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Hi hackers,

when I first came in contact with paleo, everything seemed to indicate that low-carb/zero-carb is the way to go. And I followed those suggestions precisely.

Unfortunately, when liver glycogen is sparse, T4 to T3 conversion is inhibited. So it seems that long term ZC/VLC inevitably leads to hypothyroidism. (To solve this problem actually foods rich in fructose work best for me, e.g. buckwheat honey; It seems fructose is only toxic in case of fully replete liver glycogen stores)

Now I'm really interested, if there's anybody out there who actually does/did strict VLC/ZC for months and didn't experience any thyroid issues (cold hands, lethargy, light-headedness, ...) - or if some of you also developed hypothyroidism.

Thanks :)

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I didn't always experience cold. I think it is more a function of whether you are leptin sensitive or not, and how many total calories and fat you are eating. I was only cold on a LC, lower-fat, and moderate protein version. I get cold when I up the carbs. Everything gets dysregulated when I up the carbs. (I am not VLC!) – The Loon Mar 6 2012 at 16:22
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@Thomy, you might enjoy Dr. Kruse's recent CT posts on his blog. – The Loon Mar 6 2012 at 16:22
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I'd be FAR more interested it hear about people actually diagnosed by a doctor than about people with some vague hypo symptoms. – Bread-Eating Beelzebub Mar 6 2012 at 16:29
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No, you have to go to a doctor and get your thyroid tested. For example, I had some of the symptoms people peg to hypo caused by LC, such as reynaulds and low blood pressure, but when I went to the doctor, my thyroid panel was normal. – Bread-Eating Beelzebub Mar 6 2012 at 17:20
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"And what if you have 80% of the symptoms on wikipedia?" I hope you are not serious. I mean I can go there right now and add symptoms to the list, but I won't. Let's just say almost all those symptoms can overlap with other problems too! – Bread-Eating Beelzebub Mar 6 2012 at 18:12
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8 Answers

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How many people realized that they were Hypo while on low carb? Perhaps improving the diet allowed you to notice symptoms you had for a while. Food for thought.

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I think you meant if diet improves so much you notice a difference, then that is when you realize how sick you were? It's not "hypo" if that is the case. Hypothyroidism is a real medical condition that doesn't just disappear if you eat your sweet potatoes! I think people are starting to use "hypo" as a catch all for self-imposed fatigue. – DFH Mar 6 2012 at 14:28
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ZAK, yes, good point. :) Dr. Richard Bernstein has said that many of the people who come to him have thyroid problems. Not everyone goes to a doctor who knows what Dr. Bernstein knows. Some of us find out that there are/were things out of balance, which were masked by eating too many carbs. Best wishes to you! :) – PaleoGran Mar 6 2012 at 18:26
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There is probably much more to it than that.

I see a top thyroid/hormone dr and he took me OFF carbs and keeps me off to heal. It's complicated by insulin resistance too. The IR has pretty much been cleared up, at least on paper. Each time I see the doc he reminds me to avoid carbs.

When I read these comments about LC killing thyroid, they just look backwards. There has to be more to it than just that.

Maybe the ZC/LC diet is failing for some, due to some now-unknown reason that pops up on a blog a year from now and everyone will be all over it. Maybe people are doing LC for dieters and trying to do intense workouts too, and stressing adrenals, which throws off thyroid. Conclusion, LC hurts thyroid!

BS. Over training stresses the system. The thyroid thing gets the attention because it can get noticed first. Now people are looking for this and the confirmation bias will grow. "Overtraining hurts adrenals. LC hurts thyroid (supposedly). I overtrained, but I will blame it on LC/thyroid..."

Are people simply mixing the symptoms and results of over training and calling it "LC hurts thyroid?" For people this happens to that are not training, are they just starving themselves and running out of whatever it is they need to maintain robust hormones? Is it LC or HOW they are doing LC? It is something else? Too many variables.

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I suspect that one of the biggest reasons why LC works for some and not for others is genetics. I had my genes "done" a la 23andme, and I have the dreaded apoe4 alleles. My partner, however, does not. We both have been paleo for four years, but I have no carb tolerance and he thrives on potatoes and fruit along with his animal foods. Our ancestry is also very different, with 100 percent of my background being northern european, and his being southern european and african. – Bloop Mar 6 2012 at 15:02
Does this sound a bit like "Some people are insulin resistant, some are insulin sensitive?" It's the same reason some can eat cake all day and you don't notice, and some gain just walking past it. When WWGF came out, the book seemed to be missing something. He can't be talking about everyone, can he? Taubes filled in the blanks when Dr Oz was arguing with him about this. Taubes is referring to IR people and goes "these are the people I am talking about..." The debate between the IRs and the IR-nots just goes on and on... – DFH Mar 6 2012 at 15:19
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Oh sure - but I'm wondering why some people are insulin resistant etc. Is it genetics? Or something else? I have never been obese, have never eaten anything but a whole foods diet my entire life (my parents are health nuts), and so I don't think that I developed metabolic derangement due to lifestyle. I think I was honestly born this way. I remember having insatiable hunger as a kid. It wasn't until five years ago that I discovered LC, then paleo, and it all made sense. – Bloop Mar 6 2012 at 16:04
It's best to not go there. If you are, you are. It's genetics. It's environment. It's weight. It's caused by weight. It's stress. It's genetics. It's your inability to overcome the food reward forces of nature in your brain, you made yourself eat, gain, and become IR. OK, kidding on the last one... People argue too much how. It's real. What matters is what to do about it. IR people need to reduce carbs, that's a fact. If people want to argue that the cause is the same as the fix, nor much I can say to that except "not clever." BTW-my doc is convinced mine is genetic. – DFH Mar 6 2012 at 16:43
Knowing the mechanisms/casue may help in finding solutions... – Michael Nov 13 at 6:00
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It may be problematic to refer to it as actual hypothyroidism since most people get TSH/T4 tested, which will come back normal if your carb/selenium intake is insufficient. If T3 comes back right where you want it, then by all means eat whatever amount of carbs you want.

Personally, I don't need to get a full thyroid panel to know that a waking oral temperature of 95 degrees + feeling uncomfortably cold all day is not gonna happen. I also got sick repeatedly due I'm sure to what is essentially a persistent reverse-fever. That was on 100g of carbs a day. Increasing it beyond 200g increased waking temperature 1.5-2 degrees and I feel warm all day. Same effect occurred back when I started to supp iodide/selenium. These measurements were done for a week before and a week after, so it wasn't a fluke. I suppose I wouldn't have noticed if I lived at a legitimate latitude or had more insulation.

It's all relative though. I'd imagine that the sedentary can get by on very little in the way of carbs with few perceptible effects.

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I tested low t3 on a low carb paleo diet when my doc was testing me like crazy to figure out why I wasn't having my period. I had never been tested for thyroid hormones before, so I can't objectively state that my body started having t4 conversion problems at the same time I went low carb, but I certainly never felt the symptoms I now associate with it before I went low carb.

I have no idea what my t3 levels are now that I stuff myself with bananas, rice, potatoes and oranges, but I sure feel good. Oranges and tangerines in particular make me feel happy after I eat them for some reason. :-)

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is your period back? – Bread-Eating Beelzebub Mar 7 2012 at 6:27
There is more going on than just T3 vs bananas! – DFH Mar 7 2012 at 10:41
Absolutely DFH. I was having many problems and trying many things at once. All I know for sure is that carbs do not hurt my thyroid or cause inflammation or auto-immune reactions (I have celiac disease), and that being low carb did not help me at all. That doesn't mean carbs necessarily have anything to do with anything. I think your body's preferred energy source is unique and based on activity and genetics and other than that, I'm skeptical of focusing on things like carbs vs. fat. And yes, I've had regular periods for 10 months now. – heather Mar 7 2012 at 16:26
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Like Manimal said, I think that anyone who goes on a calorie-reducing diet for any reason, either because they are deliberately reducing calories or naturally reducing them through a low carb diet may see this. Personally I lost weight on a lower carb diet and the weight loss slowed when I initially went higher carb for a few days and then lower carb, but now I believe that it was mostly due to being in winter and being low on D. It is really hard to say with n=1 because it is hard to control all the variables well. I don't buy the idea that only people on low carb diets have trouble with their thyroids. I see TONS of people on traditional CW diets with thyroid problems. Low carb does not have the corner on this!!!!!! The way I prefer to look at it is that people who have disrupted thyroid function often gain weight, this causes them to try to do something about their weight, and they may find that any type of reducing diet results in sub-stellar success until they deal with the real problem. I am really a fan of Dr. Kruse's leptin reset precisely for this reason. He is the only one who has an explanation why paleo, "safe" starch, or low carb diets may not work well for all people all of the time.

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It's think it's hard to compare paleo with diets that allow grains, you never know if the hypothyroidism is caused by an autoimmune reaction to gluten. It would be quite interesting to see how moderate to high carb diets without gluten affect the thyroid. – Thomy Mar 6 2012 at 16:33
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Thyroid problems due to calorie restriction are real. When you starve, the body makes rT3 instead of T3. Initially this is not damaging but a natural famine response. Wear this out and you have no thyroid and become a hormone train wreck. If this happens, its not the same as hypothyroid due to inflammation. Its high rT3. Good thyroid drs have their hypothyroid patients do LC to heal. There goes the "LC causes it" theory... – DFH Mar 6 2012 at 17:07
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+1 thomy, you never know what all the variables are, and then well-controlled studies supposedly control for them, but then you lose the interactions between several variables. – The Loon Mar 7 2012 at 1:58
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I think it is a lot more than carb content that factors in as some have said- I have been DX with what they call tertiary hypothyroidism and I had all the symptoms and same free ts/t4 levels when I was a carb loading competitive swimmer as I did when I was DX. Before now I was playing around a lot with PSMF to lose weight which utterly tanked my hormones and now that I am on a true VLC paleo diet I find my energy levels so much better and temperature great. However, I am also on T3 treatment for it so obviously that helps. My goal now is to get my period back. All of my health issues were pre-paleo or any carb restricting- I actually put myself into remission from lupus when I started with Scwarzbein and then paleo. So moral is- as it usually is- it is entirely dependent on YOUR body which can be a pretty frustrating answer when all you want is to feel better (trust me- I know).

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Sorry, I realize this reply is rather late, but I did have thyroid issues, but have managed to resolve them. Iodine supplementation helped some: there was a huge effect at first, but it faded, and still had some symptoms, just not as bad. Ray Peat has an interesting article on gelatin, and adding that in was a major win for thyroid function, and I would say things are now "normal," which is better than most of the people I interact with at work.

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Joe, do you have a link to that article? I'd love to read it. – tbunchylulu Nov 13 at 11:24
The article is at: raypeat.com/articles/articles/gelatin.shtml I did not follow the biochemistry he uses, but he nailed my two major complaints, insomnia and hypothyroid, perfectly. I thought making stocks from gelatin rich sources would be too time consuming, so wound up buying Great Lakes Gelatin (from googling, seems a popular choice for paleo folks). It's pure, unsweetened gelatin from grass fed cows. You can buy a couple of pounds on amazon for around $35, and that will last a few months, so it's a cheap experiment. For me, thyroid is happier, but insomnia still persists. – Joe Nov 14 at 1:29
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I don't know if I can call this hypothyroidism or metabolic slowdown but this symptoms happend to me after this combination: vlc + intense daily workouts + big caloric deficit. Dissapeared soon after eating more protein/fat calories for a day or two (less effective) or after carb up (CKD style - this is what i'm doing right now).

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Hypothyoidism is a real medical condition. You just overdid it! Not the same thing. :) – DFH Mar 6 2012 at 14:04

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