, and am not allergic to it either, but he advised against it due to its sugar content), and whey from my diet as much as possible. So I did my best, mostly succeeded (lots of gluten-free everything, I missed milk, substituted with almond milk), wound up gaining a few pounds and my sleep did not improve.
And I guess you've figured by now that some of this is about the opposite of what Peat would suggest? Peat favours milk as a good source of protein, sugars and calcium, if you have some that agrees with you. And he favours sugars - preferably from fresh ripe fruit, honey etc.

I was walking miles every day around the city (for about a year), often carrying a purse and heavy laptop bag, not overeating or eating poorly whatsoever, and was still at my heaviest weight (180 lbs).
One way the body can adapt to chronic undereating and overexercising can be to get better and better at storing fat and slowing metabolism.

After discovering Dr. Peat and his view on PUFAs last week, I realized that I’d been eating a lot of polyunsaturated fats and am now cutting that out as much as possible, and incorporating sugar and dairy back into my diet (what a relief). Also a bit of seafood now, which I did rarely before, and things like liver pate
Yay. :)
Bone broth will sometimes give me brain fog for some reason.
I wouldn't push it if it makes you feel bad - brain fog is no fun.
You could try getting gelatin in some other form (fruit jellies?) or collagen hydrolysate.

Thirsty - at night, yes, very, but only if I haven’t had at least 48 oz of water throughout the day along with my few cups of coffee. Otherwise not too thirsty.
If that's a couple of litres or so a day, that sounds pretty normal.

My breathing is stressed, and I’ve noticed this for years. It’s all in my chest and it’s shallow or staggered. In June I bought an Emwave and learned to recognize thoughts that stress me out that I wasn’t previously aware of (work, mostly). I have tried meditation frequently, and it feels great during the time that I’m doing it, but the effects don’t linger for long even though it does remind me to be cognizant of breath. “The New Rules of Posture” by Mary Bond is a good teaching aid for breathing, and other books/articles I’ve come across, but I still feel like I don’t know how to breathe correctly.
This could potentially make quite a difference - it did for me. Whnen we hyperventilate (breath too much), CO2 levels go down, and all sorts of things don't work as well. Good CO2 levels are needed to get oxygen to tissues, to allow nerves to relax, to support good circulation to periphery and digestion, and many other things. I couldn't have made the gains I did with this without also attending to hunger, and maybe getting the alkaline minerals up a bit - calcium, magnesium, potassium, sodium.
There are people here who are much more dedicated and expert than me on improving breathing, but the low-hanging fruit I tackled helped. I retrained from often thoracic breathing to pretty reliably diaphragmatic breathing with the help of a belt tightened around my chest for an hour at a time a couple of times while going about my business at home, and then a night or two with the belt round my chest. Forced me to use the diaghragm to breath down into my belly instead. Once it got going, it became automatic quite quickly. If you have a habit of sleeping with your mouth open, mechanical aids can make a big difference too - chinstrap or tape (I used tape). If I noticed tense breathing and you have a minute to pause, relax and breath out, and don't be in a hurry to breath in again until you really need to, make it nasal and diaphragmatic. I was informed by normalbreathing.com (Buteyko method), but there are other methods too, and there are some threads here about CO2 and breathing. (I'd not follow all the normalbreathing diet and lifestyle advice - he was into promoting PUFA consumption last I looked, and a level of endurance exercise that would not necessarily be helpful for everyone. )

I do have a slight goiter, doctors notice it quickly but it is minimal.
You might be OK with progesterone now, but this might be a good reason to be cautious about it at least to begin with. After you've got the goiter down, the risk would be less, and it might be helpful.

Two (more like two and a half) years ago, when I first received my hyper diagnosis, I had no idea what the thyroid even was, or did. I was more focused on a potential heart issue and the discomfort of the tachycardia (hence the initial visit to a cardiologist). Funny, after the cardiologist informally diagnosed me with hyperthyroidism on my first visit, she casually wrote down the name of a surgeon and told me that I would most likely need to have my thyroid removed, like it was no big deal, so I naively walked out thinking I'd book an appointment and it would really be no big deal. I started to research. I then saw two different endocrinologists, who were both miserable to deal with. I didn't keep track well enough of every piece of paperwork, blood test, visit date, letter, etc., that I had during the first few months, because of how new everything was to me. It wasn't until several months in that learned how much I really didn't know. I now have absolutely everything in one place, but some of my early test results are misplaced, and I've forgotten specifics from two-ish years ago.
I'm glad you got yourself informed!
You have high thyroid hormones (T3 and T4 ), but symptoms of hypothyroidism. So something is interfering with your thyroid hormones. It is very likely that this is diet related. If I were you, I would first work on my diet before trying progesterone.
+1

I think blood levels of minerals probably only give a limited view of whether you have enough, because the system works quite hard to keep the blood levels stable, even if that means depriving other tissues.

If you can get the thyroid hormones working better, the goiter may improve, and the estrogen issues too.
If you can leave out most of the PUFAs and increase your fruit, milk and carbs and calories, with occasional liver and oysters, you may find you have more energy in a few weeks or months.
 
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veritas

veritas

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Just wanted to say thank you to everyone who has commented. I'm reading and reading through the very helpful, informative posts in this forum as well as Peat articles, interviews, and experiences elsewhere, and I'm making some more informed modifications to diet and life based on everything I learn. I'll post here again soon with updates and more data (temp, hr, weight, diet, etc.) in a month or so.
 

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