Hypothyroidism Archives - Perfect Health Diet. We’ve been looking at papers put forth by Anthony Colpo in support of his idea that low- carb diets can cause “euthyroid sick syndrome” (see his original post on July 1 and a post expanding his case on August 2. Briefly, an extreme low- carb diet can create a glucose deficiency, especially if endurance exercise or infection increases glucose requirements, and glucose deficiency invokes the body’s glucose conservation measures, which primarily consist of lower T3 and higher r. T3 hormone levels – two hormonal markers of euthyroid sick syndrome. I also offered my view, unchanged from our book, on what level of dietary carbohydrate intake is needed to avoid a glucose deficiency. MSN Health and Fitness has fitness, nutrition and medical information for men and women that will help you get active, eat right and improve your overall wellbeing. Now it’s time to look more closely at the evidence to see if my perspective is consistent with the literature. Our thyroid expert, Mario Renato Iwakura, has been looking into Anthony’s papers to see if they report any negative effects from Perfect Health Diet- level carb intakes. In his first post (Low Carb High Fat Diets and the Thyroid, Aug 1. ![]()
SOURCES: Atkins, R. Atkins for Life. Martin’s Press, 2003. Atkins web site. Atkins’ New Diet Revolution: Revised and Updated. Matt Farina is in the process of using the Perfect Health Diet to recover from hypothyroidism, and wanted to report his progress to PHD readers. BibMe Free Bibliography & Citation Maker - MLA, APA, Chicago, Harvard. Get information, facts, and pictures about nutrition at Encyclopedia.com. Make research projects and school reports about nutrition easy with credible articles from. Anthony’s July 1 post were generally very high omega- 6 diets and therefore did not refute our diet, which prescribes low omega- 6 intake. Anthony’s August 2. Mario is going to look specifically at the issue of carbs. How much carbohydrate intake is needed to avert a glucose deficiency as indicated by decreased T3 and increased r. T3? Mario had assistance from JS Stanton of gnolls. ![]() Without further ado, here’s Mario! Anthony seems to have supposed that my post was intended to reply or refute his July 1 post. It was not; my post was intended as a treatment of thyroid health generally, and was designed to answer the question of whether the studies Anthony had cited in any way refuted the Perfect Health Diet prescription for thyroid patients. In the developed world, most cases of hypothyroidism – up to 9. Hashimoto’s autoimmune thyroiditis. Hashimoto’s is a complex disease, whose causes are too complex to explore in this post, but in my opinion it is generally caused by exogenous toxins (gluten, mercury, bisphenol- A, bromide, etc) that disrupt gut flora and cause gut permeability and disturbed immunity that allows infections to enter the body and take root in thyroid tissue, after which in susceptible persons an autoimmune attack on the thyroid can develop. Which infections are associated with Hashimoto’s is still an object of study, but we do know that many of the likely pathogens benefit from high gut, serum, or cellular glucose levels and therefore we can suspect that a high carbohydrate diet might promote the disease and a low, but not too low, carbohydrate diet, such as PHD, might be therapeutic. So even if some thyroid- related problems, like euthyroid sick syndrome, may become more likely on a low- carb diet, others, like Hashimoto’s, may be relieved by a low- carb diet. It is therefore necessary to look closely at each condition and at the literature to see which diet optimizes thyroid health – and whether specific thyroid disorders demand different diets. In looking at the papers cited by Anthony, I’ll borrow his section headings so that readers have an easier time finding the part of his post that I am responding to.“Here Comes the Boom!”Anthony, in an attempt to refute my assertation that PUFA may cause thyroid impairment on LCHF diets, cites two papers. The first was Danforth E Jr et al. In all studies, provided fat was rich in omega- 6 fats: The excess fat in these diets averaged 8. The ratio of saturated to unsaturated fatty acids in these diets was 1: 2. Anthony wrote: However, as you scan through the above paper, you will notice that one of the groups followed a zero- carb diet consisting of nothing but lean meat, fish, fowl, and vitamin and mineral supplements. In other words, they ate next to no PUFA. This particular diet was actually a “protein- supplemented modified fast” consisting of: a 6- wk period during which the subjects received a protein- supplemented modified fast including 1. This was supplemented by 2. So this “zero- carb diet” provided at most a few hundred calories per day. Anthony’s conclusion: During this very low PUFA diet, T3 concentrations fell steadily and at six weeks were equivalent to those found after 7 days of fasting (8. Here’s the data from the study: The initial concentration of T3 in these subjects was 1. Initial r. T3 concentrations were 2. Slower but similar changes in the concentrations of T3 and r. T3 to those of fasting occurred with administration of a protein- supplemented modified fast for 1 wk. During the first week of the diet, T3 concentrations fell from 1. T3 concentrations rose from 3. It does not speak at all to Perfect Health Diet- style low carb (4. Anthony next discusses Bisschop PH et al. But what diet caused a significant decrease in T3 levels? ![]() A diet supplying only 2% carbohydrate out of 2. Again, Perfect Health Diet recommends 4. Anthony quoted the following passage from Bisschop PE et al: Apparently, isocaloric carbohydrate deprivation induces a catabolic state with respect to protein metabolism compared with diets with a normal composition and compared with starvation. This catabolic reaction to carbohydrate deprivation is associated with decreased insulin secretion. Apparently, exogenous carbohydrates and/or insulin induced by exogenous carbohydrates are required for a proper utilization of dietary proteins. Well, remember how I said that Dr. Bisschop and his team also measured urinary nitrogen excretion in the male subjects? Urinary nitrogen excretion is a long- standing and widely employed marker for protein (as in, lean tissue) breakdown. Low- carb diets have repeatedly been shown to increase nitrogen excretion, which is one reason why they suck the big one for building muscle. The carbohydrate deprivation diet comprised 2% of carbs and 1. On a 2. 48. 3 calorie diet, this is only 4. Paul estimated of 6. The body simply isn’t being given enough amino acids to meet the body’s glucose requirements. Muscle breakdown necessarily follows. But, let’s see what happens when you provide more carb+protein. The Volek study . Here is Table 2 from Volek et al . And yet fat mass was significantly (P < . Lesson: if you don’t want to lose muscle on a VLCD, eat extra protein and at least a bit of carbs!“Why The Volek Study Proves Absolutely Nothing . Just one wee problem: Volek et al didn’t even measure levels of T3, the critical thyroid hormone in question! Instead, as I explained in my article, the pro- low- carb and Atkins- sponsored Volek team chose to only measure T3 uptake, a test also known as “resin- binding T3 uptake”. This, of course, is just fine by Mario, who happily extrapolates the results of unrelated studies examining the relationship between thyroid hormones and a bunch of other hormones; studies, I should point out, that did not involve low- carb diets. The Volek study . As for the failure to measure T3, I agree this was a flaw. However, you cannot reasonably argue that T3 may have decreased with no detectable effect on the human body. You absolutely cannot say that T3 can decrease with no effect on testosterone, IGF- 1, glucagon, sex hormone- binding globulin (SHBG), fat mass, or lean body mass. Maybe in an alien body or in another parallel universe . Study subjects were taken through a succession of diets, eating each diet for only 7. The two diets that caused the greatest changes in T3 and r. T3 were the first two: a diet of 1. Paul has argued that gluconeogenesis is hormonally limited and can generate at most 4. So it is no surprise that these zero- carb diets produce the elevated r. T3 – depressed T3 pattern that is the body’s response to a glucose deficiency. Again, this does not argue against Perfect Health Diet- style low carb. What is interesting about Otten et al is that the diet of 5. T3 and an increase of 3. T3. It looks like even high- carb diets can induce high r. T3 and low T3 if the diet is unbalanced and deficient in protein. Perhaps the problem is not so much low- carb, but malnourishment in general! High r. T3 and low T3 reduce metabolism and may help conserve protein during malnourishment, regardless of whether the threat to protein stores comes from dietary restriction of carbs or protein.“Fifty Grams I Tell Ya, FIFTY GRAMS!!”Anthony proceeds to comment on a study, Spaulding SW et al. In this study, only fifty grams of carbohydrate on a high fat diet was enough to restore T3 levels to normal: As anticipated, total fasting resulted in a 5. T3 in association with reciprocal 5. T3. Subjects receiving the no- carbohydrate hypocaloric diets for two weeks demonstrated a similar 4. T3 but there was no significant change in r. T3 with time. In contrast, the same subjects receiving isocaloric diets containing at least 5. T3 or r. T3 concentration. In doing so, they totally ignore the fact that this result was hardly a universal finding. They totally ignore all the other studies showing T3 reductions at higher carbohydrate intakes. Based on Paul’s view of things, it would be no surprise that this was not a universal finding. Paul estimates that 2. Any perturbation – exercise, infection, protein restriction limiting the availability of substrates for gluconeogenesis – might induce a glucose deficiency. But it is significant that when circumstances are right, 2. T3 drop and r. T3 rise that is associated with glucose deficiency. So Spaulding et al is a positive contribution to the debate, and once again it tends to confirm Perfect Health Diet’s analysis. Anthony cited several other studies in which 2. T3. First, Mathieson et al . Both diets caused significant reductions in T3, with the ketogenic diet causing the largest decline. Recall that Paul believes that 2. These diets only had 5. As carb+protein intake was insufficient to maintain glucose status, it is no surprise that the diets induced a fall in T3. The other study cited by Anthony was Serog et al . Anthony writes: Serog et al examined four isocaloric (mean intake 2.
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