Looking For A Good Doctor

iLoveSugar

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Sep 19, 2013
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I've well documented my struggles over the past several years. My weight has been steadily climbing now. Since 2016, I've gone up 45 lbs to be exact. I've had thyroid tests done, and all seem good. I still suspect it's an issue as I dont know what else could cause the rapid weight gain.

Problem is, I'm in an awful area for finding a good doc to prescribe and help me with thyroid meds. I just dont feel comfortable self treating, exp if its not my issue. Any suggestions for docs that maybe do phone consults and dont charge my right leg?

I'm in Pennsylvania.
 

boris

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What is the result of your thyroid tests?

Pulse, temp, achilles reflex will show if you are hypothyroid.

Usually the blood tests are just extra information on your thyroid state and not enough to make a diagnosis.
 

iLoveSugar

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My pulse is very sporadic. Resting typically low though, 60s-70s. During sleep, gets down to 40s. Temp is almost always 96-97s. Reflex is tough to tell. My feet and hands are typically always cold, and I do feel hypo. Blood tests have always come back pretty good (TSH, free t3, total t3, t4).

RP said I'm eating too much for my metabolic rate right now, where people on the forums always say I'm not eating enough. I'm getting fat though. I'm just scared to venture into thyroid to much alone. Currently I'm nibbling very little pieces.
 

boris

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If your hands and feet are cold in a warm environment then it is almost sure that it‘s hypothyroidism. Adrenaline will do that to keep your vital organs warms. Did you test prolactin?

The reflex test is very simple to perform by yourself it you didn‘t already. I think it‘s easy to judge, there should be no delay for a good metabolism.

I‘d say people on the forum say you‘re not eating enough on the topic of raising your metabolism. Whereas Peat probably told you are eating too much for your metabolic rate in regards to the fat gain.

Thyroid should be very safe if you have enough nutrition and pay attention to how you feel.
 
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boris

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Cholesterol has to be high enough before starting thyroid supplementation. I think something over 200 according to Peat.
 

boris

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This too:

B Complex Deficiency, Sympathetic Nervous Dysregulation, & Starvation

This post is both testimony to the importance and healing power of the B vitamins and an urgent request for help.

A couple of years ago, I often had low energy but was strong, athletic, and active. Now, I cannot leave home without a wheelchair, and in April, I was hospitalized for starvation. After a miraculous recovery lasting until a few weeks ago, I am again struggling to eat.

What explains these drastic changes of fortune?

My History, Part I: The Risks of Taking Peat's Ideas Out of Context
Like many newcomers to Ray Peat's work, I was captivated by the potential rewards of raising metabolism and did not pay enough attention to the less sexy tasks of correcting nutritional deficiencies and recovering from the stresses of years of excessive work and over-training. After experiencing great benefits from liver and B vitamins, I gradually lost interest in them -- figuring I'd fixed any deficiencies -- and increased use of thyroid, caffeine, white rice, and sucrose. But no matter how hard I pressed the metabolic accelerator, and no matter how many other improvements Peating brought me, I experienced long periods of fatigue, which should have been a warning sign.

Then the racing pulse and heart palpitations started, to be followed later by chest pains, elevated blood pressure, shortness of breath, and other fun symptoms. As time passed, even small stresses could set off these reactions. Anything that raised metabolism made the problems much worse. I had to keep cutting activity to prevent the symptoms from ratcheting up. Eventually, I couldn't leave home except to go to medical appointments, and often had to rest after walking around the room -- not because of any cardiovascular or muscular weakness, but because of the need to keep the adrenergic symptoms from spiraling out of control.

In early 2019, I became unable to eat without causing huge and ever-worsening stress reactions. (Same adrenergic symptoms as above: chest pain, shortness of breath, etc.) I starved, lost 50+ lbs (from an initial weight of roughly 250), and in April, was hospitalized. Doctors could not do anything, so they discharged me. Still couldn't eat. Outlook was grim.

My History, Part II: Saved by B Vitamins
Around Easter, I experimented again with vitamin B1. It greatly reduced the intensity of my reactions to eating, and, indeed, to all other activity. The connection between my adrenergic symptoms and my B1 intake is so close that I now believe a B1 or B complex deficiency likely caused all my problems. Taking small amounts of salt every 15-30 minutes when stressed (idea stolen from @theLaw) also helped, as did liver and IdeaLabs' Energin B complex. The months of May-October were a dream: I was able to return to eating almost normal amounts of food and gradually increase my activity. It looked like I was on my way to recovery.

Two problems brought the dream to an end.

First, as my B1 doses increased, I developed (or discovered) a B3 deficiency; main symptoms are GERD, intense stress before bowel movements, and diarrhea. Niacinamide eliminates these symptoms, but seems to aggravate the B1 deficiency symptoms, and B1 seems to worsen the B3 deficiency. So just pounding back ever-larger amounts of B1 to eliminate the B1 deficiency seems risky.

Second, and more importantly, each time I encounter excessive physical stress, I need more and more B1 to recover, and the recovery is less and less complete. Over-exertion on a few consecutive days can wipe out weeks or months of progress.

Current Challenges
In late October and November, the combination of an experiment gone bad and a few consecutive days of accidental over-exertion put my adrenergic symptoms back into overdrive. I'm again getting bad reactions to eating. The reactions occur almost immediately as soon as enough food reaches my stomach, so I suspect they're triggered by some sort of sympathetic nervous response rather than endotoxin, etc. I'm already taking a lot of B1, and it's not enough to enable me to eat more than tiny meals. Of course, inability to eat causes a vicious cycle, intensifying my stress reactions, which in turn make eating even more difficult.

The Biskinds fixed suspected B complex deficiencies with individual B vitamins and desiccated liver (equivalent to at least 2-3 oz of whole liver per day). My version of their protocol is B1, B3, Energin, and desiccated liver. Even the equivalent of 2 oz/day of liver seems to reduce my (already low) metabolism, so most days I use 1-1.5 oz, but I'm open to trying more.

Diet, Supplements, Lifestyle
When I can eat normally, my diet is mostly fruit, fruit juice, eggs, gelatin, shellfish, beef and beef liver, dairy, occasional low-fat fish, and carrots. I handle liquids fine and starch poorly. I'm currently taking around 4 g of thiamine HCl per day and a few hundred mg of allithiamine. For me, allithiamine is vastly more effective than Thiamine HCl. Other supplements include Energin B complex (20 drops per day), niacinamide (30 mg 0-5 times/day), magnesium, methylene blue, vitamins E and D. I also take clonidine, cyproheptadine, and very low doses of diamox. By necessity, I'm completely sedentary and get little sunlight.

Questions
Let me know your thoughts on fixing my B complex deficiency (e.g. more liver or B1?) or managing the adrenergic symptoms. Also let me know if you think something else besides B complex deficiency is at work. Top priority is to be able to eat enough to keep me out of the hospital.

It's common for people deficient in one B vitamin to be deficient in other Bs as well. Does my story make you suspect any other particular deficiencies besides B1 and B3?

Thanks
I want to thank everyone whose posts and comments on this forum (especially about B vitamins) helped me recover from starvation, including: @charlie, @Amazoniac, @haidut, @RatRancher, and @theLaw. Without your help, I don't know if I'd be writing this post today. Please share any thoughts you may have on my case.

Thanks in advance for all contributions.

Concluding Thought
Part of my intent in posting is to help others avoid the hell I've experienced by conveying in a graphic way the importance of the B vitamins. If metabolic stimulants like thyroid create problems for you or you have any other reasons to suspect B deficiencies, read the posts by @charlie, @haidut, @Amazoniac, and many others on this topic.
 
Last edited:

iLoveSugar

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Sep 19, 2013
Messages
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I‘d say people on the forum say you‘re not eating enough on the topic of raising your metabolism. Whereas Peat probably told you are eating too much for your metabolic rate in regards to the fat gain.

Thyroid should be very safe if you have enough nutrition and pay attention to how you feel.

What is enough nutrition though?
 

boris

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Oct 1, 2019
Messages
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What is enough nutrition though?

I mean mainly making sure to have everything that is needed for hormone synthesis:

Cholesterol
Vitamin D best from sun
Vitamin A
Sugar


And good metabolic function in general, so:

Adequate protein
Magnesium
Calcium
Copper
Salt
Zinc
B Vitamins
Vitamin K
Vitamin E if necessary
Saturated Fat
Daily Carrot Salad / Cooked Mushrooms


And keep metabolic disruptors at a minimum or avoid them completely:

PUFA
Grains
Legumes
Fermentable Fibers
Heavy Metals
Xeno- and Phytoestrogens
Goitrogenic foods (Brokkoli, Cabbage)
Anything that promotes excess Serotonin
Endotoxin
 
Last edited:

thomas00

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Nov 14, 2016
Messages
872
I'm just scared to venture into thyroid to much alone.

There is no real reason to be. Unless you are doing something silly like t4 only or ridiculous amounts of thyroid then there is nothing to fear. There is a lot of hysteria over using thyroid.

There isn't anything a doctor could do for you that you couldn't just do by yourself. There are no secrets. Quality seems to the only variable. Personally I wouldn't bother with anything other than cynomel and cynoplus. Tyromax seems to be the only decent NDT these days.

'You aren't eating enough' is all too often the solution to every problem around here. Sigh.
 
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