Puzzle Pieces ... Low Carb & Thyroid

So ... it' been a while, almost a human gestation period, since I reported my miraculous selenium insomnia cure.  In a nutshell, I started taking Se to see if it might help and within days I was sleeping like a baby through the night.  Although I found adding starches in somewhat difficult at first, I've also recently made clear that I'm eating a good 100g/day most days now ... at least that would be the average ... for starch.  I still eat a lot of veggies that I don't bother counting the carbs in and fruit several times a week, so probably getting about 150g perhaps up to 200 total grams of carbs these days.  


I'm now officially through menopause -- over two years now -- and though I find the Estroven helpful still, I'm not real regular about taking it anymore.  When my current stock is gone I'll probably not buy more.  (Ladies if you have a Costco membership it's really cheap there and worth trying in my opinion!).  I haven't had a hot flash or dealt with night sweats in well over a year now.  I've also slacked on the selenium ... which brings me to my point.

Look folks, whatever it is, long term very low carbing does not agree with  a lot of people.  And for me VLC was like my autopilot default setting for over 2 years with wonderful weight loss results and many feelings of good health and all that.  So I can certainly relate to the fear or trepidation or whatever of change and not wanting to acknowledge a feeling of "drift" if you will.  What do I mean by that?  Well in 2009 I had pretty much plateaued out low carbing and what was odd was that some of those things I thought LC had likely cured or helped incredibly ... well those returned slowly and I found myself not wanting to admit it.  

Now whether it's thyroid or whatever -- and I do hate those "if you answered yes to two of these 10 questions you might be XYZ" quizzes -- I've always had some of the symptoms ... especially the sensitivity to cold.  Despite other improvements, my fingernails were paper thin and I had to get my nails "done" in 2009.  But I am pretty much one of those people who only goes to the doc if I've got a problem, though as I age I'm trying to get better at that.  I did have the routine thyroid test done and all was normal.  I'm still trying to find an endo that's not into HCG (I was all set to get a full workup with one that looked so promising until I saw her on TV hawking that diet -- sorry, I just can't go there) and optimally takes our insurance.  But in the meantime, perhaps some puzzle pieces just fell into place.

Maybe low carb depletes selenium ... and maybe that impairs thyroid function ... or whatever ... and who knows, maybe I'm like an Inuit banana eater in January or something ... but maybe it's leptin receptor sensitivity that goes out of whack and throws me off circadian cicles or something.  But selenium fixed a problem I didn't even think was related to my diet -- insomnia -- and now even though I've pretty much stopped taking it I'm still sleeping well.  And what got me thinking was that Richard Nickoley recently mentioned in one of his carb experiment posts that he's sleeping better these days.  

So whether it's rT3 or whatever, or something totally unrelated, I've been noticing lately that a lot of low carbers seem to have trouble sleeping.  As I did.  And I spent two years writing it off to stress and such when that certainly hasn't changed and here I am sleeping normally again.  Of course it could be that the female hormones have settled out too, but I suffered on and off with insomnia well before menopause hit, so I'm pretty sure that's not it ... especially since I had such an abrupt turnaround with the Se. 

I'll end this with a fizzle because I don't really have some profound point to make.  I just thought I'd share that now I sleep a LOT better w/o supplements.  Is it something in the carb foods?  Or perhaps something the VLC metabolism sapped?  Can't know for sure b/c I don't do a lot of testing.  But I for one can't dismiss the reportings of low carb malaise that seems to crop up after a while in so many.   So to add to sentiments from a recent post, if some anecdotes are relevant (and they can be), then ALL anecdotes should be relevant.  I'm not telling anyone to change what's working for them, but I do think we all have a tendency to rationalize and convince ourselves that things are going along swimmingly when they really aren't.  If you are a low carber and your sleep is disturbed, it's something to consider changing.

I've been up too late tonight!  Nighty nite peeps!












Comments

Sonnenschein said…
I will add my personal experience: I have an underactive thyroid due to Hashimoto´s desease and I am on medications since I am 11 (I am 33 years old now). I have never suffered from the "typical" symptoms (I have always been at the lower end of a healthy weight, rarely had low enery etc.), maybe because I received the right medication from a young age on. At the end of 2010 I radically lowered my carb intake because I went Paleo then (out of health reason, not for weight control). I gained pounds that didn´t go away and I it was a struggle not to put on more weight. I had my thyroid tested several times and all markers they tested for fluctuated widely. I added back "Paleo carbs" (rice. potatoes and, yes, even some soaked/fermented grains) and lost the weight without effort. I have no proof that all this was related to my thyroid function, it might also be that I just underestimated my fat-intake on low carb but I think it might be connected...
Josh said…
Paul Jaminet mentioned selenium deficiency in his excellent series on the dangers of zero-carb diets. Perhaps very low carb can cause the same problem to a lesser degree - "One difficulty with zero-carb diets is that they seem to deplete selenium levels. Selenium deficiency is a common side effect of ketogenic diets. Some epileptic children on ketogenic diets have died from selenium deficiency! [12]" http://perfecthealthdiet.com/?p=1139
Sue said…
Just came from CheeseSlave site where she is increasing carbs to balance hormones and increase body temperature after being a low carber.
Unknown said…
Hi, first post from a newly-rehabilitated carbophobe.... potentially this could be adrenaline release (hence difficulty sleeping) to maintain blood sugar in a low-carb environment? Particularly if you got that "wired" feeling which you can get with fasting or low-carbing. Or Robb Wolf's favourite "pregnenalone steal" (which I'm not 100% convinced isn't the new candida/adrenal fatigue etc...)
Leighan said…
Omg yeah, I can totally agree with this. In December I started going VLC, almost 0g a day, and I found I just couldn't sleep at all. I'd rarely get to sleep before 3 am and I'd actually be awake until 4 or 5 sometimes. Since I un-carbophobed myself in the last 2 weeks, I'm sleeping like a baby again already with no issues!!
CarbSane said…
Welcome to the Asylum! It's odd, I didn't feel particularly wired ... since I was going through a lot of stress I just wrote it off. I do think a lot of the adrenal fatigue stuff is overblown, but there's got to be some thing to some of this, whatever the underlying cause.
CarbSane said…
I'm naturally a morning person, never been a night owl. With the insomnia I was a semi-obligatory night owl. I much prefer the current sleep pattern! It didn't happen overnight, but slowly for me.
CarbSane said…
Y'know, maybe I sleep-read that blog post and it's where I got the idea to try Se. I don't recall exactly why I decided to take it -- and it wasn't for insomnia -- but man, to sleep soundly through the night so quickly was amazing.
CarbSane said…
She should stop being so antagonistic and suck it up for the team - grin. I'm so sick of that -- what "team"? I'd like to see Jimmy's supplements list these days. So many LC'ers take more crap than bodybuilders.
undertow said…
One year VLC for me. Now 2.5 years into recovering, my sleep is just getting back to something normal in the last month, where I sleep from 10pm to 6am straight through.

I went from waking completely 2 times every night, every 3hrs at the end of a sleep cycle... More unrefined sucrose, is what seems to be helping me (liver glycogen??), shutting down stress hormones?? But should note my diet has been 50-70% carbs for the last 2.5yrs... it can take a long time.
undertow said…
OH also wanted to add, that since I have decreased liquid intakes, which would help keep the bodies salt and glucose concentrations stable, I believe that is part of the puzzle too.

http://180degreehealth.com/2012/02/how-much-water-should-you-drink
Lesley Scott said…
thanks so much for mentioning this. I've been trying to adopt a few of the PHD's vitamin recommendations, and now selenium just zoomed to the top of the list. I have such trouble sleeping through the night and get up wicked early; I like the getting up early part, but I wish I felt more alive when doing so. When I tried VLC, I really did want it to work and loved the appetite-suppression it seems to provide (even if it's a placebo effect as you pointed out) but it did such a number on my thyroid.
Unknown said…
Well, I don't have much to offer except that LC, even VLC when I do it doesn't seem to affect my sleep (I still can't keep my eyes open after 10:30-11PM...) but I'm 30 years old (male). I've heard brazil nuts have gobloads of Se in them, I suppose adding a few into the daily routine is no big deal? I've read it only takes a few nuts/day (and you don't want to go overboard on these, they supposedly do have ridiculous amounts of selenium in them) but I've no experience with it. Might buy a small bag to try.

Supplement wise the only thing I take regularly is Magnesium before bed, I find myself less dehydrated in the morning when I do (fwiw I typically have very dry mucous membranes in the morning sometimes leading to sinus problems and have for years, even well before considering LC, and LC didn't seem to help or hurt it)
Key said…
I don't have time but if you search scholar you will find lots of info on carbohydrates and thyroid. I know for a fact there are a couple studies showing zero-carb negatively effects thyroid and one study shows animals on a high butter diet suffered from hyperplasia of the thyroid gland. Probably a lot more studies if you take the time to comb through them all.

This one is mostly about the effect of insulin on carb free diets(they become extremely insulin resistant) but it covers some info about the thyroid and mentions the butter/hyperplasia study-
http://jp.physoc.org/content/60/4/293.full.pdf

This study is very interesting, they compare a 60% sucrose/fat free diet(high CHO) to a standard diet that contains 55% complex carbs-
"The dose of T3 required to achieve 50% maximal response was reduced 3-7 fold by the high CHO diet"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC371445/pdf/jcinvest00689-0179.pdf

In regards to estroven you might want to check out www.raypeat.com and read his articles on estrogen. You would probably have much better benefits using progesterone over trying to raise your estrogen. Estrogen isn't something you want to mess around with.
Key said…
Liver glycogen is the rate limiting factor for t4-t3.
Kindke said…
There was 1 commenter pointing out there that Selenium deficiency was coming from protein restriction since its found in concentrations in meat/seafood.

The insomnia thing is very real though, going into deep ketosis seems to make it take longer for me to fall asleep when my head hits the pillow, I dont sleep as deeply in ketosis and my sleep duration is reduced. My energy levels are way higher in ketosis though, which I think is part of the insomnia.

High levels of ketones seem to be very excitatory as observed after drinking high dose coconut oil, it feels like ive just drunk 30 cups of coffee and my brain is spinning.

Is it related to the postprandial somnolence thing perhaps? Where insulin spike allows tryptophan to have higher unimpeded access to cross the blood brain barrier to make serotonin?
CarbSane said…
I've never had any reaction to CO or MCT's other than running to the bathroom if I have too many MCT's! I've certainly been in ketosis many times in my life and unlike others I don't feel any real dramatic difference (no low carb flu and such). I'm convinced now about the insomnia though.
CarbSane said…
Thanks ... Estroven is soy flavanoids and some other stuff. It may be helping me make a bit more estrogen, but it's not estrogen per se. My husband says he noticed the difference when I started taking that -- he didn't know I was doing it at first and I asked him after the fact and he was like "now that you mention it ..."
Chris Kresser said…
What's interesting to me is that the VLC community is so skeptical that this is a real phenomenon in some people, and well documented in the scientific literature. I've seen a lot of "show me the studies" complaints lately, so I thought I'd gather up a few in preparation for my interview with Jimmy Moore on this subject later in March.

Here they are, for anyone interested:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC371281/?tool=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/1249190
http://jcem.endojournals.org/content/48/4/577.short
http://www.ajcn.org/content/45/2/391.full.pdf
http://www.sciencedirect.com/science/article/pii/0026049578901373
http://www.ncbi.nlm.nih.gov/pubmed/3702673
http://www.ncbi.nlm.nih.gov/pubmed/11167929
Anonymous said…
I thought Dr. Atkins wrote that low carb depresses thyroid function in his first book.. If that's so, why is this idea so controversial in the low carb community?

Re: selenium, I was surprised to find it really reduced my OCD symptoms.

Re: sleep, I recently had my husband raise the head of our bed 6" as an experiment, as I read it can help with varicose veins. So far, I've found I sleep much better. (I also now remember my dreams, which is odd for me.) My husband has noticed no difference, but he sleeps well generally.
Unknown said…
Now that's preparation! And one podcast I won't want to miss.
Lerner said…
"... why is this idea so controversial in the low carb community?"

yep, because they are advocates and attack or ignore anything that doesn't fit in with the trend that they espouse.

My own experience with stomach acid went like this: Wolf was often talking about how people need to take acid supplements. I was dabbling with LC Paleo just to see what it would be like, and would sit down to a meal of 3/4 pound ground beef plus some broccoli. Within an hour I'd have a terrible acid stomach, which I otherwise would never get eating normally. So, that told me I was not hypoT and I therefore also didn't have to worry about not absorbing minerals properly - which might exacerbate hypoT in those who already have it, vis-a-vis Magnesium.
Lerner said…
who's interviewing who? Okay, kidding aside and just out of curiosity: has Jimmy ever been the interviewee anywhere?
CarbSane said…
I'm with Nance! Looking forward to it Chris, as I do all of your podcasts.

@Lerner, well can we count Sean?
Sanjeev said…
His stance was that there was nothing special or unique to low carb or VLC about this; ALL low calorie diets depress thyroid, regardless of composition.

IOW, calories count when I want, don't count when I don't want: Dr A must have got his degree from the humpty dumpty medical school[0]

to be fair to Atkins, contrary to his later followers, in later chapters (of the edition I first read) he specifically wrote that many who think they have broken metabolisms didn't.

[0] Is that the name of Yale's med school?
Sanjeev said…
> fair to Atkins ... think they have broken metabolisms didn't.

and they gained weight because they overate.

This was where he was discussing people who added back carbs, were able to add back a lot of carbs and maintain stable weight.
MM said…
Just curious how much Se you are/were taking. I didn't see a dosage in either post. Thanks.
CarbSane said…
I have that book and it is in there. Odd, eh? BTW if you find anything that works for the veins do tell!
CarbSane said…
Initially I was taking 200 microgram per day. After a while I was almost sleeping too soundly so went to every other day then less often. Soon I forgot to take it but that coincided with eating more carb and the insomnia did not return.
CarbSane said…
I hope things keep improving for you! I honestly didn't have acute symptoms. In a way that may be worse b/c you don't even realize health is indeed deteriorating due to diet.
MM said…
Did you have to take it right before bed? That is, did it matter what time of day you took it? Sometimes my husband suffers from insomnia, and I thought maybe this was worth a shot.
CarbSane said…
Actually I had it in the morning. I don't think the timing matters ... or at least it didn't for me. I've got a bottle of melatonin I was going to try for the insomnia and I've never used it b/c I read where if you take too much and/or are exposed to light/artificial wakening (e.g. snoring hubs) it can be counterproductive.
Galina L. said…
I think we don't know enough about thyroid function. I have been on Synthroid since 35 years old(am 51 now), all my tests when I was on the medication were normal despite having all symptoms of under-active thyroid gland (low cold tolerance, needed sleep more, trouble loosing weight...), and my need in medication slowly was climbing. At November 2010 I switched on Armour thyroid, and everything changed - warm hands and feet, no need to sleep so much, more desire to move, do not need a jacket when everybody around was cold. However , such huge difference didn't correlate with the change of ANYTHING in my blood test. So my guess is, when thyroid is tested, there is something not on a radar.
For selenium I eat 2 Brazilian nuts a day, it is my nut indulgence excuse.
Rad Warrier said…
"High levels of ketones seem to be very excitatory as observed after drinking high dose coconut oil, it feels like ive just drunk 30 cups of coffee and my brain is spinning."

"I've never had any reaction to CO or MCT's other than running to the bathroom if I have too many MCT's!"

True about my favourite coconut oil! In fact, true about any fat. Too much of fat and I will be visiting the toilet many times. I don't think I will ever be able to follow the advice of low carb extremists regarding fat. If I "up the fat" above my normal intake, I will be spending more than my normal time on the commode :)

One thing I don't really understand is the glorification of lack of hunger by low carbers. If you read some of the posts of low carbers in various e-forums, you would think that not being hungry any time is a very pleasurable and desirable state. I on the contrary welcome hunger. Normally, I do become hungry at meal times. Hunger adds to the enjoyment of food. If I am not hungry, I don't really enjoy food. If am sick or my tummy is out of order, I don't become hungry. This has led me to equate lack of hunger with sickness and stomach problems.

Regards,
Rad
Galina L. said…
@Rad, I have a first-hand experience to tell you about the reason why some LCarbers are happy about less hunger. Probably, some who are like me ,first time in their life experienced how it feels to be like other people and be free to delay their food if they had to because on LC diet being hungry stopped being an emergency. No more I panic that I will not be able to return home after some trip by the time I would be hungry, no more I had to have some emergency snack with me. I enjoy my food when I eat it, but I am free now from an abnormal desire to eat, I don't carry the food toward my mouth with shaking hands any more.
I feel my best in ketosis, calm but high energy level, perfectly balanced mood, no pre-menopause symptoms. I don't think it is any reason to over-consume fat in order to get there, there is enough in one's body already.
Nigel Kinbrum said…
Galina, the Reference Ranges for TSH, FT4 & FT3 are as wide as barn doors, as they encompass 98% of the population. Often, FT3 isn't even tested as there are no meds to treat low FT3.

A diagnosis of "normal" means very little. I had a diagnosis of "normal" when my FT4 was 9.8 (RR = 9 to 24). My "healthy" FT4 is ~18.

I eat 10 Brazil nuts a day and I don't smell peculiar (a symptom of excessive selenium intake).
Galina L. said…
I remember reading that long time ago people were given medicine for under-active thyroid based on their symptoms, not lab results. I can see how it may be not a perfect solution, but nowadays symptoms tend to be totally ignored.
Why do you eat so many of the nuts, I thought you were not very fond of O6?
Nigel Kinbrum said…
Brazil nuts grow in a hot climate, so they aren't high in pufas.
Galina L. said…
Sure, just about 30%, I am still for to minimizing nuts because it is a binge-food for many, but probably not for you.
Leighan said…
Just to give you my experience, I tried melatonin whilst going VLC for a few weeks and all it did for me was make me remember my dreams. It made no difference to how well I slept, I still couldn't sleep until around 3am regardless.
Leighan said…
to add to my comment above, I haven't tried it whilst on a medium-high carb diet and don't intend to because I've learnt of its possible effects of limiting how much melatonin you make naturally.
Nigel Kinbrum said…
Pufas are 30% of total fat, or 20% of total weight. 10 Brazil nuts don't contain that many grams of pufas.

I don't binge on them. I lay out 10 nuts & 10 prunes and eat them one at a time, washed down with a mug of milky coffee. That's my breakfast.
Anonymous said…
This comment has been removed by the author.
Swede said…
I've found that melatonin can be useful as an occasional sleep aid. The doses sold in tablet form are too much for me. The smallest I have found is 3 mg. What I do is buy a liquid supplement in which four droppers provide 1 mg of melatonin. Usually just one dropper (which would be 250 mcg) is plenty for me. I do have somewhat of a weird feeling the next day, but it beats being sleep deprived. The weirdness is minimized for me by taking such a small dose. A 3mg dose would probably put me into a coma!
Lesley Scott said…
I have the strangest dreams when I take melatonin & actually wake up feeling woozy - not bad, just disoriented.
Swede said…
"I have the strangest dreams when I take melatonin..."

Dreams can be quite vivid.

This has been a common 'warning' about melatonin since it first came out. I went on a long hiking trip with a guy who was borderline sane - he was never homeless, but at the same time rarely held regular jobs and was into conspiracy theories and such. I lent him some of my melatonin to help with sleep, and the next morning he couldn't stop talking about all of the crazy dreams that he had!

The main thing that I did to improve my sleep was to remove ALL stimulants - coffee, tea, soda, etc...
Lesley Scott said…
so what you're sayin' is I'm crazy! Kidding! Good point about the stimulants. I pretty much won't have any coffee after about 1 or 2 at the latest in the afternoon, but definitely found that eating starches again has helped with sleep.
Keenan said…
Melatonin is a stress hormone and inhibits the thyroid

"A large experimental evidence exists suggesting the inhibitory action of melatonin on thyroid growth and function; this effect has been revealed by using different experimental models: by chronic and short-term melatonin administration in vivo, by light restriction, which is known to increase the activity of the pineal gland, by pinealectomy, etc."
http://www.ncbi.nlm.nih.gov/pubmed/12019356
Keenan said…
Body temp+pulse can give a pretty good indicator of thyroid function, especially when used in conjunction with blood tests. An achilles reflex test is the most accurate measure of thyroid function from what I've heard.
Keenan said…
10 brazil nuts contains 10g of omega 6, that's pretty significant.
Nigel Kinbrum said…
Ah, shaddup-a you face! ;-p
Anonymous said…
Nigel, that seems like a lot of selenium, is that quite safe?
Nigel Kinbrum said…
I'm not showing any signs of selenium toxicity, so yes. See http://en.wikipedia.org/wiki/Selenium#Toxicity

If Brazil nuts were that toxic (they're actually slightly radioactive!), there would be a warning on the packet "It is dangerous to eat more than X nuts".

I also occasionally eat a whole 213g can of Alaskan wild red salmon. That's equivalent to taking 21 1000mg fish oil capsules.

I like to live dangerously!
Dawn said…
Nigel, that sounds like a delicious brekky. I wish my blood sugar would tolerate that many prunes at once (but I'm afraid it wouldn't). Maybe I'll live dangerously and try it sometime as an experiment.
Anonymous said…
I can best you on living dangerously. I eat coffee flavored Nips candy. So delicious. So choke-y. At least they seem so to the OCD with choking paranoia. But the selenium eases the freak out.
Nigel Kinbrum said…
Do prunes disturb blood glucose levels much? I thought that prunes were low-GI because:-

1) They're high in fibre.
2) They're high in fructose & sorbitol (which gives you colic, wind & diarrhoea if you eat too many).

My brekky gives me a good run for my money! ;-p I'm also lucky in that I can now eat anything I like without suffering from hyperinsulinaemic lethargy followed by ravenous hunger. I used to be muscularly very IR.
Nigel Kinbrum said…
Do I sense a challenge? ;-p
Galina L. said…
Second day in a row I am checking my food intake with a fitday, and so far I exceed my selenium intake. Yesterday it was 177% RDA, today 166%RDA. Why did children have so much selenium deficiency on a ketogenic diet? Probably they restricted very much their protein sources. May be I have no excuse to eat my Brazilian nuts after all. In case if somebody is interested, yesterday I ate 1541 Cal, 114 grams of fat, 70 grams of carbs, 62 grams of protein, today it was 990 Cal, 58 fat, 47 carbs,72 protein.

@Nigel, I think it is very important how somebody feels after a meal, it is the bottom line. If it doesn't put you in a sugar coma, it keep you satiated for at least 3 hours - it is right for you. From my perspective nuts/prune combination looks like a snack, I personally like to feel that I had a meal, something egg-based for a breakfast, but it is just a personal staff.
Nigel Kinbrum said…
10 Brazil nuts + 10 prunes + 250ml of milky coffee = satiated for >3 hours.

The coffee contains ~100ml Gold-top milk, so my brekky also contains milk proteins. The casein micelles in milk coagulate into curds in my stomach and casein is very slow to digest. This keeps my stomach happy.

I don't care about RDAs. If I got 100% RDA for Vitamin D, I'd be screwed. I get 1,250% RDA and have normal blood levels of Vitamin D & calcium.
Anonymous said…
TimFerriss Brazil nut selenium “Going in and out of ketosis had created a selenium deficiency. Unbeknownst to me, longterm
ketogenic dieting has been associated with selenium deficiency. This was a real lightbulb
moment.” http://paste2.org/p/1762113

-
And unrelated, looks like DrG's latest vol8 is out . | ..
Nigel Kinbrum said…
Tim Ferris said...
"Too much selenium hurts swimmies..."
Due to pituitary failure, FSH = 0.
I no longer produce any swimmies to get hurt. Thanks to Testogel, my libido is, uh, just fine (TMI)!

P.S. Tim, you know where you can shove those EDTA suppositories! ;-p
Satasha said…
I wouldn't wait for selenium to become toxic. It's quite strong, so err on the safe side!
Satasha said…
PS: In this (old) text (about animals) they write selenium was much more toxic when lifestock and pultry were eating lots of carbs. Very interesting!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1529622/?page=1
CarbSane said…
Thanks Satasha, and welcome!
Anonymous said…
Evelyn, how much selenium were you taking when you took it regularly?
CarbSane said…
200 mcg (microgram) because that was the common dose. I took mine in the morning with my coffee as that is the best time for me to take something on a regular basis. Don't think timing matters.
Anonymous said…
OK, thanks.
Tracy said…
First time commenting here... after being VLC for 6+ years, and re-gaining weight & having all sorts of symptoms, I tested my thyroid and found that my TSH is elevated and my free T3 is in the toilet at a dismal 1.3. I had no idea that thyroid function could be affected, and it could explain a few things (like why my weight loss on LC, VLC, ZC etc was soooooo slow, why I had periods where my hair was coming out in clumps). I am taking Se too (not for sleep, that's fine) and adding starch back to see if that helps. So far though, can't find a doc willing to take any of this seriously. Sigh. I am celiac so am concerned about possible Hashi's, which may have always been the case and VLC just brought out hypo symptoms eventually. Hard to know for sure.