Intermittent Fasting as a Therapy for Hypothyroidism

Reader Adam Kadela has begun intermittent fasting and wonders how it might affect his hypothyroidism:

I have a question pertaining to the section at the end of the book covering extended fasts. I regularly practice the 16-8 fast/feast protocol (breakfast at noon, last meal before eight), and plan to throw in a 36 hour fast once a month per your book. However, I am hypothyroid (hashimoto’s) and take synthetic T4 and T3 (unithroid and cytomel), so I’m wondering if an extended fast could affect my thyroid function negatively.

This is a great question. I think the daily 16-hour fast should be therapeutic for hypothyroidism, but I’m not sure about the 36-hour fast.

In today’s post I want to talk about why daily intermittent fasting may be therapeutic for Hashimoto’s, which is an autoimmune hypothyroidism.

Food Sets The Circadian Clock

The circadian clock is strongly influenced by diet: indeed, food intake dominates light in setting the circadian clock. If you regularly eat at night and fast during the day, the body will start treating night as day and day as night. [1]

(Alcohol consumption at night will also tend to reset the clock, which may explain why college students are often night owls!)

This suggests that controlling the timing of food consumption can help to maintain circadian rhythms.

The Circadian Clock and Hypothyroidism

The thyroid follows circadian rhythms. There is a circadian pattern to TSH levels:  high at night, low during the day.

The thyroid’s circadian pattern is diminished in autoimmune hypothyroidism. In a study of hypothyroid children, the night-time surge of TSH averaged 22%, compared to 124% in normal children. Only one of 13 hypothyroid children had a night-time TSH surge in the normal range. [2]

The study authors concluded:

We suggest that the nocturnal surge of TSH is important for maintenance of thyroid function and conclude that the nocturnal TSH surge is a much more sensitive test than the TSH response to TRH for the diagnosis of central hypothyroidism. [2]

Shift Work and Hypothyroidism

If circadian rhythms are important for thyroid function, we would expect shift workers to have high rates of hypothyroidism. Shift workers sleep during the day and eat at night, which disrupts circadian rhythms.

It turns out that shift work doubles the risk of autoimmune hypothyroidism:

Stress induces autoimmune disorders by affecting the immune response modulation. Recent studies have shown that shift work stress may enhance the onset of the autoimmune Graves hyperthyroidism. On the other hand, the possible association between occupational stress and autoimmune hypothyroidism has not yet been investigated…. Subclinical autoimmune hypothyroidism was diagnosed in 7.7 percent shift workers and in 3.8 percent day-time workers with a statistically significant difference: Odds Ratio (OR) 2.12, 95 percent Confidence Interval (CI) 1.05 to 4.29; p=0.03…. Our data show a significant association between shift work and autoimmune hypothyroidism. This finding may have implications in the health surveillance programs. [3]

Shift Work Affected Adam Too

In a follow up email, Adam told me that night shift work may have helped cause his hypothyroidism:

[T]he paper about thyroid and fasting … is particularly interesting to me due to my experience with night shift work for 10 months last year. My circadian rhythm was all out of whack due to experimenting with different sleep schedules and trying to workout around midnight before going into work at two a.m. I also played around with different diet strategies (grazing method w/ small meals, warrior diet, and ultimately settling on the 16-8, which is by far superior imo). My thyroid, along with other hormones, did not enjoy these trials.

Intermittent Fasting May Be Therapeutic

Since the circadian rhythm is affected by both food and light exposure, lifestyle practices can enhance natural circadian rhythms. These practices should optimize the circadian cycle:

  • Light entrainment:  Get daytime sun exposure, and sleep in a totally darkened room.
  • Daytime feeding: Eat during daylight hours, so that food rhythms and light rhythms are in synch.
  • Intermittent fasting: Concentrate food intake during an 8-hour window during daylight hours, preferably the afternoon. A 16-hour fast leading to lower blood sugar and insulin levels, and the more intense hormonal response to food that results from concentration of daily calories into a short 8-hour time window, will accentuate the diurnal rhythm.
  • Adequate carb intake:  Eat at least 400 “safe starch” carbohydrate calories daily during the afternoon feeding window. Relative to a very low-carb diet, this will increase daytime insulin release and, by increasing insulin sensitivity, may reduce fasting insulin levels. It will thus enhance diurnal insulin rhythm.

Adam tells me that intermittent fasting seems to be improving his hypothyroidism:

I think you’re correct in that I’ve experienced some curative effects. However, with the improved nutrient absorption and gut health from healthier eating and fasting, I think I fluctuate a lot b/w slightly hypo, normal, and hyper, since my medication is constant. I’m still in the process of finding a balance, but it’s a bigger improvement than my past state.

Conclusion

Many doctors mistakenly assume that little can be done to cure autoimmune disorders. In fact, however, autoimmune conditions commonly disappear once the chronic infections, food toxins, or poor health practices that cause them are eliminated.

Circadian rhythms have powerful influences on many biological processes, and disrupted circadian rhythms are a common feature of disease. Without clinical trials it’s impossible to be sure, but efforts to enhance circadian rhythms may be therapeutic for diseases such as hypothyroidism.

Intermittent fasting, daytime light exposure, excluding light from the bedroom, night fasting and daytime feeding are simple practices. But they may be underappreciated keys to good health.

References

[1] Fuller PM et al. Differential rescue of light- and food-entrainable circadian rhythms. Science. 2008 May 23;320(5879):1074-7. http://pmid.us/18497298.

[2] Rose SR et al. Hypothyroidism and deficiency of the nocturnal thyrotropin surge in children with hypothalamic-pituitary disorders. J Clin Endocrinol Metab. 1990 Jun;70(6):1750-5. http://pmid.us/2112153.

[3] Magrini A et al. Shift work and autoimmune thyroid disorders. Int J Immunopathol Pharmacol. 2006 Oct-Dec;19(4 Suppl):31-6. http://pmid.us/17291404.

Leave a comment ?

126 Comments.

  1. I have Hashimotos, so anything on this topic is interesting to me. I’m not on any thyroid meds though, so I’m experimenting with how to stay off them.
    This could be another experiment.
    Since I first found out I had it I’ve managed to get my TSH down – now borderline high, and anti-bodies down, but still quite high. T3 T4 low normal but I have no clinical symptoms.
    I’ve been paleo – strict gluten free, I also add a variety of organ meats, liver, hearts, etc. Try to balance n-3:6’s, take vit D, selenium, magnesium.
    I did try iodine earlier this year, but had a very negative experience, enlarged thyroid, weight gain, and my TSH rocketed up. So I stick to Dr K’s advice not to supplement iodine. I just have a little seaweed only and that’s okay.
    Thanks for the article.

  2. Nice post! I was unaware of the mechanisms underlying intermittent fasting which improves health. Thanks for sharing this information.

  3. I am hypothyroid, too, so this post also interests me. I mentioned what you said about the timing of eating setting the circadian rhythm to my husband (a research biochemist), and he said, “makes sense, because the liver sets the circadian clock”. When I pressed for more details he didn’t know, he just remembered hearing about the liver in a talk at some point.

    Do you know more about this?

  4. I may not have understood your post correctly but if food sensing affects circadian rhythm, why would fasting during the day improve hypothyroidism? Wouldn’t this send signals to the body that are more similar to when the body is sleeping?

  5. Hi julianne,

    I think iodine has to be increased very slowly. It takes a month to adapt to a doubling of iodine in my experience, so going up from a little seaweed to one Iodoral tablet ought to take 6 months. I spent 4 months and had mild goiter and hyper symptoms several times.

    Hi Anna,

    The hypothalamus is the primary clock-keeping organ I think, but every cell has its own circadian rhythms and the liver is certainly a major circadian player. I will do a post about metabolic syndrome and circadian rhythms at some point, and circadian rhythms will come into the zero-carb dangers series too. I have a feeling research is still at early stages — circadian rhythms touch almost everything, so it’s hard to disentangle their role.

    Hi woly,

    The key is that the feeding window should be in daylight hours.

    Given that all feeding is done in daytime, I think extending the fast would accentuate the diurnal rhythm, even if the fast extends into daylight hours.

    It’s an open question I think whether it would be better to feed in the morning or afternoon. Morning is the time of peak insulin sensitivity and highest blood glucose levels. I tend to suspect afternoon feeding would have been more common in the Paleolithic (after some hunting and gathering). But the world’s oldest man, Walter Breunig, practices morning feeding and afternoon fasting: http://perfecthealthdiet.com/?p=401.

    Best, Paul

  6. I was diagnosed with Hashimoto about 2 years ago, after a annual checkup. I did not and still not have any significant symptom. I only had a slight increase in weight and thyroid volume.

    In these two years, I have tried to learn as much as I can about Hashimoto. Two things that I know for a fact have had quite an impact on my blood tests are: gluten and mercury (from removal of 12 amalgams).

    Iodine (I take 50mg) has not affected my antibodies neither for good or bad, but helped to increase my body temp from 96.8ºF (I have had this temperature since my childhood) to 98.6ºF. TSH increased temporarily, for about 3 months, and then started to fall. No impact on T3 and T4 (total or free).

    Bromide contamination (among others endocrine disruptors) is very high nowadays. And I don’t know a better way to get rid of it other than taking iodine, selenium and some sodium from sea salt:

    http://www.ncbi.nlm.nih.gov/pubmed/16601782
    http://www.ncbi.nlm.nih.gov/pubmed/15717853

    To get an idea of how high are bromide levels, take a look at this recent research from China:

    http://www.ncbi.nlm.nih.gov/pubmed/20715770

    Iodine: 2.68 (0.51-10.5) ng/mL
    Bromide: 2120 (1050-4850) ng/mL !!

  7. Very thought provoking! Would you expect similar results for non-immune mediated hypothyroidism? Also, how long might it take to see improvements in thyroid symptoms or actual lab markers after adapting these changes?

  8. Thanks Mario! I also believe in iodine.

    Hi Rodney,

    According to the papers, it should work for central hypothyroidism as well as autoimmune.

    I don’t think this will be curative by itself, but it should improve thyroid function a bit. I don’t know how quickly improvements would be noticeable. I would welcome feedback from anyone who tries this.

    We believe in doing a lot of helpful little things, and influencing the body in a positive direction. How the body heals itself is mysterious, but supporting natural processes seems to be the most effective approach to overcoming disease.

    Best, Paul

  9. Great follow up post to our emails Paul. One thing I’ll add is that I was hypo for eight years prior to working nights. Upsetting my circadian rhythm dramatically made things worse and my symptoms more pronounced.

    It wasn’t until I switched back to a normal schedule and adopted many of the recommendations from this site and others like it that I returned to a “normal” state.

    As for the fasting, I think the greatest benefit from it is improved digestion and overall gut health. When the body can absorb nutrients better, it has the tools to support those natural processes that heal disease and keep us healthy.

  10. I started a paleo style diet with IF (10 hour window) this past April 2010. Great results the first 2 months in that all my joint pain went away, got very lean while maintaining good muscle mass, skin improved dramatically…smooth and clear with no acne or psoriasis.
    I was eating what I thought was low carb but in retrospect, as Paul has pointed out, it must have been very low carb, mostly vegetables and meat, eggs, yogurt, and some white rice.

    Month 3, I hit a wall in that I had zero energy and felt like cr@p even though my calories were good. Estimate 2500, I’m 5 9 1/2, starting weight in April at 185# went to 160# in 3 months. I was not trying to lose wait but hung in there until the energy issue forced me to add carbs and I removed the 10 hour eating window and went to 3 meals spread out.

    I’m still gluten free but eat alot of rice and sweet potatoes and my energy has returned to normal. But the joint pain is back, weight is up to 166#, lost some hair when I reintroduced carbs as well.

    I have Paul’s book due any day from B&N and have many questions, but I thought I would read it first. (I suspect infections). I thought I would just drop a little story here in the mean time.

    Regards and love this blog, thanks.

  11. Hi Perry,

    That’s interesting. Infections could be contributing to the problem – and increasing your glucose requirement. The two-month time frame for problems to appear, however, suggests that some kind of nutrient deficiency was developing. Many nutrients become depleted only gradually and deficiency symptoms will appear after a few months. My scurvy symptoms started 8 months or so after I went zero-carb.

    The most common very low-carb nutrient deficiencies seem to be in antioxidants (selenium, C, glutathione, zinc, copper) but there are probably other deficiencies that develop.

    The infection and nutrient deficiency possibilities are connected, since infections will raise nutrient requirements, especially for the antioxidant nutrients.

    I’ll look forward to your questions, Perry!

    Best, Paul

  12. Re: reducing carbs and nutrient deficiencies. With time, I’ve found I’m just not very hungry. I wonder how many people eat to appetite, and the appetite is low, and the diet becomes lacking in nutrients.

  13. Hi Michelle,

    It’s a possibility … But I’ve also found that the more micronutrients I supplement, the lower my appetite, and when I had scurvy, I was ravenously hungry .. So I think micronutrient status is a big influence on appetite. But I don’t know which micronutrients are able to generate appetite when they are deficient. Surely not all.

  14. With regards to appetite and nutrient deficiencies – I’ve noticed this too. If I just start craving food, even though there is no particular reason I should be hungry I’ve found a good multi plus a few other supplements and the problem is fixed. Since I’ve been eating organ meats weekly though, I’ve not had any cravings. Getting just enough starch too is important for me.

  15. Perry,
    Have you ever been tested for HLAB27 gene? Starch consumption is linked with joint pain for some with this.

    I have a client with this and she can’t tolerate any starch, or even the filler in her multivite. She is pain free without starch and uses small quantities of fruit to get enough carb calories. She can eat any amount of non starch vegges too. She can’t even eat glucose as it is derived from starchy grains and triggers pain.

  16. Paul, I have been living in Alaska for the past 2 1/2 years. I believe the sunlight factors here can have some very unhealthy effects. Currently we have sunrise at about 10am and sunset at about 4pm. Summers are completely opposite with about 18-19 hours of straight sunlight.

    Since it gets dark before I get off work and have a chance to cook dinner, would it be wise to eat a larger lunch or even skip dinner a few times a week to try and normalize my circadian clock?

  17. Thanks, julianne! In my case the influence of C on appetite was so clear – as soon as I started supplementing, appetite diminished dramatically – that I became convinced that micronutrition is key to appetite. Now that my micronutrition is good, I find that I am content eating very few calories. Maybe 1500 calories per day. Yet I still gain muscle and weight. Somehow micronutrient deficiencies make the body waste a lot of calories.

    Thanks also for the info about starch intolerance.

    Hi Tyler,

    Perhaps you should consider a light box / UV lamp for use indoors, perhaps even at work? That would more directly address the light issues.

    Work schedules can be hard to combine with intermittent fasting, daytime eating, and shopping and cooking at home (which is so important for nutrition). So compromises have to be made. That’s why we usually eat around 8 pm, well after sunset. You have to try to find what works best for you.

    I think if you pick one side of work to refrain from eating on, so that you have a sleep plus work fast or work plus sleep fast, then you are doing great. Have lunch or a snack midway through work, then the main meal on one side of work, nothing on the other.

  18. Thanks very much for that info Julianne, I was unaware of that gene and the starch intolerance connection. I do know that right now, small amounts of fruit would not be enough to fend off the glucose deficency I experienced when I initially very low carbed. (there’s’ a verb for you!)

    I was eating some rice, yogurt, and berries and it wasn’t enough. I am trying to figure out why I had the glucose problem, i.e, infection, nutrient deficiency, or some other factor such as lead poisoning.

    I did a long project about 4 years back and stupidly exposed myself for a decent period of time. Shortly afterward I started experiencing problems (other than the joint pain which has been with me about 10 years, I’m 47) such as ringing in the ears and heart pain like little stabs that are not demand related and usually occur when relaxed. Calcium score is zero, nuclear stress test clear and the Cardiologist is unconcerned.

    A blood test for lead levels last month (finally checking it, never occurred to me) was only 4 in what ever units, which is not high but it may be out of blood and in bone and tissue at this point, but I really don’t know. I do know that very low carb completely took the chest pain away and it returned when I added starch back. The tinnitus has been unaffected.

    The joint pain seems more gout related although I have never been diagnosed with that and in a recent checkup, uric acid levels were 5.5 mg/dl which is in the healthy range, not too high. I lean towards the low carb, high fat and protein as having been a trigger though.

    Well enough of me rambling, thanks to all.

  19. It is common for women to develop thyroid problems post-partum. I had always assumed it was due to the rapid changes in hormones. However, it might be due to the wretched sleep when one has a newborn.

  20. Hi Emily, Interesting thought. I see 5% to 9% of women get postpartum thyroiditis, which is the same rate among shift workers. I think shift work is probably a more severe circadian disruption. If fathers got postpartum thyroiditis at similar rates then I would believe in sleep deprivation as the cause, but I can’t find any data on male postpartum hypothyroidism. This paper (http://www.ncbi.nlm.nih.gov/pubmed/20421883) blames immune dysregulation during the pregnancy.

    • Do you have any children, Paul? You may not be aware that, in most cases, women take the brunt of the sleep deprivation. Some of it is cultural (many men just aren’t willing to lose the sleep), some of it is economic (many men have to go to work in the morning while the mother stays at home, and so the couple chooses to protect male sleep), and some of it is biological (women who are breastfeeding must wake up to do so, but men are not needed for this, and so are allowed to sleep through). Out of all of the many couples I have spoken to since I had my son, I have only met one where the man woke up as often as the woman at night.

  21. Paul
    Your energy intake of 1500Cal seems astounding to me. Was that a typographical error? From your book (or posts)I have the idea that your weight is ~ 180lbs. I weigh 150lbs,am moderately active, follow a diet very close to the one you recommend. My energy intake is 2600-2700Cal and I lose weight easily (unintentionally)if I increase activity.

  22. Hi Morris,

    I’ve been busy at work and very inactive, just sitting in a chair all day, so that may have something to do with it. But my appetite has been very low. I fast until afternoon, and frequently eat one meal only, or a few snacks.

    I haven’t measured food to count calories, but I’m fairly confident I’m eating about half what I was a year ago. 1500 is just a ballpark number. And there are days I eat 3000.

    Today I had a bowl of cranberries, baby spinach, and coconut oil; 3 egg yolks; half a sweet potato; a bowl of fish head soup; and a bowl of beef tendon stew (potatoes and carrots and a bit of rice with the beef tendon). These are typical cereal bowls.

    Looking at nutritiondata.com, the egg yolks had 150 calories, the coconut oil was probably 3 tbsp or 400 calories, the half sweet potato was maybe 50 calories, the fish head soup had a bit of meat with some onions and might have been 200 calories, and the beef tendon stew might have been 500 calories. That adds up to 1300 calories. This was less than I usually eat so probably 1500 calories is too low as an average — I guess I’d say 1800-2000 is probably more accurate — but I definitely am eating much less than I used to.

    I’ve been in this eating pattern for most of 2010.

  23. Hi Paul
    That is interesting and suggests that adapaptation may be at work. There was a reason for my comment re your energy intake ie whether energy requirements go with immune system activity? In my case, 4 months into a rigorous diet (66F/16C/18P)I am consuming almost 500Cal above conventional recommendation for my weight and age, yet I am slowly losing small amount of fat but (just) maintaining weight. I am confident of the accuracy of my current energy intake and esimate that my HC diet was about 2100 Cal or 5-600 Cal less. Prior to the diet change I was of normal weight and suffered from a longstanding periodontal infection and less certainly from other infections (ie small symptoms). There have been a number of positive but small/unmistakeable improvements in bio-markers and a large inprovement in my gums and I feel great. So it may be that there is a temporary higher energy requirement?

  24. Hi Morris,

    Like julianne the strongest correlation with appetite for me is micronutritional status. I wrote the micronutrition part of the book at the beginning of this year, did a lot of research for it, and increased my vitamin and mineral consumption as a result. My appetite seemed to decrease after that.

    Three years ago, my appetite decreased a lot when I added vitamin C.

    When I first went low-carb my appetite increased. But I was malnourished then. When I had scurvy I was probably eating >4,000 calories a day but losing weight. Now I eat half that and maintain a larger weight.

    I’m not sure what’s responsible for the increased appetite in your case, but I would try adding micronutrition and seeing if anything changes. I think your macronutrient ratio is excellent.

  25. My husband slept great after both girls were born – until I kicked him to go get him to change a diaper. I do think women are lighter sleepers than men, especially those first few years after a baby is born.

  26. Heh. Well, it would be very interesting to measure TSH levels in both parents before and 3 months after delivery. Maybe some hospital will do a pilot study sometime.

  27. Emily – you hit the nail on head. Exceptions are out there, I’m know, but by and large, it’s the moms who suffer the most sleep deprivation with newborn infants.

    I couldn’t sleep at all with my newborn in the same room (neither of us could sleep with him in the same bed, and I wasn’t going to kick my husband out of bed to make room, either). I heard every tiny noise my baby made while he slept (who knew babies were so noisy while sleeping?). At 6 weeks, to get some sleep, I moved him into his room down the hall (both doors open) and finally got some sleep. At 7 weeks, he was sleeping 11pm-5 or 6 am (we all were!) and generally remained an extremely good sleeper all the way through infancy and toddlerhood (eventually reaching 11-12-even 13 hour nights at one point). I still had to get up at 5 am to pump a bit of milk to avoid leaking (because the milk factory doesn’t hold production at night while baby sleeps).

    Now and then a growth spurt or developmental change would disrupt his sleep pattern, and I’d be halfway down the hall before I realized I’d heard something and was awake. I learned to turn around, wake up my husband to take care of the comforting, and I’d go back to sleep.

  28. Great post!

    I did IF religiously (Fast 5) for almost four months back in 2009. I initially lost weight but quickly plateaued out again. Several on discussion forums wondered whether IF further suppressed the thyroid. Never had mine tested, but my metabolism seems to be a bit sluggish, moreso with prolonged low carbing.

    I might try it again following PH guidelines as an experiment. I’m thinking light entrainment (not so much the daylight but the night time) needs to be addressed as well. Hubby likes to sleep with the TV on 🙁

    I’m about 1/3rd way through the book with the holidays and all. I’ll try to pick up my pace 🙂

  29. Carbsane – Perhaps the Victorians had the right idea with their separate bedrooms!

  30. interesting post!
    I have just started being treated for hypothyroidism with a very low dose of armour to start and my doctor has prescribed a 9 day fast which includes 4 days of vitamin and amino acid rich shake in the morning and dinner and main meal at lunch consisting of protein and vegetables and then 2 days of just shake repeated for nine days. i have read that that fasting can impede your thyroid function. could this kind of fasting be a problem and make matter worse? he feels that this will get my metabolism to burn more fat. he says also that it is packed full of nutrients.

    thank you

  31. Hi Loretta,

    Well, you have an innovative doctor!

    I like his willingness to experiment with fasting and low-carb dieting, both of which tend to bring a lot of health benefits, but I am not sure that his advice is optimal. For one, I don’t agree with protein shakes. Real food is better. It’s much more nutritious.

    I think getting your metabolism to burn more fat is good, but you don’t need a fast to do that. You can just eat fat.

    More important for the thyroid is cutting out grains, especially wheat. That’s step number one for thyroid disorders.

    I would expect that his diet/fast will make things better, because fasting usually brings health benefits, but I think a healthy, grain-free, nutritious diet that can be sustained indefinitely would do better over the long run.

    I think daily intermittent fasting would be more helpful than a long 9 day fast. Again, it is something you could continue indefinitely. Healing is a gradual process, it takes time.

    I’m guessing you may be a bit overweight? I favor eating for the long-term and focusing on healthy eating rather than on short-term weight loss. As the body heals weight will tend to normalize. I would rather try to normalize the thyroid to promote weight loss, than try to force weight loss to improve the thyroid.

    In short, I think his 9-day fast is probably beneficial, but not necessary; I would look toward a healthy diet and intermittent fasting as the truly effective long-term strategies.

    Best, Paul

  32. I have been on Synthroid for the past 6 years. I have recently changed my diet to removing wheat, reducing carbs considerably and upping sat fat. I am a vegetarian but am trying to keep carbs within 150gms (higher end of your plateau). Also taking 2000 IU of Vit D. Thinking of adding seaweed and brazil nuts to my diet after reading this post.
    Given these changes, would it be misguided to just stop taking my meds without getting a test? I dont even know what my TSH levels are currently.

  33. Hi Jay,

    For vegetarians, we don’t feel strongly about the 150g limit. You can go over that, just do it with safe starches like white rice, potatoes and sweet potatoes.

    You should keep in mind that it may take months to become replete in, say, selenium or iodine if you have been deficient. So I would not be rash in modifying medication levels, especially if you don’t know your TSH.

    An appropriate thing to do might be to cut the dose gradually, e.g. by 12.5 mcg increments (or 25 mcg increments) and see what happens. You can try cutting pills with a razor to get incremental doses, if you don’t want a new prescription.

    If TSH is near zero then it’s much safer to reduce dosage.

    It’s a good idea to try to fix the underlying issues and be able to get off the synthetic hormones. But it’s best to do it gradually.

  34. Thanks for your reply.

    The thing is I don’t really notice a change with or without the meds (when I forget to take them). This is why I am tempted to stop.

    Does iodized salt help at all with the iodine intake?

  35. Hi Jay,

    Iodized salt does help, but the doses are very low. I would try kelp seaweed or, even better, iodine / potassium iodide pills like Iodoral. But you should work up to those VERY gradually.

    Best, Paul

  36. Thanks so much! Recently bought your book and have started reading it…Looking forward to a healthier year.

  37. Hi Paul,

    Your comment to Jay, 2 posts up-thread, reminded me of a question: If my current desired dose of Iodine is 1 mg per day, would it be okay to take that in twice-weekly doses of 3.5mg, or in a once-weekly dose of 7mg? (I ask because the only iodoral-type iodine I can find here in BC – without a prescription – is a product called Ioplex, and the smallest dose it comes in is a 6.5 mg capsule.)

    Thanks, Paul. Hope the new year is treating you and Shou-Ching well thus far.

  38. Hi Sammy,

    I’m not sure, your thyroid might have trouble with sudden large doses. Tablets may be easier to cut. The Iodoral 12.5 mg tablets can be easily cut with a razor blade into quarters.

    You can try an experiment and see. The more you can divide the doses, the less likely you’ll experience fluctuation in thyroid function.

    Thanks, we’re doing well. I hope you are too!

  39. Thanks much, Paul. Sounds like sound advice. I’ll do what I can to ensure as even a daily distribution as possible.

    I’m doing well as well. An update and some new questions to follow at some point soon.

    Thanks again.

  40. It’s interesting to see discussion about appetite control being due to something missing from the body rather than with somebody lacking self-control or being a glutton. I find that I can fast if I’m busy, during the week, but on Saturday and Sunday less so, also, that I can fast generally no problem without hunger, but once I start eating I eat a lot, or that is what it feels like.
    I need to do some measuring and getting back to basics, not enough carbs and maybe not enough protein for those carbs, maybe another reason too and my metabolism started to slow down. After that, eating too many deserts I put weight on rapidly.(that is I maintained my weightloss of 37 kgs (almost 6st) from June until Christmas) and lost only 3 kg from February until June.

    Paul,
    what is the best thing to do to kickstart again the fat loss process, eat fat for a day, or only protein for 3 days like Pierre Dukan says? It seems I have to set my calories even lower than 1200.

  41. Hi simona,

    That’ll be Tuesday’s post. I think you want adequate protein and carbs — say, 700 calories total — and as little fat as you care to eat. Your body will draw the fat it needs from adipose tissue. But eat whole foods, supplement, be well nourished. Eat egg yolks and beef liver for choline.

    Best, Paul

  42. Papillary Thyroid Cancer in 1999. Total thyroidectomy and I-131 a year later. I’ve been on 150 mcg suppressive dose of Synthroid with virtually no changes for past 12 years…until I started intermittent fasting. I started doing a 16 fast/8 hour eating window – Leangains.com – two months ago. Just got back from my endocrinologist and had some interesting changes.

    Comparison of blood test in July 2010 and Feb 2011…only difference is the fasting (and ensuing 12-lb weight loss).

    TSH
    Then: <0.068
    Now: <0.006

    Thyroglobulin
    Then: <0.5
    Now: <0.5

    Antithyroglobulin AB
    Then:92
    Now: 96

    T4, Free (Direct)
    Then: 1.69
    Now: 2.12

    Doctor lowered my dose to 137 for two months and said he may have to lower again depending on my results.

    He wasn't sure if it was the IF that's doing this…Can IF make you more sensitive to Synthroid and cause the increase in T4?

    Thanks.

  43. Hi Jenn,

    That’s very interesting … This post was more or less the extent of my knowledge of IF and hypothyroidism. Since bad circadian rhythms raise TSH, it stands to reason that good circadian rhythms will reduce TSH and improve T4 (since that’s what triggers lower TSH). So IF should be good for T4 status.

    But that was just my speculation. It’s clinical experiences like yours that really prove it. I’m glad you’ve added to the evidence that IF is therapeutic for hypothyroidism.

    Thanks for sharing your story!

    Best, Paul

  44. Jenn, is it possible that you have also increased your iodine consumption, from food and/or supplements? I ask because that could explain your results since iodine seems to increase iodine hormone receptor sensitivity. (Also true for other hormones, e.g., diabetics able to reduce or eliminate insulin meds after iodine supplementation, remarkably). Not to say IF wasn’t the cause, just another possibility worth considering.

  45. No more iodine than usual, I don’t think. I only eat shrimp or sushi once a week – maybe – and that hasn’t changed. Lobster is rare. I eat a ton of chicken, beef and pork and loads of veggies. As for supplements, I take Xtend (BCAAs), vitamin E, ALA, CoQ10 and fish oil on occasion as well as Casein shakes at night.

    I just wondered if the meds were being absorbed more efficiently since there’s no competition. I take my pill at about 7 am and don’t eat until noon or 1 pm whereas before I would eat an hour or so after taking it. I do drink black coffee though.

    ???? It’s a mystery. My doctor said he had never heard of this happening, but wouldn’t be surprised if it was the IF. Getting re-tested in another month now that I’m on a lower dose.

  46. Hi Paul,

    I had a similar experience to Perry’s. I lost around 150# (which left me around 380) and on VLC, felt fabulous, had all this energy, I was lifting weights and doing hard landscape and just starting on a fraction of the things in life (even around the house) I’d wanted to do for years but couldn’t even think of due to lack of energy. It was like being a normal person for the first time since the age 22-24 era when I suddenly gained over 200# in less than two years.

    I was a little confused when after all that I got reactive hypoglycemia. I could eat sausage and eggs and have a blood sugar crash so severe I nearly passed out. I bought a glucose monitor and discovered that my blood sugar is actually amazingly LOW most the time. I had expected it to be nearly diabetically high, given my weight.

    I went off and on lowcarb. I felt good about what I’d accomplished that far and felt like it was ok. Later I published a chart of my on/off LC and it was horribly obvious that the instant I am not LC I am gaining weight. the graph looked like a mountain range.

    But I would return to VLC — meat and eggs mostly — when the effects of eating poorly (and I’m reactive to gluten) got too bad.

    But one day, I couldn’t do VLC anymore. Now, a lot of people have issues with food but I LOVE MEAT. I don’t like much produce. Grains and milk have heroin-like addictive qualities for me but if I simply exclude them entirely and make sure I get plenty of protein/fats, it’s not a problem. (I adore cheese which seems ok to me.) But it was like my body would not go into ketosis the way it should. It felt like “hitting the wall” in extreme exercise. My body told me clearly battery was on zero and I would eat something sweet or starchy or I would die. Possibly within minutes, the way I interpreted it. It occurred very shortly after returning to LC, several times and instantly drove me off it. If I tried to lift weights it occurred VERY fast, and if I tried to “willpower through it” (I’m a bit type-A and that was not a problem), my body would burst out bawling. I was so dense I actually thought maybe weight lifting was invoking emotional effects haha!

    I spent many, many months reading on nutrients and buying every supplement that seemed interesting and not too dangerous, from everything typical to obscure powdered chinese mushrooms and so on. Then I started what I called “hyper-nutrient” (yes. I shamelessly stole that from Petro’s ‘Hyper-Lipid’ blog title). I’m a single mom so I couldn’t afford much at once. I kept ’em in the fridge and saved everything. And then I started taking them. My theory was that I would do this every other day (except a multi-V, multi-M, and some D3), and if my body didn’t WANT it, surely it could vent it. I read a lot about toxic levels of stuff but only vitamins have much info on that.

    Anyway I was unable to do VLC for a very long time. I started my hypernutrient experiment of 1, which turned out to be mostly aversion training for swallowing pills. So after a bit it tapered off.

    1. Months later I added a liquid sublingual multimineral supplement that seemed to help with my (lack of) energy issues a bit.

    2. I ‘accidentally’ went back on LC by running out of other food and being too busy to notice. (My teen calls me anorexic because NOT eating is a far bigger problem for me than eating. My ability to sit so still I could be a statue, while working on computer, for 18 hours straight short of a couple bathroom breaks, is probably related; my eOut number is probably ridiculously low.) And it turned out I did not feel like I was going to die anymore.

    I felt “eh.” I had no EXTRA energy, but I did not feel like I had a major deficit of it, and so that was an improvement by far, and I felt ‘eh’ instead of ‘HORRIBLE’ so that was a huge improvement too.

    Perhaps only time did this. But I am willing to think the hypernutrient phase had something to do with it.

    I believe that my VLC eating has had some less than happy side effects on my body, although it has had some very happy side effects on my insulin resistance and my adiposity. However my body’s willingness to do it and feel good is another story.

    Right now I’m VLC and I feel ok, but I don’t have much extra energy. However I have loads more than I used to have on even LC, and more than I ever have when eating ‘standard’ diet (read: crap), so it’s better than nothing I suppose.

    I recently, at the same time, took a dose of supplements for 3 days that I had had so long and never taken. A ‘thyroid support’ (had iodine), a ‘cortisol support’ (both of these are NOW brand), and a tiny bit of ‘progesterone oil’ (progest-e) that I rubbed in my inner arm out of curiosity (only that one day, then I did not take it again), and an ‘adrenal’ tablet (from pig, says the bottle). The next day I had more energy than I’ve had in YEARS. I took them for two more days and I was astounded that my energy was coming up–slightly less than the first day but still high. I stopped taking them to see if there was a difference. There clearly is. I still feel ok but I don’t have the energy I did a week ago when I was doing that. So I will resume.

    I have feared taking things like that because I felt it would mess with my hormones and they’re bad enough probably without making it worse. I live outside civilization you might say so finding a doc with a clue on this is not gonna happen. But when I recently found myself seriously willing to consider everything from illegal steroids and mitochondrial poisons in the hope of amping up bodyfat loss, I figured it was time to try some hormone stuff before my brain got any more deluded in desperation.

    My cousin, with similar metabolism, went on the cocaine diet once. It worked surprisingly well. Now she is on the state prison diet. Not so effective. 😉

    PJ

  47. Hi PJ,

    Quite a story. I’m glad you’re finally finding your way.

    I think being well-nourished is extremely important. It’s very easy to be malnourished on a restrictive diet like VLC, or on calorie-restricted weight loss diets.

    Being VLC is stressful – a lot of hormones get produced to make up the glucose deficit and conserve glucose, and if protein is scarce then the starvation response is invoked – and coupled with malnourishment can easily ruin your thyroid-adrenal axis.

    You’re on the right track with being well-nourished and addressing the hormonal issues. If you can find a doctor, they can help with the adrenal and thyroid issues.

    I think you would benefit from a modest amount of starches daily, to reduce the stress on your body.

    Let me know if you have any questions.

    Best, Paul

  48. Gosh, skipping breakfast and waiting to eat until noon is the opposite of conventional wisdom to eating the largest meal shortly after waking up, lunch next largest meal, dinner smallest meal … that’s a tough one for to grasp at the moment. I usually wake up about 5:00-5:30 AM and go to sleep at 9:30 PM.

    Mark

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