Hello everyone, I am new to this forum so just an introduction here

[Ashka9]

Basically a Pharmacist but suffer from Hypothyroid (Hashimotos), Hypertension and Type-2 diabetes.

As per lab reports in July end, My current TSH Level is high at 6.16 uIU/ml and antibodies at >600 IU/ml. Total T3 is 100 ng/dl, Total T4 is 11.4 ug/dl, Free T3 is 2.6 pg/ml and Free T4 is 1.32 ng/dl.

My current dose of Eltroxin is 137.5 mcg daily on empty stomach. Actually, my TSH level went high 3 months back (9.3 uIU/ml) so my dose was increased from 100 mcg to 125 mcg daily and after checking after 6 weeks of increasing dose was found to be 6.16 uIU/ml) so was further increased to 137.5 mcg daily. Take 100mcg selenium supplement daily for reducing antibodies. (this selenium supplement also contains zinc and vit. b12)

I have severe Vit. D, Vit. B12 and Iron deficiency found about 8 months ago but still not corrected and have been taking supplements for that. I checked my ferritin levels last month which is 88 ng/ml. Iron is at 55 ug/ml (checked 3 months ago) even after taking supplements for 3-4 months. Vit. B12 was 211 pg/ml when checked 8 months ago, Vit. D is 17.53 ng/dl checked 3 months ago. I am taking Ferrous fumarate (along with other B vitamins) for iron, Vit. D sachets (60,000 IU) with water per week, Vit. B12 1500 mcg with folic acid 5 mg ( can't find supplement with methyfolate as suggested in various posts over here).

I read that thyroid and diabetes has to be corrected together. My last HbA1c was 6.3 one month ago. So doctor says, sugar control is excellent. Taking Metformin SR tablet 1g each morning and night. Metformin has been reducing the absorption of Vit. B12.

I have hypothyroidism since last 10 years and was only on 100 mcg so far until I discovered 3 months ago when my TSH went high to 9.3. Diabetes diagnosed in March 2014 and so far ok.

I am thinking of going gluten free for reducing antibodies but overall I don't feel well. Feel lethargic most of the times and recently some sleep disturbances.

I would request all senior fellows over here to advise me if I fall short somewhere to improve my health.

Thanks in advance

[bluebug]

Hello and welcome.

As a pharmacist you should be easily be able to check this up.

Firstly you can take a maximum 10,000IU of vitamin D per day so up your dose by 10,000IU more per week. It can take months and nearly a year for some people to get their level up so take the maximum dose possible. It helps if you take vitamin K2 and magnesium supplements as well. I would also take the supplements daily or every other day rather than once a week as you don't get all your vitamin D from the sun once a week.

Use vitamin B12 lozenges instead of tablets as they are better absorbed.

Also make sure you don't take any other supplements apart from vitamin C at the same time you take iron supplements as iron can cause loose bowel movements and that can happen quickly. Ideally you want to leave 2 hours between the supplement and other food, drink and supplements.

Go gluten free and look into eating a high fat low carb diet. This diet will help you control your blood sugar and there is no gluten in fresh meat, chicken, fish, vegetables, olive oil and fruit. If you go on the forum diabetes.co.uk you can see that many diabetic people are eating this way and as a result those on metformin are reducing their medication, while all are finding it helps control their blood sugar.

Finally your sleep disturbances should reduce when your nutrient levels and hormones are controlled.

[Ashka9 in reply to bluebug]

Thanks for immediate response. Well, I will increase dose of Vit. D as you suggested and also find Vitamin K3 and magnesium supplement...hopefully if it is available where I live in India. How much Vit K3 and magnesium to be taken daily?

I took Vit. B12 1500mcg chewable tablets for about one and half a month but then read in the detailed article about Metformin that it is better to take with folic acid 5 mg to reduce levels of homocysteine to below 8...mine is 22.43 mmol/L. Not done lab test for folate yet. I have a soft gelatin capsule of folic acid 5 mg with Vit. B12 1500 mcg I found so just started that. But I will add Vit. B12 lozenges additionally to that. May be I am taking less Vit. B12 as per my severe deficiency? I take iron and all other supplements at night since it can't be taken with thyroid medication which I take in the morning. I will ensure I take it 2 hours after food as you suggested.

I am going for LCHF diet also shortly but my main problem is I am pure vegetarian and don't eat even eggs. I am not sure how to increase fat to 60-70% intake of total calories taken daily. Eating only vegetables may make me weak, I can't digest more beans/legumes everyday and too low carbs may make my thyroid gland into more trouble as I read an ebook "low down on low carb" by Chris Kresser , so I have to go for moderate carbs. And also what about ketogenic effect on low carb diets if used long term? Though, I will take suggestions from dlife forum especially for Indian LCHF and see how I go from there. I will check forum diabetes.co.uk also if it can help me.

[greygoose in reply to Ashka9]

Is your B12 methylcobalamin? You should really be taking 5000 mcg with a B12 that low.

It's not difficult to get fat when you're vegetarian. Butter on your cooked vegetables (if you eat butter); olive oil in your salades; eat nuts and avocados. Avocado with walnut oil and balsamic vinager is delicious.

[Ashka9 in reply to greygoose]

Thanks greygoose for response. Yes my B12 is methylcobalamin but I will increase the dose of vit.b12 to 5000 mcg with methycobalamin chewable tablets as you suggested.

I like butter but in our home, vegetables are cooked in groundnut oil. I have to change that may be to coconut oil as lot of people suggested. I do eat nuts few times a week.

Balsamic vinegar may not be available here in India where I stay.

I think either going grain free and gluten free for sometime may help improve my health. As wheat is the main staple food since I don't eat rice that much, being gluten free may be difficult. I have to try new recipes to change my food habits and lifestyle.

[greygoose in reply to Ashka9]

Can you not get sublingual tablets? They're better than chewable. They just dissolve under the tongue.

I'm sorry, when I wrote balsamic vinager, I had no idea you were in India - and have no idea what is available in India, anyway. You could use any type of vinager - or lemon juice - to mix with the oil, to make a vinaigrette for salades and vegetables.

Try going gluten-free for three months - totally gluten-free. See if it helps. Then, try eating gluten again and see if you feel worse. If you don't notice any difference at all, then there's not point in going gluten-free permanently. Because it would have to be forever if you are sensitive to gluten.

[Ashka9 in reply to greygoose]

Ok...will try to find sublingual tablets if available here. Yeah, I can use lemon juice instead...we already use in lot of preparations.

Yeah...I will check for 3 months going completely gluten free to see whether I have gluten intolerance or sensitivity and if I feel good then, I will continue. You are correct, if I don't feel better even after going gluten free, no point in doing it for lifetime! But eliminating wheat may be good however for reducing some weight and going for low/moderate carb diet.

[greygoose in reply to Ashka9]

[helvella in reply to Ashka9]

When you look for it, it is K2 (not K3) - simple typo but might make searching difficult!

[Ashka9 in reply to helvella]

Yeah, I realized after typing...I will look into it. Thanks. But I don't know what dose of vit. K2 and magnesium supplements to be taken daily? I have to research and then look if it is available here where I stay in India.

[SmallBlueThing]

Are you in India? The preferred supplements are easily available in the UK from online sellers such as Amazon and eBay.

It's best to include the acceptable ranges with your test results, to allow any anomalies to be spotted.

Stress hormones may compensate for your hypothyroidism, leading to sleep problems.

[Ashka9 in reply to SmallBlueThing]

Thanks for response. Yes, I am from India. I have done cortisol test last month and it was found to be 10.3 ug/dl (range is 6.0 to 18.0 for morning 6 am to 10am) when blood was withdrawn on fasting of 10-12 hours in the morning around 9 am.

What stress hormones you mentioned compensate for hypothyroidism?

[SmallBlueThing in reply to Ashka9]

Many use a saliva test for cortisol, giving results at four times during 24 hours; however, our health service either doesn't trust that test, or maybe feels it's too inconvenient, so prefers tests such as the dexamethasone suppression test.

This article may be helpful: forefronthealth.com/hypothy...

[gabkad]

Ashka, are you a Jain or a Hindu? There's other sources of 'carbs' you could eat besides pulses. I know that Jains do not eat potatoes or onions. But finger millet is a good source of low glycemic index carb with a goodly dose of minerals. in Hungary they recommend millet for diabetics.

All my Hindu contacts here in Canada eat millet but they did not while they lived in India. Seems it was not readily available.

Milk and yoghurt contain natural B12. 500 ml per day is a good source except with hypothyroidism and type 2 diabetes it's not absorbed well so you are stuck with having to take a supplement.

All those various types of gourds which have no flavour but contribute lots of fibre to the diet are good additions. Orange fleshed pumpkins and karelia are good. Tea made from karela (bitter gourd) leaves is supposed to help with blood glucose as does tea made from fennugreek seeds.

Dr. john McDougall recommends a very low fat vegan diet (all whole foods no sugar added) for type 2 diabetics. I'm starting to appreciate his Starch Solution diet recommendations except I really can't tolerate absolutely no oil added. But still, worth checking out given that you are a strict vegetarian. I find that most Indian and Pakistani foods are very high in added seed oils. Plus sugar. Correcting metabolic problems means either a person goes to an extreme with no added fats or goes totally low carb and high fat. You can't have both.

[Ashka9 in reply to gabkad]

Thanks, gabkad for response. Yeah, we do use millet. I am Hindu and eat potatoes and onions. But high carb is not recommended for diabetics so try to avoid potatoes and rice having high glycemic index. We eat all type of gourds also. But my main problem is to replace wheat which has gluten in it. I wish to try to go gluten free and see if I feel better. We here eat whole foods only no refined flours or packaged food whatsoever. We cook from scratch only everyday.

Yes we use groundnut oil for all cooking and frying so may be I have to replace that with coconut oil as suggested by lot of people. I don't like much sugar but can't avoid totally in everything we cook. I know low carb may not be suitable for me due to hypothyroidism so I will go for moderate carbs with high fat as all diabetics go for....since fat regulates insulin. But I have to check which good fats to be used.

[gabkad in reply to Ashka9]

The problem with all fats is they contribute a lot of calories. 1 tablespoon of any oil is 120 kcal. You'd need to do a dietary analysis because chances are you are already consuming more than half of your kcal in fats.

fat = 9kcal per gram

carbs and protein = 4 kcal per gram

This is the problem with fried food. You can take an ingredient that is low in calories but by the time the food is cooked, you have a high calorie dish. Diabetics need to reduce the amount of fat being stored in the pancreas and the liver. Reducing calories is easier by reducing the fats. Coconut oil is just another oil. There's nothing magic about it. But you'll discover that for yourself.

This is the point of all the vegan/vegetarian 'cures' for diabetes: no added fat.

The BMI calculator for Indians is different than for Europeans because Indians have less skeletal muscle tissue. So a 25 BMI for a European is obesity for an Indian. healthy-india.org/bmi_calcu...

I have read blogs written by diabetic indian women and how difficult it is for them to change the way they eat because the rest of the family wants what they want.

[Ashka9 in reply to gabkad]

Thanks for yr suggestions but when I went through a lot about LCHF-low carb high fat diet, they say good fat doesn't increase weight. They don't count calories. They say once your sugar level and other hormones are controlled, weight becomes normal. Culprit is carbohydrate, they say....but however I won't go for too low carbs but will take moderate carbs approach. Actually, diabetics release 3 times more insulin than non diabetics when they eat carbs...this insulin stores more fat and increase insulin resistance which is the main problem for type 2 diabetics. so carbs intake has to be reduced to considerable level. Carbs convert to sugar in the end and liver of diabetics releases 3 times glucose than non diabetics due to metabolic imbalances....so have to eat less carbs as much as possible to control insulin resistance and blood sugar level both. Now these carbs has to be replaced by fat intake to consume minimum calories you need to survive! You can't take protein more than 20% of your total calories because when you eat low carbs, live converts protein to glucose when required. High protein intake may not be good for kidneys also. So, when you eat less carbs, your body stays into fat burning mode for energy creation and that's what helps...if you take carbs more, it will convert into glucose for energy and extra glucose will be stored as fat.

You are right, I too find difficult to change the food habits unless I cook separately everything for me.!

[Elven]

Hello Ashka! Lovely to hear from you. I am vegetarian too (for 48 years so far) and seldom eat eggs or dairy products. I use coconut oil in baking, cooking and for frying because it boosts my healthy fat levels and is said to be particularly helpful for people with thyroid disease.

I eat low carb and higher fat. My main sources of fat are coconut oil, olive oil, avocados and nuts (in moderation). Good luck xx

[Ashka9 in reply to Elven]

Thanks Elven, I will start using coconut oil. Many people recommends that.

[Katepots]

With Hashimotos you absolutely have to be gluten free as it is an auto immune disease so unlike normal hypothyroid. You won't feel better until you change your diet.

I also have to avoid potato, tomato, onion...

Get the Immune System Recovery plan by Susan Blum

Research leaky gut.

Read everything by Dr Datis Khazzarian

Kris Kresser just did a webinar on leaky gut, I posted it on here. Very interesting.

[Ashka9 in reply to Katepots]

Thanks Katepots, for responding. Yes, I am going gluten free now...no option left. Have to eliminate wheat from diet as many people suggested.

Yeah, I am doing research on thyroid disorders, LCHF diet and leaky gut as well

I will look into matters you suggested above.

[Treepie]

I have Hashimotos .I have reduced gluten but not eliminated, mainly because I was reducing cake ,scones etc because of being recently diagnosed diabetic. It seems to work for me I have also added a teaspoon of cumin oil daily as it is supposed to help with inflammation and auto immune problems.

[Ashka9 in reply to Treepie]

Thanks for yr response. Recently I read an ebook "thyroid disorders" by Chris Kresser and he says you can't be 80-20 in going gluten free. Infact, you have to go completely gluten free because gluten when eaten has an effect for 6 months.

Yes, Inflammation has to be looked into to cure all our diseases. I have to research yet how to reduce inflammation.

[Treepie in reply to Ashka9]

I think that must be true if gluten intolerant and most folk with Hashimotos apparently fall into that category. I must be one of the exceptions. We are all very different and have to find our own solutions using sites like this for ideas.