Primal Plunge Results – Thyroid Function and Hormones

thyroid function blood tests

Primal Plunge Results – Thyroid Function

Of course having been diagnosed in ’14 with Hashimoto’s Disease of the thyroid, I’m all over this organ in my blood work, and the journey we are on really started with that diagnosis and reversing the disease with diet.  In other words, I pay a lot of attention to this panel.  The thyroid is on the Hypothalamus-Pituitary-Thyroid (HPT) axis; the hypothalamus releases thyrotropin-releasing hormone (TRH) to the Pituitary, which in turn releases TSH (thyroid stimulating hormone) to the thyroid.  The thyroid on receipt of the signal produces predominantly T4, which is converted in the liver and some other tissues to T3, the active hormone in the body.  If you want additional detail and references on the subject, please check out my problem-solving paper on the subject.  With that as background, let’s discuss the results.

TSH, T4 and T3

My TSH is solidly within the reference range, unfortunately the references ranges cannot always be trusted.  My research has led me to conclude that the top of the range for “normal” should be 2.5, as opposed to 4.5, with “ideal” being 0.5 to 2.0; I was 2.6 when I was diagnosed.  Since diagnosis and the radical change of diets, seven thyroid panels, I’ve only been over 2.5 once, that at 2.6 in March of 2018.  Even better, it dropped from 2.38 before the Plunge; I’m good on this marker, and very close to the “ideal” range.

T4 is what the thyroid releases remember, and both it and Free T4 look good.  No issues.  According the University of Rochester Medical Center, “T4 is found in the body in 2 forms: free T4 and bound T4. Free T4 travels into body tissues that use T4. Bound T4 attaches to proteins that prevent it from entering these tissues. More than 99% of T4 is bound. Because T4 is converted into another thyroid hormone called T3 (triiodothyronine), free T4 is the more important hormone to measure.”

T3 is “Low” but Free T3 is within the reference range.  The situation is similar to that regarding T4 and Free T4, the “Free” is the more important number.  Regardless, this did give me pause.  More T3 is required to metabolize carbohydrates, and my diet is relatively low in carbohydrate; during the Plunge I averaged about 15% of calories from carbs, 25% from protein, and 60% from fats.  To put that in perspective, according to wiki “The typical American diet is about 2,200calories per day, with 50% of calories from carbohydrates, 15% protein, and 35% fat.”

Reverse T3 is in range, though up a bit from the pre-Plunge tests.  According the Mark Sisson’s post, Is Keto Bad for the Thyroid, “When you endure psychological or physiological stress, the body converts T4 into something called reverse T3. Reverse T3 does the opposite of T3—it lowers metabolism and conserves energy, in case things are falling apart around you. If that seems like a disproportional response to doing too much CrossFit without eating carbs, remember that the environmental conditions under which this physiological system evolved featured such stressors as famine, war, and disease.”

T3 does drop on a low carb diet and for reasons I am comfortable with; I’m completely asymptomatic of “hypothyroid,” and Reverse T3 is in range, I am therefore unconcerned.  Besides, my Doctor is also unconcerned.

Thyroid Antibodies

These are the indicators of trouble, and TPO, Thyroid Peroxidase Antibody, is the chief marker for Hashimoto’s.  Let’s take a closer look at my history with respect to these two markers, TPO and Thyroglobulin Antibody (TgAb), which are in second and third rows from the bottom of the table pictured below.

thyroglobulin antibodies

After diagnosis in July of 2014, that’s the first column of results, it took us almost two years to get both markers back to within their reference ranges in April of 2016.  No problem in the ’18 tests.  The pre- and post-Plunge tests in ’19 used a new protocol; I hate when that happens.  The most recent two results with the new protocol are not comparable to previous results.  Regardless, I was in range on both antibody tests at the January 2019 test, and post-Plunge I was slightly elevated on the TgAb test.  For now I’m doing nothing with this result.  I don’t think I’m doing anything to drive that number up, and I’ve been at this for 5 years now, so I think I’d know.  It could be within the test’s margin of error (see sidebar).

I have more work to do in investigating this issue, but one course of action will be to have my TgAb next tested using both the original and new protocols.  This is just not something I’m willing to leave to chance.

Thyroglobulin antibody (TgAb) methods – Strengths, pitfalls and clinical utility for monitoring TgAb-positive patients with differentiated thyroid cancer

Most current TgAb methods claim to be standardized against the IRP MRC 65/93 and report results in kIU/L. However, despite IRP standardization, analytical sensitivity limits and the cut-off values that manufacturers recommend to define a “positive” TgAb result vary 200-fold. It should be noted that this IRP is a 60-year old preparation made from blood products containing TgAb with Tg epitope specificities originally characteristic of thyroid autoimmunity that may have been changed by aging. Also of note is that each method is not directly standardized with the IRP but instead uses its own internal, proprietary TgAb standard. Tg epitope specificity differences between the IRP and these secondary standards likely contribute to the widely discrepant numeric TgAb values reported when the same serum specimen is measured by different methods.

So at the end of the day, it’s just that one number, TgAb, that I’m dissatisfied with when it comes to my thyroid.  I feel like a million bucks, but at the same time I will ensure that this question is anwered more conclusively when planning the next blood work.

Primal Plunge Results – Hormones

hormones blood tests

This panel includes another one where the test protocol has changed, and of course it’s an important test, Free Testosterone, or as it’s often referred to, Free T.  Both Total and Free T dropped slightly between pre- and post-Plunge.  I’m never happy to see a drop in T, it is a crucial hormone, playing important roles in the body. In men, it’s thought to regulate sex drive (libido), bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm. And that’s just the start.  But again, it’s the Free T that’s most important.  And that bugger four lines down, sex hormone binding globulin (SHBG), is the fly in the ointment.  As SHBG rises the ratio of Free to Total T drops.  Not good.  This situation demands another look at the historical trends.

testosterone blood work

So you can see that between the ’15 and ’16 tests my ratio of Free to Total T dropped by half, while the SHBG doubled.  Now a couple of things happened during that timeframe, one is that my Total T doubled at the same time the Free T:Total T ratio halved, interestingly, and also that I stopped supplementing with DHEA and Zinc.  If it’s in this table it’s because I have established through research that it is a part of sex hormone production.  So already I have been back on DHEA and Zinc as a part of my reinstituted supplement regimen, but I’m going to take it a step further, I’m going to significantly increase the dose of Zinc, from 50 mg 3 days per week, to 100-150 mg 7 days per week.  I’ll hold DHEA at 100 mg per day for now.

And I’m thinking of adding Boron to the mix.  Boron is another trace mineral which has been substantially washed from the soils we grow our food in, through the persistent application of chemical fertilizers and irrigation. This quote from the article Nothing Boring About Boron will get you started, “The trace mineral boron is a micronutrient with diverse and vitally important roles in metabolism that render it necessary for plant, animal, and human health, and as recent research suggests, possibly for the evolution of life on Earth. As the current article shows, boron has been proven to be an important trace mineral because it (1) is essential for the growth and maintenance of bone; (2) greatly improves wound healing; (3) beneficially impacts the body’s use of estrogen, testosterone, and vitamin D; (4) boosts magnesium absorption; (5) reduces levels of inflammatory biomarkers, such as high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor α (TNF-α); (6) raises levels of antioxidant enzymes, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase; (7) protects against pesticide-induced oxidative stress and heavy-metal toxicity; (8) improves the brains electrical activity, cognitive performance, and short-term memory for elders; (9) influences the formation and activity of key biomolecules, such as S-adenosyl methionine (SAM-e) and nicotinamide adenine dinucleotide (NAD+); (10) has demonstrated preventive and therapeutic effects in a number of cancers, such as prostate, cervical, and lung cancers, and multiple and non-Hodgkin’s lymphoma; and (11) may help ameliorate the adverse effects of traditional chemotherapeutic agents.”

‘Nuf said!  I may hold off on the Boron until after my next labs.  If I introduce or change too many of the variables I won’t know which actually had the desired or undesired effect.

Primal Plunge Results Part 3 In Summary

With “the Basics” in Part 1 of this series, and  “Diabetes and Pre-Diabetes” in Part 2 of the series, I was very pleased.  In this section I’m generally pleased but not entirely satisfied, with the results regarding thyroid function and hormones.  In particular I will be re-checking and keeping a close eye on my thyroid antibodies, and I will be working to improve the ratio of Free Testosterone to Total Testosterone.  If you are interested in learning more about the Primal Plunge, I wrote two blog posts on the subject, PRIMAL PLUNGE – TOTAL PRIMAL BLUEPRINT IMMERSION and PRIMAL PLUNGE – PRIMAL LIFESTYLE: WHY?

I am running the 21-Day Primal Transformation (PTx) monthly, starting the first Monday of each month; call it your “quick start guide” to all things Primal; on the schedule is a wave starting July 8.

Next up in the last of this series I will be discussing the impact of the Plunge on heart health, including lipids, lipoproteins and inflammation.

All the best,

John

Primal Plunge Results Part 2