Lab Results - Glucose, Liver, Triglycerides, Cortisol Is Abnormal

[yoshiesque]

hey all i got some labs done and there are a few issues:

1. The fasting glucose is higher than usual. previous tests were around 4.4 to 4.6 and now its at 5.6
2. ALT & GGT markers of LFT (liver function) are slightly higher than normal both at around 50 (should be <40)
3. Triglycerides are higher than normal for first time at 2.2 (should be <2)
4. I have gained weight - gone from around 66 to maybe 69ish. Fat around stomach and a$$.
5. I did a saliva cortisol test (4x throughout the day) and it came back low.
6. T4 is 17 (Ref Range 10-19), T3 is 5.4 (Ref Range 3.5-6.5) & TSH is 2.34 (Ref Range 0.5-4.0)

So my doctor recommends I cut down on sugars, carbs and keep fruit at 2x a day. I agree I been eating way more carbs, probably too much. So im cutting down on pure sugars i have here and there with coffee and complex carbs. Still gonna eat plenty of fruit though.

Anyway the weird thing is my TSH/T4 levels. as T4 goes up it doesnt seem to bring TSH down, any ideas why? Ill show you brief history of my lab results:

Date - TSH/T4:
2014/09/24 - 1.4/14.4
2015/03/15 - 2.17/17.5
2015/10/26 - 2.34/17.6

Now before getting "sick" (fatigued all the time), so back in 2013 when I was feeling on top, my TSH was around 0.8 - 1.4 and T4 was always slightly higher than normal (lingering around 19-21). Doctors said im not hyperthyroid and its normal for a small percentage to have very high T4. I dont have T3 values for these results but one of them from what I remember lingered around 5.6.

So question is, why was my TSH lower when T4 was lower (1.4/14.4) and why is TSH going up as T4 goes up? I thought they are inversely proportional?

Also, the 6 points above, should I be worried or is it just me eating too much and needing to cut down?

I am guessing there is some relationship between elevated LFT, elevated glucose, elevated Triglycerides with too much carbs as my doc says thats a common issue and that it means im sensitive to a lot of carbs. My guess is he is right and i need to cut down, and ill be able to increase carbs as metabolism increases (IF it increases).

Thanks guys!

 

[Stilgar]

what is your diet like?

 

[Parsifal]

You have high T4 so are you using any supplements and eating enough Selenium? Are you Peating since a long time?

 

[extremecheddar]

Did they test insulin?

 

[yoshiesque]

They only tested Fasting Glucose.

I eat the following:
- Kiwi/OJ/Watermelon daily
- Cod fish 2-3x/week
- Beef mince 2-4x/week
- Tuna 1-2x/week
- Yoghurt
- Eggs 2x/week
- Oats daily.

Supplements (recently started):
- Vitamin E
- Magnesium
- Vitamin A/D
- Vitamin K

 

[yoshiesque]

post 106350 You have high T4 so are you using any supplements and eating enough Selenium? Are you Peating since a long time?

Is high T4 a bad thing? keep in mind before I got all fatigued, I had very high T4, just over the maximum reference range. But doctors claimed it was normal for me.

 

[Mittir]

If you have increased fructose intake after your last triglyceride test then
it can explain higher triglyceride. Fructose intake more than 50 grams daily
can increase triglyceride. I think triglyceride increase with fructose intake
is not a problem. Another reason for high triglyceride is eating more calories
then needed. RP has mentioned high estrogen also increases triglyceride.

Your T4 and T3 numbers look like those are free T4 and T3 tests.
RP recommends total T3 and total T4 tests. You will need to know
reverse T3 to interpret free T3. His general commendation is that
total T4 in lower end of normal range and Total T3 at the higher end
of normal. Higher TSH can explain increased T4 and T3.
TSH can increases both T4 and conversion of T4 to T3.

Fasting glucose does not say much about metabolism.
Glucose tolerance test is a better indicator and also measuring
blood glucose after meal is more helpful.

RP thinks saliva tests are unreliable. You may have high cortisol even
with low level in saliva.

Most of your protein sources are high in phosphorus and low in calcium.
I have found good intake of calcium compared to phosphorus is the best
weight loss tool. Are you taking any calcium supplement?
Were you doing low carb during earlier tests? People usually lose
water weight in low carb by depleting glycogen. Increased glycogen storage,
which is stimulated by fructose for liver and glucose for muscle, can show weight gain.

 

[Brian]

What means have you taken to improve your insulin sensitivity and reduce FFA? This is usually at the root of poor carb metabolism.

 

[tara]

post 106359 I eat the following:
- Kiwi/OJ/Watermelon daily
- Cod fish 2-3x/week
- Beef mince 2-4x/week
- Tuna 1-2x/week
- Yoghurt
- Eggs 2x/week
- Oats daily.

How much? Average calories? How much protein per day?

As Mittir said, it looks like low calcium:phosphorus to me too.

I don't remember how tall you are, if you've said, but the last times I was down at 69 kg, I figured gaining weight would be a good thing (I'm about 176cm).

 

[answersfound]

post 106361

post 106350 You have high T4 so are you using any supplements and eating enough Selenium? Are you Peating since a long time?

Is high T4 a bad thing? keep in mind before I got all fatigued, I had very high T4, just over the maximum reference range. But doctors claimed it was normal for me.

You want lower t4 and higher t3 because that means the liver is converting. Obviously, there are other variables but this is a general rule of thumb.

 

[yoshiesque]

okay well here is some updated results of saliva tests, with reference ranges:

DHEA: 13.4 (Ref Range 0.7 - 9.4) - HIGH DHEA
Cortisol (Morning): 3 (RR <15)
Cortisol (Midday): 4 (<8)
Cortisol (Evening): 5 (<5)
Cortisol (Midnight): <3 (<3)

So my doctor said DHEA is higher than normal and Cortisol levels are low.

If these results are accurate, does this explain my fatigue issues?

I am 165cm, and i know my ideal weight is around 61-63kg

 

[Westside PUFAs]

It's normal to have high triglycerides when you're near the upper end or in the overweight category of the Body Mass Index calculator. I plugged your height and weight in:

It is normal to have high triglycerides when someone has more adipose tissue then they need. The only way for body fat to burn off and leave your body is to liberate it from the adipose sites and go into the bloodstream as free triglycerides where they can either be oxidized and literally breathed out of your mouth with Co2 or through urinary excretion. Then once at ideal body fat %, combined with good diet and low stress, they should normalize. But there is always some amount of triglyceride in the blood no matter what. We burn fat especially when we sleep so that fat has to be there to be used. Being sedentary can also raise triglycerides and unless you're a thyroid master like Peat, most can not get away with being too sedentary. Even Danny Roddy said that he walks a lot daily in SF. He is certainly burning fat with lots of daily walking. Walking is not stressful to the body like intense exercise is.

 

[yoshiesque]

post 106580 It's normal to have high triglycerides when you're near the upper end or in the overweight category of the Body Mass Index calculator. I plugged your height and weight in:


It is normal to have high triglycerides when someone has more adipose tissue then they need. The only way for body fat to burn off and leave your body is to liberate it from the adipose sites and go into the bloodstream as free triglycerides where they can either be oxidized and literally breathed out of your mouth with Co2 or through urinary excretion. Then once at ideal body fat %, combined with good diet and low stress, they should normalize. But there is always some amount of triglyceride in the blood no matter what. We burn fat especially when we sleep so that fat has to be there to be used. Being sedentary can also raise triglycerides and unless you're a thyroid master like Peat, most can not get away with being too sedentary. Even Danny Roddy said that he walks a lot daily in SF. He is certainly burning fat with lots of daily walking. Walking is not stressful to the body like intense exercise is.

Thats a good response, thank you. I find it somewhat annoying that there are people on this forum assuming that all weight gain is good, when im sure most weight gain here is just excess fat, because of excess calories. I think its bad to assume its always muscle gains when thats highly unlikely. It will lead to health issues, when we are trying to do the RP diet for health reasons in the first place.

I might do some light walking or a 10 min jog on alternate days. definitely dont wanna do too much exercise either. Im also glad you pointed out the importance of some exercise. I think too often we take it to the extreme and assume no exercise is good. Ive been in the exercise industry long enough to know that you definitely need some exercise, and the best exercise is probably just getting up and moving about...while avoiding sitting down too long.

 

[Brian]

Thats a good response, thank you. I find it somewhat annoying that there are people on this forum assuming that all weight gain is good, when im sure most weight gain here is just excess fat, because of excess calories. I think its bad to assume its always muscle gains when thats highly unlikely. It will lead to health issues, when we are trying to do the RP diet for health reasons in the first place.

I might do some light walking or a 10 min jog on alternate days. definitely dont wanna do too much exercise either. Im also glad you pointed out the importance of some exercise. I think too often we take it to the extreme and assume no exercise is good. Ive been in the exercise industry long enough to know that you definitely need some exercise, and the best exercise is probably just getting up and moving about...while avoiding sitting down too long.

Carbs can't be stored as fat unless you have some significant insulin resistance and fatty liver. How much fat are you eating per day? What are you doing to lower FFA and restore insulin sensitivity? If you're not doing some anaerobic exercise, then I would recommend high does aspirin, caffeine, niacinamide, thiamine, biotin for awhile. Once you get this fixed you should be able to eat unlimited carbs without problems as long as fat is kept low.

 

[yoshiesque]

i eat jack all fat. Probably 10-15g max.

I have been eating a lot of carbs though, i eat quite a bit of oats at night. Chuck in quite a bit of sugar in coffee.

What did you mean by lowering FFA? What is FFA?

And how can you restore insulin sensitivity? I didnt know there was a way? I thought you just do the diet and over time as thyroid gets better, insulin sensitivity improves?

Also how much is a high dose of aspirin/niacinamide/thiamine/biotin? and i have never heard of this helping anywhere on forums, is there some specific info on this?

 

[Ulla]

Oats have fats too.

 

[Brian]

i eat jack all fat. Probably 10-15g max.

I have been eating a lot of carbs though, i eat quite a bit of oats at night. Chuck in quite a bit of sugar in coffee.

That should work, but consider that oats and other harder to digest starches can feed bacteria, which could create endotoxin that will increase your estrogen and serotonin. This can cause bloating, gut inflammation and water retention that might resemble fat being formed, but it's not. Probably best to stick to no starch if your digestion isn't very strong right now.

What did you mean by lowering FFA? What is FFA?

Free fatty acids. If you have had a history of high stress of almost any kind (low carb, low calorie, low sleep, intermittent fasting) you likely have significant circulating FFAs even if you have not been eating much fat in awhile. They severely interfere with glucose metabolism.

And how can you restore insulin sensitivity? I didnt know there was a way? I thought you just do the diet and over time as thyroid gets better, insulin sensitivity improves?

There are a lot of ways to reverse insulin resistance and lower FFAs. Eating low fat, some anaerobic exercise and walking can be enough for some people. This is what I've focused on.

But some combination of high dose aspirin/niacinamide/thiamine/biotin/caffeine/B6 p5p/methylene blue is another tried and true way that can make diet and exercise even more effective.

The doses are pretty individual to the person's current condition. I'll have to refer you to others on the forum who have more experience with the B vitamin, caffeine, and aspirin approach as I have relied more on anaerobic exercise and walking to get my insulin resistance and FFA's under control.

Just do some searches for insulin resistance and aspirin for starters.

 

[tara]

post 106557 I am 165cm, and i know my ideal weight is around 61-63kg

How could you (or anyone) know this?

post 106612 I find it somewhat annoying that there are people on this forum assuming that all weight gain is good, when im sure most weight gain here is just excess fat, because of excess calories. I think its bad to assume its always muscle gains when thats highly unlikely. It will lead to health issues, when we are trying to do the RP diet for health reasons in the first place.

I can't think of anyone on this forum who has been saying that all weight gain is good. But I'll assume you are referring to me, since I'm the one who mentioned weight gain in this thread as being good in one specific instance, and raised the question in your case.
There is a difference between:
"Sometimes weight gain, including both fat and lean tissue, is a part of an overall trend towards improved health." (This is my view.)
and
"All weight gain is good." or "All weight gain is muscle." (I have never thought these things, and as far as I recall, have never said either of them.)

I don't think all weight or fat gain is always good. I certainly don't think all weight gain is always muscle, or more broadly, all lean tissue. I am sure that often a significant part of it is fat (so we agree on this part). I also think fat gain often results from factors other than overeating calories. Most likely, other important factors include choice/quality of food, but also a range of other systemic stressors, including environmental toxins, sedentry (I agree with you that it is usually a good thing to get some regular physical activity), sleep and light deprivation, social stresses, etc. Most people who basically eat to appetite stay basically weight-stable.

I think undereating can be problematic for health, that under-eating can be a contributor to low thyroid function, and that recovering from undereating may sometimes involve some gain in adipose tissue as well as other tissues.

I did not say your fat gain was good. I asked about your height and your food intake because they are relevant factors. Since I now know you are much shorter than me, I don't assume you are underweight at your current body mass. If you were 6'4" at that weight, I might be worried about you fading away. I still don't have an opinion on whether or not you are under-eating, because you have not mentioned quantities of food.

Hypothetically (and I am not saying this is you), if a man has been surviving on 1600 cals/day for a few years, he may have thereby adapted (reduced) his metabolism so that this amount maintains his weight, and may well gain fat when they increase their food intake to eat 2000 calories regularly, even though 2000 calories is still undereating compared with what they probably need to recover and run a healthy metabolism. In this case, weight gain (including fat) may be a necessary part of an overall process of restoring energy and regaining health. Continuing to restrict diet to 1500 cals (larger energy deficit wrt health) in order to maintain weight would probably be worse for maintaining health than increasing to 2000 cals (smaller energy deficit wrt health) and gaining some fat. Even better might be increasing to 3000 cals or more, so that recovery of organs and endocrine system can get underway in earnest.

Or hypothetically, a highly active athlete might be undereating at 3000 cals, and have similarly reduced their base metabolism so that this amount maintains them. In this case, reducing exercise might be necessary to restore health, and gaining weight and fat might ensue.

These are both different contexts than, say, a sumo wrestler. Or someone who already has a strong metabolism and has never restricted their food, and decides to reduce their calorie intake from 4000 to 3000, without suffering deprivation, mostly by reducing the butter and cream in their diet and replacing some of their bread intake with fruit and milk.

If you can't tell the difference, consider reading about the mortality rates for anorexia nervosa and athletica, etc, and about the Minnesota Starvation Experiment.

I don't think everybody needs to eat more, only the ones who are suffering negative health consequences from undereating. If you scan my posts (not recommending it, there are far too many of them), I think you'd find that my recommendations to eat more (even if it means gaining weight/fat) are usually in threads where people have been trying to live on under 2000 cals.

I'm sorry if this annoys you. I don't like having my views misrepresented.

I agree that we are mostly here for health reasons. Peat's key point is that producing enough cellular energy is important for health. I believe that supplying sufficient fuel is a necessary part of this. I don't know whether it is possible for most people to recover fully from chronic undereating without having at least transient fat gain.

 

[tara]

post 106655

i eat jack all fat. Probably 10-15g max.

I have been eating a lot of carbs though, i eat quite a bit of oats at night. Chuck in quite a bit of sugar in coffee.

That should work, but consider that oats and other harder to digest starches can feed bacteria, which could create endotoxin that will increase your estrogen and serotonin. This can cause bloating, gut inflammation and water retention that might resemble fat being formed, but it's not. Probably best to stick to no starch if your digestion isn't very strong right now.

Another possibility would be to try moving the oats from evening to morning - may be able to use them better then, and have less sitting in the gut overnight.

 

[yoshiesque]

I been feel nausea alot in last week or so.... Could this be related to the abnormal liver tests? Im wondering whether i should switch to rice for a while instead of so much fruits