low thyroid! I wonder how long that’s been going on?
If you look back to the end of my last two diet experiment posts ( here and here), I was discussing the low thyroid possibility. When the lipid panel labs came back a few days ago with my cholesterol numbers still too high, it lent more weight to the low thyroid possibility, so I had my thyroid activity checked yesterday with these simple lab tests.
<DISCLAIMER!!> I am not a doctor and am not AMA-certified to draw these conclusions. But as Tiberius is credited with having said back in the day, “phool or physician by phorty”. So Ima gonna say what I’m thinking about this right now:
- The chances are good that my high cholesterol is due to the low thyroid (hypothyroid).
- The hypothyroid situation suggested by my lab numbers is probably due to either a sick thyroid or in spite of a well thyroid. I’m hoping it’s the latter.
- The “well” thyroid gland in the presence reduced thyroid function is known to medicine as part of the “euthyroid sick syndrome (ESS)”
- ESS in my case would be due to the combo of low carb plus high exercise (and possibly exacerbated by lifestyle choices leading to very low body fat).
- The speculation that the mechanism at work here by which the low carb (and thus, necessarily high fat) diet can lead to high cholesterol is by means of down-regulation of liver LDL receptors as the body attempts to conserve energy by avoiding any unnecessary cholesterol syntheses in order to devote itself to the more important task of upregulating gluconeogenesis and preventing hypoglycemia.
If all this speculation actually turns out to be the case, then there are a number of conclusions that can be drawn:
- All you low carbers out there with the lipid profile of high total, LDL and HDL cholesterol and low triglycerides, take notice! It might not be the saturated fat that’s raising your numbers; it might be low thyroid. Get your thyroid function checked! It’s a cheap test.
- Here is another very good reason not to take statins to lower high cholesterol unless you’ve determined with genotype testing that your LDL receptors are not doing the job. Had I been on statins, the high cholesterol would have been masked, I would have never seen it and, most likely, my thyroid dysfunction would have gone unnoticed. So the root of the problem wouldna been treated but a symptom would’ve been treated instead.
- Not only that, my body was having a good reason to produce elevated LDL cholesterol – it was trying to allocate maximal resources towards gluconeogenesis (producing glucose from fat). What happens to this when you thwart what your body wants to do by taking a statin?
- Genetic testing is cheap now, $99. It is possible to find out whether you need drug help (such as a statin) to control high cholesterol or you will succeed using diet and exercise.
So my final thought is:
Why did my endocrinologist not order the thyroid panel when I asked him what he thought was going on with those out-of-the-ball-park LDL / HDL numbers back in Jan 2012? Is he incompetent? is he transphobic? or does he not want to deal with me ’cause I’m in his face too much? I’ll probably never know, but it might be time to find a new endo.
I do not want to take credit for the research that lead to these conclusions. I do not remember exactly which website first clued me in, but here’s a really good explanation of the proposed connection between ESS and low carb. If you google — paleo euthyroid sick syndrome —, you will find a gaggle of adherents to this thought.
This thought is actually another one of the diet-health controversies. Others are claiming ESS cannot be produced by a low carb diet.
As my doctors and I explore this condition, I’m sure we’ll find out what’s going on, at least in my case. I’ll keep y’all posted.