My personal experience with low thyroid

Something happened to me around October-November of last year.

I usually feel great. Ordinarily, my struggles are sleeping and relaxing. As with most people, I have too many projects on my schedule, though I find my activities stimulating and fascinating.

I blasted through a very demanding November, trying to meet the needs of a book publisher. This involved sleeping only a few hours a night for several days on end, all after a full day of office practice and hospital duties.

But it was getting tougher. My concentration was becoming more fragmented. Getting things done was proving an elusive goal. Exercise became a real chore.

Although I usually force myself to go to sleep, I was starting to fall asleep before my usual bedtime, and I was sleeping longer than usual.

It's been a tough winter in Wisconsin. Let's face it: It's Wisconsin. But it's been tough even for this region, with weeks of temperatures consistently below 10 degrees. Even so, I was having a heck of a time keeping warm. Extra shirts, socks, soaking my hands in hot water--none of it worked and I was freezing.

So I had my thyroid values checked:

Free T3: 2.6 pg/ml (Ref 2.3-4.2)
Free T4: 1.20 ng/dl (Ref 0.89-1.76)
TSH: 1.528 uUI/ml (Ref 0.350-5.500)


Normal by virtually all standards. I measured my first morning oral temperature: 96.1, 96.3, 95.9. Hmmmm.

My experience coincided with the Track Your Plaque and Heart Scan Blog conversations about low thyroid being enormously underappreciated, with the newest data on thyroid disease suggesting that a TSH for ideal health is probably 1.5 mIU or less. (More about that: Is normal TSH too high? and Thyroid perspective update .

Could this simply be a case of medical student-oma in which every beginning medical student believes he has every disease he learns about?

Despite the apparently "normal" thyroid blood tests, I took the leap and started taking Armour thyroid, beginning at 1/2 grain (30 mg), increasing to 1 grain (60 mg) after the first week.

Within 10 days, I experienced:

--Dramatic restoration of the ability to concentrate
--A boost in mood. (In fact, the last few blog posts before I replaced thyroid reflect my deepening crabbiness.)
--Large increase in energy, now restored to old levels
--Need for less sleep
--I'm warm again! (It's still <20 degrees, but I get easily stay warm while indoors.)

I am absolutely, positively convinced of the power of thyroid. I am further convinced from the clinical data, patient experiences, and now my own personal experience, that low levels of hypothyroidism are being dramatically underappreciated and underdiagnosed.

I shudder to think of what my life would have been like 6 months or a year from now without correction of thyroid hormone.

Now, the tough question: Why the heck is this happening to so many people?

Comments (31) -

  • Brock Cusick

    2/5/2009 12:57:00 AM |

    Here's one theory:

    http://wholehealthsource.blogspot.com/2008/12/omega-6-linoleic-acid-suppresses.html

  • Anonymous

    2/5/2009 1:03:00 AM |

    For my last thyroid test my TSH came back at .752 - which I believe is good.  I get cold relatively easy so figured before testing that my results would come back problematic.  

    Then again I'm thin, with little body fat.  

    Don't know if this means anything for thyroid results, but I've noticed a dramatic feeling in coldness when I eat milk products.  If I have milk product, I become deeply chilled in the winter time.  So I've avoided milk for around 20 years for that and other reasons.  

    Since a feeling of cold goes along with hypothyroidism I've wondered if cows milk can cause thyroid issues.

  • Diana Hsieh

    2/5/2009 3:15:00 AM |

    Funny, the symptoms you describe are basically the same as those of my dog when she developed thyroid problems.  She was very weary and down, unable to do much, always cold, etc.  However, I suspect that you didn't have the problems with your fur like she did.  Smile

    Going on thyroid meds gave her a new lease on life: it took years off of her life in very short order.  I can only imagine how much of a difference it made for her mental state from the inside -- and I wish that we'd caught it sooner.  

    For a person, the ordeal would have been even worse.  At least my dog didn't know any better.

  • Darcy

    2/5/2009 4:29:00 AM |

    One theory floating around in the hypothyroid circle...Antibiotics have kept more of us alive than would have prior to antibiotics being invented. Poor thyroid function will lead to poor immune system function. Take away the antibiotics we were given as children for our various ear infections and strep throat and many of us grown adults would not have made it to adulthood. Now we're just grown adults with wide-spread thyroid problems.

  • Anonymous

    2/5/2009 12:26:00 PM |

    All that stress may have caused some adrenal fatigue which will lower tissue responsiveness to thyroid hormone. It would be interesting to know what your Reverse T3 was, as adrenal fatigue will reverse the T3 making it useless at the tissue level but still measurable as a normal total T3. With continuing adrenal fatigue and exogenous thyroid hormone you may start feeling "hyper" in the future even with normal numbers. Heart palpitations were my "hyper" symptoms while on thyroid for Hashimoto's but with still lowish lab numbers. This was then misdiagnosed as "anxiety" (palpitations do cause anxiety) and I was put on an SSRI. Years later I addressed the adrenal fatigue, am off the SSRI, and can tolerate exogenous thyroid without palpitations.

  • Olga

    2/5/2009 2:51:00 PM |

    Hi Dr. Davis:

    I was very interested in this post.  I have recently found out that the thyroid nodule I had excised 4 years ago was most likely a nodular goitre due to iodine deficiency.  I have never felt well since the surgery.  I was put on synthroid.  More recently I've been on Armour, since I consulted a complimentary physician.  He discovered that my iodine levels were very low.  I've started supplementing with Lugol's and now I've been able to go off the thyroid meds and I'm feeling much better.  I too have had thyroid problems every fall/winter since the surgery which resolve with the coming of spring.  Once I look forward to having my lipids rechecked once my iodine levels are normalized to see if it has any effect.  I was diagnosed with familial hypercholesterolemia 20 years ago.  Your blog has been a wealth of information.  Thanks so much.

    Olga

  • Nameless

    2/5/2009 9:40:00 PM |

    Have you considered that perhaps stress and lack of sleep simply caused your thyroid functions to become 'sluggish'?

    So instead of your thyroid being the cause of your symptoms, it was your lack of sleep + stress, which then caused your thyroid to work less effectively? Meaning... your thyroid issues, if there are any, were temporary, and restoration of sleep, etc. would result in an improvement?

    Armour would improve your symptoms under such a scenario too. But perhaps simply sleeping more, etc. would have done the same. Although this is a bad analogy, it's as if you took lots of caffeine or an amphetamine to keep yourself awake, more alert, etc. Yes, you would feel better, but taking better care of yourself, sleeping more, less stress would be the better option.

    Your hormone numbers are actually pretty good, by the way. I mean, no Endo or familty doctor would ever treat you with a TSH that close to perfect, and your hormone levels, although not perhaps ideal, really weren't that bad. And TSH, T3 and T4 all do fluctuate, not only day to day, but in the same day. Your TSH could come back close to 1.0 after a couple of night's of good sleep.

    Did you have your thyroid antibodies tested? That is the main cause of hypothyroidism, and can cause symptoms on their own, regardless of thyroid hormone levels (as least that's what I believe, but some doctors may think differently).

    I don't mean to sound negative with these comments, but I'm just playing Devil's advocate. It does sort of sound like you are finding thyroid disease everywhere, even in yourself, when it may not exist.

    Generally, for a proper  thyroid disease diagnosis, you can't go by a single test if your TSH is close to normal like that. A TSH >2-3, raised thyroid antibodies, and an ultrasound are usually used. If you come back abnormal on a couple of those, then yeah, you probably have Hashimoto's or some sort of thyroid problem.

  • Jenny

    2/5/2009 10:02:00 PM |

    If you have been low carbing, there is something I read about called Euthyroid Syndrome where your thyroid slows as response to the ketogenic state--the body thinks it is starving and slows down.

    This is different from thyroid disease. Very common.

    Unfortunately, it is impossible for us ordinary mortals who don't have prescription pads to get the thyroid hormone we need.  Doctors see the normal test results and refuse to prescribe.

    For me, the only cure is to up the carbs again (with insulin) since I can't get treatment.

  • Lola

    2/5/2009 10:33:00 PM |

    A lot of the Armour/natural throid fans and proponents say that your FT3 should ideally be at the top of the range, and FT4 at least in the top third. So, by the looks of it, you were in fact having something of a thyroid dip.

  • Scott W

    2/5/2009 10:39:00 PM |

    So...how do you convince a doctor to prescribe thyroid when your lab results don't support it?

  • Dr. William Davis

    2/6/2009 12:13:00 AM |

    All great comments.

    However, I've told everyone only part of the story. For instance, in patients we are seeing marked reductions in LDL and lipoprotein(a), not to mention improved energy, weight loss acceleration, and mood.

    As time passes, I am becoming more and more convinced that first a.m. oral temperature is the best way to identify low thyroid.

  • Nameless

    2/6/2009 2:12:00 AM |

    Improvements in lipid scores is another matter. It's not subjective anymore then.

    The question of why it's so common then is an interesting issue. You can't just assume it's lifestyle or lack of D, etc.  It is possible that's the cause, but it'd be a guess and not really scientific.

    I mean, we can safely assume you are following your own plan, yet  your thyroid may be sluggish there too.

    For Euthyroid Syndrome, you'd want to get your reverse T3 tested. At least that's what my doc said to test for. And as for getting treatment when your labs don't support it... umm... it's a problem. It's difficult enough getting treatment when your labs are abnormal.

    I'm glad Dr. Davis mentioned that there are patients with reduced LDL after treatment. I've recently been diagnosed with Hashimoto's -- TSH routinely >3 this past year, elevated antibodies, and two abormal ultrasounds later, an Endo is finally treating me. My lipids have been extremely stubborn, even though I follow a low carb, very little wheat diet, fish oil, normalized D, exercise, etc. My trigs won't go below 150 & LDL is in the 120ish range. Thankfully my Lp(a) has always been low 4-5. We'll see after treatment (assuming my endo doses me enough) if my numbers improve.

  • Anonymous

    2/7/2009 1:45:00 AM |

    The free t3 result you posted was low.  Very low.  This can cause a spiral of damage & disease.

    I am one who had a normal TSH even when my free t3 falls below the normal range.  The HPA Axis is at fault.  

    This situation is not as rare as some doctors like to think.  

    I do not believe doctors should rely only on TSH (a pituitary hormone.)  Free t3 is THE active thyroid hormone, and deserves the strongest attention.  

    I like to keep my ft3 at or just above the midpoint of the lab's reference range.

  • Anne

    2/7/2009 1:21:00 PM |

    Dr Dach reviews the book "Stop the Thyroid Madness" and links to other books and websites concerning thyroid/synthroid/armour issues. http://jeffreydach.com/2009/02/06/stop-the-thyroid-madness-by-jamie-bowthorpe.aspx

    I have been on Synthroid for years and now wonder if I would feel better on Armour. I am always cold and my skin, although less dry, it is still dry. I lost hair at one time. I am no longer losing hair, but I never grew back what I lost.

  • Anna

    2/7/2009 7:18:00 PM |

    Not long ago my son and I were tested for gluten (IgA antibodies, anti-tissue transglutaminase IgA, and genes, and we both tested positive but with a slightly different combination of genes that predispose.  

    Then it occurred to me that the hypothyroid symptoms greatly worsened during the years when I was eating the most gluten, at the end of my "bread machine phase" (bread machine recipes often specify high gluten wheat flours and added wheat gluten to boost rising performance and enhance texture) and when I was low carbing, but consuming LC bread products that contained not only soy, but added wheat gluten to boost protein and reduce starch content.  Gluten sensitivity and thyroid conditions often are related, but of course, I was not checked for anti-thyroid antibodies at the time.  

    I still eat LC, but a few years ago I did drop the LC bread and wheat products (and basically grains altogether) because they didn't fit into my goal to eat less industrially processed (fake) foods.  I'm not entirely paleo, but definitely eat in that direction, with very good results.  Wish I could say that was enough for my thyroid function to improve without added thyroid hormone supplementation, but I still take thyroid hormone (T4 and T3) to feel better.

  • Anonymous

    2/8/2009 12:40:00 AM |

    Unfortunately, it is impossible for us ordinary mortals who don't have prescription pads to get the thyroid hormone we need.

    For those in jurisdictions in which importation is allowed (or for those willing to risk ordering a medication that is probably not a high priority for prosecution):

    U.K. source
    S. Africa source

  • Trinkwasser

    2/8/2009 1:08:00 PM |

    I've heard a lot of similar stories in the UK - in many areas thyroid is not treated unless TSH is over 5 or even in double figures, and T3 and T4 tests are unavailable.

    Some people simply do not do well unless TSH is around 1 and it often takes a geographical move to obtain treatment, the effects of which can be dramatic and may include improved BG and "treatment resistant" depression resolving.

    Yet others need more subtle rebalancing until T3 and T4 are in range.

    As to causal factors, no clue, but this seems commoner that it's supposed to be.

  • Anonymous

    2/8/2009 5:39:00 PM |

    Dr. Davis I'd be interested in your experiences with patients with low testosterone levels and its relation to heart disease, plaque progression and metabolic syndrome. Has restoration to "normal" levels led to improved cardiovascular health?

  • JD

    2/9/2009 2:34:00 PM |

    Regarding Euthyroid Syndrome. The full name is Euthyoid Stress Syndrome. Dr. Eades says he did not see this effect in his patients. See the comments section of this link for further information. http://www.proteinpower.com/drmike/uncategorized/vampire-myths/

  • Nancy LC

    2/15/2009 6:43:00 PM |

    People practicing CRON, calorie restriction with optimal nutrition, also report low T3 levels.  In fact, they say low T3 levels is associated with longevity and seem to think it's a good thing.

  • lynn

    3/10/2009 1:41:00 AM |

    Yes there is a school of thought that Free T3 should be at the top of the range and free T4 mid range or higher. Since this is the school of thought that actually has success with patients feeling better, I would go with that. My TSH was totally normal like yours but my antibodies were pretty high. Although, that being said I have read that a TSH over 1 in a woman and 1.5 in a man is already in the danger zone http://www.thyroid-info.com/articles/dommisse.htm. Have you had your antibodies tested?

    There is a thyroid scandal going on all around the world where those of us with hypothyroidism are neither being diagnosed nor adequately treated.

    My temps have been in the 96's for years. God knows how long my thyroid gland has been being attacked.

    FYI it has been reported that most pateints feel their best on 3-5 grains of armour. There is even a theory that in healthy individals TSH is very, very low and that TSH only activates as a kindof emergency response.

  • mike V

    3/28/2009 12:28:00 PM |

    Here is a good NYTimes overview on treatment and controversy. 3/28/09

    http://preview.tinyurl.com/ckg6uq

    MikeV

  • ~MyGalSal~

    9/17/2009 12:42:09 PM |

    I could be a poster child for what no T3 can do to you.  I wonder if you could address the recent lack of availability of Armour thyroid and the disinformation regarding such.  I have resorted to ordering glandulars from NutriMeds but I am already suffering from a week of having to go back on levoxyl because of Armour not being available.  I have called many pharmacists and physicians and asked them what they are being told and virtually EVERYONE SAID NOTHING.  Any comments appreciated on this.  To me, this borders on criminal to abruptly stop the availability with confusing and contradicting reasons and all they will say is take a syhthetic.

  • Anna

    9/17/2009 9:27:14 PM |

    MyGalSal,

    The thyroid shortage is most acute at the corporate chain drugs stores.  They almost always order via dtisributers (middlemen) rather than direct from the maker.  

    Try a compounding pharmacy, either local or via online/mail order.  If you don't know of one, try this site:  www.iacprx.org/  Compounding pharmacies make individual preparations for all sorts of reasons.  They are often located near major medical centers.

    Many compounding pharmacies still have natural thyroid supplies (though they may be limiting refills to give everyone a chance during the shortage).  Compounding pharmacies also can compound a thyroid preparation specifically for you (though it is more naturally expensive than buying ready-made pills) if they still have a supply of the bulk thyroid extract powder, but your doctor will have to know how to write a prescription for compounded meds (my HMO endo didn't know how, I had to find out for him!).

    I've been able to get Nature-throid via a compounding pharmacy (they mail it to me), though lately I've had to be flexible and split larger dose tablets in half or take two of a smaller dose.  I don't mind, as long as I can still get Naturethroid.

    Janie Bowthorpe at Stop the Thyroid Madness blog has tips for maintaining your access to natural desiccated thyroid hormone, including having your doctor write your prescription as "broadly" as possible to so that the pharmacy can fill it with different brands or tablets cut in half, etc.  YOu may have to think outside of the "shopping center drugstore box" though.  

    I haven't tried this yet, but many people are having good luck ordering thyroid hormone from Canada (there is NO thyroid hormone shortage in Canada and Europe).  Again, Janie at STTM blog has posted specifics and communication with a Canadian manufacturer if you decide to try this route

    Good luck.

  • Anonymous

    6/16/2010 12:47:50 PM |

    It's your discovery, good job!

  • Male hormone therapy Beverly hills

    7/18/2010 8:27:14 AM |

    A fantastic read….very literate and informative. Many thanks….what theme is this you are using and also, where is your RSS button ?

  • jpatti

    7/24/2010 3:30:38 PM |

    With regards to adrenal fatigue, there’s a new web site that gathers much of the information from Val, who’s been helping people treat adrenal fatigue and hypothyroidism, including rT3 issues, for a long time: http://nthadrenalsweb.org

    Highly recommended.

  • watch

    8/17/2010 10:02:05 AM |

    Well Whattadya know, yet another great site to add to my reader!
    Hypnose or hypnosis

  • buy jeans

    11/3/2010 9:10:41 PM |

    It's been a tough winter in Wisconsin. Let's face it: It's Wisconsin. But it's been tough even for this region, with weeks of temperatures consistently below 10 degrees. Even so, I was having a heck of a time keeping warm. Extra shirts, socks, soaking my hands in hot water--none of it worked and I was freezing.

  • Megaera

    2/23/2011 9:34:53 PM |

    Pardon me for sounding bitter, but you got to resolve effortlessly symptoms I had to endure for four years (actually they were much worse, but it took 3 years of being told I had perfectly normal TSH levels, so shut up, and then another year to get an appointment with an endocrinologist who said, why yes, yes, you do have a goiter, we'll try synthroidl.  Two years on that crap, which didn't help at all, eventually some t3 which didn't either, and finally a minimal dose of Armour Thyroid (1 grain) which keeps me from feeling quite so crap, but I can't lose weight -- ever -- and can't ever stay warm in winter, or regulate my body temp in summer.  I HATE doctors.  And no, I can't change endos, there are't any more endocrinologists in this area, I'm damned lucky I got this one.

  • Natasha

    6/13/2011 7:24:53 AM |

    I was diagnosed with Hypothyroidism April 2006. My doctor started me on 100 mc of synthetic drug a day. After being on the dose for 2 months TSH level was down to 1.4 and my area normal range is 0.2-4.5. My doctor decided to keep me on the 100mc Thyroxine a day to see how i went. 4 weeks later i started to feel alarming symptoms as if i had Hyperthyroid. So I decided to switched to bovine thyroid, so far I gained positive results.

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Pill pushers

Pill pushers

Have you read the latest cover story from Forbes magazine? It's entitled "Pill Pushers: How the drug industry abandoned science for salesmanship".

It's great reading. (A condensed version is available at the www.forbes.com website: http://www.forbes.com/business/forbes/2006/0508/094a.html. They require you to provide your e-mail address though it's free.)

Drug industry advertising has raised consciousness of all the prescription therapies available for us--that's good. However, they've gone so far overboard trying to squeeze more and more revenues out of drugs that they've cost this country a huge amount in increased health care costs and even lost lives. (Forbes does a great job of summarizing some of these instances.)

Drugs like Lipitor, Crestor, Zocor; diabetes agents; anti-hypertensive agents, etc., that is, medications taken chronically, a huge financial bonanzas for drug companies. Not only do they get $100-200 per month, but they get it month after month after month. That's per drug.

Now not all medications are bad or unnecessary. There are times when they can be truly necessary and beneficial. But don't rely on drug company advertising to tell us when.

Comments (1) -

  • Anonymous

    4/30/2006 8:09:00 AM |

    I feel better then I have in Years.

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The myth of small LDL

The myth of small LDL

Annie's doctor was puzzled.

Despite an HDL cholesterol of 76 mg (spectacular!) and LDL of 82 mg, her CT heart scan showed a score of 135. At age 51, this placed her in the 90th percentile.

Not as bad, perhaps, as her Dad might have had, since he died at age 54 of a heart attack.

So we submitted blood for lipoprotein testing. Surprise! over 90% of all her LDL particles were small. (By NMR, they're called "small". By gel electropheresis, or the Berkeley Lab test, or VAP (Atherotech) technique, they're called "HDL3".)

What gives? Traditional teaching in the lipid world is that if HDL equals or exceeds 40 mg/dl, then small LDL will simply not be present.

Well, as you can see from Annie's experience, this is plain wrong. Yes, there is a graded, population-based effect--the lower your HDL, the greater the likelihood of small LDL. But small LDL is remarkably persistent and prevalent--regardless of your HDL.

We've seen small LDL even with HDLs in the 90's! I call small LDL the "cockroach" of lipids. If you think you have it, you probably do. Getting rid of small LDL requires a specific bug killer. (Track Your Plaque Members: Read Dr. Tara Dall's interview on small LDL.)

Don't let anybody blow off your request for lipoprotein testing just because your HDL is high. That's just not acceptable. Loads can be wrong even with a favorable HDL.

Comments (1) -

  • buy jeans

    11/3/2010 12:23:53 PM |

    We've seen small LDL even with HDLs in the 90's! I call small LDL the "cockroach" of lipids. If you think you have it, you probably do. Getting rid of small LDL requires a specific bug killer. (Track Your Plaque Members: Read Dr. Tara Dall's interview on small LDL.)

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Don't wet yourself

Don't wet yourself

While there is more to wheat's adverse effects on human health than celiac disease, studying celiac disease provides important insights into why and how wheat--the gluten component of wheat, in this case--is so destructive to human health.

Modern wheat, in particular, is capable of causing "celiac disease" without intestinal symptoms---no cramping or diarrhea--but instead shows itself as brain injury (ataxia, dementia), peripheral nervous system damage (peripheral neuropathy), joint and muscle inflammation (rheumatoid arthritis, polymyalgia rheumatica and others), and gastrointestinal cancers.

One neurological manifestation of wheat's effect on the human brain is a condition called cerebellar ataxia. This is a condition that can affect adults (average age 48 years) and children and consists of incoordination, falls, and incontinence.

Because brain tissue has limited capacity for healing and regeneration, symptoms of cerebellar ataxia usually improve slowly and modestly with meticulous elimination of wheat and other gluten sources.

Such observations are relevant even to people without celiac disease. Celiac disease sufferers are more susceptible to such extra-intestinal phenomena, but it can also happen in people without positive celiac antibodies.



Some references:

Neurological symptoms in patients with biopsy proven celiac disease

A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment.



Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics

Two hundred and twenty-four patients with various causes of ataxia from North Trent (59 familial and/or positive testing for spinocerebellar ataxias 1, 2, 3, 6 and 7, and Friedreich's ataxia, 132 sporadic idiopathic and 33 clinically probable cerebellar variant of multiple system atrophy MSA-C) and 44 patients with sporadic idiopathic ataxia from The Institute of Neurology, London, were screened for the presence of antigliadin antibodies. A total of 1200 volunteers were screened as normal controls. The prevalence of antigliadin antibodies in the familial group was eight out of 59 (14%), 54 out of 132 (41%) in the sporadic idiopathic group, five out of 33 (15%) in the MSA-C group and 149 out of 1200 (12%) in the normal controls. The prevalence in the sporadic idiopathic group from London was 14 out of 44 (32%). The difference in prevalence between the idiopathic sporadic groups and the other groups was highly significant (P < 0.0001 and P < 0.003, respectively). The clinical characteristics of 68 patients with gluten ataxia were as follows: the mean age at onset of the ataxia was 48 years (range 14-81 years) with a mean duration of the ataxia of 9.7 years (range 1-40 years). Ocular signs were observed in 84% and dysarthria in 66%. Upper limb ataxia was evident in 75%, lower limb ataxia in 90% and gait ataxia in 100% of patients. Gastrointestinal symptoms were present in only 13%. MRI revealed atrophy of the cerebellum in 79% and white matter hyperintensities in 19%. Forty-five percent of patients had neurophysiological evidence of a sensorimotor axonal neuropathy. Gluten-sensitive enteropathy was found in 24%. HLA DQ2 was present in 72% of patients. Gluten ataxia is therefore the single most common cause of sporadic idiopathic ataxia.

Comments (13) -

  • Anonymous

    4/3/2011 6:52:08 PM |

    Doc Davis,

    Thank you for all of your generosity and energy.  You've 50 posts on fish oil and 84 or vit D.

    I'm sending people to your site, but sometimes they're overwhelmed.

    Since these seem very important topics to you, would it be possible to summarize them in a definitive, proscriptive pair of posts.

    Thank you,

    DG

  • Might-o'chondri-AL

    4/3/2011 10:03:28 PM |

    Spino-cerebellar Ataxia (SCA) researchers claim to be associated with 28 (29?) variations of gene positions (loci) on human chromosomes; with gene mutations in 17 of those loci. Hereditary neuro-degeneration becomes clinicaly symptomatic in due time, not neccessarily when young.

    Gluten/gliadin responders who make anti-bodies to tissue trans-glutamin-ase (enzyme) have this anti-body implicated in ataxia syndrome. Spino-cerebellar ataxia is a category encompassing more than stumbling (SCA clinically includes psychiatric symptoms, etc.).

    Serum from humans with ataxia and the tissue trans-glutaminase anti-bodies was injected into normal mice, and the mice temporarily got ataxia. And then serum from humans who did not have ataxia, but did have tissue trans-glutaminase anti-bodies (ie: gluten sensitive)injected into normal mice also gave the mice temporary ataxia. In other words the gluten anti-bodies, irregardless of person having pre-existing ataxia or not, were enough to trigger ataxia in the mice.

    Doc cites study with average age of 48 as development of ataxia; this is explainable as fitting classic pattern of genetic neuro-degeneration. What I do like about Doc's linkage is the  concept that the gluten/gliadin anti-bodies may be a trigger of some sort.

    As for people "without positive celiac anti-bodies" who get spino-cerebellar ataxia (including any SCA associated symptoms)at the study's average age of 48 I am  skeptical. "Idiopathic" anything is a fancy way of saying something just so happens to be; as in patient Q has idiopathic XYZ and nobody knows for sure why, it just is XYZ.

    Doc has me thinking that if SCA genetic tendencies occur in an individual along with sensitive gluten genetics then cutting out the one risk factor controllable makes sense. Since genetic tests for SCA isn't readily done the no gluten tactic had to be tried out, and Doc seemingly noticed a % of encouraging results.

  • Dr. William Davis

    4/4/2011 1:23:28 AM |

    Hi, DG--

    Point taken.

    Perhaps a "Best of the Heart Scan Blog" would be in order.

    Thanks for the excellent suggestion.

  • Dr. William Davis

    4/4/2011 1:24:40 AM |

    Hi, Mighto-o,

    You've got some wonderfully unique insights.

    I'd like to see more of your ideas chronicled. Are you blogging or writing in some form?

  • dextery

    4/4/2011 2:10:33 AM |

    Recently there have cases of four people in the TV entertainment/news on air business that for some reason start speaking in gibberish...the latest being Judge Judy.
    http://vigilantcitizen.com/latestnews/judge-judy-the-4th-to-talk-gibberish-on-air/

    Do you suspect we may be seeing some brain atrophy from consumption of wheat?  I wonder how many times this may happen to ordinary people and they don't seek medical help because it passes.

  • Might-o'chondri-AL

    4/4/2011 3:42:08 AM |

    Hi Dr. Davis,
    I am not qualified to practise medicine, nor claim to be a true
    expert on things I discuss. Most of my work has been in developing countrys, which challenged my perspective and what pick-up on.

    The only other blog I read (and comment)is Whole Health Source.
    No personal blog or publication until another 1/4 century proves my advice worthwhile.

  • majkinetor

    4/4/2011 11:41:51 AM |

    How can it prove, if there is absence of digital forms Smile ?
    You should express your thought, definitely, in whatever form.
    Bring open source to medicine !

    Cheers.

  • Dr. William Davis

    4/4/2011 12:14:29 PM |

    Hi, Dextery--

    Interesting thought.

    Making the connection between wheat/gluten consumption and a neurological syndrome can be tricky. The most confident means to establish probable cause-effect is brain biopsy or autopsy. Most people would not submit to such things, so we rely on indirect measures like HLA DQ genetic markers and the reversal of the syndrome with elimination of wheat and gluten.


    Might-o--

    Well then, keep your wonderful insights coming!

  • Geoffrey Levens

    4/4/2011 4:12:33 PM |

    "Recently there have cases of four people in the TV entertainment/news on air business that for some reason start speaking in gibberish...the latest being Judge Judy.
    http://vigilantcitizen.com/latestnews/judge-judy-the-4th-to-talk-gibberish-on-air/"

    Some of my more paranoid friends think this is from "EMF mind control experiments" being performed by our govt, NSA, CIA, etc.

  • Anonymous

    4/5/2011 7:00:11 AM |

    Geoffrey

    well that certainly proves brain atrophy, if not in those 4 tv anchors but somewhat in your friends!!

    Wink

    PS

  • Medicomp INC.

    4/12/2011 4:11:14 PM |

    While there is more to wheat's adverse effects on human health than celiac disease, studying celiac disease provides important insights into why and how wheat--the gluten component of wheat, in this case--is so destructive to human health.

    Disheartening, but facts are facts.  It's somewhat mind-boggling to fathom how much wheat is consumer everyday, and the amount of adverse effects that can inflicted among the population.  The best thing is to stay informed-It should be a priority for everyone to understand at least fairly well what we are ingesting daily.

  • Daniel A. Clinton, RN, BSN

    4/17/2011 2:57:59 AM |

    It saddens me that a gluten-free diet for six weeks isn't recommend for a whole host gastrointestingal, neurological, and automimmune diseases. Celiac markers are just numbers. Exclude gluten from the diet and see if there is improvement. That's the best way to assess wheat's role.

  • Todd

    1/25/2012 12:03:22 PM |

    Hi Mitochonri'Al!

    I love your commentaries!  Anyway, just wondering, a hypothesis of mine, given your citation about the human blood serum and mice experiment above, can trans-glutiminase anti-bodies be present in grain-fed meat and dairy products (pasteurized)?  Would that be another argument in favor of grass-fed beef and dairy (and the raw dairy of that group, if wanted)?

    Just a hypothesis, as i notice a lot of people that eat very low carbs to zero carb paleo eating start to have issues that are arthritic and ataxiatic (sic) and conditions that seem neurologic (incontinence, lower back pains, and other inflammatory issues) even from heavy whipping cream consumption.  And anecdotal journals, they tell of self-experimentation with and without dairy, and the pains depart, return and then depart again almost to a tee...

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Fat "conditioning"

Fat "conditioning"

Here's a great study from the prolific laboratory of Dr. Jeff Volek from the University of Connecticut. (Full text here.)


http://jn.nutrition.org/cgi/content/full/134/4/880
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Breakfast comments

Breakfast comments

I received some wonderful comments to the What's for breakfast blog post.

Even though comments are viewable by clicking on them, I wanted to be sure these were readily visible, since they were so helpful and augmented the few suggestions I made. I'm impressed with the variety of foods people are willing to introduce into breakfast, particularly foods not traditionally thought to be part of standard American breakfast choices.




I normally eat a handful of almonds, some raw cashews, and occasionally an orange for breakfast. I used to eat cheese with breakfast also, but found once I began eating cheese it was hard for me to stop at one or two pieces.

Anonymous



My favorite breakfast is often left over Thai curry. I omit the rice. I also like making a thai omelet which is simply 2 eggs and some fish sauce and water and serving it with Sirachi sauce or Thai peanut sauce. It is street vendor food in Thailand I hear. Here's a recipe.

I find left over dinners are quite wonderful for breakfast. You just have to get past this notion that you have to eat certain foods at certain times in the day. Where'd that idea come from anyway?


Zute



I’ve tried eating oatmeal throughout my life, really wanting to like it. Until now the mere taste or smell of it made my stomach queasy. The key for me was toasting the oatmeal. Here’s what I generally do:

For Steel-cut oatmeal with the taste and texture of rice pudding-

In a frypan:
Toss 1 TBS of butter or so into a hot pan.
Add 1 cup of steel-cut oatmeal until toasted.
--few minutes
In a saucepan:
Boil 2-1/2 cups water
Add 1 cinnamon stick (or equivalent)
Add toasted Steel-cut oatmeal and cook for 15-20 minutes or so

Add 1-1/2 cups of low-fat milk, yogurt, or some combination, etc…
-Optional- Wisk an egg yolk into the milk.
-Optional- Add ¼ tsp salt.
-Optional- 2 TBS honey or Brown sugar. I use one 1 TBS of each.
Add some lemon or orange zest

Return to a boil for 10-15 minutes and then chill before eating. The oatmeal will congeal, resembling rice pudding.
Sprinkle more cinnamon/sugar on top
Add what you like: raisins, nuts, etc...

Use the cinnamon stick if you can, it really makes the difference. I’m constantly refining this recipe.


Anonymous



Once I decided to give up my (former) love affair with breakfast cereals, I was in a quandary about what to do for breakfast. I don't have much time in the morning to get creative and don't have the inclination at that time of the day to do so either.

I've settled on a routine of 2 hard-boiled (organic free-range) eggs (I boil them up a week in advance and leave them, shells-on, in the fridge), and a home-made protein-berry smoothie (frozen organic unsweetened berries, water-based).

This 8 am combo is easy, fast and tasty (I vary the berries and sometimes add natural flavour extracts for variety). It keeps my blood sugar flat and me full until my 1pm lunchtime. And I don't miss the cereals one bit!


Anonymous



I met an out-of-town friend for breakfast the other morning at a French-style bakery cafe. I ordered the goat cheese and herb omelet, but said I didn't want the potatoes or bread with it. They offered extra fruit or a salad instead. I chose the salad, with olive oil and vinegar. My friend wondered how I could eat a salad so early. Why not?

At home I usually eat 2 or 3 eggs over easy cooked in butter for breakfast most mornings and I am comfortably hungry for lunch about 3-4 hours later. But after my nicely filling cheese omelet and generous romaine salad (with a tiny bit of fruit - I ate the berries/melon and left the super-sweet pineapple), I wasn't hungry again until very late in the afternoon so had a small snack (cheese and half an apple) to hold me off and ate my next meal at dinner time. And it was a slow-developing comfortable hunger, not the powerful, "gotta eat something, anything" hunger that follows carb-heavy food.

Breakfast food, indeed!


Anna



You are absolutely right - breakfast is the most difficult meal to change. When I gave up wheat, I started using brown rice or potatoes mixed with anything interesting - nuts or meat or veges. I have now learned that these carbs make my blood glucose skyrocket. I have dropped the rice and potatoes and my BG has dropped nicely.

My favorite breakfast is sauteed veggies with some leftover meat or even an omelette. Soups are great in the AM. Nuts are for the days I am in a hurry.

Would be a little easier if I were not dairy intolerant.


Anne



Here in South India,it is 'Idli' - steam-cooked Lentil-rice (predominantly lentil) droppings, and 'Dosa' - lentil-rice pancakes. We have altered it a bit by increasing lentil ratio and dropping the rice to a minimum. Tastes good and fills you nice, for 4-5 hours.

Neelesh



I have two or three eggs, usually scrambled, but sunny-side-up and over-easy get thrown in for variety. I cook them using butter made from grass-fed cows. I also make my scrambled eggs using whipping cream instead of the more typical water or milk. I'll put a spoonful of fresh-made salsa over the top for some zing, some sliced cheese on the side and a cup of whole, organic milk to drink.

I'm completely sold on the "high-fat, moderate-protein, low-carb" diet and especially the admonition to start the day with a strong breakfast. My overall energy levels are fantastic, running performance is as good as high-school, and my belly hasn't looked this tight in decades.


Ross

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