TSH 0.76 but have long list of hypothyroid symptoms

[Rosajo]

I'm new here and not sure where to start... I got really sick with exhaustion two months ago and have a long history of these episodes, they come every few years. A lot of stress build-up - went overseas to visit my dying father in November, came back to a deathly ill husband and promptly got sick myself with COVID. Almost lost my husband, we recovered, then my father died and I started doing gig work which was hugely stressful. Then I injured myself and within a few days I became "non-functional". Extreme anxiety, difficulty walking, insomnia, very inflamed bowels, severe fatigue.
About five weeks later I started improving slowly. At this time I had started eating a lot of wild shrimp, upped my vitamin D from 400 IU daily to 800 IU (I'm now up to 1600 as of today), but also going back to taking 10 mg of paroxetine instead of 5 mg (I had cut my dose last in early fall 2021). I do feel the vit D was a game changer. It immediately caused me to feel a bit "jacked up" which is why I had resisted increasing my dose earlier, but that feeling faded after a week or two and I had more energy.
Just a few days after that I got some lab results back which indeed showed low vit D at 20. Eight years ago I was even sicker, and it was then 3. It also showed a ferritin of 5 so I began taking iron (proferrin "heme" iron). My diet has been very low in iron for the past 10 years so I do believe it's a real deficiency. It started working pretty much immediately. I take 20 mg daily.
The thyroid panel could not be fully completed because of the lab I picked in town (not many choices available): TSH 0.76, T4 Free 1.2 and T3 Free 3.0. Antibodies less than 1. Hopefully I can get T4 and T3 with RT3 done soon.
There were a lot more labs done so let me know if you want to see the rest of it. Now I was much sicker when I had them done than I am now but it was recently done.
I had my first consultation yesterday with the osteopathic "integrative" doctor who ordered the labs and he thought my labs looked good overall, though with clear markers of high cortisol, and that I don't need any thyroid medication. If true, that's great, but I'm confused because all my life I've suffered from a long list of hypothyroid symptoms so I wonder what do I do now? Trying to figure this all out is causing so much stress. Like today I decided to start Progest-E using the directions on the website and I felt fine the first 3 drop dose in the morning but after the second dose I had panic, depression, crying then laughing, crying again. So I'm not taking anymore of that. I did read here in the forums about low vit D causing problems with progesterone.

 

[Korven]

Hi Rosajo!

It is possible to have low TSH and still be hypothyroid as TSH is suppressed by high stress (adrenaline/cortisol). What is your diet like? It is important to eat robustly to lower stress hormones so that thyroid can come up. Regular red meat consumption could be a good idea as your ferritin is very low. And I wouldn't worry too much about your vitamin D levels, it goes down during inflammation. And stress is highly inflammatory. Try to get some sun if you can.

Basically: food and rest. Some people need thyroid supplementation to feel good but I would first see how you do with just good nutrition and if possible, getting out of your stressful situation.

Best of luck, I am sure many other will chime in here as well!

 

[Elast1c]

Seems like Broda Barnes book Hypothyroid the unsuspected illness is a decent read if a person is new. Danny and Ray both mention Broda at times and it clears up some issues that took me a while that the book answered very rapidly. You can also just lookup Danny's thyroid basic information page let somewhere. It has info on thyroid etc.

 

[Lollipop2]

Seems like Broda Barnes book Hypothyroid the unsuspected illness is a decent read if a person is new. Danny and Ray both mention Broda at times and it clears up some issues that took me a while that the book answered very rapidly. You can also just lookup Danny's thyroid basic information page let somewhere. It has info on thyroid etc.

I second the Barnes book Hypothroidism, the unsuspected illness. Fantastic information source. A must if someone thinks their thyroid is struggling and/or their health is struggling with no answers as to why.

 

[Phosphor]

I started taking Lugol's several months ago to try to get fluoride out of my system. and --- hair that has been gone for a long time has grown back in, and I now have "bangs" that are an inch an a half long, from that "used to be receding" hairline. My thyroid test results have not changed, but clearly I was deficient in iodine. You may be too, and since I generally just try stuff, I couldn't tell you what tests to do. I am low on energy but it is a mitochondria problem with me.

 

[Rosajo]

Hi Rosajo!

It is possible to have low TSH and still be hypothyroid as TSH is suppressed by high stress (adrenaline/cortisol). What is your diet like? It is important to eat robustly to lower stress hormones so that thyroid can come up. Regular red meat consumption could be a good idea as your ferritin is very low. And I wouldn't worry too much about your vitamin D levels, it goes down during inflammation. And stress is highly inflammatory. Try to get some sun if you can.

Basically: food and rest. Some people need thyroid supplementation to feel good but I would first see how you do with just good nutrition and if possible, getting out of your stressful situation.

Best of luck, I am sure many other will chime in here as well!

Hello! Thank you for your encouraging reply!
I didn't know TSH is suppressed by stress hormones, that is so helpful.
Before I got sick I was eating out quite a bit but the biggest issue was probably going for so many hours before eating my first solid meal so what I typically would do is eat yogurt for like the first 8 hours after waking while running around like mad doing IC deliveries. This kind of eating or lack thereof has gotten me in trouble so many times in the past.
Currently, as of around a month, my diet is as simple as possible. 2 cups low fat plain sugared yogurt in morning. Noon, 4-5 pm, 8-9 pm (3 meals in total, same food): boiled potatoes with boiled shrimp. I get hungry after roughly 3 hours and perhaps should eat 4 smaller meals instead but it's a lot of work. I haven't measured but I think I'm getting quite a bit of calories from the potatoes. It's something I grew up eating and I do well on it. I eat a full bowl at every meal with 4 jumbo shrimp.
I've tried adding ghee to the potatoes but it caused a little too much stress on intestines 9mucous, more diarrhea) so I will try again later. I'm sensitive to so many foods. Reason I cut out beef 10 years ago was because I couldn't digest it. Even turkey is giving me diarrhea now but could be histamines as I would make a batch of it and have leftovers.

Will eating robustly even on this simple diet help me?

About vit D: it was 21 last I tested it about a year ago (when I was "healthy") and I didn't get as much sun as usual last summer. I live in MN. We had some sunny days last week and I felt better but it's mostly winterish now. Maybe in a week or two.

I've cut out all activity pretty much as my muscles are so stiff and achy making it hard, so whatever was causing this is no longer an issue but then the inactivity is quite difficult too. I try to get some walking in, brief cleaning etc.

 

[Rosajo]

I started taking Lugol's several months ago to try to get fluoride out of my system. and --- hair that has been gone for a long time has grown back in, and I now have "bangs" that are an inch an a half long, from that "used to be receding" hairline. My thyroid test results have not changed, but clearly I was deficient in iodine. You may be too, and since I generally just try stuff, I couldn't tell you what tests to do. I am low on energy but it is a mitochondria problem with me.

I'm hoping the shrimp I eat every day is giving me iodine!

 

[Rosajo]

Seems like Broda Barnes book Hypothyroid the unsuspected illness is a decent read if a person is new. Danny and Ray both mention Broda at times and it clears up some issues that took me a while that the book answered very rapidly. You can also just lookup Danny's thyroid basic information page let somewhere. It has info on thyroid etc.

I'm not completely new to Peat, been following on and off for many years but yes, this would be a good book for me. Thank you!
Barnes recommended thyroid medication for all with hypothyroid symptoms, correct? I'm now in my mid 40s and feel like this has been going on for so many years now and even when I eat a balanced calorie rich diet I still struggle. Granted, I've not been getting all the important nutrients like iodine, zinc, copper etc but I think I am doing better on that front now. Still, I'm not getting any younger and I've been in poor health since early childhood.

 

[Zsazsa]

TSH 0.76, T4 Free 1.2 and T3 Free 3.0. Antibodies less than 1. Hopefully I can get T4 and T3 with RT3 done soon.

That is a perfect thyroid score, I would look somewhere else and avoid to mess it up.

 

[danishstargazer]

if you are only eating a yogurt and 2 bowls of potatoes and shimp..... i would say you are missing to many macros and micro nutrients that your thyroid is not the problem - i wonder how your b12 is ?

 

[Rosajo]

if you are only eating a yogurt and 2 bowls of potatoes and shimp..... i would say you are missing to many macros and micro nutrients that your thyroid is not the problem - i wonder how your b12 is ?

I thought shrimp has B12 but I've been supplementing with it for many years since I was diagnosed with megaloblastic anemia some 8 years ago. Which brings me to the next question: is hydroxycobalamin good or should I be getting methylcobalamin? I've intentionally avoided the latter because of some talk about overmethylation but now I'm seeing posts about hydroxy (and cyano) making a deficiency worse. I've been experimenting with my b12 supp the past couple of weeks and it seems to make me feel off and drowsy after I take it.
Since my MCV was 83 I don't think I have megaloblastic anemia anymore though.
I eat 3 large bowls of potatoes, not 2.
For macros, I'm definitely missing fat and all the fat solubles but I don't think carbs or protein. Each of the 3 meals are quite large. My husband thinks I eat too much :)
If anyone has tips on how to add fat back to my diet I'm all ears.
What one food would you add to my spartan diet, to begin with? And just increase the amount? What calorie count should I be aiming for? I'll need to weigh my taters to see how much cals I'm currently eating.

 

[Rosajo]

That is a perfect thyroid score, I would look somewhere else and avoid to mess it up.

Where else do I look?

 

[Elast1c]

Where else do I look?

The book by Broda explains why almost all the tests aren't very reliable. Ray speaks about Broda's findings and concurs with them that the general hypo rate was above 50% in the 1950s and that the metabolic test (thermometer) is probably the most reliable. Not to mention cheap. The book also describes how supplementation can be done incorrectly and Ray also mentions that even if a person makes it to a full diagnosis that thyroxine itself problematizes most of then the situation. The framework in that book by Broda basically gives a rapid overview of the possibilities and explains why the temperature test is probably the best method to rule something as central to all cellular functioning as thyroid is, out as a possible complication while also describing how he, as a doctor who primarily has worked with hypothyroid people, has been able to assist their serious issues. As an addition now with the reality that we can actually have live interviews Ray and Danny have added farther to the information about how we can look at metabolic energy and health for possible places where it is breaking down.


View: https://youtu.be/7iQGU3idXQY


Here Ray breaks down other ways to free up the thyroid function other than use of thyroid although I would skip the supplements until anyone can get the best confidence in them.

I agree that food is necessitated for cellular function but it seems to me that with such an assault on the physical bodies of people and the likelihood of toxicity of the environment it might be good to understand the basics and a 9$ non-mercury physical thermometer is probably relatively one of the best tools to just have in general when considering physical energy even if food is completely clean and abundant in that it can show you when it is or isn't providing raw energy

 

[Korven]

Hello! Thank you for your encouraging reply!
I didn't know TSH is suppressed by stress hormones, that is so helpful.
Before I got sick I was eating out quite a bit but the biggest issue was probably going for so many hours before eating my first solid meal so what I typically would do is eat yogurt for like the first 8 hours after waking while running around like mad doing IC deliveries. This kind of eating or lack thereof has gotten me in trouble so many times in the past.
Currently, as of around a month, my diet is as simple as possible. 2 cups low fat plain sugared yogurt in morning. Noon, 4-5 pm, 8-9 pm (3 meals in total, same food): boiled potatoes with boiled shrimp. I get hungry after roughly 3 hours and perhaps should eat 4 smaller meals instead but it's a lot of work. I haven't measured but I think I'm getting quite a bit of calories from the potatoes. It's something I grew up eating and I do well on it. I eat a full bowl at every meal with 4 jumbo shrimp.
I've tried adding ghee to the potatoes but it caused a little too much stress on intestines 9mucous, more diarrhea) so I will try again later. I'm sensitive to so many foods. Reason I cut out beef 10 years ago was because I couldn't digest it. Even turkey is giving me diarrhea now but could be histamines as I would make a batch of it and have leftovers.

Will eating robustly even on this simple diet help me?

About vit D: it was 21 last I tested it about a year ago (when I was "healthy") and I didn't get as much sun as usual last summer. I live in MN. We had some sunny days last week and I felt better but it's mostly winterish now. Maybe in a week or two.

I've cut out all activity pretty much as my muscles are so stiff and achy making it hard, so whatever was causing this is no longer an issue but then the inactivity is quite difficult too. I try to get some walking in, brief cleaning etc.

I found the quote I was thinking of from Ray about stress suppressing TSH, maybe it's helpful?

"Aging, infection, trauma, prolonged cortisol excess, somatostatin, dopamine or L-dopa, adrenaline (sometimes; Mannisto, et al., 1979), amphetamine, caffeine and fever can lower TSH, apart from the effect of feedback by the thyroid hormones, creating a situation in which TSH can appear normal or low, at the same time that there is a real hypothyroidism."

(The article is also a good read on hypothyroidism in general: Preventing and treating cancer with progesterone.)​

I, too, have gotten into all sorts of trouble by skipping meals, fasting and overall just not eating enough. The problem for me was that I didn't realize the harm I was doing to myself only until later. At the time I thought it was awesome that I could intermittent fast, skip breakfast and be lean and energetic (read: too much stress hormones). If I had a time machine I would go back and force feed myself with a big bowl of porridge and milk every morning lol!

It's good that you have a regular eating schedule now! However it does look a little low in calories overall (very low in fat) and maybe some other important nutrients? What you could do is enter all the foods you eat into cronometer.com so you see what a regular day of eating adds up to. I do understand and sympathize with the difficulty of eating enough when you're having digestive issues and food sensitivities. Hypothyroidism makes digestion sluggish so that could be a contributing factor as well.

Have you tried eating full fat yogurt for breakfast? That would provide some extra calories and valuable fat-soluble vitamins.

I think of thyroid as the "luxury hormone" or abundance hormone. When your body feels safe and is properly nourished, when stress is low and you feel like you have time to relax, cortisol/adrenaline is lowered and thyroid can come back online again. Fixing low thyroid function could "simply" be a matter of enough time where you eat well, rest, engage in enjoyable activities, get sun etc. However getting on the right dose of thyroid medication can also be life-changing for some individuals, especially seeing as you've seem to had hypo symptoms for your entire life?

Thyroid supplementation is a little tricky and if you choose to go down that route it may be a good idea to work with some sort of "Ray Peat certified doctor" (if those even exists? lol).

 

[Zsazsa]

is hydroxycobalamin good or should I be getting methylcobalamin? I've intentionally avoided the latter because of some talk about overmethylation but now I'm seeing posts about hydroxy (and cyano) making a deficiency worse.

Test for B12, folate and homocysteine in blood, these will tell you if you are deficient or not.

Where else do I look?

Your diet is poor, you probably have gut and mitochondial issues.

ther ways to free up the thyroid function

With FT3 = 3 I doubt she needs to look into thyroid issues

I found the quote I was thinking of from Ray about stress suppressing TSH, maybe it's helpful?

Ditto above: FT3 = 3

 

[Zsazsa]

Where else do I look?

Morning and afternoon cortisol, SDHEA, estradiol, testosterone...

 

[Rosajo]

Test for B12, folate and homocysteine in blood, these will tell you if you are deficient or not.

Your diet is poor, you probably have gut and mitochondial issues.

With FT3 = 3 I doubt she needs to look into thyroid issues

Ditto above: FT3 = 3

Doesn't Peat say Free T3 is a useless indicator?

 

[Zsazsa]

Doesn't Peat say Free T3 is a useless indicator?

I disagree from this point of view

 

[Neeters 27]

first off, I am no doctor, but I will say your not eating anything with iron so that leads to anemia. why arent you eating red meat? if your iron is so low your thyroid wont work! nothing will. take Feramax or polysaccharide iron complex. you will feel better in 2 weeks!

I thought shrimp has B12 but I've been supplementing with it for many years since I was diagnosed with megaloblastic anemia some 8 years ago. Which brings me to the next question: is hydroxycobalamin good or should I be getting methylcobalamin? I've intentionally avoided the latter because of some talk about overmethylation but now I'm seeing posts about hydroxy (and cyano) making a deficiency worse. I've been experimenting with my b12 supp the past couple of weeks and it seems to make me feel off and drowsy after I take it.
Since my MCV was 83 I don't think I have megaloblastic anemia anymore though.
I eat 3 large bowls of potatoes, not 2.
For macros, I'm definitely missing fat and all the fat solubles but I don't think carbs or protein. Each of the 3 meals are quite large. My husband thinks I eat too much :)
If anyone has tips on how to add fat back to my diet I'm all ears.
What one food would you add to my spartan diet, to begin with? And just increase the amount? What calorie count should I be aiming for? I'll need to weigh my taters to see how much cals I'm currently eating.

this is a horrible diet by the way. its all white food! eat meat and green veg, are you male or female? age? if you are in or near menopause I would look at sex hormone replacement for certain. what is your blood sugar like? shrimp dont have any iron really and its not clean protein...

 

[Neeters 27]

Also, vitamin D3 supplementation take at least 5000 a day for a few months or get your doctor to give you injections. even with 5000 a day it takes several months to bring levels up. remember that being out in hot sun near equator for 15 or 20 mins would give you at least 10,000 a day. orally 5000 is not too much! maybe your gut bacteria is bad too, considering you dont eat much of variety.