I would also be interested in this subject - can you post something on the forum if you find anything?

amanda

Peter is following Dr. K's diet. And Dr. K doesn't want people in ketosis but as Peter says his reasons are weird and don't seem well grounded in anything real. So he looked into it himself to see if there was anything really not so good about it.

I think dieting in general causes T4->T3 conversion to slow down. The not-low-carb Calorie restriction folks have already documented this along with the news that having a little lower T3 is associated with a longer life span.

Of course low calorie dieters are in ketosis too. The definition is you're burning fat rather than glucose, right? We run into problems when the norm was established by people who are burning through the enormous amounts of glucose that people eat nowadays with the metabolic issues that comes with that.

I guess I'd be interested in finding the last of the real HG's and studying their blood! Maybe they're the true normal.

Here, here! Peter is my go-to guy for actual science rather than speculation.


There's actually a ton of it - in medical journals and books. Search for anything related to Peripheral Thyroid Hormone Disorder (unlike T4, T's 1, 2 & 3 are mostly manufactured in peripheral tissue like the liver and kidneys, and not in the thyroid gland itself) and bingo - there it is. It just hasn't made it into the mainstream media or conventional medical wisdom yet.

Long-term ketosis can (and did, for me) act in precisely the same way that starvation level calories act on the metabolism: shut it down. The specific route it takes is to convert T4 not into the metabolically active T3, but the metabolically inert Reverse T3. It does this by switching iodine molecules in a mirror image way. Result? Plenty of T4 gets made (thus showing a 'normal' thyroid function on tests, which is true since the *gland* is not affected), but not only do T3 levels plummet as Reverse T3 rises, the remaining T3 is blocked from entering the cells at the receptor level. One becomes, in effect, thyroid hormone resistant in the same way that one's cells can become insulin resistant. For reasons not yet known, this seems to happen mostly to women rather than men, and mostly to menopausal and post-menopausal women.

The prevention for this (and oh, how was Jan Kwasniewski was, to know this about 40 years ago) is to eat low carb, but at an increased level to keep you just out of ketosis -- about 50-70 carbs a day that includes glucose foods like potato and rice. Although I learned this too late to prevent myself from getting the disorder (eating 20 or fewer carbs a day for years), correcting my diet to include the higher carbs and specifically the glucose carbs from modest amounts of potatoes, rice and bread has helped. The weight re-gain has stopped, and fat burning has begun again.

The treatment is to do the same, but also to take pure T3 (Cytomel) until normal temperature is achieved once more and all hypo symptoms (like weight gain or the inability to lose any more weight far from, or close to goal) are gone. It will also correct one of the biggest symptoms of this problem (which was the one that got me to researching all this in the first place): inexplicable, outlier high Total Cholesterol levels. Although my HDL was very high (97) and my trig's very low (49-62), and my calcium and c-reactive protein levels were 50% of *low* risk -- my cholesterol climbed from 200 to 381 in eighteen months. It made no sense at all -- until I learned that the iodine molecule on the T3 enzyme signals the liver that cholesterol levels are fine -- and that the mirror image molecule in the Reverse T3 enzyme can NOT signal the liver -- that it all began to make sense to me. This is why medical texts advise treating high cholesterol caused by this condition not with statins -- but with thyroid medication.

This medication has two effects: the T3 suppresses the T4 we normally get from food, and thus signals to the thyroid that no more is needed. The Reverse T3 pool then dries up (having no source to feed it), and when completely gone the T3 cell receptors become unblocked, allowing the T3 (ingested, thus not needing to be converted from T4) to reach the cells once more. In effect, it's the same as doing what is required to make cells insulin sensitive again, and is as important to proper metabolic regulation.

I go for my first blood test since beginning T3 therapy a month ago on Thursday, and hope and expect to see if not a drop in TC, no further rise.

And oh yes -- I had to do the research, diagnosis and treatment protocol myself. My PCP didn't have a clue. Big surprise there.

Lisa

Latest research published in the last two months shows the real reason for the longer life span, and once again Dr. K is vindicated: turns out the life span gets elongated when *protein* is reduced to 'just required' levels -- regardless of calorie intake.

Kinda like finding out yellow fever is actually caused by a bite from the mosquito that carries the virus -- and not by living near the swampland the mosquito lives in.

Lisa

Very interesting stuff, Lisa, thanks for posting this!!!

What libel? Peter is an excellent blogger and commenter on studies.

And, he was asked to comment on ketosis by Dr. Kurt Harris of panu fame.

Actually he says Dr. K is usually right but doesn't always explain his reasons in his books. The weird is about Dr. K's notes about social theory based on diet.

Lisa, FANTASTIC post I had often wondered out this and you explained it so well! Do you think this effect would be mitigated by drifting out of ketosis at various points in the day?

Yes, not only just "protein" as a whole, but one or two specific amino acids, apparently. Reducing intake of methionine is being targeted in a lot of longevity research these days. Most animal sources of protein are pretty high in methionine, and some are very high, like egg whites. Vegetable sources of protein tend to be low. There are some exceptions, like animal collagen/gelatin, which I recall is quite low in methionine.

Just saw these posts. Thank you, Lisa, for your very thorough reply to my question about the thyroid!

One argument commonly used by people wishing to defend a very-low-carb diet or a zero-carb diet is that ketosis is a natural state that we fall into every night as we sleep. Which is true enough.

But can the waking state be compared with our sleeping state? I think this is a fallacy: our bodies are operating with completely different sets of chemicals whilst we are asleep.

When awake, we always have a certain amount of adrenaline running around our system, regardless of whether we are in fight-or-flight mode or not. Whilst asleep, this hormone is switched off, unless we have a hypoglycemic episode whilst asleep, in which case adrenaline is used to kick our glucose-making systems into action (ever had those nightmares when you wake up with your heart thumping madly? That's a dream caused by an adrenaline rush!)

So, to say that it is perfectly OK for the body to do something during the day that it would otherwise only do during the night is not necessarily true, in my humble opinion.

However, I do believe that if you are weaned straight onto a VLC diet, then your body will adapt to cope with it, and that it can be a totally healthy diet. But I do not believe it is the only healthy diet for humans. The writings of Weston A. Price, as well as other testimonies on hunter-gatherer diets, prove ample evidence that humans can thrive on many different diets. Human beings are omnivores, not carnivores - our teeth prove it - and we are equipped with the enzymes and teeth to eat a wide variety of foods.

The trick is finding the right balance of foods and learning which balance is right for your own metabolism: there is no "one size fits all" for most adults.

What's more, as NancyLC pointed out somewhere, most of us have had our metabolisms and bodies damaged to some degree by the modern diet they ate for most of their lives before coming to LCing, which has differing consequences for different people.

amanda

Well, we're only in ketosis a few hours a night versus 24 hours a day too.

I'm not sure where I stand on ketosis. I think it's probably not too bad, even helpful sometimes, but maybe it shouldn't be a goal for everyone.

First, thank you for the kind words. Second -- no, the effect would NOT be mitagated, if in fact ketosis is going to be a problem for you. It isn't a problem for many, mostly men.

But ketosis does put stress on the liver for many by forcing gluconeogenesis that in some, seems to go awry. Drs. Kwasniewski and Lutz (two of my LC heroes) seem to feel there's no good reason for creating the stress to begin with, and I agree. Clearly ketosis isn't needed to lose weight, so my question would be -- who needs it at all? I believe Atkins wanted it at the start of his diet because as has been illustrated a zillion times on this forum, it suppresses appetite. Which means eating not just fewer calories, but many fewer calories. Problem is -- that simply exacerbates the thyroid problem! So in effect you exchange one metabolic issue (insulin resistance, perhaps, or stored fat accumulation disorder) for another: thyroid resistance.

An update. On Dec. 1 I wrote: "I go for my first blood test since beginning T3 therapy a month ago on Thursday, and hope and expect to see if not a drop in TC, no further rise."

Well, I got my results last week. My TC -- and LDL -- dropped by nearly 100 points. EACH. That's with just one month of T3 therapy. Just as interesting: my TSH dropped to .22, which means it's suppressed. Which means T3 is starting to trickle into my cells again.

I'll have the rest of my results later this week, and I see the Endo to 'review' them on Monday. Since she doesn't know about my self-diagnosis and self-treatment with T3, I can't wait to ask her to what she attributes my astounding cholesterol change. I already know her answer: "I see you took my advice to stop eating so much saturated fat." To which I will reply: "No, I ate more of it than ever. Try again."

Then I'll sit back and teach her all about the connection between thyroid resistance and cholesterol levels.

Lisa

I would so LOVE to overhear that conversation! I have read a couple of your other posts on this topic, and I wanted to ask something: did you say you took Cytomel? Did your Dr. prescribe it?

My son says I have to stop rubbing my hands together and cackling every time I think about it.


She did not. I got it sans prescription from an online, out of country pharmacy. Most Endo's are in the same place vis-a-vis T3 that PCP's are about cholesterol, heart disease and a high fat, low carb diet. That is to say: ignorant. The former believes your thyroid will asplode, and the latter believes your heart and kidneys will asplode. And I used to think a medical degree automatically meant a certain level of intellectual and scientific curiosity -- no more!

Lisa

My Cytomel (T3) treatment is going very well too. It would be even better if I could use some hydro-cortisone with it, but my tummy tuck is next month and I can't take HC for now. But otherwise I'm doing great on T3. My endo is aware that I'm self treating with Cynomel but still won't properly prescribe it.

Also, I tried fasting for 2 days with only water to see if T3 would prevent my body to slow down and it works very well, lost tons of weight and my body was unable to slow down, so I was still warm and very awake while fasting. It makes you really hungry though.

Anyway the pills are cheap where I get them.

Patrick