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I have paralysis by analysis – please help!

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  • I have paralysis by analysis – please help!

    Okay – so this is my first post – and unfortunately, it’s to ask for help. Some history (but not too much) - I’ve been primal-ish for about 18 months…mostly hitting the 80% - average 1400-1600 calories, 50-100 carbs daily. Current stats – 39 yo female, 5’ 2”, 142 lbs. No current meds – I do supplement daily with a probiotic, chelated magnesium (250), potassium (99), and Vitamin D (12,000 IU). I have a sit-down job - and my exercise is limited to 20 minute interval training 5x week. I like to lift (and could definitely be stronger), but I have a ganglian cyst/fluid on my left wrist that has had me out of commission for the last little bit.

    Over the last few months, I’ve been exhausted – not tired – but sit-down-on-the-couch-for-15-minutes-and-I’m asleep-exhausted. That combined with bone-chilling cold and some other symptoms made me think my thyroid might be a little wonky. I went to the doctor and had a butt-load of bloodwork done, and now I’m trying to determine what my next step should be. The doc says everything’s in normal range (with the exception of 2) – but one of my concerns is that I’m at the low-end of these normal ranges. My other concern is that it was performed by Quest Diagnostics (which is not great for Vit D – not sure about other tests?) I’ve googled to my heart’s content, but now I’ve read so much – I can’t tell which way is up, and I feel like I'm backtracking. Anyone want to help me figure it out? Here’s my results (ranges in parentheses)

    Thyroid panel
    T3 Uptake - 29 - (22-35%)
    T4, Total - 7.8 - (4.5-12.5 mcg/dL)
    Free T4 Index (T7) - 2.3 - (1.4-3.8)
    TSH, 3rd gen - 0.61 - (0.4-4.50 mIU/L)

    Lipid panel – my cholesterol rocks – totally happy with it !
    Triglycerides - 30 - (0-149 mg/dL)
    Cholesterol, Total - 198 - (125-200 mg/dL)
    HDL - 71 - (40-999 mg/dL)
    LDL - 113 - (0-129 mg/dL)
    Chol/HDLC Ratio - 2.79 - (0.00-5.00 RATIO)

    I also had a comprehensive metabolic panel ran – here are a couple of items from that

    Glucose - 90 - (65-99 mg/dL)
    Bun/Creatinine Ratio - 24 - (6-22) – this is high, not sure why?
    Potassium - 4.8 - (3.5-5.3 mmol/L)
    Calcium - 9.8 - (8.6-10.2 mg/dL)
    Protein, Total - 7.2 - (6.2-8.3 g/dL)
    Alkaline Phosphatase - 31 - (33-115 U/L) – this is low, not sure why?
    Vitamin D, 25-OH, D3 - 41 - (30-100 ng/mL) – if Quest is usually high, does this mean mine’s
    even lower than 41? Even with supplementing 12k?

    Iron, Total - 102 - (40-175 mcg/dL)
    Iron Binding Capacity - 340 - (250-450 mcg/dL)
    Vitamin B12 - 485 - (200-1100 pg/mL) – this seems low, and could account for my

    Okay – I didn’t mean to post all of that (and to think, I left some of it out – I also have a complete CBC panel )

    Anyway – any help would be greatly appreciated – thanks so much!

  • #2
    <<listening to crickets>> guess not? My google search continues...


    • #3
      * 1400-1600 calories a day
      * 39 yo female, 5’ 2”, 142 lbs.
      * I’ve been exhausted – not tired
      * bone-chilling cold... hands? feet? all over?
      So the problem is that you are worse than tired, and don't know why?

      What is your BP and your resting HR? What is your typical diet, especially breakfast?

      1st pass,
      1) I think your calories per day is too low,
      2) I think training 5x a week is too much. You need at least 1 day to rest between workouts.

      Best to you,
      Last edited by Grizz; 12-09-2010, 08:17 AM.


      • #4
        I had some of the same tests as you and my creatinine was elevated due to high protein consumption. However, my B12 was "off the charts high" according to my doctor because I was eating so much meat. I also had the same sit down/crash out tiredness that you had and my doctor said it was from too much exercise. She had me take a week off completely and then go back to exercise slowly after that. It has helped a lot.


        • #5
          @Grizz - I guess the problem is that I'm worse than tired, but only for the last few months...I had bloodwork drawn to see if anything jumped out, and now I'm making myself crazy trying to "self-diagnose" - my doc doesn't see a need to do anything, since everything came back normal. The coldness has been a constant since I started - mainly hands and feet - I figured it had to do with dropping the carbs, but then wondered if maybe the carbs were masking an undiagnosed thyroid issue...I just wanted to see if something jumped out at someone else...

          Exercising could be the cause...but I was doing the bottom levels of Simplefit until the cyst in my wrist sidelined me. I'd taken some time off to allow the cyst to burst (and then the fluid to go down) and hope to pick up a modified version of the program, because I really liked it. The "worse than tired" didn't start until I'd been off SF a few weeks (I'd considered the fact that the removal of SF was in part the cause - still not sure on that one). I started the sprint intervals a couple of weeks ago - mainly because I have a very sedentary job - and very little time. I get up 20 minutes earlier and hit the elliptical before I get in the shower.

          BP's normal - usually 110/70s; resting HR is about 66? I just checked...

          Typical diet is coffee in the morning (with 1 T coconut oil and 2-4 T cream), I usually have some nuts and/or fruit mid-morning; then 2 biggish meals for lunch and dinner. Lunch is generally leftover meat (at least 4 oz) and vegetables (usually a cup or more, seasoned with bacon grease or butter), sometimes a salad, sometimes part of a potato - just depends on what's in the fridge. Dinner is the same, only larger portions. I average 1400-1600 calories - some days are high, some a little low - depends on what I've decided to cook that week. FatSecret has my average ratio 60/20/20 (fat/pro/carbs).

          Calories are something else I've thought about - I'm constantly busy, but it's not the type of busy that I'd relate to burning calories (getting me/kids/husband out the door for school/work, desk job, cooking dinner, cleaning up, homework, baths, laundry, etc.). So I find it hard to think that I need more calories - especially if I'm using my hunger as a measure. But maybe that's something I can tinker with...

          @Adrianne - what was weird is that the BUN and Creatinine came back normal, it's the ratio that was high...I would have thought my B12 would be high, too - but it actually looks a little low -

          Thanks so much for your responses - I know being on the low end of the Vit D and B12 scale is something to look at...but I was also looking at secondary hypothyroidism (where the TSH is on the low end, but others are normal) - I think I'll start next week with upping the calories - see where that takes me...


          • #6
            geez - no wonder no one wants to read/answer this post - can I NOT write a book next time?


            • #7
              My intuition says adrenal exhaustion.
              Ancestral Nutrition Coaching
              Pregnancy Nutrition Coaching
              Primal Pregnancy Nutrition Article


              • #8
                Your Total T4 is at 41% of it's range. Your Free T4, as indicated by the results given, is at 38 % of it's range--I've not seen it described with "index (T7)". Many people feel best with numbers at midrange or better. However given your TSH you'd, most likely, be hard pressed to find a doctor that would treat you.

                T3 Uptake is an old test and tells you nothing. To see where you are in terms of T3 you need a Free T3 test done.

                Tiredness and feeling cold can be indicative of low ferritin. Ferritin is the body's iron stores. It can be low long before a problem with other iron measures, such as your total iron, take place. Low Vitamin D can also be a problem.

                Are you getting enough selenium, (200mcg)/day? Not getting enough can impair thyroid function.


                • #9
                  My very quick first impressions would be 1) thyroid and 2)B12. Find yourself a naturopath who will give you weekly B12 shots until your energy improves. And try to use iodine and selenium to kickstart your thyroid. The naturopath would also be able to help you with adrenals if you feel that may be a problem.


                  • #10
                    You don't need to worry about writing a book ... many of us do that.

                    If you want to try the B12 approach, I'd suggest getting the methyl form of B12 (methylcobalamin, I like the Jarrow brand) and putting a tablet under your tongue till it more or less dissolves. Also make sure that your bedroom is good and dark. If you find that your sleep improves (longer, deeper), then B12 may have been part of your trouble.

                    Have you tried taking ubiquinol? (It's CoQ10 in an improved form). It is one of the things which I can really tell I'm taking.

                    I also got a mood boost when I started taking krill oil, just one gelcap a day. I like the NKO (Neptune Krill Oil) brand, put out by Source Naturals, but no doubt others are fine, too. Check the label. It should have 1.5 to 2 milligrams of astaxanthin per gram of oil. I find that krill oil is far more effective than fish oil, and also keeps better. Someone pointed out that it's phosphorylated, while the fish oil is not. Some day it would be nice to find out what that meant.

                    You want the alkaline phosphatase low! That was the one my dad would watch to see if his cancer was getting worse. (It's high in cancer patients.)

                    Do you have any way of knowing how your female hormones are? You don't want to be estrogen-dominant. You're a little young for perimenopause, though many women start it even earlier. Sometimes a carefully timed small dose of progesterone cream (you get it at the supermarket, since as a natural product it can't be patented!) will do wonders for energy.

                    Maybe trading off your workouts and a nice slow ramble outside (every other day) would leave you more rested. For someone very busy, just the time alone can help lower cortisol levels, and so forth.

                    By the way, that brings up one more thing to try: ashwagandha tincture ( carried Herb Pharm brand.) Google it, it's a lot of fun reading everything from the most tight-laced official medical study to mystical Ayurvedic sites with sitar music in the background. Ashwagandha is the "queen of Ayurveda". It's also called "Indian gingseng." Unlike Chinese ginseng (panax), it gives a calm energy which doesn't leave you all riled up. I find it's a very gentle mood-enhancer. Thousands of years in use, millions of people, the only warning I've found about it is that for some people already hot (like having hot flashes) it's a little heating.


                    • #11
                      Cook, I find that it's best to be as specific as possible when starting a new thread. You should have put the word "thyroid" in there somewhere to catch the attention of people who know about thyroid issues. Also helps to add tags to the thread (at the bottom of the screen). I just added thyroid and metabolism for you.

                      Anyway...I'm not a big supplement user, but there's a supp I've used a couple of times in the past that I love: liquid Floridix iron plus herbs: Costs a small fortune, but one bottle should do ya. The idea is that the plant extracts make the iron very easily absorbable. Did the trick for me; I was bouncing around with energy after a few days.


                      • #12
                        I second the Floradix recommendation. It was the only iron that I could take that didn't make me sick to my stomach and constipated. It comes in liquid and pill form. I buy it at my local organic store.


                        • #13

                          I just looked at my multi-vitamin jar and was surprised to see ZERO iron supplements. Another very good reason to eat liver.

                          Originally posted by Article
                          It used to be called "iron-poor blood," but now we know it as anemia. Whatever you call it, one way to help treat it is to eat foods rich in iron (most doctors recommend taking a supplement, too).To boost the amount of iron in your diet, try these foods:
                          * Red meat
                          * Egg yolks
                          * Dark, leafy greens (spinach, collards)
                          * Dried fruit (prunes, raisins)
                          * Iron-enriched cereals and grains (check the labels)
                          * Mollusks (oysters, clams, scallops)
                          * Turkey or chicken giblets
                          * Beans, lentils, chick peas and soybeans
                          * Liver
                          * Artichokes
                          And here's a tip: If you eat iron-rich foods along with foods that provide plenty of vitamin C, your body can better absorb the iron.
                          And then there is the related subject of Choline Deficiency & Fatty Liver Disease:

                          We eat chicken livers with LOTS of onions frequently, and many of the foods in the above list, so we should be OK (fingers crossed).
                          Last edited by Grizz; 12-10-2010, 06:46 AM.


                          • #14
                            This article is fascinating.
                            Originally posted by article
                            The symptoms of iron deficiency are:
                            - Lack of energy, feeling tired and weakness.
                            - Pale skin on the lining of the eyes, the inner mouth, gums and the nails.
                            - Rapid and forceful heart beat.
                            - Low blood pressure with position change, from sitting to standing up.
                            - Finger nails become thin, brittle and white. They may grow abnormally and get a spoon-shaped appearance.
                            - Severe menstrual pain and bleeding.
                            - Tongue may become sore, smooth, shiny and reddened.
                            - Decreased appetite especially in children.
                            - Headache - frontal-
                            - Shortness of breath during exercise. (even during a simple exercise like walking)
                            - Brittle hair.
                            - Reduction in immunity and increased vulnerability to infection.
                            - A strong desire to eat nonfoods such as ice, paint or dirt. A condition called pica.
                            - Disturbed sleep.
                            - Abdominal pain.


                            • #15
                              @dragonmamma - thanks so much for the tags...I guess I was so busy trying to not write a book (and ended up doing it anyway)...anyways - thanks to everyone for their responses, lots of good information and things to consider

                              @Dragonfly - I'd thought about adrenals, but I associated suppressed immune system with adrenal problems (of course, I may be wrong). My immune system is pretty good - nothing more than sniffles for the past 18 months. The test for adrenals is a saliva test, right?

                              @marcadav - should the Free T3 be something I need to ask for? Given the other test results (and my ranges) - seems like it's just a little under. I don't know how much selenium I'm getting in my diet - it would mainly be from animal products (with some seafood) selenium could be another avenue to try.

                              I was wondering why ferritin wasn't listed on my lab results - I googled, and it looks as though the "iron binding capacity" means iron storage - my level is 340 (with a range of 250-450). The higher the level, the lower the stores. I've had anemia issues with all three of my pregnancies - especially my last (5 years ago) - there wasn't a steak within 20 feet of me that was safe

                              @Roo - I did try one bottle of iodine (after reading about iodine deficiency on MDA, I think) a while back - I can't say I noticed a difference. Do I need to take selenium with it? B12 shots are definitely something to look into (I'd love to find a naturopath, as well - so two birds, one stone).

                              @piano-doctor-lady - I will keep the B12 in mind (and the ubiquinol) - I currently take CLO 2-4 times a week (when I can remember) - when that runs out I may have to switch to krill oil (I get so confused on which is better). Thanks for the heads up on the alkaline phosphatase - I'd never heard of it, but good to know I'm doing something right there! Will definitely do some research on Ashwagandha - sounds fascinating...

                              I had my female hormones tested a couple of years ago - surprise, surprise - they were normal. I didn't think to get the actual lab results, so I'm not sure where I fell. I can have them tested again at my next annual exam (in a couple of months).

                              I actually switched my sprint interval out this morning for a less intense routine. A bit faster than a ramble, but still less intense than the intervals. That will work well - sprints MWF, rambles TTh. And then if I get out for a walk, it's a bonus!

                              A couple mentions of Floradix - I've got it in my shopping cart as we speak. I hated the iron supplements my docs had me take when I was pregnant, hopefully this will be easier to "stomach".

                              @Grizz - still trying to muster up the nerve to eat liver...and figure out how to talk my fam into eating it (I'm primal, they're not - but I'm working on it). I have a couple of the iron deficiency symptoms you listed (including the headache - I thought it might be stress, but I guess it could be stress coupled with iron deficiency)...

                              Stress is another thing that could be a factor. I'm a pretty high strung, type-A personality. I thrive on deadlines & schedules - that thriving might actually be me floundering...something I know I need to change, just haven't gotten around to it yet.

                              Again - thanks so much for your've definitely given me food for thought...