Thyroid problems, digestive issues and acne: low carb or moderate carb diet best? page

[QuirkyPixy]

Howdy all!

I've been dealing with some health problems (hypothyroid, elevated cortisol, undiagnosed digestive stuff[dysbiosis?]) and acne for over a year now, and am confused on which approach to take to help with these issues: low carb or moderate carb.

I've read that low carb helps with acne but isn't good for the thyroid, and I've read that carbs may flare up acne and exacerbate gut dysbiosis issues. But I'm also trying to gain weight and stimulate my thyroid, and therefore I'm not sure if ketosis is bad for me or not. I'm currently in ketosis out of fear of flaring up my acne with carbs but am feeling like a cabbage, so I think I'm doin' it wrong.

My thyroid tests in July (pre-primal) were this:
TSH: 3.4, up from 0.95 one year prior
Free T4: 1.21 ng/dL (.82-1.77)
Free T3: 2.9 pg/mL (2.0-4.4)
TPO: 8 IU/mL (0-34)
Antithyroglobulin AB: <20 IU/mL (0-40)

And two weeks ago, after approx 5 months primal, my labs were this:
Vitamin D: 86 ng/mL (30-100)
Ferritin: 40 ng/mL (11-307)
TSH: 1.25 uIU/mL (0.34-5.60)
Free T3: 2.33 pg/mL (2.50-3.90) LOW
Free T4: 0.99 ng/dL (0.54-1.24)

Upper GI series with small bowel follow-through was totally normal.

And as far as auto-immune stuff, I think I'm in the clear:
ESR: 16 (0-20)
ANA: negative
Lyme Antibody AB: negative
Gliadin Antibodies (IgG, IgA): negative (but saliva IgA was positive. huh?)
ANA: negative
RPR: non-reactive

And here's the cortisol results:

Screenshot-2..jpg

My doctor is good and is ordering some stool tests (culture, o & p with Giardia antigen, cryptosporidiosis, c. diff antigen), but I'm not sure where to go from there and I don't think he is either.

I currently take 30mg of Armour thyroid (started Tuesday), Vitamin D, Magnesium, Zinc, Selenium, Vitamin C, and Iron.

Any suggestions? This is an awful lot for me to piece through, and I'm not sure what approach I should be taking here.

[Jyoti]

Low carb is always best, but I'm almost positive you've got other issues going on. I think you're on the right track with intestinal dysbiosis, which has to get cleared up first. That's also probably what's driving your adrenal glands so hard, which in turn suppress thyroid function (although FIRST, make. Darn. Sure. that it's not autoimmune-related, because almost all thyroid issues ARE). Removing sugars from your diet will certainly stop feeding certain organisms, but other organisms (such as certain parasites) LOVE high-protein Iron-containing foods like beef and dark chicken meat, so a good diet alone won't kill them off.

First, get thyroid labs, including antibodies (although these ab tests are often false-negative, a positive result is definitive). And don't just test TSH, either.
Next, get your GI tested (usually a stool analysis, although most doctors will look at you funny if you mention it - try to find someone with a clue ). I wouldn't just shoot in the dark on GI issues - I don't see peoples' health return until they're cleared up (including myself), no matter what else they're doing right, and there's a LOT of overlap between symptoms of candida, other types of dysbiosis, hormonal issues, and food intolerances. Best to know for sure.
Then, of course, go completely Primal - as in, the whole lifestyle. The nutrition/dietary part ROCKS, and most of us really do need to play more. What got you (and all of us) into our mess in the first place is not only a poor diet before, but also STRESS. Stress suppresses stomach acid secretion, which then robs you of your nutrients and severely disturbs the normal healthy balance of good gut flora. Stress can be found EVERYWHERE; our society is designed for it, so fight back. Turn OFF the news. Log OFF of Facebook every once in a while. Don't talk very often with the friends or family members who love to stir up drama. Move closer to work, or work closer to home (or work FROM home). Most people don't realize what a stressful waste of a life it is to sit in traffic 2 hours every day - ugh! Lol

Hope that helps

[profdjj]

I second the thyroid recommendation. You must have a full panel done (TSH, T4, and T3) and make sure your doctor is listening to your symptons. Just because you're in their precious "normal range" doesn't mean you aren't suffering. If your doctor won't listen to you, get another doctor.

From a nutrition standpoint, there's not a lot you can do. I've been hypo for 5 years and eating low carb works best for me. You should stay away from raw goitrogenic foods (like Broccoli, Brussel sprouts, Cabbage, Cauliflower) but cooked is fine. You're also supposed to stay away from peanut butter which can limit thyroid hormone production.

While I don't necessarily go looking for these "bad thyroid foods", I don't refuse to eat them.

Darlena

[QuirkyPixy]

I just posted my labs; probably should have posted them to begin with!

@ Jyoti: Why do you say low carb is always best? I definitely have other issues here. I've had digestive problems since birth (parents had to feed me only soy formula as a baby as it was all I could keep down), and was on Amoxicillan for at least a year when I was 3 or 4 yrs old. The issues flared up a few months after a week-long course of Ciprofloxacin, which is why my bets are on dysbiosis. I agree that the gut problems likely caused the thyroid problems, as I didn't get the thyroid symptoms until several months after the digestive issues worsened.

If I have any TPO antibodies, is it auto-immune? Mine are all in range.

Also, I am pretty much 100% primal now, and have been for a few months, but I'm not feeling much better, which is what leads me to believe that I might need to tweak something. I definitely need to work on stress reduction, haha. You're right that the "play" part is super important, and I'm trying to shift my focus to that but it's hard when I'm not feeling so great.

@ profdjj: My doctor is great in that he prescribed me Armour thyroid solely based on my symptoms and low T3 even though my other numbers were "normal." He is very helpful, so no problem there! And I don't eat many raw foods so I think I'm OK as far as goitrogens go. Glad to hear that low carb works for you despite your hypothyroid. About how many carbs do you eat daily? Do you eat fruit?

Thanks again for the help you guys!

[slacker]

Make sure your C, D and minerals, including selenium intakes are OK. Selenium deficiency will cause low thyroid symptoms, but your thyroid levels will nonetheless come back normal or near-normal. Do not exceed 400 mcg -- that's micrograms -- per day from all sources, as it is quickly toxic taken in excess. Coconut oil is also your friend.

[slacker]

...also...

Avoid fried food at all costs. This includes all chips, etc. that are factory fried. If you crave fat, take coconut oil.

[Pandadude]

Indeed selenium deficiency is the most widespread deficiency in the US, and whether "good sources" contain any appreciable amount at all depends on the soil where crops were grown.

I don't know much about thyroid, but acne was the reason I went primal. It never cleared me up on its own, even when I was dairy free or VLC, but it did make it less inflamed (as a side note, I think ive finally outgrown it, hooray!). Any numer of vitramin/mineral deficiencies could trigger or worsen acne, so if it's possible for you to test for these that would probably be very helpful for you (some will recommend high dose zinc/vit a/whatever as a cure for everyone, but it's just because it's common to be low in these nutrients on a standard diet).

If you have any gut issues that could certainly also be a trigger, and for me bouts of indigestion would be linked to breakouts. Fermented foods or a good probiotic can help with this, but determining why you have gut issues in the first place and removing the cause is obviously also key.

Pretty standard answer, but hope you find a way to fix it

[emmie]

I can only help with the hypothyroid--I've been hypo for about 10 years. That low T3 is the issue for you, since that's the hormone that controls how we feel. The Armour should help, but I'd suggest you get at least 30g-50g of carbs daily, as much as possible from veggies. There's nothing in our way of eating that can heal the thyroid (supplemental hormones as needed), but that carb level will support thyroid function. Any lower carbs may lower thyroid hormone levels.

Keep in mind that if you need to go VLC for any reason, your T3 may drop (mine did), but your doctor can adjust your T3 supplement to compensate.

[Jyoti]

@ Jyoti: Why do you say low carb is always best?

Just cuz I can't think of any situation where high-carb is better.

I definitely have other issues here. I've had digestive problems since birth (parents had to feed me only soy formula as a baby as it was all I could keep down), and was on Amoxicillan for at least a year when I was 3 or 4 yrs old.

Were you breast fed? If so, for how long? (Makes a big difference - lifelong.)

The issues flared up a few months after a week-long course of Ciprofloxacin, which is why my bets are on dysbiosis. I agree that the gut problems likely caused the thyroid problems, as I didn't get the thyroid symptoms until several months after the digestive issues worsened.

Makes sense. Leaky gut is the culprit behind the mechanism that activates autoimmune disorders in the genetically predisposed. Thyroid gland is a major target.

If I have any TPO antibodies, is it auto-immune? Mine are all in range.

Yep, can still be autoimmune. I see a lot of false-negatives in my practice.

Also, I am pretty much 100% primal now, and have been for a few months, but I'm not feeling much better, which is what leads me to believe that I might need to tweak something. I definitely need to work on stress reduction, haha. You're right that the "play" part is super important, and I'm trying to shift my focus to that but it's hard when I'm not feeling so great.

I completely understand your frustration. Until the dysbiosis (a fancy umbrella term for gut bug of any type) is resolved, your improvement will be limited and blunted. These things wreak havoc for decades.

A note about the anti-gliadin antibodies - if you're EVER positive (or even borderline) you're definitely positive. Even if one test comes back negative and another is positive, consider yourself completely positive. Primal is awesome for gluten-reactive people (which you are - don't feel bad, so is practically everyone else ) - your main source of contamination will be restaurants and any food you get in bulk bins, as well as conveyor-belt contamination in boxed/processed foods (if you eat them).

Hope that helps

[QuirkyPixy]

@ Slacker: I supplement with all of those things, D levels are great, and I eat a lot of coconut oil. All of those things have helped a little bit with my thyroid symptoms though (namely, energy levels), so good suggestions.

@ Pandadude: Thanks for the help! It does all circle back to the gut issues, I'm sure; I too have noticed correlations between gut and skin flare-ups. Must be a huge relief to be growing out of your acne.

@ emmie: Totally can do 30-50g of carbs, no problem! Thanks for the input.

@ Jyoti: I was breast-fed for about a month, then fed solely soy formula (Isomil circa 1988, no fancy omega-3 and vitamin fortification back then). So, am I screwed for life, then?

So if it's dysbiosis, is the plan of attack something like the GAPS diet + large doses of probiotics? I haven't a clue how to go about this, and the docs and naturopaths I've seen are equally puzzled.

Good to know about the anti-gliadin antibodies. I only tested positive on the saliva test, which I'm not sure is accurate. I won't be able to go entirely gluten-free until I find a new job (I work part-time at a bakery), but when I get a chance to do it again I'll be sure to be more careful about those sources of cross-contamination.

Thanks again for the help!!