Tyronene/T3 adderall like effect

[T-3]

@bubble Yes, T3 (Liothyronene) has been the most powerful and consistent mood stabilizer for me. It brightens mental 'tone', enhances productivity, deepens mental focus, etc.

I was never on adderall, so I can't compare it with T3.

I never suffered from Irritable Bowel Syndrome or colitis, so I should be cautious in wanting to 'agree strongly' with your experience.

I will say that no other Peat-inspired intervention brought so many unexpected benefits and such a consistently high ratio of benefits to unwanted side-effects as T3 (from 2015, so just into my 10th year on it).

[bubble]

@T-3 it is great to hear that the effects are long lasting! I was worried they may wane after the first week or so honeymoon phase. What type of dosage do you take?

[T-3]

@bubble
It's a long story, motivated by different contextual cues (different problems I was working on) at different points in time and different responses I noticed at different times to identical dosing. I’m a type-1 diabetic since I was a teenager, male, 50+ years old, in the gym most days with good muscle tone and low bodyfat, feeling unusually healthy for my age most days aside from stress-related depression and other cognitive/personality/mental/mood problems that are my main focus at the moment. When I started T3, I had many other symptoms of metabolic/oxidative stress (low body temperature, brain fog, persistent high-cortisol symptoms over many years, and possibly ‘adrenal burnout’ if one believes in such a phenomenon, as there has been some good criticism of this term on the old RPF). All of those hypothyroid symptoms are happily resolved after 10 years on varying doses of T3, with other unexpected beneficial effects along the way.

After 10 years on T3 (with some NDT experiments in those years, too), I have come back to Peat's advice over and over again: to dose sparingly and avoid superphysiologic dosing (nothing more than 2 to 4 mcg per hour) by gnawing small amounts from a 25mcg tablet (or an equivalent single-drop dose of Idealabs' Tyronene). I strayed wildly from Peat’s recommendations in the spirit of “science” (i.e., self experimentation and desperation). I don’t regret those experiments. But Peat’s conservative advice re how much to dose – and when -- has proved best for me at present.

I gnaw a slightly larger dose (closer to 4mcg) if I have a large meal or feel cold, or if I wake up tired, or with brain fog, or feeling like I’m getting sick (any out-of-the-ordinary stressor). Most of the time when I feel like my metabolism is in good shape, I take nothing. Days go by when I don't need any T3 anymore. I do think I needed a full physiologic replacement dose (25-75mcg per day) every day for several years, however. I needed much larger and more frequent (i.e., daily) doses to work out of a metabolic rut. It’s only been in the last two years, when I’ve spent a lot more time outdoors in the mid-day sun, that my basal metabolic rate consistently feels “comfortably warm” and my head is mostly free from “brain fog” on its own without exogenous T3. This high dose is "extreme" and far too much for most people's contexts, I would think. I don't recommend going this high without experimenting for a long time with much smaller doses.

Like Peat suggested for himself, I need less in summer months and more in response to the stress of cold weather or not enough sunshine.

There were a number of excellent posts at RPF by high-quality posters, although they weren't always cross-linked. It’s noteworthy how many people had so much trouble getting T3 to work well for them. I always liked the subjective feeling of T3 as a subtle mood brightener promoting mental/physical “resilience”. I assumed others would feel these incredibly positive effects from T3, but we’re all different—more so than I appreciated before reading RPF.

I tried to read everything that was posted about T3 using various key terms searching RPF. For example,@ecstatichamster posted about the idea of "Dr. Wilson": taking superphysiologic doses for a short while to 'clear reverse T3 (RT3)'. Ecstatichamster rightfully criticized (if I'm recalling correctly) Dr. Wilson's recommendation of slow-release-T3 and other non-Peaty recommendations. I also would recommend against slow-release-T3.

I wound up finding some merit in Wilson's idea (clearing RT3 and restoring the body’s endogenous T4-to-T3 conversion), but I don't have blood work to prove it (because reverse T3 tests are expensive and very slow where I live). Based on other RPF posters, I assumed that my T4-to-T3 conversion was blocked or compromised. At my max dosing (2017-2018), I got up to 150mcg in a single day. Once or twice, I took 100mcg as a single dose. This is risky. Very heavy and rapid heart beat for 4 hours or so. And it probably shouldn't be done for very long (if at all). It’s hard to sort out subjective wishful thinking (placebo effects) here, but I did feel like my basal metabolic rate was noticeably better after: 1 the 100mcg ‘clearing’ dose a few times, followed by 2 physiological 25-50mcg daily dosing carefully spaced by gnawing on a tablet hourly during waking hours.

Many people hate the hyperthyroid side effects even from much lower dosing. Please proceed with caution and with plenty of anti-thyroid food/supps as antidote in case the rapid and heavy heart beats scare you. (Raw broccoli or cauliflower will do, although a litre of full-fat milk usually made me feel the calmest and best if I needed it). Fast/heavy heart beats scared me at first. But I later convinced myself that my body could handle it without a heart attack, without developing a permanent arrhythmia (what most doctors would be worried about) and without any osteoporosis risk.

I took the arrhythmia risk seriously for a little while but couldn’t find any studies that were convincing enough to stop my self-experimentation. The doctors here strongly discourage all exogenous T3 and most will not consider writing an Rx for it. Most of the are not well-trained in statistics or experimental design. Their interpretations of the research literature really is indoctrination and not “evidence based.” Regarding osteoporosis risk, doctors--especially in Commonwealth countries, I believe--push this as a scare tactic to discourage all T3, regardless of context. If you try to get a T3 script from your doc, you will likely hear this propaganda. I read all the studies I could find circa 2018. The falsely claimed risks (T3 will give you heart problems and brittle bones) is based on wild extrapolation from rather poor epidemiological studies, e.g., on post-menopausal nurses in the UK, where sicker participants were taking higher doses of many medicines simultaneously, and statistically illiterate epidemiologists falsely attributing causality to positive correlations between T4 and osteoporosis. Few if any of the studies used to warn patients away from T3 actually have anyone taking T3. Instead, most are correlations between free-T3 from thyroid blood panels in already-sick patients taking T4. Nearly all of these studies used to scare the peasants away from wanting thyroid meds were in already-sick, non-random samples.
Along the way, I also got NDT and T4 Rxs so I could learn what these meds “feel” like. Synthetic thyroxine (the T4 that docs prefer to Rx) made me feel the most hypo I’ve ever felt in my life. NDT felt good but different. I think my free-T4 blood work showed almost zero (way below normal) for a while, and taking NDT gave smoother (consistent warmth) for a month or so before I seem to get overloaded on T4 (or maybe I get overloaded with RT3). A large single dose of T3 (10mcgs, which is already 2.5 times the max physiological does of 4mcgs per hour) produces a noticeable clearing effect when I need it (in line with Dr Wilson’s theory). The symptom that prompts me to want a "RT3-clearing dose of T3" is whenever taking thyroid supplement (NDT or T3) has a counterintuitive effect of causing hypo symptoms. In that case, I repeat the Dr Wilson clearing protocol (with a much smaller clearing does, and only once or twice is usually enough), followed by modest subphysiological/supplementary T3 (2mcg-4mcgs max at any one time). This situation where I worry about RT3 blockage only occurs if I've taken NDT or anything with T4. T3 by itself almost never leads to opposite-from-intended hypo symptoms. In contrast, T4-containing meds sometimes do have opposite-from-intended effects.

To summarize: I approached T3 dosing very cautiously at the start (just a few mcgs per day for 3 months, then up to 20 mcgs per day, which I think should be enough for people not in an adrenal/metabolic crisis). Then (because of chronic high-cortisol symptoms, high-stress, brain-fog, prolonged multi-year rock-bottom enervating depression), I did the 'high-risk' Wilson protocol for a few weeks (based on the theory of wanting to unblock T4-to-T3 conversion and jump-start neurotransmitters/adrenals after suffering with undiagnosed hypothyroid most of my adult life util age 45 or so). As my basal metabolic rate recovered (I felt warmer, less brain fog, less depression, less OCD, less joint inflammation, better blood-glucose control, dramatically lower cortisol/sympathetic-axis-fight-of-flight symptoms, and somewhat less autistic, depending on who you ask)...I found that less and less T3 dosing was needed so long as diet/sunshine/sleep/rest-of-life-stressors were dialed in. This is a success story by my own reckoning, a profound one in many ways.

I relied on Peat's comments about Broda Barnes' books (e.g. using waking temperature, reflex speed, subjective feeling of 'being warm', etc. as I think I was too worried about heart arrhythmia, runaway hyperthyroid symptoms (rapid, heavy heartbeat, twitchiness, white fingernails, etc.). Higher libido is also an established "side effect" of being hyperthyroid. I learned to not worry if my heartbeat became fast and heavy for an hour or so, but my cardiovascular health was strong. I guess that going extremely hyperthyroid with T3 supplementation for a short time is far less risky (for me) than doctors think it is. At the same time, I can't rule out that it was my dumb luck that I avoided any complications with being hyperthyroid on blood tests for 5 to 8 years +.

Most of the last 10 years, I was on 25-75mcgs of T3 per day, gnawing at 25mcg tablets throughout the day. That's a full replacement dose (multiplying Peat's 2-to-4 mcg per hour x 24 hours). This high dose gave me hyperthyroid symptoms, most of which I liked. I had to beg my doctor not to order thyroid blood panels frequently, because I needed to stop taking meds and eat raw broccoli/cauliflower for a week until I felt awful and was freezing cold in order for my blood work to show up hypothyroid enough to get the next Rx for T3, which makes all doctors in my country nervous (as in, they could lose their license to practice, because it is so outside what's "normal").

All along, I was worried about shutting down endogenous T3 production. There were many RPF threads about it. Most suggested that people’s bodies could re-start within a few days after being on suppressive full-replacement doses for years. There are some Peat quotes with anecdotes to this effect, which I found encouraging.

I have gradually tapered and am now averaging less than 10mcg per day, dosed only on days or in situations where I'm facing unusual stressors (e.g., under-rested, coming down with cold/flu symptoms, work stress, etc.). I think I'll always want to have T3 on hand and will continue using it sporadically. But, to my great surprise, I think my endogenous T4/T3 system is mostly functioning well again – after feeling like T3 was lifesaving everyday medicine that I desperately needed for 8 years or so. I now think I wouldn't die without it. I was less worried about suppression, because I am a type-1 diabetic, dependent on exogenous insulin in any case. The risk of adding another dependency on exogenous hormones was far exceeded by potential upside. I didn’t find any suppression effects, long-lasting or otherwise.

Finally, @bubble, you mentioned that IBS and GI-tract problems were among your motivations to try T3. As an aside, my dad was a colitis sufferer and all the men in my family have allegedly auto-immune problems (3 of us type-1 diabetics, colitis/IBS, eczema, asthma). It doesn’t surprise me that there could be strong similarities among those of us on this board suffering from autoimmune conditions. For any type-1s reading, you will likely know Dr. Richard Bernstein’s “diabetes university” videos. He pushes low-carb, keto and a bunch of non-Peaty recommendations, which I had the good sense to ditch after finding RPF 10 years ago, but one interesting thing he said that I’ve taken to my doctors is the following. His clinical practice has several hundred type-1s. He says they are all hypothyroid even though it doesn’t always show up with elevated TSH on blood tests. Thus, he assumes by default (I think) that all type-1s are hypothyroid and puts them all on exogenous thyroid. I think he was onto something important there, although I stopped following him 10 years ago. Peat’s insight that treating undiagnosed hypothyroidism can improve many conditions with clinical presentations that appear very different is the point that I think deserves underscoring, which hopefully could lead to broad changes in clinical practice, factoring in thyroid and pursuing more aggressive interventions to upregulate metabolic health (achieving well-functioning glucose oxidation and ample ATP). Unfortunately, given the corrupt and mostly innumerate state of the medical profession, we probably have to do it ourselves.

https://en.wikipedia.org/wiki/Broda_Otto_Barnes

[DonkeyDude]

@T-3 Thanks for your incredibly detailed and valuable post. This is why I continue to browse these forums.

I have a friend who is a type 1 diabetic and he has kind of given up on ever feeling good or functioning well (or living past 40, I think). He is bitter over the fact he cannot eat his favorite candy anymore, and he gorges on a few high-carb foods he is allowed by doctors (such as pistachio nuts or peanut butter) like a finished hog.

I have been wary of giving Peaty dietary recommendations to him due to his diabetes. Care to describe your general diet/training/supplementation/insulin use and how you manage to live well with your illness in general?

[Mr. X]

@T-3 thx for these detailed review!!! This is pure gold

[banquos-ghost]

@T-3 Thanks for the thorough response. I'm glad to hear you're feeling much better. Suffering through years of slow metabolism and other issues is not fun, but your persistence and success are admirable. Congrats!

[T-3]

@banquos-ghost Thanks for the well wishes!

Although it probably sounds vainglorious to reflect too enthusiastically on one’s successes, I will say that Peat's ideas enabled me to profoundly turn around my physical health for the better and significantly improve my mental health during the last 10 years (with much debt owed to self-experimenters and smart posters in Peatdom). I think I can confidently raise my hand as a 'success story’ and describe my current state of physical health as thriving – objectively in terms of blood work and subjectively.

As a 50+ year old with chronic illness since I was teen (type-1 diabetes), I marvel at how healthy I've become Peating, although it took a long time and my path -- from running on cortisol and adrenalin, being physically broken from more than a decade of low-carb/Keto, high-intensity interval training, fasting, sleep deprivation, anger, etc... to thriving physical health (last 4 years or so) -- was far from linear or steady.

Nearly all my friends complain of sleep problems, whereas my sleep is deep, long and satisfying, with lots of dreams that seem (at least to me) meaningful. My digestion is good. I eat far more nutritious food (3500-5000 calories per day, I would guess) than my 20-year old sons (who are athletes) and more than anyone my age whom I know, while staying (mostly) slim. (I put on an extra 10kg during Covid lockdowns and ensuing mental depression, but I've lost most of it and would be considered muscular and unusually physically fit.)

I enjoy consistently good body temps and a subjective feeling of warmth that contrasts sharply with the frank hypothyroid chills and adrenalin-cooled outer limbs I suffered from before (sensations that I can now recognize and distinguish between, thanks to Peatdom). In contrast, many I work with exhibit multiple hypothyroid symptoms. I wouldn't have been able to see these symptoms in myself or others without Peat's work and 10 years of experimentation taking exogenous thyroid of multiple kinds, which, again, has played a critical role, I think, improving my health.

My friends and colleagues appear cold even when it's warm outside. They overheat quickly when the temperature rises a bit (e.g. 75+ degrees Fahrenheit). People around me generally eat miniscule amounts. That basic Peat insight (articulated forcefully by many amongst us): simply eating enough and enjoying what one eats plays a critical role in healing and good metabolic health.

Many around us don’t seem to care much about nutrition, and that’s probably just fine! (This is 180 degrees opposite of my view from 10 years ago, when I thought everyone should be as orthorexic as I was!). The non-health-conscious often look better and appear relatively healthier or more stable health-wise than those intensively interested in nutrition, which usually means fad-ish/odd/extreme diets (of which I had tried many, e.g., vegan, fish-oil, other metabolism-slowing supplements, Atkins, keto, etc… from age 17 onward). My friends who are most ‘into nutrition or health’ tend to be far more orthorexic than most of us in Peatdom!

Many on these threads have observed that both the young and the middle-aged appear to have fading or depleted androgens/youth-steroids. Sexually, I feel at peak health, with better body awareness, self-knowledge and confidence than ever.

I eat 3+ eggs nearly every day. I drink lots of coffee, 2-3 litres of full-fat/whole milk and a litre or so of orange juice. I’ve been taking 500mg aspirin every 6 or 12 hours (one to three times per day) for the last couple of months (with two-week wash-out periods every two 6 weeks or so). I eat a high-carbohydrate diet with lots of fruit and fruit juice (which contrasts so sharply against the extreme-low-carb/keto diet I was on for 15+ years, while achieving extremely tight blood-glucose control from ages 20-to-35). I now have occasional stints with very high sugar intake: maple syrup/brown-sugar/refined-sugar/molasses. And my hemoglobin A1c (3-month-average) glucose levels are now higher than they were before when I was carb-restricting, but I think that's a fair trade-off. Fewer hypoglycemic episodes now on high-carb Peat-inspired diets have led me to far fewer bouts of extreme/dangerous hypoglycemia. But that's just because of my more cautious dosing of insulin after reading on RPF about all the stress hormones that hypoglycemia causes. My doctors used to get angry at me for keeping my glucose control "too tight": I aggressively took lots of corrective insulin doses, which led to many hypos (several per week for 20 years or more). Now I have fewer hypos and my blood-glucose tests look like a "well controlled diabetic" from orthodox medicine's point of view.

Occasionally (when I crave butter), I’ll have a short stint with unusually high-fat intake for a day or a few days (i.e. when I intuitively sense that youth steroid production would benefit from some additional butter/tallow/cocoa-butter/stearic-acid etc). You can see from the high egg intake (and wide variety of meats including substantial amounts of pork, chicken and beef muscle meat) that my PUFA restriction is somewhat looser than it was than my first 5 years of Peating (with fully hydrogenated coconut oil and trying out some of the recommendations on Haidut’s PUFA depletion thread). I’m still OCD/ortho about avoiding seed oils but, from whole-food sources, I have loosened up to very occasionally eat fish or avocado in small amounts, aiming for variety (proactive diversification of the nutrient-intake portfolio) and enjoyment of food.

One of the most unhealthy behavioural traits that developed from my two decades of strict keto and other restrictive diets before was “great willpower”. I was a strict drill sergeant with myself about all food intake from age 17 until 40 or so. I was good at it, and very positively reinforced for applying strict willpower in many domains of decision making. When I discovered Peat, I applied drill-sergeant tactics for at least 4 years. I think there were some powerfully good results even in those first years -- from more calories, fruit carbohydrate and PUFA restriction. But the big breakthrough -- when my metabolism started feeling “healed” and re-calibrated at a significantly faster/warmer basal metabolic rate -- only occurred once I let willpower go. Free feeding to taste and abandoning the self-defeating and stress-inducing practice of willpower with respect to food is one of the most pronounced shifts in my Peat-inspired regimen and I think it has played a critically positively role in my healing.

Of course no one has everything dialed in. But I'm a good example, I think, of Peat principles and 'our Peat community' creating conditions of possibility for thriving physical health, despite chronic illness and the many aggravating stressors that we’re all facing. If the subject were to turn to mental health and maladaptation to workplace stress, however, I would have another less self-congratulatory (asking you to join me in condemning my own behaviour), long, multi-volume, epistle-length set of stories I could tell about my 'challenges' or 'mental/behaviour problems'. But on the physical side -- according to simple Peat/Broda-Barnes indicators of thyroid health and basal metabolic rate, standard blood work that GPs and endocrinologists order routinely, and subjective sensing of one’s physical health -- I think I've gotten lucky or been smart (in some dumb combination) to thrive physiologically like never before (or maybe like I was a 3- or 4-years old again).

I would encourage everyone who’s interested to experiment with exogenous T3 but to do so very cautiously. I’ve read many reports of people who responded very poorly to rapid heartbeat and other typical hyperthyroid symptoms. Rapid heartbeat doesn’t phase me at this point, but that symptom deserves respect and ample caution.

I just read in another thread about someone contemplating taking 1000mcg of T3. If you’re reading, please don’t! An extreme dose like that could be very dangerous. For yourself and for the rest of us who (selfishly) don’t want tighter restrictions on access to T3, please don’t wind up in the emergency room because of a T3 overdose!

I think that a number of people at RPF reported that they had wound up in the emergency room because of a racing heartbeat, even after rather modest doses like 10 mcgs (which is already 2.5 to 5 times the amount that Peat said was a physiological dose at any one time).

A dose of 10mcgs at once would make my heart race at least a bit, maybe intermittently (not continuously) for 4 to 6 hours. If I’m sloppy and bite off too much, this might happen even now, and I would regard it as no big deal. Or more typically, I might be trying to use up some outdated supply, which I suspect is weak, but I’m not sure how weakened it has become.

With proper T3 that’s not sun-exposed and not yet past its expiration date, I wouldn’t normally take any more than 4 or 5 mcgs (measured crudely by gnawing approximately 1/10th chunks from a 25mcg tablet, i.e., aiming for approximately 2.5mcgs but sometimes slightly more if I’ve had a large meal, am tired, sick or otherwise stressed).

I have conflicting thoughts (not medical advice) about T3 dosing. It’s bound to be individualized rather than one-size-fits-all. If you have enough experience taking T3, then you’ll have learned how remarkably hard it is to kill oneself or give oneself a heart attack, even though the racing heartbeat can feel alarming.

It’s that experience and conditioning from slow upward titration that makes it “reasonable” to undertake a “high-risk” experiment with super-physiologic dosing (e.g., with the objective of clearing RT3). On the other hand, please go extremely cautiously and titrate up very slowly, starting with the smallest possible dose. Titrate over weeks or months and not days.

I think Peat was right that the concern about shutting down endogenous thyroid production is discussed and worried about more than it needs to be. In reality, most our bodies are remarkably adaptable and good at re-establishing homeostasis.

For the first 9 years I was on T3, I carried a supply everywhere I went: at work, on vacation, etc, trying to drip a near-physiological (or half-physiological) dose most of the time. In the last year, however, I’ve backed off quite a bit and have been experimenting with “stopping T3” for two or more days (after 10 years of continuous daily dosing). In the past, when my metabolic health was still recovering, my hypothyroid symptoms returned quickly (e.g., 2 to 6 hours) after my last T3 dose.

But now that my basal metabolic rate has seemingly adapted to a high-calorie/high-carb/high-thyroid/high-ATP/glucose-oxidation homeostasis, I can now skip doses or otherwise walk away from T3 supplementation and notice no symptoms. This stability of what I am referring to as my “new” or “recent” metabolic homeostasis has only appeared in the last 9 months or so, where I can forget about T3 for a day or two is new.

I could probably stop altogether now, and I just might. T3 is so light-sensitive and temperature-sensitive. It degrades quickly, even with careful storage. And it’s expensive! I’m now starting to consider “experimenting” with taking a break for longer than 1 or 2 days, although T3 has been an essential daily medicine for 9 of the past 10 years. I’m recently starting to think I may be healthy enough to not need it as much anymore. But it’s been one of the most important tools, one which I’ll want to continue to have on-hand. Our weather in the Southern Hemisphere is getting cold now and I’m dosing everyday (this last week) after skipping 30 or more days over the warm-weather months where I live (November-February).

We just got another thread showing that T3 (and T4) promotes wound healing (with an impressive effect size (e.g., 14 days in the T3-treated vs. 60+ days in untreated skin cultures). I bet there will continue to be plenty of compelling reasons for many of us to want to have T3 in the medicine cabinet or pantry.

Writing this “success story” about myself made me imagine you rolling your eyes with skepticism or scorn, and fair enough! I hope there might be some useful info therein.

I treasure many of the people posting on these threads and the information their posts contain. It’s worth underscoring and expressing gratitude, once again, to you smart, honest and endearingly disagreeable people debating on RPF (over the last 10 years) -- and now bioenergeitc.forum! (Do we have an acronym that everyone recognizes yet? BF?). You all have been a boon for my health!

Even though years would go by without me posting much at RPF, that forum was the main source from which I was able to gather a lot of worthwhile ideas, reports from self-experimentation, and virtual (but sill very much meaningful) 'moral support' from an 'extended family' or 'community' (as much as we're probably tired of those overused words/metaphors).

I send sincere appreciation to everyone showing up here to keep Peat-interested people talking about things that matter to them, proposing new hypotheses and debating how to interpret the available 'data'.

[T-3]

@DonkeyDude I think it's terrific you're thinking about offering potentially helpful ideas to your type-1 friend. I have had only limited success sharing the 'sugar is not poison' message and other Peat-inspired diet/exercise/mental-outlook recommendations with people I’m close to. It's a work in progress. Enough progress has been observed, however, to not give up on communicating Peat's ideas to others. We've had some threads on the theme of communicating Peat's ideas to the as-yet uninitiated. And I'll look forward to hearing anyone's success stories on that front -- hopefully yours!

There were at least three excellent type-1 posters at RPF: Taramander, JohnHafterson and another from early on (whose name I’m forgetting) that posted 30 or more times in the early RPF years. [Does anyone know if Taramander or JohnHafterson on bioenegetic.form? If anyone's private-messaging them on RPF, I hope you'll invite them to contribute here.]
There are probably others, too, whom I’ve overlooked.

Taramader's and JohnHafterson’s posts are a rich source of type-1-relevant posts with much of interest to non-type-1s, too. Here’s an example where JohnHafterson gave some supplement recommendations:
https://raypeatforum.com/community/threads/what-supplement-s-actually-work-for-insulin-resistance-high-fasting-glucose-a1c.43848/#post-747422
You might look up those two on RPF and copy and paste some of what they’ve posted into a document for your type-1 friend.

I’m sorry to hear that your friend isn’t feeling good about diet and glucose management. I’ve been there. It’s a difficult-to-describe variety of “demoralizing experience”, watching one’s body go out of control, the slight to one’s ego of not having been able to get the desired glucose test result, the stress of willpower (which I seriously discourage – see below) and food guilt -- plus the physical sensations of lethargy and slow circulation (plus something else that feels awful sometimes when sugars go way too high) -- and then the extreme physical sensations during hypoglycemic episodes, which include loss of taste, walking feels spongy or like there’s no more terra firma, losing all cognitive capacity, physical spasms and social embarrassment going hypo.

As far as recommendations for your friend go, I’d suggest to eat whatever candy he wants and just take more insulin to cover the additional carb content. (I was extremely resistant to that line of advice, which my doctor friends frequently gave to me, encouraging me to eat birthday cake with everyone else or stop carb restricting so strictly.) So I can’t be confident how any recommendations would be received. But the Peat world has so much quality-of-life boosting potential for type-1s (and everyone, I’d suggest) that we should probably creatively try to do our best to introduce it to people we care about. I’d think starting with the pleasure of all the food restrictions your friend could let go of if he was willing to ignore what docs/nutritionists recommend and eat more fruit, candy, ice cream and nutrient-dense food in general (except for the damned pistachios!!!).

Unfortunately, nearly all the doctors and nutritionists I’ve run across that specialize in type-1 push nuts and seeds very heavily (protein and relatively low-carb, so they think it’s a good diabetic food even though in Peatdom we know differently). I used to eat bags and bags of pistachios and pecans and walnuts – some of the highest-PUFA and easiest-to-oxidize (go rancid). Dropping nuts and seeds from my diet 10 years ago was a major change.

To a diabetic, nuts or meat or cheese all look like “free foods” where I don’t need to inject insulin immediately if I eat it, whereas I’d need a unit of insulin to cover one apple or ripe orange. Injections are painless (they miss the nerves) more than 2/3rds of the time (based on the density of nerves and fineness of the needle). So in my view, diabetics accustomed to injecting shouldn’t mind taking more frequent injections. Most of us who pursued very strict control were taking micro half- and quarter-unit corrective doses 15+ times per day in any event, even when carb restricting. And there’s no pain from taking more insulin, although there is increased risk of hypoglycemia. That risk must be squarely acknowledged: eating more carbs requires more insulin which, in turn, means that the absolute value of any fixed percentage error in one’s dosing leads to potentially greater deviations from blood-glucose targets. A 10% error with a 5-unit shot would mean I took a half unit too much or too little. A 10% error with a 10-unit shot would mean I took an entire unit too much or too little. Even an extra half unit could lead to a serious bout of hypoglycemia.

I think it’s worth making the case that ice cream (without carrageenan or stabilizers), creamy desserts, gummy bears, even rock candy that’s almost pure glucose can be interpreted as anti-stress medicine, as a nootropic cognitive enhancer, etc. I think so much of my identity was built around drill-sergeant restriction and self-control: it was important to say no to candy and coke in large part to reaffirm who I thought I was and express my well-honed self-control/willpower. What’s going so well for me now is having completely abandoned rigid willpower as a value or goal concerning dietary decision making. Much of my healing came from loving the way food tastes and not interpreting it as a guilty pleasure. Rather over the last 5 years, I have tried, over and over (it actually required some concentration and concerted effort!) to view food as (sounds “woo” but isn’t, I don’t think) life-giving, nutrient-providing, energy-creating, regenerative-building-block-containing sustenance – rather than my old way of thinking in which, by default, every food option was “mentally interrogated” as a potential villain or compromise of my commitment to a “restriction and willpower” mentality.

I think if your friend could eat more freely, take more insulin to cover the increased carbs, get rid of the seeds/nuts, and be sure to test more frequently to avoid a serious hypo, then he might feel more energy.

The life-expectancy numbers are estimated very imprecisely. The first time I tried to buy a life insurance policy from State Farm for only $100,000 cover (after my first son was born), I was quoted an annual premium of over $4,000. I complained and the agent showed me the “life tables” they were using: type-1’s expected lifespan: between 41 and 42. That was more than 30 years ago. The lifespan stats apparently have improved but it’s not a bell-curve shaped distribution. Some proportion of type 1s crash out on dialysis, amputated toes, blind (diabetic retinopathy) in their late 20s or early 30s. With only very modest “blood sugar control”, however the lifespan may be statistically indistinguishable from non-diabetics or at least not much different. The averages include both types of glucose-management profiles.

I used to worry about dying early a lot and that drove some of my militant glucose-control mentality. I’m in a different place with those thoughts now. And the stats (despite the uneven quality of the big epidemiological studies of glucose control as measured by hemoglobin A1cs on lifespan and other clinical outcomes) are noisy and variable enough to justify telling your friend: our bodies are amazingly forgiving; the glucose control used in those studies to establish a positive association with lifespan was not at all stringent control. If I recall correctly, I think they grouped the population of diabetics into a few discrete categories (like good, fair and poor control). When I read them, I was shocked at how high the thresholds they used to define the “good control” group! It may not require that much tight glucose control to live a long and healthy life, so long as other things are working in your favour to limit oxidative stress and glycation measured in the hemoglobin A1c test (if that’s even causative of complications like retinopathy, impotence, wounds that don’t heal, etc). Reading Peat, I came away thinking that orthodox medicine and endocrinology in particular knows a LOT LESS about actual physiological mechanisms that cause problems for diabetics than we were taught to believe.

There is a well-established statistical association between depression and type-1 diabetes. If we accept Dr Bernstein’s statement that virtually all type-1s are hypoglycemic and have a T4-to-T3 conversion problem, some T3 (if you could source it, which isn’t always easy) was the most potent anti-depressive med I ever took. (I never took SSRIs or benzos although dangerous doctors have frequently Rx-ed them to me over and over during the last 30+ years). I tried all the herbal anti-depressive treatments (some with terrible effects) and most of the tamer Rx suggestions from Idealabs/RPF. T3 was subtle at first but lifted my mental tone, energy levels, reduced brain fog, etc. Thus, it might be worth seeing if you could find the link of Dr Berstein talking about how he doses thyroid to type-1s. It’s a big conversation recommending thyroid so maybe this isn’t a good first- or seventh-conversation topic with you friend.

It would be great to get Taramander and JohnHafterson to weigh in along with others. I’ll be keen to hear any updates about your friend and whether you succeeded at coaxing him to eat more candy! You can tell him that German parents give their children glucose tablets before math tests. You can tell him it’s good brain food and promotes wound healing (topically), which there are papers on. The over-arching theme of your conversations might be about enjoying eating, enjoying living, questioning the learned helplessness that the medical industrial complex instructs those of us with chronic illness to surrender to, and engage in some productive self-experimentation to take some matters at least into his own hands: how does eating candy to my heart’s content make me feel? Can I manage the insulin adjustments safely after eating like this for a week?

Another issue is meal timing. I trained myself in my militant-control days to never eat carbohydrate if my sugars were high. The orthodox procedure: take corrective insulin; wait thirty minutes to 2 hours (however long it takes for sugar levels to return to normal); then eat the carb-containing food. That’s probably still best practice in the sense that you generally need less insulin overall if you do it that way.

The relationship between insulin and blood glucose is not linear, however, despite what nutritionists teach (e.g. one unit of insulin covers about 15 grams of carbohydrate). It’s decidedly non-linear in practice! When my sugars are very high, I need more insulin to move down the glucose scale a fixed number of points or to cover intake of more carbs than if I am starting at euglycemia.

When I read about Peat’s story of some doctor in Europe in the early 20th century before insulin was discovered/invented who kept his type-1s -- with raging out-of-control high blood sugar – ALIVE, by feeding them kilograms of sugar per day, I started trying it! Now when I have very high blood sugar, I take huge amounts of insulin (for me) and drink orange juice or grape juice or eat white rice to taste. These high-glycemic-index foods would have been among the worst choices from my previous mindset, predicated on the goal of minimizing the time and, thus, area under the deviation-from-euglycemia curve.

In other words, eating sugar when one is already too high makes one’s deviation last for a longer period; it should result in more glycation and more rapid progression toward complications from high blood-sugar.

I’m no longer convinced this orthodox view is correct. My corrections from highs now usually coincide with some carb intake (sometimes I’ll even have a coke! because I have acute sugar cravings whenever I have extreme hperglycemia). My corrections are now more dangerous in the sense that I have to take substantially more insulin and thus bear more hypo risk if I overshoot. But my subjective sense of the stress experience along the correction path is that it’s easier on my body (in other ways perhaps having to do with less inflammation and stress hormones, although I’m just hand-waving and guessing here) to eat sugar or carbohydrate all along the adjustment path from hyper- to eu-glycemia.

For your type-1 friend (from my post just above), the following also might be worth passing along:
I now have occasional stints with very high sugar intake: maple syrup/brown-sugar/refined-sugar/molasses. And my hemoglobin A1c (3-month-average) glucose levels are now higher than they were before when I was carb-restricting, but I think that's a fair trade-off. Fewer hypoglycemic episodes now on the high-carb Peat-inspired diet has led me to have far fewer bouts of extreme/dangerous hypoglycemia. That's because of my more cautious dosing of insulin after reading on RPF about all the stress hormones that hypoglycemia causes. My doctors used to get angry at me for keeping my glucose control "too tight": I aggressively took lots of corrective insulin doses, which led to many hypos (several per week for 20 years or more). I always thought the doctors were too worried about hypo and not worried enough about complications of hyper. Thus, I always fought with them arguing that my frequent hypos were a reasonable tradeoff in favour of avoiding dialysis, blindness, impotence, etc. Now I have fewer hypos and my blood-glucose tests look like a "well controlled diabetic" from orthodox medicine's point of view. My bet may go badly and I’ll get one of those complications from high blood sugar. But I don’t think so. My circulation, androgens and regenerative tissue repair are too good for those aging processes to unfold by the mechanisms in the textbooks. The statistical associations are there, but the biological mechanism for accelerated aging isn’t there. Therefore, I believe there’s virtually zero probability that I’ll wind up blind or on dialysis or impotent.

[Repeated from my previous post above, for your type-1 friend and for everyone to consider is my statement against willpower. What do y’all think?]
One of the most unhealthy behavioural traits that developed from my two decades of strict keto and other restrictive diets before was “great willpower”. I was a strict drill sergeant with myself about all food intake from age 17 until 40 or so. I was good at it, and very positively reinforced for applying strict willpower in many domains of decision making. When I discovered Peat, I applied drill-sergeant tactics for at least 4 years. I think there were some powerfully good results even in those first years -- from more calories, fruit carbohydrate and PUFA restriction. But the big breakthrough -- when my metabolism started feeling “healed” and re-calibrated at a significantly faster/warmer basal metabolic rate -- only occurred once I let willpower go. Free feeding to taste and abandoning the self-defeating and stress-inducing practice of willpower with respect to food is one of the most pronounced shifts in my Peat-inspired regimen and I think it has played a critically positively role in my healing.

Regarding my insulin regimen: On average, 50 to 100 units daily, depending on carb intake. I take 12 units of basal (long-acting) twice per day, plus variable amounts of fast-acting insulin depending on the carb content each day and other factors (e.g., stress causes the liver to dump glycogen and sometimes type-1s will throw a very high blood sugar even after having eaten no carbohydrate or after fasting). But generally, I’d say, I take about 5 units of fast-acting insulin with most meals, up to 10 if it’s an especially carb-intensive meal. With four or five meals plus small corrective doses after testing 10 or 15 times during the day, my total insulin intake could reach 40 units most days and 50 or 60 on exceptional days (e.g. if I eat 250 grams of brown sugar or a pint of maple syrup!). I recently upped my basal dose (without a clinician weighing in on it) to 15 units twice per day, because I am consciously eating more frequently and I’m not on the road at the moment (so I can easily have juice/candy with me at all times, in case a hypoglycemic episode strikes, e.g., at the gym), which means it’s a safer time for me to experiment with upping basal insulin dosing.

[DonkeyDude]

@T-3 said in Tyronene/T3 adderall like effect:

stress causes the liver to dump glycogen and sometimes type-1s will throw a very high blood sugar even after having eaten no carbohydrate or after fasting

This is the exact "profile" of the guy I know. He has an extremely stressful lifestyle and seems to be disappearing before my eyes; I assume cortisol is aggressively breaking down his tissues in order to supply glucose. The doctors told him his type-1 might be caused by stress and since then he has only ramped it up.

Thank you for your informative posts. I greatly appreciate what you do here and I do hope I can make some use of it.

[T-3]

@DonkeyDude said in Tyronene/T3 adderall like effect:

I assume cortisol is aggressively breaking down his tissues in order to supply glucose. The doctors told him his type-1 might be caused by stress and since then he has only ramped it up.

I hope you can convince him to look at food in a new light and take a step back from medical orthodoxy.

I'm not sure how easy it is for a doctor who hasn't felt what "running on cortisol/adrenalin" for years on end feels like to 'get' it or give useful advice. Running on stress hormones may even feel like it’s “working well” for a while (a decade more wouldn't be out of the question) before serious problems emerge. "Running on stress" isn't a single-toned feeling. It’s variable. Sometimes manic/quasi-euphoric and sometimes catatonic/exhausted/fogged.

I don’t think most doctors have much insight regarding sympathetic/parasympathetic dominance.

Do we think we understand how ephedra/aspirin/caffeine promotes weight-loss while (counterintuitively) raising cortisol (counterintuitive because long-elevated cortisol levels are positively associated with weight gain)?

When I was running on stress hormones (stress-hormone-dominant), I used to pride myself (foolishly) as “king” of the all-nighters: I could stay awake for longer than most others could, and I took pride in being able to push through extreme stress running on cortisol/adrenalin. I think I used sleep deprivation, fasting, arguments/yelling, stressful gym routines to produce cortisol, which made me feel something I thought I wanted to feel (in the first decade of being stress-hormone dominant, before I crashed metabolically and psychologically). It would have been hard to talk me out of my cortisol habit at that time. I knew that I liked to do intense/extreme things, but I don’t think I had any self-awareness that I was using endogenous stress hormones like a drug. Behaviorally or economically, the stress hormones brought some (short-term) benefits (e.g. staying up all night to complete a work/study task). Long term, it brought exhaustion, inflammation and much worse.

It would be helpful if the medical orthodoxy would collect information during routine GP/endocrinologist visits to help us measure and track sympathetic/parasympathetic hormonal balance. Hopefully someone will chime in with how to use routine blood panels from GP visits to track sympathetic/parasympathetic tone. And while we’re at it (expanding our diagnostic wish list), wouldn’t it be great to be able to see a complete thyroid panel in real time (including reverse T3). It would be valuable to us self-experimentation enthusiasts if we had more real-time sensors to get high-resolution hormone measurement (faster and at more points in time).

I think you’re right that cortisol eventually destroys healthy tissue to liberate building blocks for energy production, responding to long-term hormonal alarm signals that there is insufficient energy. I don’t think it will be easy for his doctors to provide diagnostics to test our theory. They could run a 24 hour cortisol test (salivary) and a thyroid panel, but I wouldn’t trust them not to get side-tracked (even or especially if they are a “lifestyle medicine” practitioner…lots of carb-restriction advocates in that segment of the doctoring world). Maybe try to rule out Cushings Disease.

I wonder if a large volume of milk, tropical fruit, candy and other dairy should be among the first ‘food offers’ you make, regardless of whether he goes to the doc or not. The calcium in the milk would hopefully be perceived by him as soothing, calming and grounding.

Best of luck!

[Peatly]

@T-3 Great post and thank you for taking the time to update. I had some questions from your first post on this thread but you have since answered all of them. Out of interest, have you noticed any change in your salt requirement when using high dose t3? Some people notice edema with t3 and I am wondering if this is related to salt intake.

It hopeful to read of someone being so positive about "peating"

[bubble]

@T-3 thanks for sharing your experience in such great detail! I still have just been doing about 8-16mcg daily diluted in water sipping on it throughout the day. So far I haven’t experienced any racing heartbeat or anything like that. I of course was hoping this would be my panacea and cure me of all my ailments but it seems I haven’t been so lucky. Mentally though, T3 has helped me tremendously. It also seems to make me feel much lighter. There were times before where I just felt so heavy and would require effort to even lift my legs to walk up the stairs from the heavy feeling but now I feel light on my feet again.

I do not feel I’m dosing it properly because everyone says to take it with food but I have not done that. Since I have such GI problems I have completely stopped eating before or during work for the past several years as it’s just too much of a risk for me. I don’t want to fast all day, but the way things have been for me it was impossible not to. So I have been sipping on the diluted t3 throughout the work day while fasted although not truly fasted as I have sugar from 24oz of redbull. My overall feeling of well being and mental clarity and hopefulness is still great on it. I wish that I could eat during the day with it but that’s something I’m afraid to experiment with.

Not sure how bad it is to be taking t3 on a prolonged empty stomach like that.

[T-3]

@bubble I experience a similar subjective feeling of "lightness" in mental tone and also in how agile I feel I'm able to move my legs. Great that you're seeing some positive effects.

I don't think there's any reason to avoid food with T3. Orthodox clinicians prescribing T4/thyroxine often say to avoid taking it with calcium (i.e., better on an empty stomach), but Peat said otherwise. In the case of T3, I've never heard anyone talk about food interfering with absorption. In fact, taking T3 with larger meals especially (or some carb intake) would be more in line with what Peat wrote.

Why are taking T3 on an empty stomach? Is it to help your sensitive digestive tract? Have we seen reports of people experiencing digestive upset from T3? I don't think I have.

Given that you don't have racing heartbeat, it sounds like you could try titrating up to see if benefits increase? I hope the T3 experiment brings more of what you’re wanting from it.

[bubble]

@T-3 i take it on an empty stomach because I cannot eat at work. Eating often causes GI upset for me which I cannot risk happening at work. That’s why I take it on empty stomach just because I don’t eat all day until night time.

I noticed today the effect on mood is quite profound it gives me almost a very subtle euphoria. I am happy/content with just simply living with a positive outlook whereas for past 10 years I have experienced daily dread and doom feelings especially if any obstacles arrives in my path.

[T-3]

@bubble That's a very nice result for mood and mental tone. My dad suffered from ulcerative colitis since I was a kid and I am highly sympathetic as to what it's like being at work or in public while trying to keep one's gut happy. Challenging is an understatement. Hopefully there will be improvements quieting that inflammation forthcoming.

Do I understand you correctly that, despite your digestive tract sensitivities, taking T3 on an empty stomach while at work is causing no digestive irritation?

I always thought T3 was as easy on the gut as any supplement/med. Of course it would be good to know if others have experienced otherwise.

[bubble]

@T-3 yes it doesn’t cause me any gut related issues now. Redbull doesn’t either which I also drink during the day. It would cause me issues previously before I started taking B1. B1 was one of the things that healed my gut near instantly from immense daily pain and discomfort. I actually could not believe the effect it had.

[inthe4ttic]

I've used both (Ritalin rather than adderall mostly) and can see where you're coming from in regards to it alleviating anxiety and boosting productivity like addy (although I've often found adderall to be one of the most anxiety inducing drugs I've used).

Semi off-topic, but interestingly enough, adderall (not sure about ritalin) inhibits TSH, which in turn suppresses follicular release of T3 and T4. Amphetamines are seriously nasty and I would only ever take them with a heavy stack to mitigate the negatives. I would be interested to see how a dose of T3 to normalise levels would effect the adderall experience.