Cutting Calories = Cold Hands

Since I’ve cut calories significantly on several days out of the last week my hands and feet have become cold, suggesting thyroid/metabolism slow down.  I’m not going to go down that road.  So instead, I’ve decided to turn to the macro percentages identified using this Keto Calculator.  Given my height, weight, and activity level (“lightly active”) my energy expenditure appears to be 1885 calories per day.

Holy crap…it says I have about 90 pounds of fat on me (including 14 lbs that are essential).

If I choose to eat 20g of carbohydrate per day and around 70g of protein per day, then 128g of fat per day would mean a 20% calorie deficit of 1512 calories per day.  Maybe I’ll try this for a week and tweak based on how it goes.

I’m going to focus more on exercise to get the insulin down.  That might mean eating more than the numbers above, depending on how I feel.

Analysis Paralysis

Yesterday I was in the car for 4 hours, and in that time I listened to 3 or 4 podcasts featuring Ray Peat.  I think I understand now why I’m having trouble with hunger in the mornings but less so in the late afternoon and evenings.  I start each day in a state of metabolic stress.

Here’s how it works:  A healthy person can store enough glycogen in their liver to get through the night (8 hours) without running out.  I’m not healthy.  What happens overnight is I run out of glycogen (which the body uses to maintain a healthy blood sugar level).  The body’s first reaction to running out is to increase adrenaline, which “squeezes the last bit of glycogen out of the liver,” according to Peat.  That same adrenaline will sometimes wake you up in the middle of the night.  If you don’t eat when this happens the body’s next step is to increase cortisol.  Cortisol is the guy that turns protein into glucose for the body to use (gluconeogenesis).  Protein, meaning muscle.  Hmmmm…so you don’t eat enough sugar, and your body raises cortisol to turn your muscle tissue into sugar.  The appetite is suppressed (which is why I used to love low-carbing), but the thyroid is also suppressed in order to reduce the number of calories required to live. Our bodies are remarkable at shutting down important processes to keep us alive.  All about the big picture.  Anyway, yadda yadda yadda, now I have a lot of cortisol-induced abdominal fat and sub-optimal thyroid function.

Another thing I learned is that it’s the lowering of stress hormones that makes you feel tired after eating a high-carbohydrate meal when your body has been depleted of glycogen.  I’ve always wondered about that.  So you’re cruising along on the adrenaline/cortisol high of low-carb and suddenly you decide to have some orange juice or some rice…or you supplement thyroid hormone.  In an hour you’re exhausted.  Yeah, that’s because finally your body is able to rest and put the stress hormones away because you finally fed it what it needs.  So your true fatigue shows up – the fatigue resulting from pushing yourself, staying up too late, waking up too early, running on adrenaline all day long.  Suddenly you feel all of it.

So it seems I wake up with my body all saturated with cortisol from having no glycogen stores overnight.  I’m going to focus on a pure Peat-friendly diet (no starches, which I’ve been eating sporadically) and I’m going to stop measuring my blood sugar throughout the day (with the exception of fasting blood sugar in the morning).  I’m going to listen only to hunger cues.  I think all the testing and micromanaging of my blood sugar, pulse, temperature, calories, macronutrients, and weight is interfering with me actually learning to feel what I need to be healthy.  Also, I’m going to eat some fruit and/or sugar before bed and see what that does to my fasting sugar levels and my hunger the following morning.

Update:  Wow…this chick said it way better than I ever could.

Updated Labs and Gut Health

I didn’t get everything tested – just the basics, which is what I could afford right now.  Here they are, with the current results in RED.

3/27/2012 11/14/2012 9/6/2013 12/30/2013
Units Ref
Glucose 98 98 117 114 mg/dL 65-99
Hb A1C 6.4 <7.0
Uric Acid 5.9 5.2 5.4 5.4 mg/dL 2.5-7.1
BUN 19 25 18 18 mg/dL HIGH 6-24
Creatinine 0.69 0.73 0.57 0.6 mg/dL .57-1.00
eGFR 108 101 113 111 mg/dL >59
BUN/Creat Ratio 28 34 32 30 HIGH 9-23
Sodium 138 139 139 138 mmol/L 134-144
Potassium 3.8 3.8 4.5 4.1 mmol/L 3.5-5.2
Chloride 1.3 104 103 104 mmol/L 97-108
Calcium 9.3 9.2 9.4 9.2 mg/dL 8.7-10.2
CO2, Total 28 20 mmol/L 19-28
Phosphorus 3.6 4.1 4.0 3.4 mg/dL 2.5-4.5
Protein, Total 6.8 6.9 7.2 7.1 g/dL 6.0-8.5
Albumin 4.3 4.4 4.4 4.1 g/dL 3.5-5.5
Globulin, Total 2.5 2.5 2.8 3.0 g/dL 1.5-4.5
A/G Ratio 1.7 1.8 1.6 1.4 1.1-2.5
Bilirubin, Total 0.2 0.3 0.3 0.3 mg/dL 0.0-1.2
Alkaline Phosphatase, S 63 64 70 62 IU/L 25-150
LDH 142 137 137 143 IU/L 0-214
AST (SGOT) 20 14 12 15 IU/L 0-40
ALT (SGPT) 25 17 18 20 IU/L 0-32
GGT 14 14 27 20 IU/L 0-60
Iron 66 81 116 88 ug/dL 35-155
WBC 8.7 x10E3/uL 3.4-10.8
RBC 4.36 X10E6/uL 3.77-5.28
LIPIDS
Cholesterol, Total 222 297 270 274 mg/dL HIGH 100-199
Triglycerides 107 203 288 312 mg/dL HIGH 0-149
HDL Cholesterol 54 56 43 46 mg/dL >39
VLDL Cholesterol 41 58 mg/dL HIGH 5-40
LDL Cholesterol 147 200 169 166 mg/dL HIGH 0-99
T. Chol/HDL Ratio 4.1 5.3 6.3 6.0 HIGH 0.0-4.4
Estimated CHD Risk (Tot. Chol/HDL) 1.4 1.8 HIGH 0.0-1.0
OTHER
Vitamin D 34.2 67 (on 11/11/13) ng/mL 32-100
Insulin, Fasting 27.9 uIU/mL HIGH 2.6-24.9
hs-CRP 8.65 8.12 13.58 mg/L HIGH 0.00-3.00
THYROID 3/27/2012 11/14/2012 6/19/2013 12/30/2013 Units Ref.
TSH 1.7 4.01 1.55 2.92 uIU/mL 0.450-4.500
Thyroxine (T4) 4.1 8.9 7.4 6.9 ug/dL 4.5-12.0
T3 Uptake 32 25 27 24 % 24-39
Free Thyroxine Index 2.5 2.2 2.0 1.7 1.2-4.9
T4, Free (Direct) 1.04 0.97 ng/dL 0.82-1.77
Reverse T3 20.9 10.2 ng/dL 9.2-24.1
Triiodothyronine (T3) 126 120 ng/dL 71-180
Thyroid Peroxidase TPO Ab 10 8 IU/mL 0-34
Antithyroglobulin Ab <20 <20 IU/mL 0-40
Free T3 2.9 2.8 pg/mL 2.0-4.4

The first two columns (3/27/12 and 11/14/12) are when I was eating low carb with about 5% of my diet being carbohydrates for the first, and 10-15% for the second.  The third column (9/6/13) I was floundering around, trying on various diets/lifestyles.  At that time, about 20% of my diet was carbohydrate.  In November I started paying attention to Ray Peat and I increased my carbohydrate consumption to 40-50%, most in the form of simple sugars/fruit.  My blood sugars started soaring though, so a few weeks later I switched from simple sugars to starches and cut the quantity down to about 30%, while increasing protein.

So how am I doing?

Blood sugar – fasting glucose is high (but not over 126), HbA1C is not ideal, but is not in the diabetic range, and fasting insulin is high.  These factors suggest to me that I am more likely VERY insulin resistant, but not necessarily diabetic yet.  The fact that my body is still pumping out that much insulin is a good thing.  My pancreas isn’t dead yet.  I’m certainly very close to type 2 diabetes, if I’m not there yet…and I know I need to take this very seriously.

Thyroid – I was hoping eating carbs would help thyroid function.  However, if TSH is a reliable marker (and Ray Peat says it is) it looks like I did best with some carbs but not many.  Of course my triglycerides were happiest with none, but you can’t please everyone.

Lipids – OMG, I’m so about to die of a heart attack.  Triglycerides absolutely not going in the right direction…HDL was highest on low carb, LDL a bit better now than it was last winter but still not good.  I have been taking very small doses of T3 every day (6mcg), but that clearly isn’t enough to have an impact on cholesterol.  Will have to increase it.

Other – That CO2 number is terrible.  What happened there?

My ability to interpret labs is limited – please feel free to add your interpretation in the comments.

And in other news, I’ve decided my gut is completely torn up from 2 rounds of antibiotics this year, and that’s why I’m having trouble tolerating the potato starch.  I’ve decided I’m going to mix it with all kinds of junk and make it into BIONIC FIBER.  (<– Imagine I said really loud with an echo.)   I’m on day 3 of probiotics.  I’m going to fix my gut biome, dammit!  But most importantly, I have baseline data for my Resistant Starch Experiment.

Ray Peat Is Awesome

I have been wanting to write this post for 2 days but my daughter has been sick…and when she’s sick she’s not sleeping and then I’m not sleeping.  So I’ve been out of my routine.  But still really excited to write this post.

The things I’m learning are CRAZY.  I mean CRAZY.  Everything I thought I knew about nutrition was undone when I went low carb.  I learned that saturated fat was good (not bad!) and that high cholesterol does not mean I’m statin-deficient.  I learned that people and companies and even entire governments lie and the lies continue on and on and on for decades until an entire nation is fat and blaming their mother for their fatness. I learned that calories in/out is not how you get fat or thin.  I learned that I shouldn’t feel ashamed of my body because I didn’t have the right information to help myself get healthy.  It wasn’t that I “lacked motivation,” was “sabotaging” myself, or was doing any of those other things popular psychology makes us think about ourselves when we’re overweight.

I lived pretty happily eating low carb/Paleo for a while.  About 6 months, actually.  And then it stopped being easy and it stopped working.  I started having cravings and finding it impossible to stick to for any stretch of time.  I gained 20 pounds and have been unable to lose them.  I didn’t blame the diet though, I blamed myself for coping poorly with a very stressful situation.  Well, I was wrong.  A low-carb diet just isn’t good long term.  It comes with a very high metabolic price tag.

And NOW, well, now I’m learning that there are even MORE misconceptions about health and nutrition.  Here are some of the Low-Carb/Paleo rules that I’ve recently learned are simply not true:

  1. Sugar is bad.
  2. Dairy is bad.
  3. Fructose is bad.
  4. A ketogenic diet rocks.

Sugar gets a bad rep because it eats up nutrients really quickly (raises your metabolism) and if you don’t have a nutrient-rich diet you’re going to have problems (like, acne, cavities, heart palpitations).  Dairy is a great source of macronutrients and micronutrients and also raises the metabolism. Fructose is an excellent (and low-glycemic) source of carbohydrate and when eaten as fruit or juice it comes with an array of important nutrients.  A ketogenic diet may work for losing weight (it didn’t for me, but it does for some folks)…but over time it results in suppression of the thyroid making a loss almost impossible to maintain and remain healthy.

So what causes people to gain weight and become unhealthy?  Dr. Peat says the answer is stress hormones.  When you don’t give your body the basic nutrition it needs (e.g., depriving it of what it needs to make glucose for energy) it adapts to keep you alive by raising stress hormones – cortisol, adrenaline, and others, which effectively slow down the metabolism to cope. Other types of stress also raise stress hormones – emotional stress, allergies, exposure to cold (yeah, I said it).

But here’s probably the coolest thing I’ve learned lately.  Those following Ray Peat’s wisdom gauge their metabolic health in part by measuring their temperatures and heart rates (HR) throughout the day. By doing this I’ve learned something very interesting.  When I eat something that causes physiological stress my temperature drops over the next hour – usually a degree or so.  Typically that is paired with an increase in HR and an unpleasant mood change/fatigue. I’m learning that these are classic signs that stress hormones have increased in my system…and that as long as stress hormones run the show I’m going to remain overweight and unhealthy.

I tested pork chops – major temp drop and heart rate increase, plus my throat and eyes became itchy and my nose ran.  It actually caused a histamine response (which increases inflammation!).  Having never had that reaction from pork before I asked my friends on the Ray Peat Facebook page what was going on.  The answer I got was this: when you start eating a non-inflammatory diet and then introduce something crappy, you’ll be much more sensitive to it.   Huh…really?  So what else is my body hating on?

I tested beef – just regular supermarket beef – not grass-fed.  Yes…a temperature drop and my throat got itchy.  I tested table sugar, coconut sugar, orange juice, milk, cheese – all of these brought my temperature up and increased heart rate somewhat – indicating an increase in metabolism (good!).  Brown rice pasta =  temp drop, increase in HR = stress hormones (plus I felt tired).  I tested candy corn, which I thought would be a thumbs up because it’s mostly sugar, but it made me feel like killing someone, plus my temp dropped and heart was racing.  Stress hormones.  I tested chocolate with soy lecithin in it – temp and HR stayed the same, so maybe a mildly poor reaction, as I would expect a temp increase from the sugar.

Well, I’m done experimenting for now.  All of the things Ray Peat says to eat have caused a positive reaction, and all the things he says to avoid (grains, additives, industrial meats) caused a poor reaction.  I think the man knows what he’s talking about.  When I just eat dairy (milk, cheese), orange juice, eggs, sugar, and salt I feel awesome!  My energy level is high and I feel happy and peaceful.  (There’s certainly more to it than just those few foods – I’ll get into protein sources in another post.)

I’ve just started tracking what I eat so I’ll give a macronutrient breakdown in a future post as well.

Checking In

I’ve been gone from the blog for a while but in the rest of my life I’ve been doing some serious thinking, researching, calculating, experimenting, and more thinking.  I’ve been in such a cerebral place lately that I don’t think I’ve made eye contact with anyone but my daughter for like a week.  I am the absentminded professor stereotype…mismatched socks, dishes piled in the sink…child eating Skittles for breakfast (hey – it was just Halloween!)…I offer a distracted wave when asked how my day was…because there is no “was” – my day is never really over when I get like this.  I just keep going and going and going until the thousand-mile stare tells me it’s time for bed.

After much consideration, I’ve decided to give Ray Peat’s principles a try.  I gave it a whirl a few weeks ago and didn’t feel awesome.  Now I realize that was because I hadn’t yet given up processed foods and starches, and I was also taking T3 – two seriously confounding variables.  In the last week I went about 5 days eating just orange juice, organic milk, cheese, some meat, liver (once), shellfish (once), and no starches, no processed foods, no thyroid hormones…and I felt great.  It didn’t last because I felt so great I wanted to experiment with ThyroGold – a version of over-the-counter thyroid hormone supplement.  And also I got sick (a cold) for the first time in about 5 months.  The combination of ThyroGold and Robitussin was not good – my heart was racing and I felt like crap.  I quit both and waited for the storm to pass.  It did, and I’m better now.  No more of either.

I want to get back to the feeling I had before I screwed it up by trying to make things even better.

Will report my progress, as well as relevant details, as usual.

 

OJ and Milk and Salt, Oh My

I’ve been trying to follow some of the diet recommendations cobbled together by followers of Ray Peat.  Dr. Peat has a Ph.D. in Biology and has written lengthy and seemingly well-researched articles outlining his theories on nutrition and health.  Although he hasn’t come out and written a diet protocol (and appears happy to share his knowledge with the world for free), he has a lot of devoted followers around the web.  I was intrigued by his thoughts because they are Just. So. Different. from what everyone else thinks.  I mean, there’s mainstream (eat less exercise more), and then there’s counterculture (low carb/high fat/paleo) and then there’s Ray Peat.  Ray Peat makes low carb/high fat look mainstream.  If he was a planet, he’d be Pluto.  If he was an animal he’d be a bongo.  If he was an astrophysical concept, he’d be dark matter.

Intriguing, yet obscure.

Those who follow his teachings advocate increasing metabolic rate by eating lots and lots of sugar – preferably orange juice for it’s micronutrient properties – up to hundreds of grams of sugar per day, and drinking lots of and lots of milk – up to 2 quarts per day – for the calcium.  They recommend adding salt and/or sugar to milk or OJ, again to boost metabolism.  Protein should be eaten in moderation (about 100g/day).  Vegetables and exercise are a waste of time at best and harmful at worst.  Shellfish and liver should be consumed around once per week.  It’s all very well thought out, and as I mentioned, very well annotated and documented. I would have to spend a LOT more time combing through his writings to really understand where these conclusions come from.    I haven’t devoted that much time.  But just for kicks I decided to try out eating this way for a few days, just to see how I feel.

I was concerned about eating all that sugar.  One of my main problems is my struggle to lower my fasting blood sugar (and probably my post-prandial blood sugar, but I haven’t been testing that).  I was sure this would tip me over the end to full on hyperglycemia, so I haven’t been eating HUNDREDS of grams of sugar, but I’ve been drinking about 3 16-oz servings of OJ per day for a few days, each of which contains 44g of sugar – around 132g right there.  I’ve eaten some starch also – I’ve had rice one day (in the evening) and some gluten-free bread here and there.  I’ve also eaten some gluten-free cookies (one each day for the last few days).  (Note: Peat does not appear to advocate much starch intake, so my experiment is not without confounding variables.)

Well, the last few days my blood sugar has hovered between 95 and 110 – lower than it was when I was eating low-carb.  Interesting…eating more fruit sugar does not make blood sugar higher…not within 3 days, anyway.

How do I feel?  Well, I initially felt alright.  It was kind of nice tasting something sweet after so long not doing so.  It’s been literally YEARS since I’ve had more than 10-20 grams of sugar in one day.  I didn’t seem to have the hypoglycemia when I got hungry anymore…I just got gradually hungry instead of having my blood sugar bottom out several times a day.

What I didn’t love so much – heartburn…from all the OJ?  I had to raid the 2-year old jar of antacids in the back of the linen closet.  I haven’t needed them since I was pregnant 4 years ago, but I’ve needed them several times over the last few days.  Also lots of napping.  I seem to be taking a 2-hour nap every day.  That could be from adjusting to the T3 – maybe I’m not sleeping as soundly at night as I was before?  Or it could be Reactive Hypoglycemia from the sugar?  I haven’t needed naps during the day since the last time I ate lots of carbs, over 2 years ago.  Also I feel like I’m retaining water from eating lots of salt.

In any case, I’ve decided to table the Ray Peat diet for a while and just see how my body responds to T3.  Later on I may try this again.

T3 and Cravings

Well I’ve been experimenting with taking T3 (thyroid hormone) as I learn more about energy metabolism and thyroid health.  One thing I learned (as I sit writing this at 4AM) is that you shouldn’t take T3 in the evening.  It will fuck with your sleep.  Good to know!

In general I feel fine and actually better in the 3 days since I started taking T3. I’ve been splitting the little 25mcg tablet into 4 or 5 doses and experimenting with how far apart to take them.  I’ve had no hyper symptoms (except not being able to sleep, but lesson learned regarding the timing).  Day 1 I took only 1/6 of a tablet – about 4mcg.  I felt fine, no overt effect.  Day 2 I took two doses of about 6mcg each, felt fine.  Day 3 (yesterday) I took the entire pill spread out across the day in 4 doses. Felt good.  I’ve been forgetting to take my usual caffeine pill, so apparently there’s a little boost in energy.  I think I’ll continue along taking the equivalent of one 25mcg pill split up into small doses every 3 hours or so.  I’m also going to start taking my temperature throughout the day.  Temperature and heart rate can apparently be used to gauge dips in metabolism efficiency.

A few weeks ago I was at my parents’ house.  My mom (the forever-dieter) confessed to me that she had eaten an entire jar of peanut butter than we left over at her place.  I said to her, “Well Mom, maybe your body needed it.”  Most of her adult life she’s repeatedly (without success) pursued low-cal, low-fat dieting as the key to health and happiness.  Similarly, I finally got her to give up her trans-fat laden margarine for a margarine that doesn’t contain trans fats (butter would not even be considered…it’s a dietary evil in that house).  A couple weeks later she said she had to go back to the original margarine because the other one tasted so good she just kept eating too much of it.

Again, Mom…maybe your body needed it.

It was easy for me to see this when we were talking about her, but when it’s my behavior I’m analyzing all of my judgments get in the way about what I should/shouldn’t be doing or eating.  It’s an interesting idea though…maybe if you just give in to every craving your body will work through it and come out better on the other end.

Yesterday I was craving cheese melted on bread. We have gluten-free bread in the house, but I’ve been considering bread (starch, carbs) the devil for so long that I don’t even consider it as an option.  So I ate the cheese.  10 minutes later…still thinking about cheese and bread.  Ate more cheese.  Finally after about 4 different snacks, all trying to substitute for what I really wanted, I just had the damn cheese and bread.  Seriously.  These kind of mind games make one obsessed with food, eating, dieting, and the self-flagellation that comes from creating dietary rules that then must be followed.

I’m considering just following every instinct, completely independent of dogma and diet guidelines, and just listening to my body for a few weeks.  While I’m at it maybe I’ll put the scale in the garage.