Yes, yes, yes - thrilled you’re covering this, thank you. Hypothyroidism tangled with insulin resistance - and loss of estrogen, is an absolute, confounding nightmare, that feels like slowly sliding down a cliff made of gravel - it’s hard to find any handhold. A year ago, I quit processed foods, sugar, upped protein and fats, vegetables, went back to the pool, tried to regulate my sleep cycle, spend at least an hour outside every day - no matter the weather, started taking iodine drops - basically everything one can think of. There’s been some small improvements in body composition, but am still insulin resistant, still have all the symptoms of hypothyroidism (despite being on T4 and T3) still 20 lbs overweight, still thick around the middle. I have abs of steel, surrounded by an inch of lard - like a Beef Wellington - meat wrapped in a layer of pastry, and the needle is stuck. Majorly stuck in every direction. I thought perhaps it might be some pituitary issue (with no axillary or leg hair for 20 years, though the internist said there didn’t appear to be an issue, but now says I’ve developed some autoimmune markers for RA.) 👀The more I think I’m headed on the right path, the more confused I’ve become. And I’m sure I’m not alone. At least the migraines and heartburn are gone -small mercies. 🫠 Anyway, I LOVE your channel, love listening to the Niagara Falls of information you have at your fingertips. The passion you have for your research is apparent - and appreciated. 🪔
Goodness your story sounds similar to mine. But it's been a long 25 year journey of bad doctoring. Diagnosed after my 1st child. Horrible symptoms for 15 of those year. Started keto 10+ years ago and working towards feeling better. Still trying to stabilize. Even switching to NP thyroid I still feel sluggish. My rt3 went down, but is not where it should be. This year started seeing a naturopath and got on HRT. More improvements, but needing to adjust. Makes me screaming mad that docs don't know how to help women with these symptoms. I love the description of your body! Same! Been working out for several years now, but can't get ride if that lard! Muscle are firming up though!
I don't know that this could help you but I've had problems for 27 years until I started taking magnesium in the morning and it stopped with the overproduction of glucose from my liver.
Interesting configurstion, thanks for sharing. Upfront, some things are crossing my mind: cortisol, fructose, Insulin, NAFLD, systemic inflammation, and generalized mitchondrial disease. Besides that, if you take T3 it is not possible to diagnose hypothyroidism. Instead, either you are resistant to T3, or your liver is not producing T3 from T4, which brings us back to insulin and inflammation. It could be systemic unspecific, or chronic specific, meaning, caused by a bug. Your internist needs to measure cortisol, TSH, fasting insulin and hsCRP. Cortisol should be nomal as your sleep and rhythm is good, but you only know if you measure. If I would be in your shoes, I would definitely implement TRF 16/8, and take B1 + PQQ for energy production and healing the mitchondria (which wuld erquire a bunch of other subtle interventions) Finally, there is even the kind of exotic possibility that your gut is leaky like a sieve from hell. That could destroy glut4 insulin receptors, cause inflammation and insulin resistance,... so probably not that exotic. Here, bacillus bifidus and high doses of b1 can help.
THANK YOU for the analysis of low T3 and ketogenic/carnivore diets, it is very helpful. I have been keto/carnivore for five years now. But my search continues as I also have highTSH and below range total and free T4 as well as well below range total and free T3. I'm a 65-year-old man, 5'6", 135 lb, was on levothyroxine for 17 years. This year I finally found an endocrinologist who agreed to look more carefully at it, and I went off the Levo in August. Labwork in September showed the free and total T4 at 0.58 and 3.6, with the total and free T3 at 44 and 1.6. The TSH was very high at 44. A lab for TSH only (I was being cheap) showed it at 76. The endocrinologist was a bit shocked and advised me to resume the Levo (I was on a 75 mcg dose), but she was also intrigued because I had no symptoms of hypothyroidism. I'm high energy, sleep well and enjoy a mentally stimulating job. The next lab and appointment are early next month. If I continue to feel as I good as I do now, I'm going to decline the Levo again, and ask for the next appointment in July. If all is still good, then it's goodbye to the Levo. Nick Norwitz, of Oreo cookies + statins fame, had made a passing reference to low T3 not being an issue for those on a ketogenic diet because the T3 is more geared to helping carb metabolism. But this presentation by Dr. Bikman is more thorough and detailed. And now to figure out why I feel so good even though my TSH is so high.
thanks, I take 50mg levothyroxine, I read recently that helps with T4 but not T3 and we need to bolster that, need to find something that does that easily, this was interesting, I like a mixed diet, it sounds like lowering my carbs and increasing meat consumption a bit could be good, I like vegetables so will not cut those out completely
"not always" LOOOL ... you are absolutel right, i am completely p****** *** by those "normal" values, derived from a population, wherre 80+% of its members are metabolically sick
After starting keto several months ago, my liver enzymes and A1C are in the normal range - that alone tells me that I am in the right track. My thyroid gland started feeling swollen, as though my TSH was too high... It was, but so was RT3. I tried increasing my dose, but that made it worse; the solution has been to reduce my thyroid dose. I surmised that this reduced need for exogenous thyroid hormones was because of improved liver function but it is apparently due to reduced need (or both)... Thanks, Dr Bikman!
Everything you've described is exactly what I've experienced over 37 years without a Thyroid gland. At my worst health in my mid 30's I was a carboholic couch potatoe and was 35kg over weight. I needed 1800 mcg a week to get to normal levels. On a ketogenic diet I quickly (within months) had to reduce meds to1200 mcg a week. It's been that low for nearly 7 years now. I just wanted to add that's a 33.3% reduction or inversely, a 50% increase. Wow!
I saw a testimony from two people who have had their thyroid removed..after a period of time of clean eating and fasting, one had reduced her med dose by 3/4 and the other eliminated the need altogether...this suggest, after the removal of the gland, and the cleaning up of toxins, the body was able to find alternative ways to compensate for the thyroid gland function...perhaps part two could explore this further??🤔
Loved this lecture. You are such a great teacher! I was wishing you had been my teacher at BYU so very long ago. I am learning and relearning so much in your metabolic lectures and my 73 year old (former biology teacher) brain is loving the challenge. Everything you said makes perfect sense and is very clear. I think your lab should indeed dive in and see about getting a new thyroid-health tracking indicator using T3 instead of T4. Also, I was wondering ... what about all of the other functions of T3 in the body? Are other body processes in jeopardy at all with lowered levels of T3 being caused by lower glucose in the blood. All of this must be in a delicate balance. Does glucose act on the thyroid directly at all in association with TSH or perhaps in the conversion of T4 into T3? If so then your premise here makes even more sense to me, indicating that glucose is an important regulator of T3 levels as well as TSH. I guess I am just wondering how the body "knows" it needs less T3. Perhaps this was all addressed in another video(s)?
As someone with diagnosed hypothyroidism, I really appreciate this video. Keto is where I metabolically and mentally feel the most comfortable, but it is hard to sustain due to social pressure, plus other anxiety-inducing and stressful factors in life. I know eating carbs will only exacerbate the situation and put me in a bad rabbit hole, but my key to a healthy and sustainable life is to find that right balance of not being sedentary and keeping carbs down to the needs of those physical activities. Also, sleep as much as needed and not procrastinate to induce anxiety. Gotta add that I also have ADHD and autism, which really don't help, but I won't use them as excuse. Thanks again for the lecture!
I went low carb in 2017 and lost 25% of my body weight (60lbs). I started feeling funny on my thyroid meds. I went to an endocrinologist, my doctor sent me, asking if I needed to lower my meds because thyroid meds are weight dependent. I was told no!! I have been on a healing journey ever since. Being over medicated made my thyroid swell and I stopped losing weight. No help out there, there needs to be more understanding of this.
Thank you so much Dr. Bikman. My son was born without a pituitary gland (34 years ago!). This amazing explanation of thyroid hormones is fantastic information for me (and I'll share with the hypopit groups I'm in). Decades ago much of this knowledge was still to be uncovered - in fact when he was born, we could test TSH but not T3/4. Totally agree with you - my wonder at how we are all (mostly) still walking around, grows daily. PS I'm on keto hence why I found you.
Yes, Ben please work on this in your lab. I believe this is an epidemic as big as diabetes but doesn’t get the band width. I would be interested in your take on the study that stated 80% of the population placed on thyroid replacement hormone should not have been put on it. I believe it was a study by Cornell University. Also take a look at a TH-cam channel Rejuvagen, he reviews thyroids lab numbers. Look for his Lab Interpretation segments. Maybe you could do some research with his ideas in mind, or talk about is he on track?
People are being told they've destroyed their thyroid because of being low carb. NIH need to start funding studies that actually matter. The new admin is being pushed to look at metabolic health. Lets hope they listen.
Are you actually in remission, or is your thyroid "dead"? I stopped producing antibodies, thinking I was in remission, but upon scan, my thyroid was shriveled up. 😢
Brilliant stuff. I searched dozens of thyroid expert videos trying to find if low T3 is a problem, given a keto diet. Nobody explained the linkage to the GLUT4 receptors. Happy for the explanation, sad about the state of medicine.
as he explained, the conclusion that the thyroid is not working based on low T3 is not valid. key is hoow you feel: do you have dry skin,, brittle hair, feeling cold, feeling fatigued, foggy brain DESPITE you do all other things right? Or do you have antibodies? How is your mitochondrial health? After clarifying that you can start to think in this direction
Thanks Ben. Mixed thyroid growth removed40 yrs ago. Labs always normal but a man mri ( for another reason) 5 years ago still showed a multi modular thyroid. Always cold and constipated. But I have a new doctor who will be the first to order thyroid antibodies. So at least someone is interested in investigating.
It seems that TSH and FSH act similarly. Post-menopause FSH skyrockets when estrogen is depleted in the same way TSH seems to increases when T3 decreases outside of a Keto diet
I have seen some discussion lately how people are VERY low in iodine. There has been suggestion to take MUCH more than the RDA by some professionals, and the organs all need much more than the operating level of Iodine with regards to the thyroid gland. Can you share you thought on this and-do we really need both Iodine and Potassium Iodine, as in the "Lugol's supplements? Thank you so much for your expert perspective.
This is timely. I just educated my medical provider on T3 AND reverse T3. She had no idea because she just looked at TSH, T4 AND Free T3 but did not really understand how to put it all together. She just looked at the lab "normal values" on the lab slip result.
I am an RN and have been on a 2 year journey now to resolve my Hashimoto's disease. I started out as carnivore then when animal based (adding back in carbs of fruit and honey), it was a transition away from junk foods/seed oils. I cut out all "cheat" meals including restaurants a year ago. I only had a reduction in thyroid medication (3x so far) when I added back the carbs, but when I did I started to gain weight. I recently switched back to a low carb, mostly animal products and have added back in some carb cycling every two weeks. I go back for bloodwork this month and I am curious as to what my TSH and T3 will reveal. There is no where for me to go to for what I need to resolve my condition, I am basically using myself as an n=1 study to see what I get. Even 100 grams of carbs (the minimum often recommended) is too much for me for weight control.
@@KenJackson_US I am currently going to my healthcare practitioner every 3 months, she is well aware that I am trying to come off my meds. She is respectful with our interactions but I am not sure how much she is on board with my beliefs about this chronic condition (there is an intellectual curiosity that is missing, I have gone from 300mcg of Levoxyl to 88mcg). I have told her what I am doing but there are not many questions.
@@KenJackson_US I am going every 3 months to my healthcare practitioner while I try and come off my meds. She is supportive of this goal but there has been a lack of intellectual curiosity of what I am doing. Perhaps most patients she sees just wants the magic pill. I feel I have to use the medical industrial complex healthcare system because it is what my healthcare insurance will pay for. I would love to go to a naturopath, functional doctor, or the like but it is not the way our healthcare delivery system at least in the US is designed.
@@jules7723 When I asked my doctor for the antibody tests that would indicate if I have Hashimoto's or some other hypothyroidism, he asked why. He said the treatment is the same in either case, so it doesn't matter. I explained I want to find the cause so I can eliminate it and thus not need to take levothyroxine. He was totally uninterested and unsupportive.
I am on a keto-carnivorish diet since 2019 but I have Hashimoto's and take 75 mg of synthetic T4 and in these days I got my blood tests done and THS is high, Ft3 and Ft4 are low, my fadting glucose (I also am on OMAD) is 124 and A1c is 6.7. I do not understand how my numbers can be so awful on a keto-carnivore diet. Is it all depending od a thyroid gland that doesn't work even after so many years almost without carbs? My trigs are very low (60) and my HDL is high (75), my fasting insulin is about 5, so these numbers are good, how can be glucose so bad? I love your lectures. Ciao from Italy.
The A1c is a somewhat limited metric. You should look up some TH-cams about how carnivore can make your A1c higher. This isn’t a bad thing because your blood cells are healthier and live longer, and therefore have a longer period of time to accumulate glycation, which makes your A1c higher. But ultimately your cells are healthier and living longer which in this example means that you’re higher A1c is not a problem. It would be a “false positive”.
Do you get in enough protein and fat for the whole day on just one meal. The gallbladder can only make enough bile for maximum 50gms of fat at one sitting. If you're undereating that might be a problem.
Great topic! I’m trying to understand is whole system. I lost most of my pituitary due to a tumor about 27 years ago and have been taking Levothyroxine since then. I have been using a ketogenic diet for the past 20 months and have dropped weight from 230 to 170lbs. Thyroid levels have been stable but a generally feel cold. Also interested in the implications of iodine as I’ve greatly reduced my use of iodized salt. Related to the question posed about low T3 on keto, I wonder if average T3 has increased over the last 100 years as general metabolic health has gotten worse.
Research Dr. David Brownstein. He is an expert in iodine. Here is a good video to start: th-cam.com/video/Jkpf2j-qNJk/w-d-xo.html -- His book, "Iodine Why You Need It" is excellent. Says we need both iodine & iodide and says that iodized salt is insufficient for our iodine needs.
I have hyperthyroidism with very low TSH (has been as low as 0.005), but T4 and FT3 are in normal. Dr. Bikman, do you recommend higher carb diet for someone like me? I will say that a couple of years ago, when I was eating mostly carnivore, my TSH was closer to normal than it has been in over 23 years. I do have multiple nodules, and had 1/2 of my thyroid removed in 2005. Currently Only take 5 mg of methimazole 3x/week.
Excellent! Now if only I could heal my thyroid and eliminate my need for levothyroxine. Sadly, my doctor displayed a total lack of interest. Does supplementing iodine make sense?
It only makes sense if you are deficient in iodine, a very easy way to check this is to buy colored iodine, put it on your forearm, if it is absorbed, you are deficient, then keep repeating until the body will not absorb it. I take natural thyroid hormone, since being on KETO, I feel like i am hyper, so probably should recheck the thyroid meds.
@@BrJon-uh8cm I've off and on supplemented iodine. The problem is that it plays havoc with my sinuses. I'm not giving up on it, but it's a real bother.
Oh, gee! I forgot one important fact that should have been included in my previous comment: I'm also taking 4-5 drops of Lugol's 5% solution a day! That is something I DID tell my doc and he said it would be fine. But, honestly, he said it so flippantly I'm not sure he had really thought about it.
Thanks Ben I had Hyperparathyroidism and had a parathyroid gland removed the surgeon told me it was bright orange. 🍊 18 months later I’m much improved. I have Celiac and Raynards and my body struggles to dispell chest/lung infections I’m on antibiotics now sigh ☹️ My tummy dislikes any medications. Lucky I’m tough.
I needed to hear this! My naturopath is very open minded but we are currently trying to figure out why my cortisol is running higher in mornings and my thyroid could be better. She wondered if it was that I need to eat more carbs.
@@clutzfrmr3645 I definitely, will. Thank you! We did a 24 hour cortisol and mine is still high. She is pondering if it is my ketogenic lifestyle but I also have a hx of hyperthyroid which has resolved. If it's not the diet, I am just curious what else it could be. It's not near high enough to be Cushings and I sleep mostly fine.
key point is that there is no such thing as a functional hormone. They are messengers whose specific physiological effects across tissues is deterind by the differential distributions of receptors. Considering just the absolute level of a hormone, or measuring a hormone in a single shot does not tell much (and unveils a pofound ignorance about the workings of hormones), even when considering its releasing hormone. As in the case for insulin, where the test is called a tolerance test, which is kind of misnomer, together with HOMA-ir, which relates the hormone to its physiological effect, a test for the thyroid system would have to doa similar thing. Suggestion: triggering a cortisol response via a standardized, fasted, 10 min physical stress at 80% VO2max. The ratio of max elevation of T3 to baseline T3 is much smaller in resistant than in non-resistant people.
Thyroid actions are crazy enough to begin with but when you add in Graves’ disease and its typical treatment of destroying the thyroid, it’s no wonder I can’t figure out what’s going on. My TSH is checked frequently and doc and I try to keep it on the low end of the acceptable range. I take Synthroid (thyroxine, so T4). But I still display symptoms of low thyroid, lethargy, obesity. Would it be helpful to have T3 and T4 levels tested? Per this discussion, logic tells me that if TSH is low, the T4 I’m taking is converting fine.
OK your head might explode on this one. I have no thyroid (cancer) and take Synthroid. I'm keto, pre-type2 and take Ozempic, which works well. A1C 5.6. Anything I should look out for? I don't take any T3. Its been 10 years since the cancer, so endo is lowering my thyroid levels to normal, they were elevated per protocol to keep TSH low. Unfortunately, knowbody understands this like you. Anything to watch out for?
I just want to know why I am not losing. Maybe thyroid? I got a full metabolic blood count last summer. Nothing was said to me. I had little to no hormones so I am on bio identical hormones at present. I cut out coffee and cream… praying it helps
So, I have recently adopted a carnivore diet. I am on amour thyroid medication. Is it possible to come off it in time? I do not have damaged thyroid. I was put on it because of low adrenal function 🤔
After nearly two years of being a carnivore my hair is drasticly falling out. I was low in vitamin D3, so I am taking that now, because I was very sick before that. In the summertime I can not easily go outside, because of severe hayfever. I hope my hair will turn around and grow again. I think D3 is also important for the thyroid to function.
Nothing compares to getting natural sunlight. The D3 pills are not good to depend on. I would get a Sperti D lamp if I couldn't go outside. Just be careful because they work really well and can get your levels up high. My hair falls out on Carnivore if my fats or proteins are too low. At 5ft 2 I need about 120grams of protein and fat to keep my hair healthy.
what about testosterone resistance (and I'm not refering to the genetic/developmental one which lies behind the intersex people but an acquired one in adult age...) ?
My TSH is below normal but my T4 and T3 are normal. I take Levothyroxine and T3. My thyroid support group says low TSH is normal if you are on T3 but the doctor has cut my Levothyroxine from 150mg to 75mg. Is this the right course of action? Taking meds has not improved any of my symptoms.
@@ameliaashton-brooke2454 There is quite a range of “normal” for TSH so I’m not sure what you consider “below” normal. But the lower it gets means that your body is say “whoa! We have plenty of T3/T4”. It sounds like your doctor lowered your levothyroxine because you were getting more than enough T3/T4. You didn’t say what symptoms you are experiencing to make you think your meds aren’t working.
@donnatodd4119 Thank you for replying. My TSH is 0.01. Symtoms are dry skin, fatigue, always cold and brain fog, plus of course the constant battlexwith weight. I lose and regain the same 10 pounds every few months but really i need to lose 30lbs. x
@ Well, 0.01 is truly very “below normal” or “hyperthyroid” so I’m truly confused by your symptoms which are typically “hypothyroid” caused. Just when you think you understand the thyroid then this sort of stuff pops up.
Proffesor...❤ You have such an awesome Carezma and honesty, Would you dive in cancer cell biology as scientifically proven, l am eager to see watch and carefully listen And many others do....thank you.
Yes. Elevated RT3 will raise TSH and cause hypo symptoms. RT3 goes up when you are sick and the body wants you to rest, or if you take thyroid hormones, when your dose is too high. After starting keto, my TSH and RT3 went up, causing my thyroid gland to swell. Taking an extra dose worsened the symptom, skipping a dose resolved the symptom. I tend to feel best when I miss a dose so I have been reducing my daily intake. 😁
High Rt3 is an indicator of poor t4 to t3 conversion. Which can be because by many issues. Even metabolic issues. One can have good TSH and good t4 numbers but high rt3. Or you can be making lots of t3 but it's not available/being blocked from cell and raising rt3. I used to be in t4 only, switched to NP thyroid and my rt3 went down. So confusing. Never thought to lower or skip doses. Postmenopause now too. So that may be playing a roll. Adjusting to hrt now as well. Maybe too many variables?
@@lisachelton4599I have had a similar experience with the thyroid gland swelling and doctors increasing the meds, my Rt3 has always been low, skipping and lowering the dosage makes the neck/thyroid feel better and RT3 has been going up back to the normal range.
Yes, yes, yes - thrilled you’re covering this, thank you. Hypothyroidism tangled with insulin resistance - and loss of estrogen, is an absolute, confounding nightmare, that feels like slowly sliding down a cliff made of gravel - it’s hard to find any handhold. A year ago, I quit processed foods, sugar, upped protein and fats, vegetables, went back to the pool, tried to regulate my sleep cycle, spend at least an hour outside every day - no matter the weather, started taking iodine drops - basically everything one can think of. There’s been some small improvements in body composition, but am still insulin resistant, still have all the symptoms of hypothyroidism (despite being on T4 and T3) still 20 lbs overweight, still thick around the middle. I have abs of steel, surrounded by an inch of lard - like a Beef Wellington - meat wrapped in a layer of pastry, and the needle is stuck. Majorly stuck in every direction. I thought perhaps it might be some pituitary issue (with no axillary or leg hair for 20 years, though the internist said there didn’t appear to be an issue, but now says I’ve developed some autoimmune markers for RA.) 👀The more I think I’m headed on the right path, the more confused I’ve become. And I’m sure I’m not alone.
At least the migraines and heartburn are gone -small mercies. 🫠
Anyway, I LOVE your channel, love listening to the Niagara Falls of information you have at your fingertips. The passion you have for your research is apparent - and appreciated. 🪔
Goodness your story sounds similar to mine. But it's been a long 25 year journey of bad doctoring. Diagnosed after my 1st child. Horrible symptoms for 15 of those year. Started keto 10+ years ago and working towards feeling better. Still trying to stabilize. Even switching to NP thyroid I still feel sluggish. My rt3 went down, but is not where it should be. This year started seeing a naturopath and got on HRT. More improvements, but needing to adjust. Makes me screaming mad that docs don't know how to help women with these symptoms. I love the description of your body! Same! Been working out for several years now, but can't get ride if that lard! Muscle are firming up though!
Yeh, that "Beef Wellington" comparison cracked me up.
I don't know that this could help you but I've had problems for 27 years until I started taking magnesium in the morning and it stopped with the overproduction of glucose from my liver.
Interesting configurstion, thanks for sharing. Upfront, some things are crossing my mind: cortisol, fructose, Insulin, NAFLD, systemic inflammation, and generalized mitchondrial disease. Besides that, if you take T3 it is not possible to diagnose hypothyroidism. Instead, either you are resistant to T3, or your liver is not producing T3 from T4, which brings us back to insulin and inflammation. It could be systemic unspecific, or chronic specific, meaning, caused by a bug.
Your internist needs to measure cortisol, TSH, fasting insulin and hsCRP. Cortisol should be nomal as your sleep and rhythm is good, but you only know if you measure.
If I would be in your shoes, I would definitely implement TRF 16/8, and take B1 + PQQ for energy production and healing the mitchondria (which wuld erquire a bunch of other subtle interventions)
Finally, there is even the kind of exotic possibility that your gut is leaky like a sieve from hell. That could destroy glut4 insulin receptors, cause inflammation and insulin resistance,... so probably not that exotic. Here, bacillus bifidus and high doses of b1 can help.
Try carnivore for 90 days
THANK YOU for the analysis of low T3 and ketogenic/carnivore diets, it is very helpful. I have been keto/carnivore for five years now. But my search continues as I also have highTSH and below range total and free T4 as well as well below range total and free T3.
I'm a 65-year-old man, 5'6", 135 lb, was on levothyroxine for 17 years. This year I finally found an endocrinologist who agreed to look more carefully at it, and I went off the Levo in August. Labwork in September showed the free and total T4 at 0.58 and 3.6, with the total and free T3 at 44 and 1.6. The TSH was very high at 44. A lab for TSH only (I was being cheap) showed it at 76. The endocrinologist was a bit shocked and advised me to resume the Levo (I was on a 75 mcg dose), but she was also intrigued because I had no symptoms of hypothyroidism. I'm high energy, sleep well and enjoy a mentally stimulating job.
The next lab and appointment are early next month. If I continue to feel as I good as I do now, I'm going to decline the Levo again, and ask for the next appointment in July. If all is still good, then it's goodbye to the Levo.
Nick Norwitz, of Oreo cookies + statins fame, had made a passing reference to low T3 not being an issue for those on a ketogenic diet because the T3 is more geared to helping carb metabolism. But this presentation by Dr. Bikman is more thorough and detailed.
And now to figure out why I feel so good even though my TSH is so high.
thanks, I take 50mg levothyroxine, I read recently that helps with T4 but not T3 and we need to bolster that, need to find something that does that easily, this was interesting, I like a mixed diet, it sounds like lowering my carbs and increasing meat consumption a bit could be good, I like vegetables so will not cut those out completely
We need a list of "normal" lab values for folks on a keto diet - they are not always the same as metabolically unhealthy folks eating the SAD.
"not always" LOOOL ... you are absolutel right, i am completely p****** *** by those "normal" values, derived from a population, wherre 80+% of its members are metabolically sick
After starting keto several months ago, my liver enzymes and A1C are in the normal range - that alone tells me that I am in the right track. My thyroid gland started feeling swollen, as though my TSH was too high... It was, but so was RT3. I tried increasing my dose, but that made it worse; the solution has been to reduce my thyroid dose. I surmised that this reduced need for exogenous thyroid hormones was because of improved liver function but it is apparently due to reduced need (or both)... Thanks, Dr Bikman!
👏🏿👏🏿👏🏿👏🏿👏🏿 congrats on this discovery!!!
now you know how self-experimentation feels 😎
There is such a need in the healthcare system to educate regarding this! Thank you so much!
Everything you've described is exactly what I've experienced over 37 years without a Thyroid gland. At my worst health in my mid 30's I was a carboholic couch potatoe and was 35kg over weight. I needed 1800 mcg a week to get to normal levels. On a ketogenic diet I quickly (within months) had to reduce meds to1200 mcg a week. It's been that low for nearly 7 years now.
I just wanted to add that's a 33.3% reduction or inversely, a 50% increase. Wow!
I saw a testimony from two people who have had their thyroid removed..after a period of time of clean eating and fasting, one had reduced her med dose by 3/4 and the other eliminated the need altogether...this suggest, after the removal of the gland, and the cleaning up of toxins, the body was able to find alternative ways to compensate for the thyroid gland function...perhaps part two could explore this further??🤔
So what do you consider "normal" thyroid hormone levels for folks on a low carb or even carnivore diet?
Mr. Data says: no data possibly available, because normality can not be defined, at least not for the next 40 years or so
Low T3 and normal TSH is exactly what happened to me on keto.
Loved this lecture. You are such a great teacher! I was wishing you had been my teacher at BYU so very long ago. I am learning and relearning so much in your metabolic lectures and my 73 year old (former biology teacher) brain is loving the challenge.
Everything you said makes perfect sense and is very clear. I think your lab should indeed dive in and see about getting a new thyroid-health tracking indicator using T3 instead of T4.
Also, I was wondering ... what about all of the other functions of T3 in the body? Are other body processes in jeopardy at all with lowered levels of T3 being caused by lower glucose in the blood. All of this must be in a delicate balance. Does glucose act on the thyroid directly at all in association with TSH or perhaps in the conversion of T4 into T3? If so then your premise here makes even more sense to me, indicating that glucose is an important regulator of T3 levels as well as TSH. I guess I am just wondering how the body "knows" it needs less T3. Perhaps this was all addressed in another video(s)?
Holy moly, I was hoping you would cover this ...
As someone with diagnosed hypothyroidism, I really appreciate this video. Keto is where I metabolically and mentally feel the most comfortable, but it is hard to sustain due to social pressure, plus other anxiety-inducing and stressful factors in life. I know eating carbs will only exacerbate the situation and put me in a bad rabbit hole, but my key to a healthy and sustainable life is to find that right balance of not being sedentary and keeping carbs down to the needs of those physical activities. Also, sleep as much as needed and not procrastinate to induce anxiety. Gotta add that I also have ADHD and autism, which really don't help, but I won't use them as excuse. Thanks again for the lecture!
I went low carb in 2017 and lost 25% of my body weight (60lbs). I started feeling funny on my thyroid meds. I went to an endocrinologist, my doctor sent me, asking if I needed to lower my meds because thyroid meds are weight dependent. I was told no!! I have been on a healing journey ever since. Being over medicated made my thyroid swell and I stopped losing weight. No help out there, there needs to be more understanding of this.
Thank you so much Dr. Bikman. My son was born without a pituitary gland (34 years ago!). This amazing explanation of thyroid hormones is fantastic information for me (and I'll share with the hypopit groups I'm in). Decades ago much of this knowledge was still to be uncovered - in fact when he was born, we could test TSH but not T3/4. Totally agree with you - my wonder at how we are all (mostly) still walking around, grows daily. PS I'm on keto hence why I found you.
I just wanted to thank you for taking the time to out out these very informative 'lectures'.
I'm so honored to attend your lecture via TH-cam!! Thank you!! ❤
Yes, Ben please work on this in your lab. I believe this is an epidemic as big as diabetes but doesn’t get the band width. I would be interested in your take on the study that stated 80% of the population placed on thyroid replacement hormone should not have been put on it. I believe it was a study by Cornell University. Also take a look at a TH-cam channel Rejuvagen, he reviews thyroids lab numbers. Look for his Lab Interpretation segments. Maybe you could do some research with his ideas in mind, or talk about is he on track?
very nice lecture, thank you Ben 👍
Your argument makes a lot of sense and very concise.
When I fast for thyroid blood work my numbers are all out of whack. When unfasted my numbers are all in normal range.
People are being told they've destroyed their thyroid because of being low carb. NIH need to start funding studies that actually matter. The new admin is being pushed to look at metabolic health. Lets hope they listen.
How does this discussion relate to Hashimoto’s, especially if it is in remission? Thank you so much, Ben!!
Are you actually in remission, or is your thyroid "dead"? I stopped producing antibodies, thinking I was in remission, but upon scan, my thyroid was shriveled up. 😢
Fascinating! Can’t join your group yet but I will as soon as I can, excited you started this!
Brilliant stuff. I searched dozens of thyroid expert videos trying to find if low T3 is a problem, given a keto diet. Nobody explained the linkage to the GLUT4 receptors. Happy for the explanation, sad about the state of medicine.
Could you give some insight into patients who have a non functioning thyroid on a ketogenic diet
as he explained, the conclusion that the thyroid is not working based on low T3 is not valid.
key is hoow you feel: do you have dry skin,, brittle hair, feeling cold, feeling fatigued, foggy brain DESPITE you do all other things right? Or do you have antibodies? How is your mitochondrial health? After clarifying that you can start to think in this direction
@monnoo8221 - I have Hashimoto's and my tests after a while showed no more antibodies. After a scan, they said my thyroid is shriveled up.
Thanks Ben. Mixed thyroid growth removed40 yrs ago. Labs always normal but a man mri ( for another reason) 5 years ago still showed a multi modular thyroid. Always cold and constipated. But I have a new doctor who will be the first to order thyroid antibodies. So at least someone is interested in investigating.
It seems that TSH and FSH act similarly. Post-menopause FSH skyrockets when estrogen is depleted in the same way TSH seems to increases when T3 decreases outside of a Keto diet
Thank you so much Dr. Bikman! You are a true gem! ❤
Fantastic lecture
I have seen some discussion lately how people are VERY low in iodine. There has been suggestion to take MUCH more than the RDA by some professionals, and the organs all need much more than the operating level of Iodine with regards to the thyroid gland.
Can you share you thought on this and-do we really need both Iodine and Potassium Iodine, as in the "Lugol's supplements?
Thank you so much for your expert perspective.
In New Zealand where I live we buy iodised salt, as there is little iodine in our soils. As well you can eat seaweed to supplement
Brilliant lecture. Thank you so much.
So grateful sir, doing the great work.
This is timely. I just educated my medical provider on T3 AND reverse T3. She had no idea because she just looked at TSH, T4 AND Free T3 but did not really understand how to put it all together. She just looked at the lab "normal values" on the lab slip result.
And that’s the problem.
A similar discussion is underway with the ratio between Total vs Free testosterone levels.
I am an RN and have been on a 2 year journey now to resolve my Hashimoto's disease. I started out as carnivore then when animal based (adding back in carbs of fruit and honey), it was a transition away from junk foods/seed oils. I cut out all "cheat" meals including restaurants a year ago. I only had a reduction in thyroid medication (3x so far) when I added back the carbs, but when I did I started to gain weight. I recently switched back to a low carb, mostly animal products and have added back in some carb cycling every two weeks. I go back for bloodwork this month and I am curious as to what my TSH and T3 will reveal. There is no where for me to go to for what I need to resolve my condition, I am basically using myself as an n=1 study to see what I get. Even 100 grams of carbs (the minimum often recommended) is too much for me for weight control.
Do you rely on your doctor's annual blood test? Or you get your own tests done more frequently?
@@KenJackson_US I am currently going to my healthcare practitioner every 3 months, she is well aware that I am trying to come off my meds. She is respectful with our interactions but I am not sure how much she is on board with my beliefs about this chronic condition (there is an intellectual curiosity that is missing, I have gone from 300mcg of Levoxyl to 88mcg). I have told her what I am doing but there are not many questions.
@@KenJackson_US I am going every 3 months to my healthcare practitioner while I try and come off my meds. She is supportive of this goal but there has been a lack of intellectual curiosity of what I am doing. Perhaps most patients she sees just wants the magic pill. I feel I have to use the medical industrial complex healthcare system because it is what my healthcare insurance will pay for. I would love to go to a naturopath, functional doctor, or the like but it is not the way our healthcare delivery system at least in the US is designed.
@@jules7723 When I asked my doctor for the antibody tests that would indicate if I have Hashimoto's or some other hypothyroidism, he asked why. He said the treatment is the same in either case, so it doesn't matter. I explained I want to find the cause so I can eliminate it and thus not need to take levothyroxine. He was totally uninterested and unsupportive.
I am on a keto-carnivorish diet since 2019 but I have Hashimoto's and take 75 mg of synthetic T4 and in these days I got my blood tests done and THS is high, Ft3 and Ft4 are low, my fadting glucose (I also am on OMAD) is 124 and A1c is 6.7. I do not understand how my numbers can be so awful on a keto-carnivore diet. Is it all depending od a thyroid gland that doesn't work even after so many years almost without carbs? My trigs are very low (60) and my HDL is high (75), my fasting insulin is about 5, so these numbers are good, how can be glucose so bad? I love your lectures. Ciao from Italy.
The A1c is a somewhat limited metric. You should look up some TH-cams about how carnivore can make your A1c higher. This isn’t a bad thing because your blood cells are healthier and live longer, and therefore have a longer period of time to accumulate glycation, which makes your A1c higher. But ultimately your cells are healthier and living longer which in this example means that you’re higher A1c is not a problem. It would be a “false positive”.
Do you get in enough protein and fat for the whole day on just one meal. The gallbladder can only make enough bile for maximum 50gms of fat at one sitting. If you're undereating that might be a problem.
Great topic! I’m trying to understand is whole system. I lost most of my pituitary due to a tumor about 27 years ago and have been taking Levothyroxine since then. I have been using a ketogenic diet for the past 20 months and have dropped weight from 230 to 170lbs. Thyroid levels have been stable but a generally feel cold. Also interested in the implications of iodine as I’ve greatly reduced my use of iodized salt. Related to the question posed about low T3 on keto, I wonder if average T3 has increased over the last 100 years as general metabolic health has gotten worse.
Research Dr. David Brownstein. He is an expert in iodine. Here is a good video to start: th-cam.com/video/Jkpf2j-qNJk/w-d-xo.html -- His book, "Iodine Why You Need It" is excellent. Says we need both iodine & iodide and says that iodized salt is insufficient for our iodine needs.
@@Robin-lr2zw, thank you for your recommendation. I’ll take a look at it.
I have hyperthyroidism with very low TSH (has been as low as 0.005), but T4 and FT3 are in normal. Dr. Bikman, do you recommend higher carb diet for someone like me? I will say that a couple of years ago, when I was eating mostly carnivore, my TSH was closer to normal than it has been in over 23 years. I do have multiple nodules, and had 1/2 of my thyroid removed in 2005. Currently Only take 5 mg of methimazole 3x/week.
Excellent! Now if only I could heal my thyroid and eliminate my need for levothyroxine. Sadly, my doctor displayed a total lack of interest. Does supplementing iodine make sense?
It only makes sense if you are deficient in iodine, a very easy way to check this is to buy colored iodine, put it on your forearm, if it is absorbed, you are deficient, then keep repeating until the body will not absorb it. I take natural thyroid hormone, since being on KETO, I feel like i am hyper, so probably should recheck the thyroid meds.
@@BrJon-uh8cm I've off and on supplemented iodine. The problem is that it plays havoc with my sinuses. I'm not giving up on it, but it's a real bother.
can you tell me something about hipethyroidism autoimune Graves disease
Oh, gee! I forgot one important fact that should have been included in my previous comment: I'm also taking 4-5 drops of Lugol's 5% solution a day! That is something I DID tell my doc and he said it would be fine. But, honestly, he said it so flippantly I'm not sure he had really thought about it.
Thanks Ben I had Hyperparathyroidism and had a parathyroid gland removed the surgeon told me it was bright orange. 🍊 18 months later I’m much improved. I have Celiac and Raynards and my body struggles to dispell chest/lung infections I’m on antibiotics now sigh ☹️ My tummy dislikes any medications. Lucky I’m tough.
I LOVE ypur lectures!!!
What about if my thyroid was removed and I am doing the keto diet.
You will need less thyroid medicine.
My TSH went to 34!
I started desiccated thyroid.
Ben ❤❤❤ you're a hero 💖🙏💖
I needed to hear this! My naturopath is very open minded but we are currently trying to figure out why my cortisol is running higher in mornings and my thyroid could be better. She wondered if it was that I need to eat more carbs.
So ask your naturopath if she is familiar with the "dawn" effect that naturally and normally raises cortisol in the morning due to circadian rhythms.
No need to eat more carbs, you probably need a little fat in the morning to feed your body, not carb/sugar.
buy a whoop.
@@clutzfrmr3645 I definitely, will. Thank you! We did a 24 hour cortisol and mine is still high. She is pondering if it is my ketogenic lifestyle but I also have a hx of hyperthyroid which has resolved. If it's not the diet, I am just curious what else it could be. It's not near high enough to be Cushings and I sleep mostly fine.
Professor Ben!!! ❤❤❤
Thank you 😊
What if your hypo thyroid before you go keto, no antibodies
Thank you Dr
I volunteer to be a subject in your thyroid/keto diet research if you do it!.😊
Signed up today. 👍🇨🇦
key point is that there is no such thing as a functional hormone. They are messengers whose specific physiological effects across tissues is deterind by the differential distributions of receptors. Considering just the absolute level of a hormone, or measuring a hormone in a single shot does not tell much (and unveils a pofound ignorance about the workings of hormones), even when considering its releasing hormone.
As in the case for insulin, where the test is called a tolerance test, which is kind of misnomer, together with HOMA-ir, which relates the hormone to its physiological effect, a test for the thyroid system would have to doa similar thing. Suggestion: triggering a cortisol response via a standardized, fasted, 10 min physical stress at 80% VO2max. The ratio of max elevation of T3 to baseline T3 is much smaller in resistant than in non-resistant people.
Do you feel that there is an optimal level of TSH that would be in a tighter reference range? If so, what would it be?
I went low carb and found my Synthroid dose was way too much
@@michaeltyner7069 My doctor took me from 200mcg down to 75 (over the course of 8 months) after just a loss of 15 pounds and a better diet.
Thyroid actions are crazy enough to begin with but when you add in Graves’ disease and its typical treatment of destroying the thyroid, it’s no wonder I can’t figure out what’s going on.
My TSH is checked frequently and doc and I try to keep it on the low end of the acceptable range. I take Synthroid (thyroxine, so T4). But I still display symptoms of low thyroid, lethargy, obesity. Would it be helpful to have T3 and T4 levels tested? Per this discussion, logic tells me that if TSH is low, the T4 I’m taking is converting fine.
I had low thyroid symptoms until I took t3. Now I take Armor and feel so much better, It has both t3 and t4
You should always get a full thyroid panel. TSH, Total t4, Total t3, free t4, free t3, Reverse t3, TPO antibodies, Tg antibodies
OK your head might explode on this one. I have no thyroid (cancer) and take Synthroid. I'm keto, pre-type2 and take Ozempic, which works well. A1C 5.6. Anything I should look out for? I don't take any T3. Its been 10 years since the cancer, so endo is lowering my thyroid levels to normal, they were elevated per protocol to keep TSH low. Unfortunately, knowbody understands this like you. Anything to watch out for?
I just want to know why I am not losing. Maybe thyroid? I got a full metabolic blood count last summer. Nothing was said to me. I had little to no hormones so I am on bio identical hormones at present. I cut out coffee and cream… praying it helps
Thankyou, thankyou, thankyou!
Is it the higher level of Tyrosine in a meat diet?
Is insulin a peptide?
Thanks
So, I have recently adopted a carnivore diet. I am on amour thyroid medication. Is it possible to come off it in time? I do not have damaged thyroid. I was put on it because of low adrenal function 🤔
Wow. I would try to get a second opinion (polite for: likely a mistreatment, more experimentation than treatment)
What is the difference between Synthroid and levothyroxine? Besides cost. Does it matter?
My understanding is that levothyroxine is the generic name for the Synthroid brand name.
After nearly two years of being a carnivore my hair is drasticly falling out.
I was low in vitamin D3, so I am taking that now, because I was very sick before that. In the summertime I can not easily go outside, because of severe hayfever.
I hope my hair will turn around and grow again. I think D3 is also important for the thyroid to function.
Nothing compares to getting natural sunlight. The D3 pills are not good to depend on. I would get a Sperti D lamp if I couldn't go outside. Just be careful because they work really well and can get your levels up high. My hair falls out on Carnivore if my fats or proteins are too low. At 5ft 2 I need about 120grams of protein and fat to keep my hair healthy.
what about testosterone resistance (and I'm not refering to the genetic/developmental one which lies behind the intersex people but an acquired one in adult age...) ?
Is this why my body heats up so much and my heart is pounding when I eat a bunch of carbs?
what is a bunch of carbs? CGM can now be bought over the counter.
It's super simple. These levels are inversely proportional to each other.
My TSH is below normal but my T4 and T3 are normal. I take Levothyroxine and T3. My thyroid support group says low TSH is normal if you are on T3 but the doctor has cut my Levothyroxine from 150mg to 75mg. Is this the right course of action? Taking meds has not improved any of my symptoms.
@@ameliaashton-brooke2454 There is quite a range of “normal” for TSH so I’m not sure what you consider “below” normal. But the lower it gets means that your body is say “whoa! We have plenty of T3/T4”. It sounds like your doctor lowered your levothyroxine because you were getting more than enough T3/T4.
You didn’t say what symptoms you are experiencing to make you think your meds aren’t working.
@donnatodd4119 Thank you for replying. My TSH is 0.01. Symtoms are dry skin, fatigue, always cold and brain fog, plus of course the constant battlexwith weight. I lose and regain the same 10 pounds every few months but really i need to lose 30lbs. x
@ Well, 0.01 is truly very “below normal” or “hyperthyroid” so I’m truly confused by your symptoms which are typically “hypothyroid” caused. Just when you think you understand the thyroid then this sort of stuff pops up.
Proffesor...❤
You have such an awesome Carezma and honesty,
Would you dive in cancer cell biology as scientifically proven, l am eager to see watch and carefully listen
And many others do....thank you.
huh, references are now behind a paywall?
what about reverse t3? how does that effect the working of the system. does high levels of reverse t3 raise tsh?
Yes. Elevated RT3 will raise TSH and cause hypo symptoms. RT3 goes up when you are sick and the body wants you to rest, or if you take thyroid hormones, when your dose is too high. After starting keto, my TSH and RT3 went up, causing my thyroid gland to swell. Taking an extra dose worsened the symptom, skipping a dose resolved the symptom. I tend to feel best when I miss a dose so I have been reducing my daily intake. 😁
High Rt3 is an indicator of poor t4 to t3 conversion. Which can be because by many issues. Even metabolic issues. One can have good TSH and good t4 numbers but high rt3. Or you can be making lots of t3 but it's not available/being blocked from cell and raising rt3.
I used to be in t4 only, switched to NP thyroid and my rt3 went down. So confusing. Never thought to lower or skip doses. Postmenopause now too. So that may be playing a roll. Adjusting to hrt now as well. Maybe too many variables?
@@lisachelton4599I have had a similar experience with the thyroid gland swelling and doctors increasing the meds, my Rt3 has always been low, skipping and lowering the dosage makes the neck/thyroid feel better and RT3 has been going up back to the normal range.
interesting
😊❤
Too much iodine and you can get thyroid rage.
First🔝👏🏻👏🏻
Second!