Hair loss, protein intake and thyroid function
 

The IDEAL DIET Newsletter - April 2004
http://www.theidealdiet.com/newslet...04WWZ/Apr04.htm

(I don't know how many subscribe to this newsletter but it's free and often has good insights. There are a couple more articles at this link.)

Hair Loss with Low Carb Diet

"I started doing Atkins about 2 weeks ago. Why is my hair starting to fall out?"

I received this question on the form at low-carb-diet-physician.com. My initial response was that a lack of vitamins can cause hair loss.

Many people forget that Dr. Atkins recommends a variety of supplements to go along with his diet, because the vitamins you would normally get in fruits, vegetables and other foods are severely restricted. Whether you use the Atkins diet or not, I recommend a good multivitamin with minerals for everyone. An additional B-complex supplement can be helpful for the hair.

After posting this response I had some emails from a few people who disagree, and they bring up a good point. Here is what one person had to say:

"I strongly believe that low-carb (MEAT & FAT) is the way humans are designed to eat and would gladly eat nothing but protein with plenty of natural fat if it wouldn't slow my metabolism down. I have found in the past that eating unlimited amounts of protein tends to bring on hypothyroid symptoms. I think this is why many Atkins & Protein Power dieters complain of hair loss -- it's not because carbs are too low. Rather, it's because protein (unlimited) is too high.

Broda Barnes MD who also advocates low-carb for hypothyroids states in his book that he had to quadruple his own thyroid meds when eating unlimited amounts of protein (mostly veal, hence also likely too lean). He then adapted the diet to limit protein to no more than 1 gram per kilogram of bodyweight. He also states that a study in the medical literature indicates that excessive amounts of protein use up thyroid hormone very quickly -- unfortunately, there was no foot-note reference. However, it's the only reasonable explanation for this hair-loss side-effect in connection with low-carbing that I've ever heard.

The notion that it's the stress of losing weight is silly unless someone has lost 100 pounds; the notion that it's a vitamin deficiency is also silly because it's happened to low-carbers who take copious amounts of vitamin supplements; the notion that it's because of ketosis is also silly because obese people have plenty of stored body fat to use for fuel. Therefore, I believe that Broda Barnes is onto something when he mentions the unlimited protein as potentially creating metabolic problems. Also, given that so much meat in the US is trimmed down and skinless chicken breasts abound, it is very easy to eat tons of protein without sufficient fat".

I have not seen any studies indicating that excess amounts of protein lower thyroid levels, but studies have shown that carbohydrate restriction does have this effect. Studies on dieters who stopped losing weight showed that a carbohydrate-free diet produced a 21 percent decline in RMR (resting metabolic rate), as well as a decrease in circulating T3 (the active thyroid hormone) and insulin. When carbohydrate was added, keeping the same caloric intake, RMR rose toward baseline, and weight loss continued. This was accompanied by a rise in serum T3, but not insulin.

This study shows that you cannot discount the effect of carbohydrate restriction on thyroid function and weight loss plateau. I have noted this with many of my patients, and find that weight loss is more consistent when carbs are not eliminated from the diet. This is why I designed the Metabolic Switch diet, which uses carbs to "stimulate the metabolism" while still allowing the low-carb aspect of the diet to encourage fat burning. This carb intake apparently keeps the T3 levels from dropping.

My patients have not complained of hair loss or other symptoms consistent with low thyroid levels, and I did not realize it was a common complaint with the Atkins and Protein Power diets.

As for high protein intakes being responsible for decreased T3 levels, I have not seen any studies on this. The recommended intake of protein on a typical diet is 0.8 grams per kilogram of body weight (pounds divided by 2.2 equals kilograms). When using a low carb diet, the body converts some protein to glucose for its essential needs, so additional protein should be consumed to provide for this, in order to avoid losing muscle mass.

The chart in DIET TRUTHS REVEALED indicates the minimum daily protein intake based on weight in pounds, while using a low carb diet. In some weight ranges this will calculate at up to 1.2 grams per kilogram. In the IDEAL DIET I do not place a maximum limit on protein, so more than this amount can be consumed.

Based on Dr. Barnes' observations, if you are stalled in your weight loss you should calculate your protein intake and keep it in the range given in the chart for your corresponding weight. Remember that as you lose weight your protein needs will be less, so check the chart frequently during weight loss. Replacing excess protein in your diet with fat is reasonable.

It really is not silly that the metabolism would decrease while a person is in ketosis. Even when a lot of body fat remains for fuel, the body does not want to keep burning it. It is very common that persons on very low carb diets stop losing weight and even have trouble staying in ketosis because the metabolism decreases, probably due to decreased T3 levels. People who have lost weight and then regained it may have this occur quite rapidly when they diet again.

My recommendation to eat carbs does not mean that carbohydrate intake is necessary for humans. Carbs are not necessary but glucose is, and the body converts protein to glucose for its essential needs. However, this requires energy input, while carbs give the body easy and rapid fuel. The body's response to losing energy - both in weight loss and in converting protein to glucose - is to decrease its metabolic rate in order to save its fat stores.

Interesting, but I strongly disagree that hair loss is common. At most, I'd say it's occasional. I wonder if this person inquired about the soy content in her patients' menus. Between protein shakes, Atkins bars, etc; it can add up really fast. :exclm: Soy is a known thyroid "mucker-upper".

I disagree about the hairloss though. This can happen with an drastic change in a diet, whether dropping calories or carbs.

I go to a thyroid specialist, because I have autoimmune thyroiditis. Severe low thyroid, underdiagnosed for years.

He tells me carbohydrates are POISON to my disease.

Obviously, according to him, who is listed as a premier thyroid specialist nationwide, the diet does not cause low thyroid, but is a partial part of the remedy.

My experience would say this report is not true.

My mother and I experienced the opposite with Atkins...our hair grew in thicker than ever, especially my mom, who had gotten worried about her thinning hair. Of course, she was eating like 600 calories a day in an effort to control her weight, so in her case the extra protein was really needed.

Total disagreement here. Any diet can lead to hair loss. Used to hear about it all the time from Jenny Craig folks, Nutrisystem Folks and others. Seems to have more to do with sudden weight loss than anything.

My hair thinned out a little at the beginning and has come back even thicker than when I started. I think it's more a "shock to the system" that happens whenever you change your life so drastically. I went from eating copious amounts of rice, pasta and potatoes one day to low-carbing the next. No wonder my system showed an outward reaction (not to mention the weight loss ;)).

2 weeks after starting Atkins seems kind of soon, most people don't shed hair until about 3 months after a trauma. This has to do with the basic biology of the hair growing cycle, so in this case I would wonder if something happened to the new dieter about 2 months or so earlier than Atkins to cause that.

I shed hair for a few months too, in my case I think ketosis was indeed the trigger. I can eliminate most of the other possible causes for myself. However, I think what a body percieves as a stressful event can be very individual, ranging from emotional to physical (including changing a diet). I have also been under the impression that LC can be beneficial to the thyroid in cases where low thyroid function is from imbalanced hormones and poor lifestyle and diet. At any rate my body temp has risen somewhat with LC, which would not be the case if I had become hypothyroid.

I am no expert in this area, but was glad to see what magnamater posted. I have had hard to control thyroid problems for over 15 years. (also undiagnosed for the first few). This is my first time trying lc and within days I felt like a new women. Most of my thyroid symptoms are better if not gone, praise the Lord! As for my hair, this is the first time it has stopped falling out and both my hair and nails seem to be growing very quickly. Never had that in my life. Magna......I wish I heard that years ago!

Hair loss is a common side effect on any diet. I remember back in my Nutri-system days it was an issue they had to deal with. I think it is the body's reaction to quick weight loss.

I don't lose weight quickly and my hair also doesn't fall out.

Oh pooh, this is an old thread and I am repeating myself!

My hair didn't fall out either but I only lost 20. My hair & skin seemed to be more healthier. Plus I agree about 2 weeks being to soon. When I had some sort of trauma it took a few months for my hair to start falling out.

I always thought low carb was good for thryoid. When I started doing phase 1 of south beach my TSH levels went from 2.29 in the beginning to 1.62 in a matter of a couple of weeks. That is huge!! I also have more energy than I have in so so so long.

I'm 24 and have hypothyroidism and for 2 years I struggled to get it all done, I struggled to have enough energy to play with my little girl and now I have enough energy to do it all and then some- that is HUGE!

I have to admit that hearing about how protien changes the t3 levels have me a little worried and I'm not real sure what to do with that information. Maybe add another serving of fruit??

I began low carbing in June 05, my hair has been falling out since the end of October and my doctor did thryoid levels to see if that was the cause and it was not. She told me that the hair loss would probably end in 3-6 months. I have begun taking biotin and cod liver oil in addition to my other supplements. I will see the doctor next month and if the hair loss continues I will have her run a battery of labs to see if I am deficent in something.

I am recently trying an experiment where I keep carbs lower and eat higher ("unlimited") amounts of meat and fat.

This is my fourth day, and you know what? All evidence shows I am hypermetabolic if any change at all. First of all, the first day of my experiment I ate copious amounts of fatty salmon. Calories were the same or slightly higher. First day I kept peeing and drinking water; next morning I was down 2.5 lbs. It couldn't have been liver glycocgen from cutting carbs alone, because my carbs were not all that much reduced to lose THAT much weight. Plus I could tell my lower body was a lot less bloated. In the minesotta starvation study when the guys were food restricted and then given more protein this also happened, they lots lots of water and became hypermetabolic. If the weight was all glycogen, then surely it was a simultenous increase in anabolism (putting greater demand on glycogen stores) also responsible, not just simple carb reduction. My carbs are not THAT low, nor are they relatively that reduced.

Already my body composition has already changed more favorably, in that my body looks more shapely and my waist and thighs have decreased in size. I look a lot healthier and slimmer (as in less fatty and bloated). My mood is extremely higher. My skin quality is much better and the eczema on my hands is clearing up. After eating my body feels like a heat furnace (especially after the salmon and egg foods)

This is not about calories only, but protein and fat. It's about energy and materials to build stuff with, and carbs are a crappy source of both for me and lots of other people. I tried increasing calories without specifically increasing fat and protein and decreasing carbs. It was a disaster. I gain a lot of fat, become bloated, eventually feel worse, and metabolism does not increase that much.

Maybe in deep ketosis there could be problems; I have not been in deep ketosis for 2 years now and when I was I don't remember feeling good. For me, though, more protein and fat is just what my body needs and it is the only thing that has really raised my metabolism.

Woo, out of interest, what calories (approx.) are you consuming on average, and how many/what carbs? What would a typical day's menu look like? I managed to get another 20 odd pounds off by reducing calories, but my metabolism has slowed way down. Also, how would you see body composition changes in just 4 days?

Woo,
Eczema is linked to Omega 3 deficiency, and salmon is high in Omega 3. Egg yolks are great source of biotin, which is great for healthy skin and hair.
http://www.whfoods.com/genpage.php?...utrient&dbid=42

Here is my fitday information between 01/10 and 02/28. This is a 50 day spread, and I was into relatively consistent eating habits (restricting to lose)…Although, the date range is still TOO small IMO to come up with any hard facts about my metabolism, but I think it is a good rough guesstimate.
It's also likely the cals shown here are if anything slightly higher than what I actually ate, since I tend to overestimate more when I feel full but do not underestimate when I feel hungry.

01/10 - 02/28
Average: 1323 raw calories, 1266 actual (after fiber is subtracted)
66g fat (594 cals, 47% of net cals)
104g carbs (79g net carbs, 25g fiber...316, 25% of net cals)
89g protein (356 cals, 28% of net cals)

Weight: The average between 01/09 and 01/11 was 120.5. The average between 02/27 and 03/01 was 115. This means I lost somewhere around 5.5 pounds. I know not all of it is fat, but still, it's as good an estimate as I have to go on. This means I burned 19,250 cals for a daily deficit of 385 per day. That means the absolute max my metabolism was over this period of time was 1651. IMO I consider that pretty craptastic considering I was increasing exercise much of this log, overestimating food intake, AND that is only a *best case scenario* and in all likelihood it's probably less. Plus I just felt pretty crappy.

Now my "experiment" has been running since 03/04, and I have just 4 days of data on it.

03/04 - 03/07
Average: 1583 raw calories, 1545 actual (after fiber is subtracted)
93g fat (837 cals, 53% of net cals)
72g carbs (54g net carbs, 18g fiber...216, 14% of net cals)
123g protein (492 cals, 32% of net cals)

Changes:
calories increased by 279, a 22% increase
fat increased by 27 grams or 243 calories, and is now 6% more of my net cals than they were before (47% -> 53%). Fat gram consumption has increased by 40%.
carbs decreased by 25 grams or 100 calories, is are now 11% less of my net cals (25% -> 14%). Carb consumption has decreased by 32%.
protein increased by 34 grams, or 136 calories, and is now 4% more of my net cals (28% -> 32%). Protein consumption has increased by 38%.


As we can see, the biggest changes came from what was increased, not what was reduced. That’s what leads me to believe this is mostly from “eating more meat as fat and protein” and not about reducing carbs that much.

The most dramatic change was that I am consuming 40% more fat than I was. This is followed closely by the relative increase in protein, at 38% more. In last is the relative decrease in carbs at 32% less.
Calorie level changes appear far less impressive, but considering the fact I am eating 22% more yet experiencing so many improvements is is significant in it's own right.

This data does not show other things that have changed. For example, the types of proteins and fats and carbs have changed as well. The overwhelming majority of my proteins came from stuff like salmon, chicken, and eggs. Before, much more of those fats and proteins were from legumes, nuts, dairy, and grains. It is my personal opinion this is very significant, since each time I would eat a large quantity of such food I felt very warm and "workout tired" in that I could feel like my body was very anabolic and wanted me to sleep to build stuff (not deprivation of energy tired as in a sugar coma). Sleep has been very deep and strong, too. I feel better rested and, when I wake up my body feels leaner and stronger. I have more energy into the day. When I come home from work or school I no longer feel like I can barely make it and am so hungry and just weak. Because I eat generously now if I go without food for awhile I do not feel so profoundly weak and starving; in fact today I ate barely anything but I feel not hungry nor especially weak or tired.


Let me start with what has changed:
I am now careful to eat a lot of animal protein and fat, and at least some animal fat with every meal. I have stopped the stupid thinking that reducing calories is more important than keeping my metabolism working. If my meals are under 50% fat or under 25% protein I try to add some, particularly an animal source… I’ll pop a bit of chicken or tuna w/ mayo or something. This has made a tremendous difference in sugar stability, and IMO my moods as well.

The foods I eat most often are meat and eggs. I make eggs a whole variety of way so it appears my meals are very different; I make them into cheesecakes, pies, quiches, and a wide variety of omelets. I think eggs are very important for my metabolism and satiety. The great thing about eggs is they are tofuesque in that you really can make them so many ways and even use them for sweets. Whenever I eat eggs I feel very warm and can tell metabolism is really active., and they satisfy like no other food.

I ate a lot of salmon especially fatty skin, chicken with skin and fat (and the soft bone portion as well), and a TON of nuts particularly peanuts. Salmon I ate a lot of but over a continuum of time I don’t eat it that much. I am going to start eating salmon more often because I love It and I always feel wonderful afterward (and my metabolism seems so much higher, I feel like a furnace).

Relative to calories nut consumption has gone down, but I still consume at least an ounce of nut-food daily (peanuts, peanut butter, almonds, walnuts). Dairy consumption has reduced too, I ate very little cheese and almost no yogurt.

I ate lots of low carb veggies including green beans, romaine salads, tomatoes, onions, cukes, asparagus, lots of broccoli, carrots. Berry consumption was decreased to like half (I’m more like 1-1.5 oz per day whereas before it was more like 3 oz daily). Veggie consumption has dropped slightly.

I have completely eliminated “junk food” which I used to have small nibbles of (like real cookies and what not). I do eat protein bars , in the same frequency (roughly half per day or half every other day). I also ate chocolate for my treats (good quality) and I have always drank green tea every single morning.

I suspect the reason I can tell so early on is because I am already rather thin. When you are already very thin even slight changes in body fat or muscle levels are easily detected; at least this is my experience. I can see the fat on my thighs and visceral section have gone down especially. I can also see muscle tone there has increased. This morning I looked in the mirror and I noticed my hips were sticking out a lot more relative to my hip bones and waist. Of course my first thought was “oh no, my hips are fatter”. Then I realized my hips weren’t fatter, but the section above it was now slimmer because it appeared “bonier” than I recall it having been before. In clothes my waist is more well defined. My thighs, which always are so big and bloated, are now much more slim and shapely.

Plus, I can just *tell* my metabolism has increased a lot. The first night I kept drinking and peeing. The next morning I was down 2.5 pounds.
Seeing as my average carbs were only decreased by 25 that couldn’t be enough to cause extreme glycogen loss, especially when you consider the fact that I had eaten *so much food*. I know that water loss was caused by a relative increase in anabolic/metabolic activity and not simply reducing food. My body has been tending to bloat for awhile now… I think the phenomena of edema is closely related to excessive restriction/semistarvation. This also occurred in the minnesota starvation study. They experienced famine edema, in that they gradually retained water throughout the day that peaked at night. After eating a big meal, and thus, revving metabolism with all the available fats and proteins, they lost a LOT of water and were several pounds lighter the next day.

My lower body was *much less bloated* the next day.

SO the fact I lost so much water, even though carb levels were not much lower *and* food energy had increased lead me to believe I had somehow increased my metabolism enough to get my body to stop retaining water, to start building tissues and using energy at an increased rate.

Also, I should mention that even though my present weight is still lower than what it was pre-experiment (this morning it was ~ 112.8), I suspect I am actually slowly gaining and not losing weight. The first day I went down to 112.5. Next day I hadn’t slept more than 5 hrs so that doesn’t count (114, still lower than my pre-experiment weight mind you). The third day, another night of adequate rest, I was at 112.6. This morning was slightly less rest but relatively sufficient (7 hrs) and I was at 112.8.

Another thing of interest is that my morning weights are now stable. Prior to this if I weighed in a variety of positions a variety times I would get 1-2 pound swings. I think that is from the water I was carrying. Now I get a very very similar weight no matter how many times I get on and it does not swing more than under half a pound.

Regarding the slowly increasing weights. I do not think I am gaining fat, but I do think I am building heavier lean tissues and decreasing fat. I can see that in my appearance. I can tell how I feel that I just feel so much better, like I instinctually know this is the right thing. Because my particular body has so much to build this is probably why I am experiencing hypermetabolism and actually gaining weight on the scale (slowly). For someone who has been restricting for a shorter period of time and has not wasted as many tissues they might not experience such a profound increase in metabolic activity or scale weight gain (since fat loss would exceed lean tissue synthesis g for g).


I apologize for the epic post :)
Hope this info proves useful.
I will continue to closely monitor my eating, weight, body and well being. I hope to report good things next month. I suspect I will.

Wooo, this sounds suspiciously like man-speak...

I actually did this diet...when Atkins first came out with little or no cheating for 10 months, I experienced a lot of hair loss (but, then I have tons of hair), until I met a man who had lost 160 pounds.....and told me his Doctor insisted he take the suppliment vitamin -Biotin, I am not a Doctor, of course, and others might want to look into it for themselves, but it certainly worked for me, and I was sure to make certain I had it to begin LC again!

I have never done this great help

Bah! Did it again.

Perhaps this is the role of exercise? It increases the metabolism, or at least prevents a decline in efficiency. Maybe the body needs the challenge of variable metabolic demands (rather than adjusting to the same daily expenditure) in order to burn fat.

FWIW I've had the opposite result...after over 4 years on Dr Bernstein's 30gm carb per day plan, my hair loss is reduced...the thin spot, according to the mirror, my wife and the barber, has filled in.

Points and laughs at Nancy