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10: All Things Thyroid (Thyroid 101) | Chris Kresser

10: All Things Thyroid (Thyroid 101) | Chris Kresser

AIR DATE: March 22, 2012 at 7PM ET
FEATURED TOPIC: “All Things Thyroid (Thyroid 101)”


Licensed acupuncturist and integrative medicine practitioner Chris Kresser is one of the most highly-sought after voices of reason in the realm of health on the Internet today. He has personally been through the wringer with the traditional medical system as he shared with me in Episode 464 of “The Livin’ La Vida Low-Carb Show.” But that set him on a quest to discover more about his own health by gathering and analyzing the medical research staying up-to-date on everything he could get his hands on. There are a lot of health myths that unfortunately pervade in the realm of health and Chris regularly addresses these on his highly popular ChrisKresser.com web site and wildly-popular Revolution Health Radio podcast. One area of specific interest to him is the subject of thyroid. Around 20 million Americans deal with some form of thyroid disease and yet it is left undiagnosed due to a variety of reasons. Yet there is a lot of confusion about thyroid conditions that we will hopefully have Chris help bring clarity to in this episode!


NOTICE OF DISCLOSURE: http://cmp.ly/3

Here are some of the questions we addressed in this podcast:

Are there any dietary changes that will “treat” hypothyroid?

There is a meme that has spread quickly to Paleo sites that low carb causes low T3, and is a cause of hypothyroidism. How can this be? My doc who treats hypothyroidism and insulin resistance had me do low carb, and it worked. How can low carb be both the cause and part of the solution? Someone has this wrong. What is going on?

I am a 53 year old female who had a Total Thyroidectomy four years ago due to thyroid cancer. My doctor keeps me just a smidgen “hyper” with Synthroid replacement medication to help the cancer not grow back. I have lost 50 pounds. In one year on a low carb diet, I feel great. But I have been stalled for two months now. I can’t seem to lose any more weight. I need to lose 50 more. I know I need thyroid replacement meds but could this be the reason I can’t seem to lose anymore?

Which is better–natural or synthetic thyroid hormone (like Synthroid) or a combination?

When I went zero carb Paleo, my T3 dropped out of the range and I needed to take antibiotics for a mouth abscess. I resumed carbs and gained back the weight I lost. I am now trying to drive down the carbs again. What can I do to ensure that my T3 remains ok. I am hypothyroid (take 100T4 + 20T3) and I was assessed a few years back by a former family doctor as having low adrenal function. Are adrenal and thyroid metabolism related and can a low adrenal state lead to a low T3?

What is your opinion of Jack Kruse’s Leptin Reset Rx and Cold Thermogenesis on the thyroid?

I underwent a total thyroidectomy in January of 2006 following a thyroid cancer diagnosis and will be on replacement T4 (Synthroid) for the rest of my life. Are there any modifications that those of us without a thyroid need to keep in mind when following a Paleo diet?

My wife had about 90% of her thyroid removed several years ago after undergoing a thyroid storm and goiter. She’s on levothyroxin and we’ve switched over to a Paleo diet about two years ago, and she’s pretty good with adherence, especially when it comes to avoiding wheat and grains. One of my real concerns is with her long term bone health due to the thyroid removal. She currently takes anywhere from 2000mg to 3500 mg of calcium each day to combat calcium loss from her bones. She takes 5000 IU of D3 daily, as well as K2 to help with proper absorption. Her blood calcium levels are usually high, but if she doesn’t take the oral supplements she gets pain in her hands, wrists, and other joints. What supplements would you recommend for proper calcium absorption? What are some good blood markers you’d like to to indicate proper function?

Can you discuss the role of antibodies (AB), both blocking and stimulating, on thyroid health? When the typical thyroid labs appear “normal”, could there be an AB issue occurring, causing the autoimmune response?

Since giving up soy milk and grains (including daily wheat germ) when I started on a low-carb regimen about a year ago, my arthritis symptoms have virtually disappeared, and my thyroid started working better (I was able to lower my dosage of levothyroxine slightly). During the same period, my osteopenia has progressed to osteoporosis. The latter may just be age, but what I want to know is, could the same root cause underlie co-existing hypothyroidism, osteoarthritis and osteoporosis?

My TSH increased from 3.86 a year ago to 5.23 last month. I have no hypothyroid symptoms but my doctor want to put me on levothyroxine. Does this make sense?

Other relevant blood values
T4 free 1.09
T4 total 5.9
T3 uptake 38
TPO antibody: 19
Total cholesterol increased from 197 to 215 over last year.
T total 417
T free 45
Free T% – 1.1%
SHBG 79.6

I am a 42-year-old female who has been eating Primal/Paleo (low to moderate carb) for over one year now (after being a vegetarian and vegan for almost my ENTIRE life). I had my one and only child almost three years ago and lost all my baby weight (and then some) by changing my eating habits. I looked so much better after changing my lifestyle, but still had low thyroid symptoms (FREEZING cold, tired, digestion issues, etc) AND it was discovered I had near zero sex hormone production (estrogen, progesterone, and testosterone). Also, I had BEYOND low Free T3 and Free T4 (TSH was all over the place, but is now quite low). I was diagnosed with hypothyroid due to a pituitary disorder. I have been put on Estradiol, Prometrium, and a small amount of topical Androgel (testosterone). I have also been taking Armour. I have gained 30 pounds thus far. I am miserable.

My questions are:

Do you believe in supplementing with sex hormones or should the thyroid medication be sufficient?

Would daily intermittent fasting be contraindicated for someone with issues like mine (or does this stress the adrenals too much)?

I want to be HEALTHY. But I cannot lie, I am so OVER being overweight. I would love to find a healthy balance.

This question is about real thyroid health vs “health on paper” (good test results). I’ve been treated for hypothyroid, chronic fatigue, and insulin resistance since 2007, with good results. I see a top doctor that deals with all three and they use the so-called bio-identical T3, hormones like testosterone or progesterone cream, and a lot of supplements. I lost 120 pounds quickly and look much different. My blood work went from train wreck to awesome. Weight is normal enough and I feel fine, even though I have low calorie requirements now (about 1,400 a day, and I’m male 51, 5″8, 192 pounds)

My question is how do I know if I get to a point where I’m spending a lot of money on meds and supplements and maybe need to back off and let the body take over? My doc wants to keep doing what has worked. Am I broke forever, or should I think about cutting back on supplements and hormones and let the body handle more?

I am wondering if thyroid problems is the cause of hair thinning in a woman? Are there any other causes that should be investigated as well? And what can you do as a first intervention?

What thyroid tests do you recommend when weight loss has stalled? (In my case TSH is elevated but the HMO will not test T3 or rT3–is it worth paying privately for those tests to have a more complete picture of what might be going on?)

Do you have any insight on what might cause thyroid nodules? (I have several, and biopsies show them to be non-cancerous at this time. One doctor recommends surgery; another says they are nothing to worry about)

  • Di

    Where do I click to listen? there seems to be no link?!?

    • LLVLCBlog

      Patience guys, my producer Kevin is working on the audio now. We had to bump up Chris is post production since his audio was softer than the rest. It should be up around midday Eastern time.

      • lifewith2pei

        Am I missing it? Is it up yet? Where?
        I keep getting the ads and not the interview.

  • Lindy

    I can’t find the link to listen

    • LLVLCBlog

      Click on the play button above.

  • Brenda

    Eagerly anticipating the chance to listen 🙂

    • LLVLCBlog

      It’s ready right now! Enjoy!

  • Jennifer Eloff

    That was awesome!! Thanks – very knowledgeable man!

    • LLVLCBlog

      Thanks Jennifer.

  • Jillm

    Wonderful interview. Thank you!

  • Tlbunnell

    How does one start out by saying that thyroid function although it might not be necessary to live, and then go into this whole tirade and preamble of thyroid hormonal effects to our minds and bodies. I can’t equate this. Somebody help me. — This is a great and important interview. This thing has got to be dealt with. Thyroid hormones are our “life”. — Nothing is more important because of the millions of people involved and the millions of more people coming down the pike.

    It’s a travesty what’s going on out their.

    I realize he’s speaking and mouthing conventional wisdom that somehow manages to “downplay” and “up-play” at the same time.

    Great work Jimmy!

  • Tlbunnell

    Mayo says iodine deficiency , although once thought to be the cause of thyroid disfunction, is no longer seen that way. Iodine supplementation is not recommended and could be problematic. I personally believe that removing all of the unnatural sugars and starches from our systems gives our bodies the ability to restore our bodies systems and body chemistry back to optimal and normal.

    Problem being that we are addicted and when we reduce or quit sugars and carbohydrates our adrenaline gland goes to work fighting the addiction withdrawals and in the process, a lot of analysis comes in to the wrong conclusions.

    It can take up to six months to get through all of the withdrawal symptoms and get our adrenaline back to normal.

    Most of us don’t last that long, our addictions draw us back, creating a vicious circle and the search for other answers.

    Nature will heal a cut and nature will optimize our health, if the toxins and supplements and vitamin bombardment, as well as the sugars and carbohydrate consumptions and bombardments are ceased.

    Even with all of the toxins in our environment.

    We are made perfect, if we leave ourselves alone and allow ourselves to heal vs ingesting all this stuff, trying to help the process along but in the process, “”Hindering” and effecting the results and our health.

  • Jimmy, I think something got scrambled during editing. The audio downloaded from itunes jumps around, then back, like portions of the audio were cut and pasted randomly. I could follow it once I figured it out, but this would be a hard one for the newbie to listen to, since the correct advice doesn’t always follow the topic, and sometimes gets cut off midstream (then comes back minutes later).

    • LLVLCBlog

      I haven’t heard anyone else dealing with this issue and it didn’t happen when I played it back. Can you email this issue to me at livinlowcarbman@charter.net with EXACTLY what is happening so I can let me producer know? THANKS!

      • Thanks, Jimmy. I’ll download it again and see what happens. Weird.

  • lorraine

    As a thyroid patient, struggling with all the issues that thyroid patients struggle with, I had been aware of, and concerned by, the reduced T3/increased rT3 levels associated with carbohydrate restricted and calorie restricted diets. I read a lot of the literature, including the old stuff from way back in the 50’s and a couple of textbooks, and while it confirms the changes in the levels of the hormones with carb/calorie restriction, generally it appears that resting energy expenditure only decreases on severely restricted caloric diets. So, are the changes in T3 and rT3 levels really clinically significant; ie, do the changes in the levels mean that thyroid function itself is harmed by carbohydrate restriction? A discussion of this question appears in a 2004 paper by Wolfgang Kopp in the journal Medical Hypotheses in which the author reviews the literature on the topic and indicates that, “The sharp decline in T3 levels as a result of very low carbohydrate diets is not associated with a reduction in the resting oxygen uptake, or symptoms of functional hypothyroidism (cold intolerance, dry skin, increased need for sleep). Despite decreased T3 concentrations, basal TSH levels are normal or even mildly decreased. The lack of clinical symptoms, together with normal or mildly decreased TSH levels suggest that the organism does not suffer from a deprivation in thyroid hormone in association with carbohydrate restriction.” His rationale is that our modern “normal” levels of T3 may be quite higher than our paleo ancestors exactly because of the carbohydrate load of modern diets. He concludes that “the metabolism of dietary carbohydrate is a thyroid hormone consuming process.” I really liked this guest and felt he had a great command of the thyroid and how it works. However, I felt he implied that carb restricted diets decrease thyroid function (not just thyroid hormone levels), sort of like you should watch out that if you carb restrict and lower your insulin levels that you won’t be able to convert T4 to T3, and you’ll go down this metabolic dead end with production of rT3. It appears there is a reasonable argument to be made that in the carb restricted state, you don’t need as much T3, and that this lower level of thyroid hormone is more aligned with that of our paleo ancestors.

  • jake3_14

    Just caught this podcast, and it was very educational. Kresser’s comments dovetail with Jaminet’s examination of euthyroid sick syndrome on VLC (less than 100 g of carbs from starch) diets. As Kresser and Jaminet note, though, we shouldn’t assume that everyone on a VLC diet suffers T3 conversion problems, or that everyone’s LDL gets elevated with a VLC WOE. I’m not completely buying Jaminet’s theory, either, since the Masai and the Kitivans, as C. Masterjohn points out, have completely opposite traditional diets, yet both enjoy excellent health.

  • Paula

    Hello, Jimmy, I found your podcasts and I listen to them all. They have given me encouragement. I have been on the Paleo for a month and I lost 10 lbs. and feel great! I have not had angina for a month for the first time since my heart attack two years ago. I would like to ask Kris Kessler the next time he is a guest about how to bring my gut back to health. I am a 63 yr. old , overweight ( 5′ 1″ 170 lbs.) woman with three heart stents and I am taking a number of heart meds such as Crestor 40 mg, Amlodipine Besylate 10 mg, , Clopidogrel75mg, Bisoprolol Fumarate 10 mg. , Ezetrol 10mg, coversyl 4mg daily low dose aspirin. I am taking Pantoprazole 40 mg for GERD . I am experimenting without Pantoprazole and I find I still get burping, heartburn and stomach bloat. My question for Kris is how can I go off this drug and restore my digestive system to normal. I have always been very sensitive to stress and I have been working on coping with meditation, deep breathing etc. and I am better than I was, but stress still will show up in my digestive system. The Pantoprazole has been a wonderful help, but I have been reading Practical Paleo and a number of other books by the various Paleo authors and I am not sure quite how to go about restoring balance to my gut. I have been on Pantoprazole for over 4 years now and I realize it may take time. My doctors are no where near understanding nutrition and the naturopath is all about using an alkaline powder and digestive enezymes. The only thing that has worked consistently and comfortably is the drug. Thank you Jimmy. I was not sure how or where to post a question. I would really appreciate any advice or links to solve my problem. Paula Canada

    • LLVLCBlog

      This podcast already aired, so I can’t ask your question for Chris now. But you can contact him directly on his web site to assist you with your issue. THANKS for listening!