@war4512 said in How did you treat your NAFLD and how long did it take?:

At low glucose levels, T3 shifts its metabolic effects, promoting catabolic processes. T3 increases glucose utilization, which can result in chronically low glucose levels, leading to the suppression of glycogen synthase expression.

Low glucose levels, in turn, lead to elevated glucagon levels.

Low blood glucose is a precursor to a stress response, further amplified by neurotransmitters and stress hormones.

Compensatory intake of more carbohydrates throughout the day can be highly beneficial, provided that the root cause of all problems is not excessive neurochemical signaling; treating this process will require time.

Oh yeah. Being careful with the dosing of T3 (<3mcg per hour or two) and consuming enough carbohydrates seems to be working okay right now. I think T3, alongside the rate of glucose oxidation, also increases the efficiency of glucose oxidation. I've experimented with dosing ~1-2mcg T3 between meals and noticed it increased the amount of time I can stay euthyroid. But I mostly swallow instead of chew the T3 as chewing leads to too fast an increase in metabolism which can make it harder to dose, and prefer to have it with meals.

@CrumblingCookie said in How did you treat your NAFLD and how long did it take?:

Consider three to four times as much daily choline.

Is this recommendation from personal experimentation or from a study? If it's from a study, could you please share it? I couldn't find it.

@CrumblingCookie said in How did you treat your NAFLD and how long did it take?:

Consider TUDCA and monoterpenes and CoQ10.
Consider a cholagogic of your choice like sylibine, chlorogenic acid (coffee), coffeine, emodine, artichoke leaf extract, gold coin grass, liquorice.

Awesome, thanks.

@CrumblingCookie said in How did you treat your NAFLD and how long did it take?:

Consider the possibly detrimental and exacerbarting impact of additional T3 on an already burdened liver.

In my understanding from reading Peat's work and some papers T3 is helpful in energizing the liver. Did you mean T4?

@war4512 Thank you so much.

@evan-hinkle That's great news. Found the thread.

A few questions:

• Did you work your way up to 1200mg/day?
• How much sugar?
• Did you make any changes to your diet during this time?
• Did you use any other supplements? B1, K2, magnesium, aspirin, thyroid, etc?
• After the two weeks, do you stop caffeine completely or settle at a baseline?
• Did you lose or gain any weight during this time?

@war4512 I was hoping to crowdsource ideas to try myself but personalized suggestions are great too.

I've tried to answer all the questions below:

• I weigh 203 pounds (92kg) at 5 feet 10 inches (178cm). I'm overweight and abdominal fat is slightly higher than the rest of the body, but not overly so. I have a little more muscle than a slender person as I used to lift weights.
• Till a week ago, I consumed 2800-3000 calories a day with a 64/15/21% C/P/F ratio (448g/100g/64g). I dropped my T4 dose from 50mcg to 25mcg and increased my T3 dose to 20-25mcg almost 3 weeks ago which has led to a decrease in appetite. So this week I've consumed 2300-2500 calories per day in a similar ratio. I'm physically sedentary apart from a 45 minute daily walk. A decent amount of mental work though.
• I was consuming 500mg choline via eggs and milk, but added an extra egg 2 days ago to reach 700mg choline per day. 10-11mcg B12 per day.
• The past several months I was only taking thyroid, 2-5000 IU vitamin D, and 2mg vitamin K (every few days). This past week I added 300 IU vitamin E and 200mg aspirin daily.
• Blood work

  Triglycerides:      48mg/dL
  Cholesterol, Total: 184mg/dL
  Cholesterol, HDL:   68mg/dL
  Cholesterol, LDL:   107mg/dL
  TSH: 0.05µIU/mL (Used to be 2.3 before thyroid supp)
  ALT: 27U/L
  AST: 34U/L
  GGT: 52U/L
  Albumin: 5.06g/dL
  
  I have outdated prolactin, DHEA etc measurements that I should get tested again.
  

Overall I feel significantly better than I used to and I think treating liver + glycogen storage is the final step for me. Sleep is deep and sound, though I wake up once in the middle to replenish sugar. Digestion is smooth with 1 BM per day (sometimes 2). I'm calm and patient and at peace pretty much all the time though I avoid excursions or putting myself in challenging situations because I know I become hypoglycemic. Even the daily walk with my dog leads to a little hypoglycemia midway through so sometimes I want to, sadly, cut it short.

RP on a diseased liver: “Eliminating all PUFA would be the most important thing, and having lots of orange juice, other sugars including honey, and milk and gelatin. Cytomel, aspirin, acetazolamide, and progesterone all protect the liver and help to slow cancer growth. Some people use extremely large amounts of aspirin, which require supplements of vitamin K, to prevent bleeding. Fibrous foods such as bamboo shoots and laxatives such as cascara help to reduce the absorption of bowel toxins that promote cancer and burden the liver.”

I reread this quote by Peat recently and put more emphasis on the gelatin, cytomel, and aspirin. I was already doing everything else. Found some papers which demonstrate direct effects on liver health in NAFLD – T3 sheds fat and promotes synthesis of glycogen in the liver. Gelatin, Vitamin E, and Aspirin papers here.

Would appreciate any more suggestions.

The prevalence of NAFLD is already widespread and only increasing. The liver is central to metabolism and probably one of the hardest organs to heal.

RP: "The liver, to the extent that it's injured, will ruin the whole organism. It's the chemist for the whole organism."

pikeypilled on X posted their liver score (ALT+AST+GGT) and it was a whopping 36. For reference, mine is 113 and I struggle with bouts of hypoglycemia every 2 hours.

So what did you do to bring your enzyme levels down, improve glycogen storage, and ultimately raise metabolism through the supercharged conversion of T4->T3?

@GreekDemiGod I'm in a similar boat and chalk it up to a sluggish liver. I've tried 100mcg T4, reduced that to 50mcg, and now to 25mcg. I've increased T3 to 25mcg to reach a 1:1 T3:T4 ratio. My temps and pulse are lower but my blood sugar is stabler and I feel warmer, paradoxically. My insatiable appetite for sugar is also reducing. I think the constant bouts of hypoglycemia that are caused by a diseased liver convert T4 to rT3, which make me more hypothyroid (despite good temps and pulse), so correcting liver function is my priority right now.

RP: "The liver, to the extent that it's injured, will ruin the whole organism. It's the chemist for the whole organism."

RP on a diseased liver: “Eliminating all PUFA would be the most important thing, and having lots of orange juice, other sugars including honey, and milk and gelatin. Cytomel, aspirin, acetazolamide, and progesterone all protect the liver and help to slow cancer growth. Some people use extremely large amounts of aspirin, which require supplements of vitamin K, to prevent bleeding. Fibrous foods such as bamboo shoots and laxatives such as cascara help to reduce the absorption of bowel toxins that promote cancer and burden the liver.”

I think it's important he says Cytomel instead of Cynoplus, as it is T3 which directly leads to fat-shedding and synthesis of glycogen in the liver. I might stop T4 altogether and just do T3 for a while depending on how I feel in a few weeks.

I've also added daily Vitamin E and Aspirin, increased my glycine intake, and reduced coffee to just 1 cup a day because it makes me hypoglycemic.

Relevant studies

• Thyroid hormone stimulates hepatic lipid catabolism via activation of autophagy
• Triiodo-L-thyronine stimulates glycogen synthesis in rat hepatocyte cultures
• Vitamin E can treat/cure severe fatty liver disease (NASH) in humans
• Just one aspirin (300mg) daily stops a patient’s terminal liver cancer
• Glycine (and leucine) can treat fatty liver (NAFLD and NASH)

@questforhealth The only thing I miss about a low metabolism is not having to eat so damn much all the time. Life was simpler. I've just started feeling like a super fast well-oiled high energy machine. On a scale of 1 to 10, if my metabolism was at 1 or 2 before I started peating, it's at a 4 or 5 after a year and I already feel indescribably better. I'm wondering how much better it can really get. Can it reach Jacob Collier levels? Let's see!

@BeamsOfEnergy I don't think things can be looked at in isolation like that. I doubt a person with a failing energy metabolism, unable to converse with good energy, would be good at programming uniquely. Programming is after-all just talking to a computer in a language the computer understands. Might be reductionist but if you're good at a spoken language, you're likely good at programming too.

John Carmack is another example of a high-output programmer who has a high metabolism too fueled by 9 cokes a day.

Consumption vs creation seems to be the main distinction causing the low energy metabolism in my opinion. Excessive consumption leads to high serotonin I think which starts the cascade of hibernation vs creation being a dopaminergic activity. If computers are a bicycle for the mind, then they essentially act as a force multiplier for your habits.

In my health journey, I've gone from being unable to do mental work for 5 minutes without a stress reaction to being able to work 2 hours at a stretch before needing a snack. I think working on a computer (coding, making music, designing etc) is really energy intensive. Combined with poor nutrition it just completely obliterates a person's health.

@insufferable Mindset definitely has a big impact on perceived energy levels. Which E-Ink monitor do you use? Is it good enough to replace an LED one?

Not sure if I philosophically agree with the effect on blue light from screens causing such a big problem. I can think of examples of programmers who spend north of 10 hours a day in front of a screen and have pretty high dopaminergic metabolisms. Taking George Hotz as an example – he has really long live streams doing complex high energy requirement work with little to no perceptive difference in energy which I find amazing.

It's probably one of those things that affects everyone at a different level and may be worth a try for me too.