@Samyo, do you have access to raw milk and if so, have you tried it? I experienced the same issue as you, even after eliminating the methane SIBO (causes constipation) that I had, when pasteurized dairy comprised the majority of my diet and my diet was fiber-free. My skin and gut were happy but like you, I had rabbit stools. Also, I’m not sure why but eggs caused constipation too, until I switched to eggs from heirloom hens. With raw milk and heirloom eggs, even without fiber, my eliminations are perfect.

@GRay, I’m not sure if the same can be said for calcium supplements, but I’ve always taken NDT with meals to slow its absorption so I can dose more than the physiologically appropriate 4 mcg of T3 per hour without running into problems, and my thyroid numbers and stats (temps, pulse rate etc.) are the best on a dairy-based diet so it hasn’t been my experience that dairy decreases the absorption of thyroid. I don’t recall Ray ever saying to take thyroid away from dairy, either. I only ever heard him say it’s better to take it with food and he recommended dairy so…

@SpaceManJim, I believe it comes down to personal context. Take me, for instance. One would think given my small size (99 lb at 5’2”) and relatively sedentary lifestyle that I wouldn’t need nearly as much protein as a large male who lifts weights and/or does hard, manual labor and yet I do—I average just as much protein as my brother who is 200 lb at 6’4”. When I don’t get enough, my blood pressure, temps and pulse rate tank, my muscles atrophy, I lose hair and bone density, and my blood work shows a protein deficiency, something the vegan community in particular claims is impossible for someone who consumes adequate calories (I average 2,500+ daily). Anyhow, all that to say, your body will most likely let you know what a good amount of protein is for you, and which proteins treat you best, if you pay attention to it.

You’re welcome, @RPadmirateur. Thank you for letting me know you sent a PM as I wasn’t notified. My apologies if I gave you the impression that I’m a health professional, but I have no medical training so I don’t do consultations.

Complex carbs triggered my hypoglycemia, but not simple sugars—the latter prevented it—and there was no transition to fruitarianism—I developed a severe case of gastritis when I had SIBO, which left me unable to digest anything but fruit. I didn’t go long without eating as that would crash my blood sugar, and there wasn’t a concern for stomach emptying time using dairy, eggs and seafood, no. I take 1 1/2 grains of Armour, no extra T3, with meals, this way I can safely go above the physiological dose of 4 mcg of T3 per hour. Since my diet varied when I still had hypoglycemia, I’ll give you an example day of eating that worked best for me and continues to:

When I first wake up (5:00 am): Tea (decaf or herbal) sweetened with honey or Dolcedi apple sweetener

Breakfast (7:00 am): Compôte with a chunk of raw cheese or flourless banana crêpes stuffed with strained yogurt and an all fruit jam (St. Dalfour), and a glass of juice

Snack (9:00 am): Hot, spiced cider

Lunch (11:30 am): A slice of crustless quiche (3rd pic from the bottom) or seared scallops with honey butter, a glass of raw milk and banana nice cream (last pic)

Snack (2:00 pm): Hot, spiced cider

Dinner (5:00 pm): Strained yogurt with jam or zucchini soup topped with eggs and strained yogurt (2nd pic from the bottom), a glass of raw milk, and a glass of juice

Snack (7:00 pm): Sweetened tea

Basically, I have fruit and animal protein at every meal and juice or tea between meals, and make sure to get sufficient calories throughout the day or else my sleep suffers.

Juice from sour, unripe oranges that are commonly used for commercial production, and the enzymes/clarifying agents and flavor packs often added, is nothing like the juice from truly ripe oranges, i.e., sugary sweet with low acidity and no bitterness, that I make at home. For example:

• Commercial, pasteurized OJ causes me intestinal burning, diarrhea, inflamed skin, hives, stuffy sinuses, tinnitus, a sore throat, hair fallout and tooth enamel erosion

• Commercial, raw OJ causes me intestinal burning, diarrhea, inflamed skin, hives, stuffy sinuses, tinnitus, a sore throat, hair fallout and tooth enamel erosion

• Juice from ripe oranges causes me none of the above symptoms, but instead results in mental clarity, joyfulness, boundless energy and soft skin

It’s hard to find juice made from truly ripe fruit in general but when I do, I take advantage of it and can drink upwards of 4 liters of it a day—apple cider is my go-to. With that said, I still find raw milk superior to juice for many reasons.

@RPadmirateur, no worries about scattered posts. I understand. I started on 1/4 grain and increased my dose by 1/4 every two weeks, yes. To discern better temps and pulse rate from adrenaline and cortisol, I measure my temp and pulse rate 20–30 minutes after eating and take note of my extremities (feet, hands, nose and ears). If I’m running on stress hormones, my temp and pulse rate are lower after eating, and one or more of my extremities are cold within an hour as my blood sugar crashes and adrenaline cuts circulation to them to keep vital organs warm.

Regarding the insomnia, I had frequent waking, as frequent as every few minutes during an adrenaline attack. As I fell asleep, I experienced a falling feeling that would jolt me awake, followed by a racing heart, heat surging through my core to my head, shortness of breath, convulsions and syncope. And because the adrenals have to compensate for the thyroid when its function is poor, and systolic reflects adrenal function (and diastolic kidney function), my systolic would spike as high as 170 with the surge of adrenaline. This went on night and day for 6 months straight until I went against doctor’s orders and took an over-the-counter thyroid glandular. Within an hour the attacks ceased completely.

The raw milk and yogurt were both whole and semi-skimmed, and I consumed other foods, as well. My hypoglycemia was both reactive and non-reactive. If I had meat or starch, I had a hypoglycemic episode, and if I went too long without simple sugars, my blood sugar would crash (as low as 50). The first time in my life that I slept through the night without needing to pee was when I followed a fruitarian diet and my mum, who went years on no more than 2 hours of sleep a night, slept through the night when she greatly increased her sugar intake so maybe trial less protein and more carbs for a few nights to see if your sleep improves? And yes, my hypoglycemia resolved with more thyroid.

My diet during recovery varied between plant-based, animal-based, and both plant and animal based, but the foods were fairly consistent—simple carbs (fruit, jam, honey, maple syrup, raw sugar), dairy (raw A2/A2 milk, goat cheese, ice cream and shakes), eggs (omelettes and quiche) and seafood (scallops, crab and tuna), with gelatinous broth, hot dogs and beef teriyaki making a brief appearance. I kept a log on the old Ray Peat Forum where I posted pics of some of my weekly grocery hauls and have also posted some here. To give you an idea of what my diet consisted of:

@RPadmirateur, I was prescribed many antibiotics during my recovery, but not PenVK, no. The last one I was prescribed was a month long course of rifaximin (550 mg 3x a day) for hydrogen SIBO. The only synthetic thyroid I’ve taken is TyroMix and I didn’t fare well on it long-term so I’ve stuck with NDT ever since. I started on a 1/4 grain and didn’t feel improvements until I was up to 1 1/2, but they were felt almost immediately. For dosing, the best measure is temp and pulse rate, IME.

In regards to dosing antibiotics, you and I are a similar size (I’m 5’2” and just under 100 lb) and my doctors have always prescribed me the same, standard course of treatment that even people twice my size are prescribed so I don’t think body size matters much among adults. If I’m not mistaken, Ray recommended a starting dose of 200 mg and lowering it as soon as symptoms subside.

Regarding the insomnia and adrenaline, have you experimented with different protein sources? Back when I had a bad case of insomnia and was suffering daily adrenaline attacks, I did an elimination diet and discovered that dairy was the only protein that didn’t cause insomnia or trigger attacks. It’s also a very anabolic food, for me. I went from 80 lb to 95 lb in just a couple of months consuming 4 liters of raw milk and yogurt daily, and it was mostly muscle and bone, proven by DEXA.

@SpaceManJim said in 3-4am waking:

Odd that nobody's mentioned it, especially after seeing your username, but...

How about salt?

Probably because he listed salt before bed under the things he has tried.

@temple-of-salt, this may seem counterproductive but to break the pattern, you could try setting an alarm to go off an hour before you typically wake (so for 2 am), keep something sugary by your bedside like juice or gummy bears and have it when the alarm goes off? Ray recommended a similar approach as a cure for insomnia.

@Insomniac, you’re welcome.