Monitoring Metabolism With Your Ankle

[Momado965]

W O W! This could mean soreness after a intense workout is a temporal hypothyroid state.

 

[Hugh Johnson]

I guess you can try overdosing on thyroid supplements and see what it does to you.

I've seen it happen on my cat. He gets to have a voracious appetite and got plump. Then all of a sudden, he loses appetite and quickly got thin. I observed loss of energy, as well as bulging thyroid glands on the neck. Not long after, he died. The night before, he was quiet, and his eyes were wide and wasn't blinking.

The next time I saw these signs on my two other cats, I gave them selenomethionine daily, and the symptoms were gone. I changed their food. I was giving them raw fish, and they were getting too much thyroid.

I don't know about people though.

No. I'm not stupid. You could make that argument about any neurotransmitter or hormone.

 

[Elephanto]

W O W! This could mean soreness after a intense workout is a temporal hypothyroid state.

Well, soreness is at least partly from lactic acid accumulation.

 

[ddjd]

another great vid thanks dan

 

[Waynish]

Have you seen any info showing that you can add thyroid hormone to a euthyroid patent and get faster relax times? I'm curious about that aspect.

 

[Dan W]

Have you seen any info showing that you can add thyroid hormone to a euthyroid patent and get faster relax times?

I haven't, but I would expect it to happen based on "naturally" hyperthyroid people having somewhat faster relaxation. I'd guess there's quickly-diminishing-returns though, like there's a natural ceiling where increasing metabolism stops speeding things up:

(source)

 

[yerrag]

No. I'm not stupid. You could make that argument about any neurotransmitter or hormone.

I could make that argument for anything, actually.

But I may have missed something thinking that hyperthyroidism isn't a good thing. I searched Ray Peat's writings in order to disprove you and I couldn't disprove you. He would speak of doctors misdiagnosing people as hyperthyroid when they are euthyroid. He has spoken of hypothyroid as bad many times, but not a word of hyperthyroidism as bad. Is this why you believe hyperthyroidism as not bad? Or do you have other reasons for your position?

 

[aguilaroja]

Thanks.
Could a large iron hammer work fine when performing the test on the stepfamily? Also, could the ankle test be performed on the back of the neck?

I suggest avoiding iron & steel hammers/hammerheads for this. Out of interest, I have tried many neurological and other hammers and implements over the years. For ethical reasons, when using novel hammer-objects, I have been the subject and asked others to be the operators.

Of the common items, the Queen Square reflex hammer (bumper end) works best, if it is well weighted. It is possible to devise a gentle DIY Queen Square (NO need for the pointy/sharpened-tip end).
Reflex hammer - Wikipedia
Reflex hammer - Wikipedia

It is possible for a skillful examiner to elicit the lagging return phase of low thyroid function at many tendons, especially if the hypothyroid state is severe. But the Achilles tendon site is usually the easiest and most reliable. Testing is best when the subject lies face down (prone) with the knees bent. As @Dan Wich mentions, in some situations, thyroid function may be disturbed while reflex testing is problematic.

Hats off to @Dan Wich and FunctionalPS for collating data. WADR, the later 20th century studies seem to have lost some lore of the early 20th century skill. It takes knowledge, sample size and receptivity to do the test well. None of this is incentivized in recent health care practice.

 

[yerrag]

We're on the same page Dan. I just asked a question at their Kardiamobile Amazon page on whether the unit will display QTc. Will let you know their response.

I got this reply from AliveCor:

"As a single-lead ECG device we are not currently FDA cleared to evaluate QT intervals. We have not performed any testing to evaluate the accuracy of QT-interval measurements using our device and do not recommend doing so. All clinical research information on the Kardia Mobile can be found on our website by clicking on the following link, AliveCor."

However, this is kind of like their playing safe, as from the link they gave me they have the following to say:

QTc intervals can be assessed with the AliveCor heart monitor in patients on dofetilide for atrial fibrillation.

The feasibility of KardiaMobile tracings for QTc assessment in 5 patients receiving dofetilide was assessed. There was no significant difference between KardiaMobile QTc and standard ECG-QTc (all ± 20 msec). None of the patients required a dosage adjustment due to QT prolongation during their stay. KardiaMobile can be used to monitor the QTc in patients receiving dofetilide for AF.
Chung EH, Guise KD.J Electrocardiol. 2015;48(1):8-9.

Not sure if the + 20 msec would be significant. But in my latest ECG from a lab, my QTc was 420 msec, and a QTc <440msec would pass. So, I guess this difference would be significant for me.

Answers from users indicate that you would have to look at the printout and manually calculate the QTc value.

So, for me, it is too much work for too little. I would not buy it if it's simply to obtain the QTc value.

 

[Waynish]

I'd guess there's quickly-diminishing-returns though, like there's a natural ceiling where increasing metabolism stops speeding things up

Right... Or rather not that increasing metabolism doesn't speed things up, but rather a ceiling on thyroid hormones being the deficiency in the metabolic pathways. I wish blood testing were better!

 

[Hugh Johnson]

I could make that argument for anything, actually.

But I may have missed something thinking that hyperthyroidism isn't a good thing. I searched Ray Peat's writings in order to disprove you and I couldn't disprove you. He would speak of doctors misdiagnosing people as hyperthyroid when they are euthyroid. He has spoken of hypothyroid as bad many times, but not a word of hyperthyroidism as bad. Is this why you believe hyperthyroidism as not bad? Or do you have other reasons for your position?

It's only a problem if it causes trouble. Otherwise it is just hormones. If my testosterone was above reference range, would only care if there were some issues associated with it.

 

[yerrag]

It's only a problem if it causes trouble. Otherwise it is just hormones. If my testosterone was above reference range, would only care if there were some issues associated with it.

I suppose hyperthyroidism, when it surfaces, can be more easily felt and acted upon to be remedied, than hypothyroidism, which is silent and undiagnosed, or misdiagnosed with a false negative. Although hyperthyroidism can also be misdiagnosed, with a false positive though.

 

[Glassy]

I’ve been thinking about this muscle relaxation speed all week. I was left wondering what affect the patient’s magnesium levels would have on the relaxation time and if there’s a relationship between magnesium levels and thyroid levels.

I was of the belief calcium influences muscle contraction while tissue magnesium is important for muscle relaxation. Is a magnesium deficiency going to muddy the diagnosis (using this method) or is it influencing or a result of hypothyroidism?

 

[Dan W]

That's interesting, Glassy, I hadn't thought of that. I'm not sure how the thyroid versus magnesium status would interact...

 

[Fractality]

Low magnesium status is indicative of hypothyroidism. I would say it's another confirming factor. It's going to be difficult to maintain euthyroid status if adequate magnesium is not maintained.

 

[Glassy]

Low magnesium status is indicative of hypothyroidism. I would say it's another confirming factor. It's going to be difficult to maintain euthyroid status if adequate magnesium is not maintained.

I like how you said euthyroid status which is related to thyroid gland function rather than the person’s thyroid hormone levels.

I was certainly not aware that magnesium played an important role in thyroid function although I know it’s an important mineral.

Interesting...

 

[managing]

I suppose hyperthyroidism, when it surfaces, can be more easily felt and acted upon to be remedied, than hypothyroidism, which is silent and undiagnosed, or misdiagnosed with a false negative. Although hyperthyroidism can also be misdiagnosed, with a false positive though.

I think where you and @Hugh Johnson are missing each other is this. RP does not say hyperthyroidism is good. He says that the vast majority of hyperthyroidism is misdiagnosed. And treating it as hyperthyroid (ie, thyroidectomy) is exactly the wrong thing to do. I don't think he has said, but he would presumably agree that actual, real, correctly diagnosed hyperthyroidism is bad. But also much, much rarer than diagnoses indicate.

 

[bcopeland]

Well done video Dan.

Just as an FYI for why you should test both ankles and what other things can cause the reflex to be aberrant:

Compare the results with other symptoms of hypothyroid because there are multiple things that can cause a reflex to be aberrant, such as:
- Peripheral neuropathy from diabetes or other diseases
- Mineral (or other nutritional) deficiencies including hydration balance
- Nerve entrapments of the lower leg
- Cerebellar dysfunction
- PMRF (brainstem dysfunction)

Always test both sides because if you have a nerve entrapment, cerebellar, or PMRF dysfunction it will typically express only on one side which would lead to a false positive for hypothyroid symptoms.

I typically use Achilles (and other) reflex tests to assess the last 3 items but once again I always compare it to other symptoms and I always compare left to right to make sure I'm not seeing something that I want to find rather than something that is there.

 

[Wagner83]

I think where you and @Hugh Johnson are missing each other is this. RP does not say hyperthyroidism is good. He says that the vast majority of hyperthyroidism is misdiagnosed. And treating it as hyperthyroid (ie, thyroidectomy) is exactly the wrong thing to do. I don't think he has said, but he would presumably agree that actual, real, correctly diagnosed hyperthyroidism is bad. But also much, much rarer than diagnoses indicate.

He said himself that if he takes too much thyroid he gets out of breath too easily. In some of the podcasts he also talked about optimal pulse rates correlated with some stuff, like maybe the ability to learn or pass tests for students.

 

[Lilac]

Excellent, excellent video, Dan Wich! I was finally able to do the test after reading about it through Ray so many years ago. My left foot is slothier than yours but better than the hypo example. My right foot seems about the same as the left but is also trickier in delivering a response. I am going to think about supplementing thyroid as we head into fall and winter.