new, need help single mom: thyroid and progest-e

[sunmountain]

Newbie here. Recently started progest-e 3 drops at bedtime. Menopausal at 50. Eat healthy.

Diagnosed hypothyroid (euthyroidic) about 6-8 months ago, took levothyroxine 25mcg for a few months, then tapered off and was fine with the help of homeopathics for 3-4 months.

Arthritis/joint and muscle pain never went away even while on levothyroxine. Fatigue did go away.

Started progest-e a week ago. Hypo symptoms are back...fatigue, arthritis is worse.

Going to get thyroid lab work done today.

Started back on levothyroxine 25mcg today. Read about cytomel. Can I combine it with Levothyroxine?

I thought the progest-e would keep the thyroid running or improve it -- that's what I read somewhere.

Should I be doing the high initial dose? Or should I first improve thyroid and fatigue?

Thanks for any help!

 

[sunmountain]

The problem is that I have no time to be sick due to work and single parenting. Is there anything that can help me function short-term, while I start work on long term health?

 

[cbar09]

Just a quick thought, you might need to increase your nutrients and/or calorie intake (esp. protein and sugar) if you are taking progest-e and thyroid.

Cholesterol (increased by fructose or table sugar) and vitamin A are needed to produce the steroid hormones along with thyroid. RP recommends raising low cholesterol before starting thyroid meds I believe. Could be as simple as having something like warm milk with honey before bedtime when you take the progest-e.

How is your sleep during this time?

 

[aguilaroja]

...Menopausal at 50. Eat healthy.

Diagnosed hypothyroid (euthyroidic) about 6-8 months ago, took levothyroxine 25mcg for a few months, then tapered off and was fine with the help of homeopathics for 3-4 months.

Arthritis/joint and muscle pain never went away even while on levothyroxine. Fatigue did go away.

Started progest-e a week ago. Hypo symptoms are back...fatigue, arthritis is worse....

Welcome to the forum. Mittir answered the T3/cytomel question in your other post.

(1) This is a forum for friendly discussion related to Dr. Peat's ideas. I am not a professional Peat-style coach, designated or otherwise.

(2) There is limited information here, so what is offered in discussion is some basics, relating only to quite rough guesses about the specific situation.

(3) Many readers here have been depleted and know life circumstances that are hard pressed. Some reading of posts here about basics, and of Dr. Peat's articles at raypeat.com and his books and interviews is strongly recommended. Mittir has many posts that discuss useful starting points. I am not meaning to omit others (WADR)-I've just read some of Mittir's posts recently.

(4) If quick boosts are needed only the fly, recent positive responses are a good clue. In your case, it seemed like the low dose T4 helped. As Mittir responded to your other post, you can add a bit of T3, divided through the day, to current T4. Many of us experienced rapid benefits when adding proportional T3 to T4 regimens.

(5) If things seemed to flare up after a small amount of Progest-E, you might cease it in the short term to notice if there are differences. It could be many things, including inconvenient coincidence. In the many dozens of women acquaintances using Progest-E, the major "side effect" I heard about was essentially heat/high alertness/rapid heartbeat in two cases from what seemed like a rapid boost in thyroid function. In both cases, these episodes were brief, and settled down simply by going slower.

(5a) How did you take the Progest-E? 3 drops of Progest-E is a pretty small amount. It is possible for instance, that the Progest-E did boost metabolism and increased nutritional requirements more rapidly than intake was adjusted.

(5b) It may be that Progest-E is not the thing for you, or not now. I am a Peat admirer but not a zealot. It's fine to search for something else that works for you. There are also some for whom starting with high Progest-E amounts works well. There's data about a short trial of a small dose so far.

(5c) Historical clues for estrogen excess (and Progest-E relief) might include: "female" problems like breast or ovary cysts, difficult periods, cramping or heavy bleeding prior to menopause, a difficult menopause transition, prolonged history of birth control pills....

(6) Start tracking and logging resting AM pulse and temperature, and do an inventory of low thyroid symptoms if not done recently. Going through thyroid symptom lists can help determine what is at the forefront.

(7) Does hypothyroid "euthyroid" mean you were told TSH and thyroid lab tests were previously normal? What were the numbers for those lab values, and the lab tests just done?

(8) Many of the Peat-y guidelines may be contrarian to the dogma of what 'healthy' eating is. They include adequate protein (> 80 grams per day), salt, adequate fruit (and sometimes sugar) avoiding PUFA and using saturated fat esp. coconut oil, minimizing grains and starches, grated carrot or cooked bamboo shoots to absorb GI toxins, and much more.

Many of these measures can be implemented quickly and make rapid differences. Again, not that much information is known here about the starting point.

(9) What's the nature of the arthritis/muscle pain. Is it located all over? Are the joints swollen or discolored or very stiff as well as achy? Do the muscles hurt at rest or with activity or both? Are things better or worse at certain times of day? Do other factors influence these symptoms?

 

[sunmountain]

Thank you all so, so much -- aguilaroja, Mittir, and cbar09! You guys are amazing!

Last night I did not take the progest-e. I slept through the night, and did not feel fatigued upon waking or during the day. The joint pain was also much less. Overall it felt like before I started the progest-e. I will hold off on the progest-e right now until I figure out what's going on.

My diet is mostly vegetarian with occasional wild salmon thrown in. More on the low carb side, though enough fat (butter, ghee, coconut oil). I did read a fair amount of Peat from all over in a fairly short time, so a bit confused but know that this diet doesn't work for Peating.

Don't know how to radically increase protein as a mostly vegetarian. Have begun eating greek yogurt at lunch. Eat a Rise protein bar (20g protein) now and then. Eat cheese every day. Not much milk. Do eat grains (steel-cut oats and buckwheat groats for b'fast every day; brown rice about once/week). Love raw carrots and can definitely add these to diet every day.

Could it be that Peat is difficult to adapt for vegetarians?

I also do castor oil packs over my liver regularly (a la Edgar Cayce), and on knees when they hurt too much like after hiking downhill. Hopefully the packs have improved my liver function.

I'm 5'2" about 110 lbs. Last Aug my cholesterol was 195. Euthyroid in my case means my labs were on the high side of normal. But because I was having severe hypo symptoms, my doc put me on Levothyroxine last year. Haven't gotten most recent results back yet. I may ask doc to repeat labs now that I've stopped progest-e and the flare-up seems to be resolving.

Hypo symptoms for me: joint/muscle pain and arthritis, intense fatigue. Other long-term: insomnia, brain-fog, memory problems, constipation (last one solved by castor packs).

I was also tested via saliva for hormones some months ago, and found deficient in progesterone and slightly low DHEA. So yes estrogen dominant.

Before progest-e, I tried progesterone cream for a couple weeks. Switched to progest-e after reading it is safer.

Progesterone helps me sleep. That by itself is a miracle for me as i have suffered insomnia so long. On progest-e after a couple days, I started waking up at night again and couldn't fall back.

Arthritis: in fingers upon waking. No swelling anywhere or discoloration. Just stiffness and some pain. In knees in general mild, but severe downhill. Stiffness in neck.

Because the flare up is resolving, I'm wondering if I need to go back on T4. I've been off it over 3 months, and did not experience feeling worse than when I was on it. The joint pains were milder on T4 but never really went away.

Would it make sense to try T3 on its own to see if it makes a difference? If it does, what does that indicate? That I should go back on T3 plus T4, or T4 only, or what? Or perhaps try glandular, or even phyto formulas?

I'll go back to progesterone cream for now in order to sleep. Once I can stabilize these other symptoms, then look into moving from cream back to progest-e. Does that make sense?

Has anyone on this board tried herbs like Maca or Vitex to balance hormones? I've taken vitex for a couple months, but don't think it made any difference.

Thank you all so much, and God bless!

 

[sunmountain]

Sorry if I'm posting this in the wrong forum. Which one shall I post in? thanks

 

[charlie]

sunmountain,


You are fine posting here, I am just gonna move it over to the "Ask for Help" section. No biggie, no worries.

 

[sunmountain]

Thank you, Charlie!

 

[Blossom]

Welcome sunmountain I'm about your height and weight and seem to do best with 80-100 grams of protein per day. Cronometer.com is a helpful online nutrition tracking tool that many forum members use. That amount of protein seems to help my metabolism and ability to detoxify estrogen. I know there is a lot of other things to consider and we are all coming from different contexts but enough protein seems to be an important factor for most of us in healing. Shellfish and white fish might be a better option than salmon as far as lowering PUFA intake is concerned. The dietary guidelines link on the forum's portal contains an abundance of very useful information! I review it myself from time to time. I think if you track your protein and aim for a minimum of 80 grams daily you will be pleasantly surprised at the benefits. Just some food for thought! Best of luck to you.

 

[Mittir]

My diet is mostly vegetarian with occasional wild salmon thrown in. More on the low carb side, though enough fat (butter, ghee, coconut oil). I did read a fair amount of Peat from all over in a fairly short time, so a bit confused but know that this diet doesn't work for Peating.

Don't know how to radically increase protein as a mostly vegetarian. Have begun eating greek yogurt at lunch. Eat a Rise protein bar (20g protein) now and then. Eat cheese every day. Not much milk. Do eat grains (steel-cut oats and buckwheat groats for b'fast every day; brown rice about once/week). Love raw carrots and can definitely add these to diet every day.

Could it be that Peat is difficult to adapt for vegetarians?

You can do a vegetarian version of RP inspired eating.
He thinks only potato has the good good quality protein in vegetable group.
2 lbs of potato has about 30 grams of protein. If starch in potato bothers you
then you can try starch free potato juice. Potato is high in
vitamins and minerals. But some people react badly to potato, it is a member
of nightshade family.Here is a link to a thread on potato juice
viewtopic.php?f=2&t=428

He is a big fan of cheese . Casein in cheese is balanced and has some special
health benefits. Fruits and cheese combination is very nutritious.
RP warns against non-animal enzyme in commercial cheese. You can make your
own greek yogurt or farmer's cheese at home. You can get about
25 grams of protein from Farmer's cheese or strained yogurt made from
1 quart of milk. Large part of calcium is lost in liquid whey.
You may have to use calcium supplement for that.
I think you can get almost all the nutrients from
dairy, fruits and vegetables. Whole milk is a rich source of vitamin A .
Vitamin A added milk has more vitamin A than regular milk.
You can use cronometer to figure out a diet providing all the nutrients.

RP mentioned that by 30s most people are saturated with high PUFA storage
unless someone strictly avoided PUFA. It takes about 4 years to completely
change stored fatty acid composition once someone change the diet.
Low carb diet can be problematic for people with high PUFA storage.
A moderate to high carb intake cane improve metabolism.
Active thyroid hormone production depends on carbohydrate intake.
Low carb diet can lower T3 production. Sugar is very effective in
lowering stress hormones.

 

[sunmountain]

Thank you Blossom and Mittir for your replies! Last night I played with cronometer...it is fun! And very educational...my protein intake yesterday was only 40g. Fat 93g or 144% (probably due to the coconut oil among other things). Carbs 100g or 77% (less bad than I thought).

I adjusted protein target to 80g. Does RP recommend a ratio for protein, carbs, and fats?

Should I lower fat intake as I try to increase protein and carbs?

One thing I'll incorporate is a Rise protein bar daily (20g protein, and only 5 ingredients) since I enjoy the taste. That would bring it up to 60g per day.

Yesterday I did not eat beans or fish, but pasta with veggies and feta cheese. I will incorporate white fish or scallops or shrimp once a week. These are foods I enjoy. And more potatoes as I enjoy those too. I will need to also to make beans and lentils more often than just plain veggies which I love too much. Not sure about potato juice, as taste is important to me.

It makes a lot of sense to address these nutritional deficits, and cronometer has been eye opening! Thank you for telling me about that!

I have also ordered T3 from Mexican Drug pharmacy and will nibble it when it comes and see how I feel on it. Will also look into ordering glandular.

I am still wondering whether to go back on T4 since I don't feel any different than on 25mcg T4. Perhaps the labs might help decide when they come in. T4 did bring my TSH number down, and I read somewhere that is important.

 

[Blossom]

I'm certain RP doesn't recommend a specific carb/protein/fat ratio because I mistakenly thought he did and a helpful forum member pointed out that error to me. My current understanding is that we should eat enough carbs with our protein to avoid any stressful reactions in the body. For me tracking with the cronometer over time has helped me realize the typical ratio that works best for me. I also find that at least a small amount of fat with each meal works well. The latest recommendation on coconut oil that I'm aware of from Peat was a recent KMUD radio show where he stated that 1 small teaspoon 3 times per day of coconut oil is enough (not a direct quote). I usually don't give fat a second thought since it naturally occurs in many foods I eat like cheese, milk and eggs etc.
I know the thyroid dosing is highly individual and there are forum members who can speak on this topic better than I can. I'm honestly still working on getting mine adjusted but I'm sure some more informed and experienced forum members will chime in.
Thanks for the update!

 

[Blossom]

I just wanted to add that I actually do give fat a second thought in the aspect of minimizing PUFA. I try to keep the polyunsaturated fats below 4 grams per day since RP has written extensively on the topic of keeping PUFA low. The cronometer helps track this as well.

 

[aguilaroja]

...my protein intake yesterday was only 40g. Fat 93g or 144% (probably due to the coconut oil among other things). Carbs 100g or 77% (less bad than I thought).

I adjusted protein target to 80g....One thing I'll incorporate is a Rise protein bar daily (20g protein, and only 5 ingredients) since I enjoy the taste. That would bring it up to 60g per day.

Yesterday I did not eat beans or fish, but pasta with veggies and feta cheese. I will incorporate white fish or scallops or shrimp once a week...I will need to also to make beans and lentils more often than just plain veggies which I love too much. Not sure about potato juice, as taste is important to me.

Part of Dr. Peat's insight about restorative factors is what to avoid. The view comes from understanding what hinders metabolism. The view seems refreshingly different from the diets which stress avoidances based on zeal about purity, morality, and catharsis.

His understanding about metabolism suppressing foods also gives insight into findings of longevity & epidemiology studies cited on the web for other viewpoints.

Foods to avoid or minimize include unsaturated oils (PUFA) and by extension, many nuts & seeds, soy (and other beans/legumes). Cabbage family (cruciferous) vegetable are best avoided in the raw/juiced forms, and when cooked thoroughly are best used only used occasionally to rarely.

IME potato (protein) juice is neutral/bland enough that it can be mixed as a base, sauce, or topping for other dishes.

http://raypeat.com/articles/articles/vegetables.shtml

 

[Blossom]

Thanks aquilaroja, your explanation about nuts, seeds, soy etc. is wonderful.

 

[tara]

Last night I played with cronometer...it is fun! And very educational...my protein intake yesterday was only 40g. Fat 93g or 144% (probably due to the coconut oil among other things). Carbs 100g or 77% (less bad than I thought).

Hi Sun, I'm no expert, but if this is typical of how much you usually eat, my undestanding is that could well be enough to explain low thyroid function in itself. 1400 calories looks like way less than any adult needs to maintain, let alone restore, a healthy metabolism - starvation tends to reduce both T4 and T3 production.
So by all means make choices for supportive foods as you figure them out, as others have suggested, but please consider increasing your calories by at least 1000. I agree with others suggesting more carbs and protein. I wouldn't cut down on saturated fat unless you can get a lot more calories in from other food. Common calorie calculators are not reliable guides to how much we need to eat for health. Good luck.

 

[cbar09]

Thank you Blossom and Mittir for your replies! Last night I played with cronometer...it is fun! And very educational...my protein intake yesterday was only 40g. Fat 93g or 144% (probably due to the coconut oil among other things). Carbs 100g or 77% (less bad than I thought).

I adjusted protein target to 80g. Does RP recommend a ratio for protein, carbs, and fats?

Should I lower fat intake as I try to increase protein and carbs?

One thing I'll incorporate is a Rise protein bar daily (20g protein, and only 5 ingredients) since I enjoy the taste. That would bring it up to 60g per day.

Yesterday I did not eat beans or fish, but pasta with veggies and feta cheese. I will incorporate white fish or scallops or shrimp once a week. These are foods I enjoy. And more potatoes as I enjoy those too. I will need to also to make beans and lentils more often than just plain veggies which I love too much. Not sure about potato juice, as taste is important to me.

It makes a lot of sense to address these nutritional deficits, and cronometer has been eye opening! Thank you for telling me about that!

I have also ordered T3 from Mexican Drug pharmacy and will nibble it when it comes and see how I feel on it. Will also look into ordering glandular.

I am still wondering whether to go back on T4 since I don't feel any different than on 25mcg T4. Perhaps the labs might help decide when they come in. T4 did bring my TSH number down, and I read somewhere that is important.

Hi Sun. After looking at your cronometer numbers I can see a few easy areas to experiment/improve upon:

1) Increasing carbs to at least 50% of total cals is probably in order (at least gradually getting up there). Fruits and fruit juices would be the first choice for this. Next would be the sugar in milk (goat, cow, sheep's milk is preferred and grass fed/fresh over others). Then potatoes, rice, masa harina and things like soaked/sprouted lentils. Table sugar or sucrose (and the sugar in things like coke or other naturally sweetened foods) is useful for those with digestion issues, but it is probably not a great thing to load up on unless you are getting many other nutrients/minerals in your diet. For instance a quality milk chocolate bar is going to be better nutrient-wise than a simple soda or most other candy. Ray might drink coca-cola for the caffeine, CO2, and sucrose but he's presumably eating lots of nutrient dense foods along with it.

2) Increasing quality protein along with your carbs. Shooting for about 3:1 carbs to protein is a good place to start in my opinion. Milk, cheese, eggs, and potatoes are all good protein sources and still vegetarian (lacto-ovo). If you're getting about 80g of protein then about 250g of carbs would be good to shoot for.

3) Eating fat just to taste and favoring saturated over unsaturated and mct (medium chain triglyceride) over others. So having a little bit of coconut oil with a meal (1 tsp) or only cooking foods in butter and coconut oil would be an easy first step. Having some fat with each meal will improve absorption, but having excess will just promote fat storage and probably impair oxidative metabolism somewhat. Restricting fat too much though is also dangerous and some saturated fat (15%-30%) in the diet will help your body overcome the damage of releasing stored PUFA.

Increasing carbs and protein will probably increase your caloric requirements as well, so something like 80g protein, 250g carbs and 80g fat will come out to about 2000cals daily. This is quite a jump from your current numbers, so increasing carbs gradually (and decreasing fats gradually) might make the transition easier.

I think one mistake a lot of peat followers make when coming off of a low carb diet is to simply increase carbs while still keeping protein and fat relatively high. Ultimately it's counterproductive to eat either high fat or high protein (I'd say more than 25% of daily cals could be considered high) when you are seeking to increase your oxidative metabolism (i.e. cellular respiration of glucose and oxygen to ATP and carbon dioxide). And more than any specific food or diet or supplement, Peat advises eating to increase the metabolic rate.

 

[sunmountain]

Just got labs.

TSH is 4.4 (ref 0.5 - 4.5). It was 2.17 on 10/4/13 (ref. 0.32 - 5.5) after levothyroxine, and 4.85 on 8/13/13.

Free T4 is 1.0 (ref. 0.8 - 1.8). Was

 

[sunmountain]

Free T4 is 1.0 (ref. 0.8 - 1.8). Was 1.23 on 10/4/13 (0.6 - 1.7) after levothyroxine.

Total T3 is 1.01 (0.8 - 2.0). Was 109 on 10/4/13 (60 - 181) after levothyroxine and was 122 on 8/13/13.

 

[sunmountain]

I had drafted a reply, and switched tabs, and it was gone. Oh well.

I'm blown away by the thought that I'm on a starvation diet. I read somewhere that a low-carb / high fat diet was good, and thought it a nice way to maintain weight, in addition to exercise of course. Oh well.

How do I start eating more? I'm just not that hungry. If I supplement T3, will it make me hungry? Can low thyroid cause low hunger and vice versa?

I haven't exercised for weeks or is it months because I have no energy.

How do I maintain weight while increasing calories?

I am making a list of foods that you guys have recommended: fruit, juice, milk, potatoes, potato juice, rice, sprouted lentils, chocolate, cheese, eggs, coconut oil, etc.

Of these, I already eat coconut oil, eggs, cheese, rice. Rest occasionally.

BTW, how often can I eat eggs? I like 2 eggs fried once a week. Is more often ok?

Where can I find potato juice?

Sorry for all these questions.

I read a book called Anti-Cancer: A New Way of Life several years ago by Servan-Schreiber, a cancer survivor (now dead I think). It said cancer is caused by a diet high in meat and sugar. He said to supplement with Omega-3's. Oh well.

I read the RP article that Aquilaroja pointed in his post. It's got me thinking. He says nuts and seeds and beans are bad because they block metabolism. Doesn't everything have good and bad in it? I wonder if cuisines historically compensated for bad foods, or if foods worked synergistically somehow.

I don't mean to be disrespectful. I'm just thinking all this through. It's a lot to take in.

If modern diseases are caused by man-made PUFA, do we have to discard all PUFA? If we eat nuts and seeds and beans in moderation as part of an overall healthy diet that has a diversity of foods, is that bad?

Thank you all so much for supporting me in this surprising new journey toward better health and better knowledge about food. I hope my questions will not be considered disrespectful. I'm simply trying to understand.