RP Says Glucose Helps T4 To T3, Then Why Fructose?

[visionofstrength]

It lost effect while taking four micrograms every few hours I think it was.

This is an interesting theory:
that T3 is not effective long term,
or that T3 doesn't work with some.
Isn't the answer to raising metabolism in some situations.

I guess I don't see how it can lose effect, any more than caffeine can lose effect, unless you're not getting enough fructose.

The product itself could be inconsistent in its ingredients, due to poor batch control.

Is there a possibility that supplementing T3 and/or T4 at a rate that tries to drive the metabolism higher than there are resources to sustain could result in the body defending itself by converting some of the T4 that is around into reverse T3, which has the effect of opposing T3?
VoS mentions fructose, which seems reasonable, but I wonder if it applies to other essential nutrients too, not just fructose and/or glucose? Perhaps protein supply could also be such a bottle neck? Or some of the micronutrients? And not just what goes into your mouth, but what is absorbed in a usable form by your digestion, in whatever state it is currently in?

Not sure I've seen a reference to protein, but you're right, I have seen Peat suggest that B vitamins and sugar are needed for a higher metabolic rate.

I think Peat has cautioned that if you take too much thyroid the excess will be converted to reverse T3, and that there may be a resulting cortisol reaction: you might feel too much of an effect, not too little.

 

[SQu]

My experience has been that supplementing is self limiting due to inactivation as you mention, which increases hypo symptoms.and so is counter productive. I find a fast heartbeat unpleasant which is the main reason why i got in the habit of dividing the t3 up so much and can't overdo it . But I think the adrenalin response of the early days is in the past. My recent increase in dose hasn't raised pulse much if at all, the range is from mid 70s to 90, at most, yet has been working, going by symptoms. Temp still low. Always been low. But toes warm - last winter too. The nightly t4 is now in the same ratio as before - 3:1 approximately - and since raising it , very slight arrhythmia subsided. I'm feeling well. My hourly/2 hourly dose t3 is 5 mcg and that's the only thing bothering me, on paper at least, not in terms of symptoms. Any red flags here?

 

[Such_Saturation]

You can also do this with caffeine for sure, try taking near a gram a day and stop abruptly, you will be unnaturally cold. The TSH is lowered. In fact I think people could try to shoot for maybe 0.2 or more when replacing, instead of 0.0000....1 as usually happens.

 

[tara]

Not sure I've seen a reference to protein, but you're right, I have seen Peat suggest that B vitamins and sugar are needed for a higher metabolic rate.

I think Peat has cautioned that if you take too much thyroid the excess will be converted to reverse T3, and that there may be a resulting cortisol reaction: you might feel too much of an effect, not too little.

The bit about protein and other nutrients wrt RT3 was an 'I wonder' speculation, not something I've read specifically from Peat.
The bit about excess thyroid hormone being converted to RT3 I've read in several places. RT3 has the direct opposite effect of T3 - I think it occupies and blocks the receptors for T3. My understanding of this is that too much supplementation of either T3 or T4 could potentially, in some circumstances, raise thyroid function less than expected.
Under conditions of low thyroid function, it is common to have higher cortisol levels.
It's one of the reasons why I think there are risks for people who supplement thyroid on low calorie diets, and why I think it makes sense to get basic nutrition in the ball-park before supplementing.

If one is supplementing thyroid too high for what one's body and current nutrient supply can support, and then reduce the dose, maybe there is still too much RT3 hanging around blocking thyroid function, and giving worse hypo symptoms than before supplementation began.
T4 has a long half life, and the T4 level can keep building for up to 3 weeks. So if someone takes a starting dose, and after 2 days they feel little improvement and increase the dose, etc, it's easy to overshoot the appropriate level.
This could be part of the problem some people have with getting thyroid dosing right.

The cautious approach to dosing that I have seen for NDT, is:
Start with 1/4 grain/day.
Monitor temps and pulse for 3-4 weeks.
If the temps do not come up to about 98 deg F after 3-4 weeks, increase by a 1/4 grain/day.
Repeat till temps are up.
The advantage of this very slow cautious approach is that it much reduces the chances of overshooting the appropriate dose, with the complications and potential suffering this may entail.

The approach Peat seems to suggest is to use tiny doses of separate T3 throughout the day, to figure out dosage, and then to keep using a little T3 through day along with the appropriate amount of T4 or mixed T3-T4 at night. I haven't yet learned how you calculate the latter from the former. The advantage of this method is that you get a much quicker response from T3, because it has a short half life.

I also wonder whether other nutrients, eg copper, or vit A, or other factors could also contribute to the body not being prepared to raise metabolism, and instead responding with more RT3.

 

[visionofstrength]

 

[narouz]

Not sure I've seen a reference to protein, but you're right, I have seen Peat suggest that B vitamins and sugar are needed for a higher metabolic rate.

I think Peat has cautioned that if you take too much thyroid the excess will be converted to reverse T3, and that there may be a resulting cortisol reaction: you might feel too much of an effect, not too little.

The bit about protein and other nutrients wrt RT3 was an 'I wonder' speculation, not something I've read specifically from Peat.
The bit about excess thyroid hormone being converted to RT3 I've read in several places. RT3 has the direct opposite effect of T3 - I think it occupies and blocks the receptors for T3. My understanding of this is that too much supplementation of either T3 or T4 could potentially, in some circumstances, raise thyroid function less than expected.
Under conditions of low thyroid function, it is common to have higher cortisol levels.
It's one of the reasons why I think there are risks for people who supplement thyroid on low calorie diets, and why I think it makes sense to get basic nutrition in the ball-park before supplementing.

If one is supplementing thyroid too high for what one's body and current nutrient supply can support, and then reduce the dose, maybe there is still too much RT3 hanging around blocking thyroid function, and giving worse hypo symptoms than before supplementation began.
T4 has a long half life, and the T4 level can keep building for up to 3 weeks. So if someone takes a starting dose, and after 2 days they feel little improvement and increase the dose, etc, it's easy to overshoot the appropriate level.
This could be part of the problem some people have with getting thyroid dosing right.

The cautious approach to dosing that I have seen for NDT, is:
Start with 1/4 grain/day.
Monitor temps and pulse for 3-4 weeks.
If the temps do not come up to about 98 deg F after 3-4 weeks, increase by a 1/4 grain/day.
Repeat till temps are up.
The advantage of this very slow cautious approach is that it much reduces the chances of overshooting the appropriate dose, with the complications and potential suffering this may entail.

The approach Peat seems to suggest is to use tiny doses of separate T3 throughout the day, to figure out dosage, and then to keep using a little T3 through day along with the appropriate amount of T4 or mixed T3-T4 at night. I haven't yet learned how you calculate the latter from the former. The advantage of this method is that you get a much quicker response from T3, because it has a short half life.

I also wonder whether other nutrients, eg copper, or vit A, or other factors could also contribute to the body not being prepared to raise metabolism, and instead responding with more RT3.

Yeah, and tara,
there is an online group which has the view
that some people simply can't do well on a T4 or T4/T3 supplement,
because (they say) the T4 just turns into RT3 and mucks up everything with those people.
So they have a protocol of supplementing for 3 months on graduated T3-only doses, upward.
They say that after about that amount of time
many people "clear" the RT3,
need to drop down to a much lower T3-only regime,
and start getting good thyroid function.
That's a bit of an oversimplification, but...

I tried it...I did fine on the T3 only...but no big "clearing" or change in thyroid function.

 

[tara]

Yeah, and tara,
there is an online group which has the view
that some people simply can't do well on a T4 or T4/T3 supplement,
because (they say) the T4 just turns into RT3 and mucks up everything with those people.

I've read a bit on a site like that, linked from somewhere on this forum. Sounds like it makes sense that it could work for some people. If the conditions that caused the low thyroid function in the first place [edit to add:] still prevail (whatever they may be for each individual), then I guess they will continue to have effect, even after such an RT3 clearing procedure.

 

[SQu]

Tara I did exactly that, took it very slow and it worked well. Maybe I'm lucky but I think the approach you mention gives you the best chance of adjusting smoothly. I stayed at a level for about 6 months because I was comfortable though still had hypo symptoms - then a month ago raised the dose again and fortunately this too has worked though I took it faster this time. By then I knew my liver was converting t4 better and not creating rt3. Also far less adrenalin response this time. Calories seem high enough, nutrients almost all covered.. Especially vit a and copper. Minimizing adrenalin seems to be one of the most important things, and that's what that approach does best.

 

[tara]

Hi sueq, I'm not sure which of the methods mentioned above that you are saying you followed - was it the NDT version? Or the synthetic separate T3 and T4 (or T4+T3)? Or the T3 only to clear RT3? Thanks.

 

[SQu]

Synthetic separate t3 and t4 approach.

 

[tara]

Synthetic separate t3 and t4 approach.

Ta.

 

[Strongbad]

Geeze, this hasn't been answered yet? Fructose keeps glucose in the bloodstream and this inhibits cortisol, which is the primary inhibitor of T4-T3 conversion. Basic facts, people.

So, assuming one keeps a steady dietary supply of sucrose (or some other type of sugar), wouldn't the constant presence of glucose in the blood stream keep insulin chronically elevated too? I have read various, and often contradictory, statements from Peat about the whole blood sugar and insulin thing. Often, he says that it is important to always keep blood glucose up to keep cortisol at bay and metabolism high. Of course, this means insulin would be elevated chronically too. On insulin, Ray sometimes says it is a good hormone responsible for anabolism and keeping tumor growth under control. At other times he has said that elevated insulin is not a good thing. So, I am bit confused about the overall dietary guidelines. Should we try to keep blood sugar elevated all the time but at a certain stable (and reasonable) level, which would imply higher (but stable insulin), or should we do pulse feeds which would temporarily bring insulin up to shuttle the glucose to the muscles and then insulin goes down and the body runs on glycogen from the liver?
I suspect a number of people on the forum struggle with this issue as evidenced by several posts of rapid weight gain, elevated blood glucose and insulin on blood tests and worried doctors making recommendations to cut down on sugar, blood pressure rising in people who did not have blood pressure issues before, etc. Some of these things could be beneficial, but there was a post by one person who said her blood pressure went from 120/80 to 150/90 after adopting the higher sugar diet and after some back and forth with her doctor she decided to quit the Peat diet. Then she reported her blood pressure normalizing after reducing sugar intake. Btw, it is well known in the bodybuilding community that cutting carbs works just like diuretics. I am not an advocate of this, but wouldn't people prone to edema and having thyroid problems get their water-retention problems exacerbated if they increase sugar/carbs intake? I guess that would happen at least initially and the theory is that as their metabolism normalizes they should be able to better utilize glucose and then lose all the excess water. So, the million dollar question is how long does one have to re-feed higher carbs diet (and suppress fatty acid oxidation through the Randle effect) until their insulin sensitivity is restored?
Finally, there have been a number of reports on Peatarian and occasionally on this forum of people experiencing proteinuria (protein in the urine) when increasing sugar intake above 200g daily. If you are eating 80g+ of protein then you probably strive to eat at least as many carbs. Peat has said that this proteinuria is due to people burning PUFA, which makes albumin leak in the urine and show up on the tests but as far as I can tell, these people were actually burning fat before adopting the higher sugar diet and only experienced proteinuria after increasing sugar intake. Of course, they could have had this issue all along and only realized it after switching and measuring their urine but there are several reports of this so I doubt it's a random thing. Somebody also posted a study on thousands of university employees and those who consumes the most sugary drinks reported the highest incidence of proteinuria.
It would be nice if we can get some guidelines on this. Personally, I use caffeine to increase the utilization of sugar and don't really have issues with it, but in theory there should be a way to handle sugar from diet without relying on sugar burning aids like caffeine and/or thyroid. Thyroid does not seem to be a good option for me, and I have tried all kinds of supplementing schedules and dosages. As I have posted on other threads, my experience with sugar only improved after I took serious measures to "normalize" my liver function through caffeine and vitamin K2, BUT my liver enzymes were NORMAL according to the standard lab ranges. If the stats are true and over 80% of people over 30 have some degree of fatty liver, which is the real cause behind type II diabetes, then I think many people adopting the Peat diet will likely experience stress reduction through the lower cortisol, but may end up making their fatty liver worse, especially is supplementing niacinamide and aspirin. Such_Saturation and I posted about this in another thread.
So, my main point is that burning sugar is definitely preferable to burning fat based on both Peat's writings and all the studies I have seen about liver disease being caused by increased lipid peroxidation byproducts, and cirrhosis (in alcoholic rats) being easily and succesfully treated by feeding about 60g-70g of saturated fat like butter or coconut oil for a week, while the rats kept drinking alcohol at the same time! So, on the point of burning sugar I think the question is settled that it is preferable to burning fat.
However, the point is to actually BURN the sugar rather than simply feeding ourselves more of it. For people with sluggish livers, many of whom also take niacinamide and aspirin, this is likely to make the metabolism situation worse by fattening the liver even more, even though admittedly the fat synthesized will be saturated since it is made from sugar. But fatty liver will increase your estrogen no matter how saturated the fat is that you are synthesizing. So, fattening up the liver even more probably won't do much good for metabolism. Another suggestion from Peat would be to increase protein intake to at least 80g a day which should support liver function, lower estrogen and increase conversion of T4 into T3. However, that will likely also not work very well in people with sluggish and fatty livers since underperforming liver will convert a lot of that extra protein into ammonia. Even Peat is clear on this point in one of his articles where he says that "hyperammonemia can be caused by exhaustive exercise or hypothyroidism". This is also evidenced by a number of studies showing that people in their late 30s, 40s, and 50s experience chronic fatigue issues that are greatly helped by giving them ammonia-reducing agents like ornithine or sodium benzoate. And those people consume nowhere near the 80g of protein Peat recommends. So, if they are having ammonia issues imagine how would the people loading up on extra protein would feel.
Which brings us to the point that for many people over the age of 30, simply increasing sugar and/or protein will likely not solve the metabolic issues. Thus, the Peat diet, while the correct way to eat, may not be a solution to the issues of hypothyroidism, but rather a way to avoid the worse option of running on cortisol and adrenalin, which while energizing in the short run will ruin you in the longer run.
Considering the Barnes book "Hypoglycemia: It's not your brain, it's your liver", which I read, it seems that restoring optimal liver function is also a key to improving metabolism. Yes, thyroid function is important too, but I think Peat's recommendation on supplementing thyroid even in the presence of normal thyroid labs may cause issues for a number of people. Charlie, and at least 20 other people have posted on struggling with supplementing thyroid. If they take it, they develop teeth issues, skin issues, anxiety or some other unpleasant symptoms. If they don't take it, their digestion slows down to a crawl or they start getting hypothyroid symptoms like brain fog or muscle issues, etc.
So, if the stats are true and the evidence I have seen is legit, then eating according to the peat guidelines is a great strategy AFTER metabolism is fixed. But if 80% of people over 30 are having liver issues or some other problems with metabolism, then the diet will be certainly supportive, but likely not "curative". And for some people with particularly bad liver problems the situation may end up getting worse in a way due to even more fatty liver issues or higher ammonia levels. Just ask anybody over the age of 40 if they are having trouble maintaining (let alone building) muscle mass.
Then the question becomes, what will aid metabolic recovery, other than blindly supplementing thyroid even in the presence of normal thyroid labs? I guess the answer Peat will give is that one needs to wait at least 4 years and get rid of the PUFA before starting to see solid results. There is some solid evidence in favor of lower PUFA fixing metabolic issues. But I wonder if working on liver health or trying to build more muscle will also help while waiting out the PUFA detox period? Uncoupling agents are probably also key, but they should probably be other than aspirin since it may make fatty liver issues worse for many people if used in the doses needed for mitochondrial uncoupling. Finally, increasing CO2 production or intake somehow will also likely have a key role. Just throwing things out there that seem to be cardinal methods for improving metabolism.
Sorry about the long rant, I just felt like this deserves some attention since a number of threads pop on the forum asking the same questions and I have been thinking about this for some time. If someone knows about Peat's definitive opinion on this issue please share it. Maybe I missed it in his articles. IMHO, after reading pretty much all of his published stuff, reading people's testimonies/complaints, cross-referencing this with studies, and my own experience, I think a number of chicken/egg question still remain.
Anybody care to comment?

Your comment needs to be stickied somehow. It's a very important warning to all Peatarian newbies, as there are risks depending on one's health condition.

I particularly agree with your quotes here, because it reflects my personal experience as a Peatarian from beginning to now:

"Thus, the Peat diet, while the correct way to eat, may not be a solution to the issues of hypothyroidism, but rather a way to avoid the worse option of running on cortisol and adrenalin, which while energizing in the short run will ruin you in the longer run."

So, if the stats are true and the evidence I have seen is legit, then eating according to the peat guidelines is a great strategy AFTER metabolism is fixed. But if 80% of people over 30 are having liver issues or some other problems with metabolism, then the diet will be certainly supportive, but likely not "curative". And for some people with particularly bad liver problems the situation may end up getting worse in a way due to even more fatty liver issues or higher ammonia levels.

BTW, the thread hasn't really answer the OP question: why fructose if the liver needs glucose? I know fruits has fructose + glucose and so is refined sugar (sucrose), but how about pure fructose powder?

 

[kineticz]

That is amazing. Exactly on trend with my beliefs. It is the primary reason I initially avoided taking Peat seriously. It seems more closely tied to people who's metabolism is ALREADY more optimum than many of ours, since blindly taking in more sugar will produce adaptation issues such as low thyroid, low adrenaline, low adrenals.


As I said in another thread, increasing ACTH without increasing fatty acid liberation solves this issue, but is extremely tricky.

The only strategy I can come up with is targetted low blood sugar during exercise and daily increases in norephiprene. The only thing that prevents a fatty liver is respiring and dense adrenal mitochondria. People get alcohol fatty liver because alcohol inhibits the STaR protein on the adrenal mitochondria inflow wall from LDL.

Unfortunately, without due diligence, sugar has the same effect on adrenal activity.

 

[RPDiciple]

haidut: i dont agree with you, so many of the "peatards" here that starts out doing the "RP diet" are smashing down sugar and saturated fat like crazy and think that full fat milk, cream and all that is great saturated fat when in reality even RP does not consume much fat and have switched even from regular coconut oil because it has some PUFA. full fat milk, cream etc has alot of PUFA. So many foods has alot of PUFA in them. The more fat in the food the more PUFA will be there and esp how cows and all are fed these days. RP has said that you should keep PUFA to lower then 4g a day for cancer prevention etc, i can promise you that 90% of the people doing RP diet has no clue on actually how little that is and how to get that since most people dont even track their calories or their foods.

Wich brings me to my next point, people on RP diet overeat like crazy on sugar and saturated/PUFA fat and gain fat. OFC no matter what you do, if you eat in excess and gain fat you will gain liver fat and everything will go down hill. Frustrates me that so many people have no clue what they are doing.

You could eat the worst diet in the world and loose liver fat and gain health on paper if you ate in a calorie deficit. Look up the professor that did the twinkie diet for example.

I get so mad when people start to bash this brilliant, humble and kind man for all his work when they start to eat like ***t and have no clue on what they are doing and think they have figured out everything after skimming trhough some of his articles and done something for 2 months based on their interpretations wich is insanely wrong.

 

[YuraCZ]

RPDiciple - exactly.. People see they can eat sugar and fat, so they go crazy...

 

[haidut]

haidut: i dont agree with you, so many of the "peatards" here that starts out doing the "RP diet" are smashing down sugar and saturated fat like crazy and think that full fat milk, cream and all that is great saturated fat when in reality even RP does not consume much fat and have switched even from regular coconut oil because it has some PUFA. full fat milk, cream etc has alot of PUFA. So many foods has alot of PUFA in them. The more fat in the food the more PUFA will be there and esp how cows and all are fed these days. RP has said that you should keep PUFA to lower then 4g a day for cancer prevention etc, i can promise you that 90% of the people doing RP diet has no clue on actually how little that is and how to get that since most people dont even track their calories or their foods.

Wich brings me to my next point, people on RP diet overeat like crazy on sugar and saturated/PUFA fat and gain fat. OFC no matter what you do, if you eat in excess and gain fat you will gain liver fat and everything will go down hill. Frustrates me that so many people have no clue what they are doing.

You could eat the worst diet in the world and loose liver fat and gain health on paper if you ate in a calorie deficit. Look up the professor that did the twinkie diet for example.

I get so mad when people start to bash this brilliant, humble and kind man for all his work when they start to eat like s*** and have no clue on what they are doing and think they have figured out everything after skimming trhough some of his articles and done something for 2 months based on their interpretations wich is insanely wrong.

Your points are very well taken. However, if you look at my points they are geared mostly at protein. Higher protein diet can be very counterproductive for a hypothyroid person coming to Peat diet and can generate a lot of ammonia. Adding tons of sugar on top of that would burden the liver even more. As far as I know Peat has not addressed this issue in any of his articles but has written about it its dangers. I guess one thing that a person can do in such situation is to keep protein intake moderate (at MOST 80g a day), eat sugar to appetite AND also supplement thyroid. I think that for a seriously hypothyroid person the Peat diet is probably not enough to dig themselves out of the hypothyroid whole even if they kept fat at a minimum. Thyroid is needed to make sure the sluggish liver processes the sugar and uses the energy to repair itself.
I guess my biggest point is that for many (maybe most) people coming to Peat, diet alone will not fix things even if they manage to keep fat intake close to 0%. Supplementation is likely necessary and often drugs like thyroid and maybe some other pro-metabolic agent (i.e. anti-serotonin, anti-prolactin, anti-estrogen) would be needed to keep the metabolism form crashing while the body recovers. There are plenty of reports on this forum of lean people getting stress response symptoms from fructose or sucrose and that I can only attribute to malfunctioning liver and maybe some sort of peripheral insulin resistance. Diet alone is probably not going to fix their issues. If it were as simple as just finding the right diet, there would be no big industry for type II diabetes, insulin resistance, etc.
Maybe what we can do on the forum is find a representative case for each type and try to work out a protocol that seems to be helping. I think the two main types I have seen mostly are overweight (where the weight gain came from eating under the Peat guidelines, maybe due to abusing fat as you say) and thin and cold all the time and unable to put on muscle. I guess the goal for one would be to maximize uncoupling of mitochondria, while for the latter would be to maximize anabolism in the body to stimulate muscle building. Ultimately both types would converge to optimal metabolism and health but coming from opposite ends of the spectrum.
So, I am not bashing Peat, I am just summarizing many of the issues I have seen people on the forum struggle with. And many of them are quite thin, so weight gain is not an issue.
Just my 2c.

 

[Strongbad]

Now I'm confused. Tom recommended high protein, you also made a post about high protein diet to curb fatty liver, yet now it's counterproductive to do so. Can you elaborate on lower-serotonin agents? It seems like I've been really high on it. My hair is shedding like crazy last night and this morning, my stress hormone is obviously high.

I'm very grateful on how helpful RP forum community has been to newcomers like me and others, but I wish RP movement has some sort of newbie guidelines for newcomers. I know everyone comes from different background with different health conditions, but we need more than just Charlie's Ray Peat Nutrition Guide post. Something that help new guys easing into. Even Paleo or low fat or all fruit diets has basic newbie guidelines.

When I found Ray Peat, I had to go through tons of Ray Peat's articles then lots of forum's threads to figure out the right Ray Peat for me (didn't turn out well). Some of the best information actually comes from threads replies they're like hidden treasure gems. It's almost like scavenger hunt of needles in haystack. I never had to go through that problem when I was in Paleo. It was relatively straight forward and if I had any complications/issues then I post questions on forums.

 

[cantstoppeating]

Now I'm confused. Tom recommended high protein, you also made a post about high protein diet to curb fatty liver, yet now it's counterproductive to do so. Can you elaborate on lower-serotonin agents? It seems like I've been really high on it. My hair is shedding like crazy last night and this morning, my stress hormone is obviously high.

I'm very grateful on how helpful RP forum community has been to newcomers like me and others, but I wish RP movement has some sort of newbie guidelines for newcomers. I know everyone comes from different background with different health conditions, but we need more than just Charlie's Ray Peat Nutrition Guide post. Something that help new guys easing into. Even Paleo or low fat or all fruit diets has basic newbie guidelines.

When I found Ray Peat, I had to go through tons of Ray Peat's articles then lots of forum's threads to figure out the right Ray Peat for me (didn't turn out well). Some of the best information actually comes from threads replies they're like hidden treasure gems. It's almost like scavenger hunt of needles in haystack. I never had to go through that problem when I was in Paleo. It was relatively straight forward and if I had any complications/issues then I post questions on forums.

I agree with many of these points.

There needs to be a boarding ramp for people coming to Peat because simply jumping in leads to all sorts of problems.

I jumped into it with sugar, OJ and high protein and found myself with diarrhea, chest fat, stomach fat, racing heart beat, high prolactin, accelerated hair loss. It wasn't until I reduced sugar, eliminated fat, added in antibiotics, thyroid, anti-serotonin (and soon anti-prolactin) that things started to get better.

Like myself, there are many who come from a Paleo diet, who gain rapidly when Peating. I have, in evernote, a copy of most of hiadut's posts since they're so valuable and I've used them to devise a protocol for myself and others coming from a paleo/highfat/keto diet, from first to last:

2 week course of antibiotics to clear the gut
2 week course of aspirin to establish insulin sensitivity
2-4 week no fat diet with caffeine, vitamin K2 and Vitamin E to flush the liver of its fat
Thereafter any anti-serotonin, anti-prolactin, anti-estrogen and/or thyroid as needed

Also we should try to persuade haidut to write a book or article or a post summing up everything he's learnt so far that can serve as the boarding ramp for people coming to Peat. I can't think of anyone better.

 

[haidut]

Now I'm confused. Tom recommended high protein, you also made a post about high protein diet to curb fatty liver, yet now it's counterproductive to do so. Can you elaborate on lower-serotonin agents? It seems like I've been really high on it. My hair is shedding like crazy last night and this morning, my stress hormone is obviously high.

I'm very grateful on how helpful RP forum community has been to newcomers like me and others, but I wish RP movement has some sort of newbie guidelines for newcomers. I know everyone comes from different background with different health conditions, but we need more than just Charlie's Ray Peat Nutrition Guide post. Something that help new guys easing into. Even Paleo or low fat or all fruit diets has basic newbie guidelines.

When I found Ray Peat, I had to go through tons of Ray Peat's articles then lots of forum's threads to figure out the right Ray Peat for me (didn't turn out well). Some of the best information actually comes from threads replies they're like hidden treasure gems. It's almost like scavenger hunt of needles in haystack. I never had to go through that problem when I was in Paleo. It was relatively straight forward and if I had any complications/issues then I post questions on forums.

I guess I have to apologize if my threads seem like recommendations on something. I usually post stuff that shows how one method, nutrient, supplement, or drug consistent with Peat's writings has been studied IN ISOLATION by some scientists and they have found beneficial or harmful effect. But that's how science works nowadays - trying thing in isolation to determine as much as possible the effects of that specific thing. So, if the study on how protein diet showed reduced NAFLD that great. It does not imply that it WILL work for you but that it MAY be helpful. Many factors come into play when determining if something will affect you well or not. For instance, if you have not been running for stress hormones for a long time (which usually means you are under 30 years old) then high protein diet will probably have very beneficial effect on your liver IF you had NAFLD. But if you are young(er) and healthier then you probably don't have NAFLD to start with.
Therein lies the trick with Peat's approach - everything affects everything else and depends on everything else. So, how do you go about solving it all? I think some of his basic recommendations are very helpful. Moderate doses of protein, combined with some sugar and keeping fat low should form the basis of your diet. How much protein? Well, maybe you can start with 50g which is what most sick people in the hospital get and seems to be the minimum to ensure organ function without burdening liver or kidneys too much. Try to ingest at least twice as many carbs as the grams of protein in each meal. Then you track temperature and pulse and monitor health signs like fatigue, brain fog, thrist, etc. Increase in any of these probably means increase of ammonia and/or lactate so you need to adjust thing. If is lactate, your muscles would feel sore and limbs would feel heavy and you may start panting from the reduction in CO2. If that is the case, you are probably not processing carbs well so adding things like thiamine and biotin should help. If you get sudden brain fog or your pee smells of ammonia too strongly then either ammonia in blood is too high or you got dehydrated. Adding more carbs and/or sweetened fluids may resolve this. Also, things like zinc or ceylon cinnamon or biotin or thiamine would reduce ammonia in blood. So, now we have two supplements that seem like they would work for both ammonia and lactate - thiamine and biotin. However, if even 50g of protein gives you ammonia symptoms consistently then I'd get some tests done for liver and kidney function as it should not be happening. Another reason for ammonia buildup from small amounts of protein would be extreme hypothyroidism and/or strenuous exercise. Peat said that in one of his articles. But I'd get liver and kidneys checked anyways.
Once you get to a basic diet that does not cause you a stress reaction or symptoms of toxic metabolite buildup you can (if needed) add some metabolic boosting agents like caffeine or thyroid (if needed). Monitor temperature and pulse and if any of these extra substances gives you a stress reaction then either back down or increase nutrients. Overall, the body is very good at regenerating. If you get to a diet that does not harm you (in terms of ratio of protein, carbs, and fat) it takes about 2-3 weeks to get to a much healthier level where you can expand on your success and change nutrient ratios or amounts, add different supplements, etc. Initially I gained more than 30 lbs on the Ray Peat "diet" until I finally figured it out, and for me it was liver function that had to improved with caffeine and vitamin K2 before things got better. That does NOT mean that this is what will work for you since your situation/context is almost certainly different from mine. But that's why you start with something common in all people - smaller meals of basic nutrients that can be controlled and adjusted and once you get to a working version of a diet that does not affect you badly you build up from there. Again, Peat write about many things that are useful IN ISOLATION, but in order for them to be working for you context will have to be taken into account. If your current context (it changes over time like everything else) is such that a supplement or recommendation from Peat stresses you out then it better to work on changing the context instead of forcing that supplement or recommendation on yourself.
Enough ranting, on to controlling serotonin. I can't directly recommend drugs but people have had good responses to small dose cyproheptadine (1mg-4mg daily) and it should be fairly safe UNLESS you have liver disease in which case I'd get that checked first (like I said above). Ondansetron has some great studies behind it in terms of being a very potent anti-depressant in low doses (4mg daily), cognitive enhancer, libido booster, etc. but it seems to have some bad effects on the heart rhythm so if you take it then it should be fairly short-term (less than month). Some of the legal LSD derivatives are (mostly) dopaminergic drugs and include drugs like Bromocriptine, cabergoline, lisuride, etc. They all have very good effects on metabolism and in fact bromocriptine has been approved for the treatment of diabetes type II. See link below.
http://en.wikipedia.org/wiki/Bromocriptine
http://www.ncbi.nlm.nih.gov/pubmed/10937514

I posted studies on cabergoline showing loss of 6g fat in just 2 months, which is unheard of in the medical world unless you take drugs like DNP, which can kill you if you are not careful with the dosage.
viewtopic.php?f=75&t=6287&p=74891
Unfortunately, most LSD-derived drugs (with the notable exception of lisuride) have some nasty side effects including fibrosis or heart and lungs. The side effect comes from the fact that all LSD-derived drugs actually have some (small) serotonergic effects as well. The specific risk of fibrosis comes from agonism at the 5-HT2B "receptor". These should be low risk if you take lower dose and for short term but it's probably not something most people are willing to risk. You can mitigate/prevent the risk by taking a 5-HT2B "receptor" antagonist like cyproheptadine, mianserin, ketanserin, ritanserin, etc. Of these, cypro is the most accessible and safest.
You can also look into newer dopaminergic drugs like pramipexole.
http://en.wikipedia.org/wiki/Pramipexole

Since it is not an LSD-derivative it does not have (relevant) serotonergic properties. As you can see from the Wikipedia page it is also a potent anti-depressant and has effects on fibromyalgia and RLS. The RLS is most likely caused by gut inflammation and/or endotoxin and a number of Peat followers on this forum struggle with the condition. So, since pramipexole cures RLS it probably means it has protective effects on the gut as well. The "bad" things about pramipexole is that is a quite new drug so its full list of side effects is likely not well known. Peat said that it takes about 20 years for a drug to be in circulation to determine what the main side effects are. In addition, it is more expensive and in some people it may cause compulsive behaviors like gambling or OCD. But I am mentioning it as an option to consider for people who cannot tolerate LSD-derivatives or are afraid of the side effects.
Overall, anti-prolactin drugs or substances have the added benefit or reducing also serotonin and estrogen as the 3 cardinal metabolic poisons in Peat world are very tightly correlated and go hand in hand. So reducing one of them tends to lower the other two as well. It just so happens that anti-prolactin drugs seem to have the biggest metabolic benefits with tolerable side effects. Anti-estrogen drugs like aromatase inhibitors (anastrozole, letrozole, exemestane) tend to have unpleasant side effects including depression so most people would not take them. A possible exception is exemestane, which is actually a synthetic version of the hormone DHT and is much safer. Peat has even said that taking DHT topically would be a good idea, so this drug would be a possible alternative to topical DHT. In people it lowers estrogen, increases T and DHT and has anti-depressant activity. The anti-serotonin drugs all have side effects except possibly cyproheptadine at lower doses. So, taking anti-prolactin drugs seems to be the most effective way to improve metabolism via multiple pathways and minimize side effects.
Natural dopaminergic substances include caffeine, magnesium (and most other NMDA "receptor" antagonists), zinc, selenium, vitamin A, etc.

I think this is good as a start. Let me know how it goes and if you need any other help/advice.
Sorry for the big rant but there is a lot of info relevant to metabolism and I did my best to synthesize it.

 

[Such_Saturation]

I get the restless legs and caffeine always can cure those. I think somehow the motor neurons become starved for dopamine.