Jul 142012

My last thyroid report was just about a year ago. So wow, it’s time for an update!

As of last July, I’d just seen a new doctor — Dr. Juetersonke in Colorado Springs. He was willing to raise my dose of desiccated thyroid from 2 grains to 3 grains — even though my TSH was already too low by conventional standards — based on my persistent symptoms of hypothyroidism, plus my low Free T3 and Free T4. (Even when I was seriously mentally and physically disabled by hypothyroidism, my TSH was never terribly high — just 3.23. So that I’d need to keep a lower-than-usual TSH isn’t too surprising.)

The results of that increased dose to 3 grains were excellent. My thyroid symptoms vanished, and they’ve not returned. My lab values are good too, and they’re stable. Happily, my thyroid antibodies (particularly Antithyroglobulin Ab) have fallen from a high of 123 to within the normal range. Hence, I hope to be able to stay well on 3 grains of desiccated thyroid for the foreseeable future.

Here were my labs from 21 December 2011, after 6 months on three grains of desiccated thyroid:

  • TSH = 0.009 uIU/mL (normal range .3 to 3.0)
  • Free T3 = 4.0 pg/mL (normal range 2.0 to 4.4)
  • Free T4 = 1.18 ng/dL (normal range .82 to 1.77)
  • Antithyroglobulin Ab = 31 IU/mL (normal range 0 to 19)

Here were my lab results from 21 June 2012, after a year on three grains of desiccated thyroid:

  • TSH = 0.010 uIU/mL (normal range .3 to 3.0)
  • Free T3 = 3.4 pg/mL (normal range 2.0 to 4.4)
  • Free T4 = 1.19 ng/dL (normal range .82 to 1.77)
  • Antithyroglobulin Ab = 29 IU/mL (normal range 0 to 40)

Also, I’m still taking high-dose iodine — 12.5 mg per day at present — because I’ve found that my menstrual cycles will not happen without it. I’ve never had any ill-effects from high-dose iodine, as some people with Hashi’s do, and I wonder if that’s because I’ve always taken 200 mcgs of selenium with it. (I’ve read that the bad reaction of some people with Hashi’s to iodine might be due to selenium deficiency, not the iodine per se.)

Alas, I’ve not had such great success with my adrenal insufficiency. I’ve gone from two adrenal supplements per day a year ago up to three, down to two, down to one, down to zero, up to one, and now up to two. My recent increase is partly due to a less potent batch of pills than before. (That’s a common problem.) However, it’s also just too damn easy for me to push myself into sheer exhaustion. If I combine too much exertion with lack of sleep — as almost always happens when I travel — I’m toast. The result is feeling sleepy and unmotivated from morning until night, even on a good night of sleep. In my recent appointment, Dr. Juetersonke gave me some suggestions for dealing with that better, so hopefully I’ll get that sorted out soon.

Oh, and I should mention that my elimination diet for gut repair is still ongoing and still working. I’ve kept off the ten pounds that I lost early in the diet without any trouble. I’m tolerating a wider range of foods, including beef and some dairy. I’m not out of the woods yet, but the path that our own Christian Wernstedt of Vital Objectives laid out for me is working well.



As I discussed in my “cookie cutter” medicine video

… I’ve been frustrated by my persistent hypothyroid symptoms over the past few months. I experienced serious carpal tunnel pain every time I tried to work on the computer. The skin on my hands was like sandpaper. My menstrual cycle was too long by weeks. I felt lethargic and sleepy all day, even after a full night of sleep.

Alas, my doctor declined to increase my dose of desiccated thyroid beyond two grains, given that my TSH was too low on that dose. Hence, I decided to see Dr. Juetersonke of Colorado Springs, because his approach is to treat based on the full range of labs (i.e. not just TSH, but Free T3 and Free T4) plus symptoms.

Happily, he increased my dose of dessicated thyroid to three grains. The difference has been phenomenal. My carpal tunnel pain is negligible. Yay! The skin on my hands is soft and supple — for the first time in years. Yay! The length of my menstrual cycle is basically normal. Yay! I’ve not gained any more weight, and I’ve been able to lose a few of the 30 pounds I’ve gained due to hypothyroidism. Yay!

To my surprise, my lethargy remained basically the same, however. After the busy fun of ATLOSCon at the end of May, I had that “just-got-back-from-vacation” exhaustion not just for a day, as is normal for me, but for two full weeks. It was miserable! A saliva cortisol test showed seriously low levels of cortisol, but a follow-up blood test showed normal levels, so Dr. Juetersonke didn’t recommend doing anything.

By mid-June, I felt that I had to try some kind of adrenal supplement, so I ordered Natural Sources: Raw Adrenal. Much to my amazement, that very day I noticed a substantial uptick in my energy levels — and even better, my sex drive returned with a vengeance. YAY!

So clearly, adrenal insufficiency has been part of the picture, probably for a long time. I’m too prone to stuffing myself into a pressure cooker with work and other projects… and that just has to stop. It’s not so much that I need to work less, I think, but rather that I need to be okay with all the stuff that I’m not able to do in a given day. Also, I’ve found that activities away from home and/or with people exhaust me quickly, so I’m trying to limit those as much as possible.

Notably, unlike with the desiccated thyroid, I expect to be able to wean myself off the adrenal supplement in a few weeks. Also, I don’t think that I would have seriously pursued the adrenal angle if I’d not done the saliva cortisol test (and some others) with Modern Paleo’s own Christian Wernstedt of Vital Objectives. Our discussion in light of the test results was very enlightening and thorough — far more so than with any doctor that I’ve ever had.

Also, I had blood drawn for a new set of thyroid labs a few days ago. I’m not sure whether my doctor will want to raise me to 3.5 grains or not. I still have a slight touch of symptoms, so I think that I’d like to try that small increase. But if my Free T3 and Free T4 look good, I’ll be pretty happy to stay where I am.

Overall, after nearly two years of battling my hypothyroidism, I can’t express just how happy I am to be doing pretty darn well… finally. It has been a rocky road, mostly thanks to a medical establishment that ignores everything except TSH and prescribes only Synthroid. My every step toward health has been an uphill battle for me. I’ve had to reject the standard analyses and protocols in favor of treatments that most doctors would regard as quackery, namely desiccated thyroid, high dose iodine, and now adrenal supplements. It’s getting ridiculous!

As a result of my experiences, when I hear people say that we should leave medicine to the experts, I feel like a small nuclear bomb explodes in my chest. If I’d done that, I would still be disabled by impenetrable brain fog, lethargy, and pain. Many, many people are suffering in that state today, not knowing of the alternatives. Hopefully, they can learn something from my experiences.

My Latest Thyroid Labs

 Posted by on 8 January 2011 at 10:00 am  Health, Personal, Thyroid
Jan 082011

On December 28, I had another round of thyroid labs done. On that day, here’s the report that I made to my doctor:

I wanted to give you another update on my progress. In essence, I’m definitely much improved since October, but I still have clear hypothyroid symptoms. I’d like to increase my dose of desiccated thyroid from 2.0 grains to 2.5 grains.

After our appointment on October 22nd, I increased my dose of desiccated thyroid from 1.25 grains to 1.75 grains. That helped alleviate my hypothyroid symptoms to some extent, but not completely. So I increased to 2.0 grains of desiccated thyroid on November 23rd, as you said I could do. Once again, the result has been improvement, although the symptoms persist.

Here’s my current state, in a nutshell. I still have near-daily carpal tunnel pain, although much less than before. My skin is still unusually dry, although better than in October. My last menstrual cycle was much more normal in length–43 days. (It got up to 77 days on 1.25 grains.) I’m definitely not as lethargic as I was, and I’m stronger. Also, I’ve not had the slightest hint of any hyperthyroid symptoms.

So I’m much better, but I’m still not feeling quite up to normal yet. Hence, I’d like to try increasing my dose of desiccated thyroid from 2.0 grains to 2.5 grains. If you prefer, I can do that gradually, starting at 2.25 then moving to 2.5 grains. But based on my progress so far, I don’t think that 2.5 grains will be too much.

As always, thank you for your help.

Here were my lab results from that day, while on 2 grains, my highest dose of desiccated thyroid so far:

  • TSH = 0.059 uIU/mL (normal range .3 to 3.0)
  • FT3 = 3.0 pg/mL (normal range 2.0 to 4.4)
  • FT4 = .96 ng/dL (normal range .82 to 1.77)
  • TPO Ab = 8 IU/mL (normal range 0 to 34)
  • Thyroglobulin = 0.9 ng/mL (normal range 0.5-55.0)
  • Antithyroglobulin Ab = 81 IU/mL (normal range 0 to 40)

Given that my TSH was so low, my doctor declined to raise my dose of desiccated thyroid. We’ll do another check of my thyroid values in three months, then see where to go from there. That’s okay, I suppose. I’m pretty glad that she didn’t ask me to reduce my dose.

I would like to find a way to reduce my thyroid antibodies; as you can see, my Antithyroglobulin Ab is high, even slightly higher than it was in October at 60. In February and March, I’m going to try a strict elimination diet, cutting out all the foods that Robb Wolf suggests are worth eliminating in the case of autoimmune disease. I’m already strict about not eating gluten (or any cereal grains), legumes, or soy. I’m also going to eliminate nightshades (including tomatoes, sadly), nuts (boo hoo!), eggs (gack!), and dairy (ugh, again).

Obviously, my primary concern will be the effect of that elimination diet on my elevated Antithyroglobulin Ab. However, I’m also interested to see whether I see any effects on a persistent quarter-sized spot of eczema that I have on my torso. That might be a useful canary in the coal mine of my immune system.

October Thyroid Labs

 Posted by on 27 November 2010 at 8:00 am  Health, Personal, Thyroid
Nov 272010

On October 19th, I had another round of thyroid labs. At the time, I was on 1.25 grains of dessicated thyroid. And I was enjoying (!) various hypothyroid symptoms, most notably terribly dry skin and severe carpal tunnel pain. Due to the latter almost any time spent on the computer was very painful for many weeks. (That wasn’t all bad, however, as that gave me the excuse I needed to buy my new horse Lila.)

The results of these new labs were as follows:

  • TSH = 1.75 (normal range .3 to 3.0)
  • Free T3 = 2.7 (normal range 2.0 to 4.4)
  • Free T4 = .97 (normal range .82 to 1.77)

Although within the normal range, those Free T3 and Free T4 numbers are still lower than they ought to be. So, realizing that 1.5 grains was not too much, as we’d previously thought, my doctor was willing to increase my desiccated thyroid dose to 1.75 grains for six weeks, then to 2.0 grains if my symptoms persisted. (I just increased to 2.0 last week, since my carpal tunnel pain returned, albeit not quite so strongly.)

The difficulty for me — as you can see from my prior lab values — is that my TSH will read as normal, even though my Free T3 and Free T4 are low and even though I’m experiencing unmistakable hypothyroid symptoms.

Most doctors use the TSH as the gold standard in diagnosing and treating hypothyroidism. Some ignore the patient’s symptoms. Some refuse to test anything other than TSH. Happily, my doctor is willing to work with me, provided that we manage the risks of too great a dose of thyroid medication, particularly increased heart rate and palpitations and osteoporosis. To monitor the latter, she ordered a bone density scan to use as a baseline. Mine was normal, with a z-score of -0.9 for lumbar spine, 1.3 for femoral neck, 1.1 for total hip. Also, we re-scanned my thyroid on ultrasound at the same time, and the single-nodule goiter had shrunk quite a bit.

The most interesting — but distressing — news was my thyroid antibodies. Due to a simple oversight, I’d never had those tested before. Here are the results:

  • TPO Ab = 11 (normal range 0 to 34)
  • Antuthyroglobulin Ab = 68 (normal range 0 to 40)

Here’s how Janie Bowthorpe of Stop the Thyroid Madness explains these tests:

Hashi’s is confirmed by two antibodies labs: anti-TPO and TgAb. The first antibody, anti-TPO, attacks an enzyme normally found in your thyroid gland, called the Thyroid Peroxidase, which is important in the production of thyroid hormones. The second antibody, TgAb, attacks the key protein in the thyroid gland, the thyroglobulin, which is essential in the production of the T4 and T3 thyroid hormones.

In essence, my hypothyroidism has some auto-immune component, although it’s not clear to me just how bad those number are.

For some people, gluten seems to be a major contributor to auto-immune thyroid disease, such that thyroid antibodies disappear on a gluten-free diet. I’ve not eaten gluten (except unknowingly and/or accidentally) over the past year, but I do wonder whether dairy consumption might be an issue. So at some point, I’ll want to do another dairy-free experiment, then test my thyroid antibodies again. I’m not sure what else I can do to preserve my thyroid over the long term. Mostly, I need to do a whole lot of reading on Hashimoto’s.

Finally… I was first diagnosed as hypothyroid on November 6th, 2009. It’s rather depressing that I’m still struggling to understand the nature of my problem and to find the right dose of my desiccated thyroid. It’s depressing that I’m 20 pounds heavier than I was a year and a half ago. Every ounce of that weight gain was due to thyroid insufficiency, in that it happened before I began taking desiccated thyroid and then when I’ve been on less than 1.5 grains. I hope that I can lose some of that, now that I’m on a decent — even if likely still not adequate — dose of dessicated thyroid.

Mostly though, I’m hugely grateful that I’m no longer in the very sorry state that I was last winter. I’ve got a working brain and tolerable energy again, and that’s huge. All the rest is gravy.

A Quick Thyroid Update

 Posted by on 18 September 2010 at 7:00 am  Fitness, Health, Personal, Thyroid
Sep 182010

I seem to have have hit bottom with respect to my thyroid on Tuesday. As I mentioned in my last thyroid update, I wasn’t doing well. Many of my hypothyroid symptoms were returning — and getting worse.

Tuesday was the worst of it. I had an utterly miserable CrossFit session that day. I wasn’t tired in any ordinary sense, but rather in the “I just want to lay down and stop moving” hypothyroid way. Even my mind kept zoning out: I couldn’t stay focused on what I was doing for 30 seconds at a time. (That never happens at CrossFit!)

Happily, I seem to have turned a corner in the past few days. My carpal tunnel pain has diminished; the skin on my hands isn’t quite so horribly dry; and my digestion is better. And I had a great CrossFit workout yesterday.

So what happened? On August 27th, I increased from 1 grain to 1.25 grains of desiccated thyroid due to my symptoms, plus labs showing my remarkably low Free T4. Since T4 is the thyroid storage hormone (as opposed to T3, which is the active thyroid hormone), I suspect that my body just required about 2.5 weeks to put the additional T4 to active use. I wonder how much I’ll improve — and whether I need to go back to 1.5 grains, if not more.

That lag is part of what makes treating hypothyroidism so darn difficult. You just can’t tinker with your meds, except on the scale of weeks or months.

Also, as another bit of good news… One element in Friday’s CrossFit workout involved alternating tractor tire flips with burpees. (Yes, it was the killer of the day.) I was outside flipping the tire, and I didn’t want to put my knees on the asphalt in doing the burpees. So I tried doing real push-ups, rather than the girly push-ups from the knees that are all that I’ve ever been able to do. Much to my amazement, I could do them! And I did all of them that way. I still need to work on them, as I should be able to get further down. However, I’m so excited to be able to do them at all — as that’s really something wholly new for me.

Overall, I’m so happy with my training at CIA FIT Gym. Despite my ongoing struggles with my thyroid and despite my limited training schedule, I’m seeing real progress!

My August Thyroid Labs

 Posted by on 11 September 2010 at 7:00 am  Health, Personal, Thyroid
Sep 112010

On August 24th, I had another round of thyroid labs. Here’s the letter that I wrote my doctor about my status:

Here’s another update on how I’m doing with respect to my hypothyroidism. As you recommended, I reduced my total thyroid medication by omitting .5 to 1 grains per week from my baseline of 1.5 grains per day. That didn’t work out so well, and let me explain how.

Starting on May 12th, I took just 1 grain on Saturdays, but 1.5 grains every other day. In that very same week, I increased the intensity of my workouts substantially by starting CrossFit once or twice per week. (That’s definitely ramped up my metabolism, as I was eating about 30% more each day, but my weight remained the same.) I felt great for a few weeks, but then slipped back into feeling a bit more lethargic and experiencing some more dry skin. I didn’t worry about it too much, however, as I was also under lots of stress (and not working out much) because I was preparing a series of lectures for a conference in early July.

After returning from the conference, I decided to try omitting another .5 grains per week starting the week of July 12th. Actually, for ease of managing my medications, I would take 1.5 grains for two days, then 1 grain for one day. So I was omitting a bit more than 1 grain per week on average. That was a small disaster: various hypothyroid symptoms returned, and I felt like my body didn’t know which way was up, I suppose due to the variation in T3 each day.

I stopped that variable dosing on July 25th. But instead of returning to 1.5 grains per day, I began taking just 1 grain per day. That seemed worth trying, given that I felt slightly better when I reduced down slightly from 1.5 grains per day. For the first few weeks, I felt fantastic again, but now I’m slightly lethargic and my skin is too dry again. Most tellingly, I’ve been gaining a pound of weight per week again, and I’ve experienced a return of some other GI problems that I had when seriously hypothyroid, e.g. diarrhea if I skip a meal. As for the weight gain, I know that I’ve gained some muscle due to CrossFit, but I’m clearly gaining fat too.

So… Yikes! These past three months have been a series of failed (albeit informative) experiments for me. I’m curious as to what the labs will say now, but I suspect that I need to be bumped up slightly, perhaps to 1.25 grains per day. (For now, I’d rather try doing that than adding T4, although I’d be amenable to trying that option next time, if I’m still not quite right.)

So what were my labs? Odd, yet again:

  • TSH = 1.650 (okay, was .115 in May)
  • Free T3 = 2.3 (normal range 2.0 to 4.4, was 2.8 in May)
  • Free T4 = .78 (normal range .82 to 1.77, was 1.14 in May)

So my TSH is back to normal, but my Free T3 is lower and my Free T4 has plummeted off the charts. Grrrr.

(I’m so glad that my doctor isn’t one of those who only tests TSH. If she was, I’d seem totally normal!)

After consulting with my doctor, I began taking 1.25 grains of desiccated thyroid on August 26th, but that hasn’t done much for my hypothyroid symptoms. The skin on my hands is terribly dry, my carpal tunnel pain has returned, my menstrual cycle has gone wonky, and I’m stalled on my strength gains. I’ve stopped gaining weight, but that might be due to cutting out dairy and nuts around the same time. I’ve only been on the 1.25 grains for just over two weeks, so I hope to see more improvement with time.

You know what I’m learning here? Hypothyroidism is a hell of a bitch to manage. Even though I’m so so so much better than I was this past winter, I want to be right… and that sweet spot seems tough to find.

Aug 282010

Here’s an interesting tidbit on cruciferous vegetables, hypothyroidism, and iodine that I found on Modern Paleo’s PaleoThyroid e-mail list:

Very high intakes of cruciferous vegetables, such as cabbage and turnips, have been found to cause hypothyroidism (insufficient thyroid hormone) in animals (68). Two mechanisms have been identified to explain this effect. The hydrolysis of some glucosinolates found in cruciferous vegetables (e.g., progoitrin) may yield a compound known as goitrin, which has been found to interfere with thyroid hormone synthesis. The hydrolysis of another class of glucosinolates, known as indole glucosinolates, results in the release of thiocyanate ions, which can compete with iodine for uptake by the thyroid gland. Increased exposure to thiocyanate ions from cruciferous vegetable consumption or, more commonly, from cigarette smoking, does not appear to increase the risk of hypothyroidism unless accompanied by iodine deficiency. One study in humans found that the consumption of 150 g/day (5 oz/day) of cooked Brussels sprouts for four weeks had no adverse effects on thyroid function (69).

That’s good to know!

Hypothyroidism Update: Odds and Ends

 Posted by on 17 July 2010 at 4:10 pm  Health, Personal, Thyroid
Jul 172010

As I reported some weeks ago, my thyroid labs in early May showed that my TSH dropped below normal, suggesting that I was a bit over-medicated. So my doctor asked me to shave a bit off my desiccated thyroid by reducing my daily dose from 1.5 grains to 1 grain once or twice per week. As I said in that post, “[My doctor] thinks that might help with my lingering symptoms, given that the symptoms of mild hypothyroidism are often the same as the symptoms of mild hyperthyroidism. (Nice, eh?)”

To my surprise, that strategy seemed to work. Starting in late May, my skin wasn’t so dry, my basal temperature stayed above 97, I never felt unbearably cold, and my mind seemed sharp, and my energy levels increased. However, I’m not sure if that was due to the slight reduction in desiccated thyroid or not. I began CrossFit in the same week as that change in medication, and that clearly kick-started my metabolism.

Then, for most of June, my life was far more stressful than usual. I had two very hard deadlines: the podcast on finding good romantic prospects and then my OCON course on luck. On top of that, the debate about the NYC Mosque was personally stressful for me. After that, OCON disrupted my usual quiet routine, required me to teach every morning at 9 am, and cut down my sleep to merely tolerable levels. Of course, OCON was a blast, but such blasts are stressful for mind and body.

Unsurprisingly, some of my hypothyroid symptoms have returned over the past few weeks, particularly just after OCON. After I returned home on Sunday, the skin on my hands, particularly around my nails on my hands and feet, dried up and split open. It looked like the early stages of some nasty disease. (Ick!) After my first CrossFit workout in weeks on Tuesday, then skipping the second half grain of desiccated thyroid on Wednesday, that skin returned to normal, even though I did nothing for it. In addition, I experienced serious memory problems early in the week: I couldn’t retrieve proper names, including of people and places that I’ve known and used regularly for years. I noticed similar problems in the stressful weeks before OCON, although far more mild. That problem has faded to a minor nuisance, thankfully. I’ve not had as much energy as I’d like, and I’ve had some minor problems sleeping too.

In short, my body is acting strangely. The stress of the past few weeks has likely had some impact, not just on my production of thyroid hormones, but also on cortisol production too. I’m curious as to the overall impact of the CrossFit workouts, as well as the reduction in my dose of thyroid medication. I wonder about the long-term effects of my high-dose iodine supplementation. All that might be difficult to sort out, unfortunately.

I don’t want to give the wrong impression: I’m doing very well, overall. Yet I’m trying to be very sensitive to changes in how I’m feeling: I want to see the patterns, as that might enable me to adjust my dose of desiccated thyroid downward even further. I would love that, and I’ll definitely talk to my doctor about it when I see her in October. I’ll have another thyroid panel in early August too, so I’ll be curious to see what’s happened with my TSH.

Of course, I’ll report back about what I find!

Another Round of Thyroid Labs

 Posted by on 29 May 2010 at 7:00 am  Health, Personal, Thyroid
May 292010

On May 11th, I had another round of thyroid blood tests. For reference, here were my prior labs on February 26th, after taking one grain of desiccated thyroid per day for two months:

  • TSH = 3.24 (normal range: .4 to 2.5)
  • FreeT3 = 2.6 (normal range: 2.0 to 4.4)
  • FreeT4 = 1.0 (normal range: .82 to 1.77)

After that, my doctor bumped me up to one and a half grains of dessicated thyroid per day for two months. Here were my new labs results on that dosage, taken on May 11th:

  • TSH = 0.115 (normal range: .4 to 2.5)
  • FreeT3 = 2.8 (normal range: 2.0 to 4.4)
  • FreeT4 = 1.14 (normal range: .82 to 1.77)

I’m surprised that my TSH suddenly plummeted because I feel basically the same as I did on one grain per day. In general though, I’ve seen almost zero correlation between my lab values and my sense of well-being. Perhaps my iodine intake — still about 25 mg per day — is having some beneficial effects. I don’t know.

Although my Free T3 is slightly higher than before, it’s not much changed. And it’s still in the low-normal range. I’ve read that it should be in the high-normal range from hypothyroid advocates, but I’ve also read that perhaps somewhat lower is better. Again, I don’t know. I just want to feel and be well.

Due to the low TSH, my doctor wanted me to back off my thyroid meds a bit, so she’s asked me to skip a half to one grain per week. I’ve been doing that for a few weeks now. She thinks that might help with my lingering symptoms, given that the symptoms of mild hypothyroidism are often the same as the symptoms of mild hyperthyroidism. (Nice, eh?)

I know that Janie Bowthorpe (of Stop the Thyroid Madness) advocates dosing with desiccated thyroid to alleviate all symptoms, even if that pushes the TSH down to zero. I’m hoping that I won’t need to do that. I’d rather take as little thyroid medication as I need. And given that I’m fully functional right now — unlike this winter, when I was a brain-dead corpse — I’m willing to play around with a more conservative approach for a while.

As for my lingering symptoms… I’ve had bouts of unbearable cold during the middle of my monthly cycle when body temperature drops naturally. I’m fine now, but I’ll find out over the next few weeks whether that happens again. (Right now, my morning temperature is about 97.3.) My skin had been terribly dry, but that’s improved in the past few weeks. My energy levels aren’t quite as high as I would like, but CrossFit seems to be helping with that. That’s it… otherwise I’m great. I’ll be interested to see what happens to my cholesterol with my annual exam this fall. My numbers improved on paleo for a while, then went to hell as I developed hypothyroidism, then improved slightly as of late February.

Oh wait… I have one more update! (I’ll be vague about this matter; you’d thank me if you knew!)

After a year of utterly perfect digestion on paleo, my hypothyroidism caused major blood sugar regulation and digestive problems. Most of that came and went with my other major hypothyroid symptoms, but some problems lingered. Despite months of tracking and testing what I ate, I just couldn’t figure out the root of the problem.

Happily, thanks to a strict elimination diet for a few weeks, I realized that the recent digestive problems were due to magnesium. Most people can take 400 mg of magnesium without a problem, but I found that even the 250 mg in my multivitamin had most unwelcome effects. So I’ve cut out any and all supplements with magnesium. Cruciferous vegetables seemed to magnify the nasty effects, so I’m taking care not to eat too much of them. Even chocolate can be a problem. Basically, I’m just exquisitely sensitive to magnesium. Now that I know that, my digestion has returned to utterly perfect. Hooray!

In other thyroid news, Mary Shomon reports on a new study showing clear benefit to some people with the addition of T3 to the standard T4-only regimen. Good!

Dairy and Weight Gain/Loss

 Posted by on 10 April 2010 at 1:00 pm  Food, Health, Personal, Thyroid
Apr 102010

Officially, this post is another update on my recovery from hypothyroidism. In fact, however, it’s a report on my own experience with weight gain and loss while varying my dairy consumption within the context of limit in a broadly paleo diet.

A few weeks ago, I stopped gaining weight — finally! Since I became seriously hypothyroid in the fall of 2009, I’d been gaining weight at the very consistent rate of three pounds per month. Sometimes, mostly due to a bit of fasting, I’d be down a pound or two, but then I’d suddenly gain back all that weight plus more within a day or two, so that I’d be on that steady upward slope again. That pattern continued, even after the worst of my hypothyroid symptoms were eliminated with the switch to desiccated thyroid and the addition of iodine.

By late February, I was up 18 pounds to just over 150 pounds, i.e. my pre-paleo weight. Since I’m fairly tall (just over 5’8″), that’s not so terrible in and of itself — although I hated it. However, the continued upward progression was really alarming. Plus, I’d outgrown almost all my pants. Yikes!

After listening to Robb Wolf talk in his fantastic podcasts with Andy Deas about the growth-promoting, insulin-spiking effects of dairy, I realized that I’d been eating a huge amounts of dairy — far more than ever before. I was buying those huge blocks of cheese from Costco, not to mention those delectable half gallons of cream. I was eating cheese-and-eggs instead of meat-and-eggs for breakfast. I was eating some high-fat dairy rather than meat-and-veggie leftovers for lunch. And we’d often have dairy as part of dinner too. As Robb would say, “Holy cats!”

When I realized that in late February, I cut my dairy down dramatically — to basically just one serving per day at most. So now I’ll have a cup of raw milk kefir or cheese on meatza, but not much more than that. I’ve also limited my nuts, as those are too easy to eat in bulk. That shift was really hard for me for the first week, as I’d grown very used to eating cheese as a staple. I experienced more than a few “Gack! What can I possibly eat?!?” moments, particularly for lunch. Once I restocked the fridge though, I was okay: I could eat my favorite uncured bratwurst, kielbasa, or ham — or large salads.

Happily, that shift in my diet immediately reversed the upward trajectory of my weight. I immediately lost four pounds, then stabilized around 146 pounds. That’s where I’ve been for a few weeks now. Of course, I’d like to lose another ten to fifteen pounds of fat, but I’m not willing to push myself much to do that. I’m already pretty stressed, and losing weight would be yet another burden. Moreover, I’m still recovering from my hypothyroidism. I’m doing well, but I’m not yet perfect. (I’m currently on one and half grains of desiccated thyroid, but I expect that I’ll need to be bumped up to two with my next round of thyroid blood tests.) Based on my body temperatures and other symptoms, my metabolism likely isn’t quite up to full speed. Losing those extra pounds might be easier when that’s humming along better.

The lesson I’ve learned from my n=1 experiment is that dairy might be something to limit or even eliminate in a broadly paleo diet if you’re struggling with your weight loss goals. Honestly, I’m not sure if that’s due to any special insulin-spiking, growth-promoting properties of dairy, as Dr. Cordain argues — or simply because it’s super-easy to consume a boatload of calories with high-fat dairy. Personally, I suspect the main problem is the calorie load, as I have the same problem with nuts, as do others. Although not all calories are created equal, a girl does have her limits!

That being said, I don’t think that it’s necessary to cut out all dairy to lose weight. My weight doesn’t seem to be affected by eating small amounts of high-fat dairy. Plus, I lost 18 pounds on a broadly paleo diet while drinking nearly one-and-a-half gallons of raw milk per week. Now I’m down to just a half gallon per week, most of it cultured into kefir. That’s manageable, I think.

As usual, your mileage with dairy may vary. People need to experiment periodically to see what foods work well for them. Of course, the major experiment in diet is the experiment with paleo itself. Yet even after that foundation is well-established, my experience shows that even the small tweaks will sometimes yield major benefits.

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