Regional Differences in Fat Tissue Fatty Acid Regulation by Insulin

Insulin Regulation of Regional Free Fatty Acid Metabolism

Alternate Title:  Why I had a fatter ass before low carb?  :-)

This study involved 26 healthy young (21-38) non-obese (BMI 18-27) individuals split evenly by gender.  Excluded were any medications known to influence FFA metabolism.  Radiolabeled palmitate was used as a tracer for FFA's.  

All studies were initiated in the 12 hour overnight fasted state and palmitate was infused for the duration of the study.  Patients received insulin infusions of different doses (3M & 3F per group) for 150 min following baseline determinations.  Controls received a saline infusion.  Blood samples were obtained from femoral vein and artery (leg) and hepatic (liver) vein.  This was to assess systemic (whole body), leg and visceral (splanchnic) rates of appearance of FFA's  (release from adipose tissue).

Below is the palmitate UPTAKE rate for leg vs. splanchnic (visceral)  regions for the different insulin infusions:

For all subjects, baseline plasma palmitate concentrations in the femoral artery, femoral vein, and hepatic vein were 133 ± 6, 147 ± 7, and 106 ± 6 µmol/l, respectively. Therefore, in the postprandial state, leg was a net FFA producer, and the splanchnic bed was a net FFA consumer. Figure 1 shows the net leg and splanchnic palmitate balance as a function of the insulin dose infused. At the highest insulin dose, the leg became a net FFA consumer, whereas the splanchnic region became a net FFA producer.
Insulin suppressed leg palmitate release in a dose-dependent fashion as compared with the saline control, achieving 77% suppression at the lowest dose infused and almost complete (93%) suppression at the highest dose. Although splanchnic palmitate release was also inhibited in a dose-dependent fashion, the lowest insulin dose did not significantly suppress splanchnic palmitate release below baseline values, and it was only 65% suppressed at the highest insulin infusion rate.  

The various flux (exchange), uptake and release rates are summarized in the table below: {click to enlarge}

At the risk of posting screen shots of everything in the article, below is the last of the bunch:
Leg (both legs) and splanchnic palmitate release as a percentage of total palmitate release is plotted as a function of insulin dose in Fig. 4. At higher plasma insulin concentrations, leg palmitate release relative to systemic palmitate release decreases, whereas splanchnic palmitate release relative to systemic palmitate release increases.

So fatty acids are released from leg fat at a relatively consistent proportion compared to fatty acids released from all body fat.  This proportion is reduced slightly as insulin increases.  However, at basal insulin levels the fatty acids released from splanchnic represent a smaller proportion vs. leg fat, but a much larger proportion with increasing insulin levels.  

I would dare say these observations are interesting!  On the simplest level, this demonstrates that insulin doesn't behave in the same manner in different fat depots.  

In summary, we examined the dose-response relationship between insulin and regional FFA release. Leg fat was found to be more sensitive to inhibition of lipolysis than was systemic lipolysis, whereas visceral fat is less responsive to insulin.   Moderate hyperinsulinemia appears to increase the proportion of FFAs reaching the liver from visceral, as opposed to systemic, sources. Our results have significant implications for understanding the effects of insulin on glucose/fatty acid interrelationships in humans.

Some parting thoughts as regards low carb diets and my personal experiences.  I've shared how my weight distribution has changed considerably since first doing Atkins now almost 14 years ago.  My legs/butt are considerably smaller compared to the rest of me now.  Indeed I can now fit my legs comfortably into pants I wore when I was some 40 lbs lighter than I am now from before I ever tried LC.  If it is true that I've lowered my insulin, FFA's have finally been released more preferentially from my thighs.

It doesn't escape me that the observations in this study seemingly counter the various low carb belly fat plans. This is just a hypothesis here, let me be clear.  But in many, particularly those going from a high-carb SAD-style diet, going LC - usually involving some sort of "quick start" VLC phase - weight loss is significant in early stages.  It is well known that visceral fat is preferentially lost first when we lose weight, which is probably why so many health benefits can be attributed to a loss of a rather modest 5-10% of weight even in the "morbidly" obese.  So it is not surprising that, in the short run, the rapid losses most experience on low carb coincide with rapid reductions in waist size.  My own husband experienced this.

But I've also shared that over the long haul, I've either retained more belly fat when losing on low carb over the longer run and seemed to gain in the belly.  Look at the first graphic again.  The lower the insulin levels, the greater the splanchnic fatty acid uptake!  It has not escaped the notice of some that many low carbers seem to still sport guts or seem to gain abdominal weight even eating low carb.  This is, of course, observation based on a non-random sample of pictures to be found.  But fatty acid uptake is most prominent when?  In the postprandial period.  Following a mixed meal or a high carb meal, insulin rises - by the top graphic this favors uptake to the leg fat (and though not measured directly, non-splanchnic upper body fat).  Eating a high fat low protein meal often produces little to no rise from basal levels.  Look at the left of the graphic.  Look where that fat preferentially goes.


Anonymous said…
My mother's body shape has changed considerably as she has aged. She's approaching Menopause (53yrs), she has upper body fat, stomach area especially. She has eaten generally, a whole foods diet most of her life.

I just wonder how accruing body fat in stomach area coincides with ones age, rather than whether one goes low carb or not; my meaning being, that my mother has never been on a low carb diet, but nevertheless she has experienced such changes to her body. I'm not sure what's normal, for those experiencing the transition to Menopause, or just generally aging. Just a wondering...
Anonymous said…
Could it be that, rather than the lower-carb intake, it is the higher-protein intake that effects those changes?
CarbSane said…
@Euler: I don't think so. I lost weight eating cottage cheese and melon many a summer and that didn't change my shape. First time I lost weight doing Atkins I was eating a high percentage of bacon, cheese and sausage - hardly higher protein.

@Jenna: It is definitely a fact that women tend to redistribute towards abdominal fat going through menopause. Visceral fat is our second source of estrogen! But my transformation occurred long before this change of life for me. I was in my early 30's when I lost around 40 lbs doing Atkins round 1. This was the first time I "retained" the belly vs. losing that weight first, and the last time I was seen sporting a crop top.
Anonymous said…
I suggested the protein intake being a factor because sometimes I see a study such as this, in which the focus is on the protein rather than the carbs:

The 'many a summer' you refer to in your comment tells me that these were summers - how long ago? I think that bodies change shape with aging, no matter what the diet or the weigh loss. Just my observation.

Yet, I know that body builders can be older and still achieve the shapes you need in competitions. Some body builders are in their 50s and 60s!

They must do that somehow... and although body builders do get lean by cutting carbs before a competition, they do also focus on protein.
Kindke said…
My personal experience is that visceral fat is super easy to loose on a ketogenic diet, however subcutaneous fat around the trunk is very hard to get rid of.

So what diet should we be following to get rid of that damn belly fat?
Anonymous said…
@eulerandothers: I would like to analyze my mums diet, but I think she would get just a bit annoyed. :) It's interesting to me because she's never really liked meat, so if it is about protein, what foods are contributing? Though perhaps it isn't about foods at all. Perhaps its stress, and her lifestyle generally, I'm not sure. There are so many variables. She certainly eats within her caloric range.

It's interesting to me that you bring up the protein thing, I've within a month lost almost a stone, from getting off the low-carb diet mentality. I didn't really need to loose weight, and I wasn't trying, as I was UK size 10, and I'm 5ft 9. I don't know what's contributed the most; I was eating too much protein before? Was I just lacking other nutrients/macronutrients; living off a way too restricted diet? I feel much better now, eating to taste; though my brother joked I eat like an athlete. It's quite liberating, not living by do's and don'ts. Also my skins/hair has really changed. I wonder whether it's something to do with the seasons changing. Anyway, I find it interesting to think about.

@Carbsane: Yes, I just wanted to understand what you thought about this progression as we age, and how it may correlate with body fat distribution besides dietary composition/choices. It would be interesting to hear whether this is a common experience of women who go low-carb, etc. Also according to gender.
Galina L. said…
Hello, Carbsane !
What a strange coincidence! Probably you remember, we mentioned body composition on different diets during our discussion on GT blog.Today I thought about sending a message to you about my observation, that I noticed more fat loss in waist while keeping it on my hips after I started IF last 3 months. I was inspired by several bloggers, and the blog "Getting stronger" was the last push. Before that on ketogenic diet I was loosing faster fat from my legs and hips, while keeping almost constant 32" circumference waist. I think it is mostly stubborn subcutaneous fat, by the look of it. Kindke is wright, ketogenic diet works well for visceral fat. Now it is constant(since New Year at least) 42" in hips, and waist is 30.5". I don't try to make any statement, just report on my experience. Body works in such complex way, it is often very different to understand or explain (at least for me). In my case moving eating into 6 - 4 hours window and introducing 1 day a week 22 hours fast change body composition without changing actual diet. I didn't increase my protein intake for sure. If you eat max 2 times a day, you can't staff yourself with too much meat, and it was not my goal. Typically it is 2 eggs and 8 oz of meat a day, sometimes less.The rest is veggies and fat.Probably, my comment would be interesting for Kindke, but sometimes different things work for different people.
Margaret said…
Jenna, I believe the fat distribution as women go into menopause has more to do with sex hormone level changes than diet composition. Women naturally put on fat subcutaneously and in the hips and breasts because that is driven by estrogens - note how it starts around puberty - and when caloric intake is excessive, they get more of the same, which is called "gynoid obesity" (gynoid = pertaining to females). Men tend to put on fat around the middle ("android obesity" - android = pertaining to males), the theory being that visceral fat is the most easily mobilized, so our hunter gatherer ancestors where the males were the hunters needed to store their fat where it was most accessible. As women go into menopause, their estrogen levels drop while testosterone stays about the same, resulting in a state of relative androgen dominance. It's because of that, that when they start putting on weight, it is in the "android" pattern, i.e. predominantly visceral fat gain. The sex hormones and cortisol, which is activated to varying extents in different tissues (there are a lot of cortisol receptors in visceral fat), are primarily driving the fat distribution over the long term, while insulin works in concert with where the fat stores happen to be in the short term.
Anonymous said…
@ Margaret: Thanks!
Muata said…
@Margaret - excellent explanation--thanks! Do they have a term for a man or woman who exhibits both android and gynoid characteristics?

* * *

I think that genes "help" the hormones with the distribution of fat also. My mother has always had "turkey thighs", which was actually her nickname growing up, a small waist, and wide hips.

It wasn't until I was in the 8th grade that I noticed I had a shapely ass and legs like a girl! And when I gain weight, I gain in the same areas that's usually associated with women. After getting as lean (read:emaciated) to sub-10% bf, the fat on my hips, and stomach were virtually gone, but the stubborn fat on my thighs, especially inner, just laughed at me.

When I regain weight, I've noticed that it's immediately in my thighs (girth increases) then it goes to my lower back then lower abs and continue to work its way up (if I don't put on the breaks). Losing it is the same process in reverse, but all fat trails seem to start and stop with my thighs ...

However, I'm finding that resistance training is definitely helping with re-shaping my body from the apple-pear (or is it pear-apple) guy I used to be because of my mom's genes and my gluttony.
Margaret said…
Definitely a genetic element also, Muata - hispanics and African Americans tend to put weight on in the butt area, for example. So genetics tend to determine how the fat is distributed to give people their characteristic appearance, including familial likenesses. But estrogens are instrumental in helping women develop those characteristic curves in all the right places, as well as making sure they have a lot of subcutaneous fat to protect the children they carry and keep them warm!
Margaret said…
I should also add that studies in women using postmenopausal hormone replacement therapy show that estrogen therapy reduces, or protects against, the visceral fat gain that otherwise occurs during menopause.
Nigel Kinbrum said…
Hi Margaret,

Does progesterone have any effects on fat distribution in women?

CarbSane said…
Wow! Didn't really intend for this post to be about weight distribution but I guess that's my fault for expanding on an afterthought :-)

I'm sure I've written in greater detail about this (probably on the Chronicles blog), but one of my lingering issues with LC is that it has changed my body shape. Always I would lose from my midsection first and generally entire top half with remaining weight in my butt & legs not budging. Remember baggy jeans? They were the only ones that ever fit me w/o gapping at the waist!

This changed when I tried Atkins the first time. I started that stint at 200-210 wearing mostly 16's and ended up at 160-170 wearing 8's. I had done this yo yo only a few years prior to predictable outcome - I don't think I will ever be able to fit into my fitted bodice wedding dress, although I can fit the pants I wore at that time. Thing was this time the outcome was quite different. I didn't lose the belly/upper body fat or maybe some even migrated there. I was barely in my 30's and nowhere near meno. Second time I was obviously older and started from a higher weight but the same thing. This last time I was premeno when I started and went through it (early :( ) during the weight loss.

I'm very well aware of the estrogen thing and redistribution of fat with age/meno for women and have probably blogged on a few articles since I'm always looking for answers to my personal situation. No doubt it has contributed some to my altered body shape as with most women. But something about low carbing perhaps permanently altered something about my hormones independently of everything else. Who knows, I don't want to blame LC, but maybe it caused the early meno for all I know! And in the TMI dept, this time not only did I not predictably go down at least a cup size, though my bra band has gone down 6", I swear if anything the cup size has gone up!

In any case, the body type I have now is that "risky" type. This is part of the impetus for my research into whether this is a healthy WOE for me. I do believe my upper body fat is mostly subQ, but I've read a crapload of studies (and blogged on at least a few) that implicate subQ belly fat, just visceral, both, neither, etc. Almost all seem to point to storing weight in one's legs as "protective".

I like being able to fit into "normal" clothes at any size these days. I'm apparently now built more like most people because I don't have to try on 20 different styles in 3 different sizes to find the one thing that fits acceptably. Now I might need to go up or down a size to accommodate style/brand differences, but most stuff fits -- if that makes any sense.

Apparently the menfolk also like this body better. Go figure!
CarbSane said…
Grrrrr (keep losing comments here :( )

@Margaret: Thanks for your input on this topic. This seems to jive with what I'm reading about visceral fat being our secondary estrogen producing "organ". Once the primary shuts down, apparently the VAT wakes up and tries to take up the slack. This would seemingly explain why the gender advantage we women have over the guys for CVD seemingly disappears after menopause.
@Galina: Hi! Good to see you here again. I did feel the most like "me" back in 2009 when I did 3+ solid months of Fast 5 IF. I did lose 10 lbs early on but that was that and it produced nothing more. In reality I felt more slender in the middle, but I wasn't. Perhaps I could "feel" less fat around my organs but most of my trunk fat is subQ? Dunno. I had an awful time trying to get back to that after trying, ironically, Eades 6 Week Cure, which almost cured my weight plateau - in the wrong direction! So I stopped pushing it. Now I "naturally" do IF most days - never been much of a breakfast eater anyway.
@Kindke: If I had that answer I'd probably stop blogging ;-) For me I'm hoping if I can gear up to lose my remaining body fat (as in total), it will have to come from my belly at some point! Otherwise there's always lipo ;-)
Margaret said…
Nige, I do read a lot about progesterone and as far as I can tell this doesn't seem to have any role in actual fat distribution, but it can cause bloating in excess, as some people find when they use progesterone - if they don't use too much it's fine (and I'm talking about bioidentical progesterone - progestins are another matter). It also increases appetite - a study in cycling women found their spontaneous food intake increased in the luteal phase when progesterone levels are highest, and it would seem logical in its pro-gestational role in pregnancy that it encourages an increased appetite to help support fetal growth (having said that, since I spent most of my 2 pregnancies throwing up, I'm not sure if there was any net benefit and I never gained an ounce either time apart from the weight of the baby and associated fluids, which of course disappeared immediately after I gave birth!)
Galina L. said…
I have been lurking here all the time. Not always sure, is it reasonable to report about mine n=1 experience. Yes, I was wearing baggy jeans for the same reason. Size 16 was mine size when my weight was 198 lb, now at 166 lb it is size 12, very tight 12 for some designs.I think your experience sends a strong warning against any diet that produces fast weight loss. If it was not for you, I would try Dr. Kurt Harris advice for a weight loss - one meal a day that consists of 40 gram of protein and fat, several decafs during the day a with splash of heavy cream, no sugar substitutes, veggies, nuts for several days. I suspect his regimen may take care of middle section even better than 2 meals a day + weekly fast.I think it is more reasonable for me to stack with a very slow fat loss for now. Things work their best when used first time. It is possible, after 52 I would need extra help, like Dr.Eades and his wife found they had to do something extra after 50.
CarbSane said…
Hmmmm.... 40g protein = 160 cal + 40g fat = 360 cal for a total of 520 cal/day - not sure the amounts of cream and nuts but that sounds awfully low cal for me. Am I missing something?
Sanjeev said…
> one meal a day that consists of 40 gram
> of protein and fat

Those numbers canNOT be correct, can they? even if that were all fat, it's only 360 calories.

I mean OMG, That is way below starvation, even for petite women. I thought most of the civilized world had moved past that kind of recommendation.

If one began that from an extremely obese state one might lose a lot of fat mass, but if one is not obese it would strip off a lot of lean tissue.

> reasonable for me to stack with a very

did you mean "stick"? "Stack" has many "pharmaceutical" connotations in many diet/exercise circles, not all as benign as ephedrine & caffeine.
Sanjeev said…
(I thought "40 grams of protein and fat" it meant 40 grams total, protein plus fat ...)

> if one is not obese it would strip off a
> lot of lean tissue

Note of clarification: initially obese people can lose a lot of fat with small losses of strength and muscle.

In losing that last little bit, trying to go below 10% bodyfat (this is something Lyle McDonald talks about a lot) - mucks the works up something awful.

those same formerly obese who maintained strength easily will now shed a pound of muscle per pound of fat, and lose a proportional amount of strength. It's one of the reasons pro bodybuilders take so many drugs.
CarbSane said…
Yeah, either way, 360 cal, 520 cal, still starvation levels of KimKins proportions!!
Galina L. said…
Yes, you missed all that heavy cream.
I didn't try it, but, as I understand, several cups of decaf or tea a day with 1 Tbs of heavy cream going into each cup may add up. Plus, it is not suppose to be a long-term meal plan and only for those who can't loose it any other way.In his 2009 post Dr.K.H. advises to eat approximately 10- 15 % of protein and 85 - 90 % fat while trying to loose weight . If I were to try it , I would do it 3 - 5 days in a row, eat my usual LC till the rest of month, then repeat. Sounds easier that Jemmy Moor's 6 days of water fast. At least it is something that I never tried.
Galina L. said…
It was my fault - 40 gram of protein is included in that one meal, also same fat.
CarbSane said…
Galina, that's still a ridiculously small amount of food - far more restrictive than what some consider "starvation levels" of 1500 cal/day, for example. Do you have a link?
CarbSane said…
P.S. I should add that I would be lying were I not to point out that I ate well <1000 perhaps around 700 cal/day many days on VLC - spontaneously. I've even forgotten to eat for an entire day. But I don't advocate doing this long term. In retrospect I did some unhealthy things in search of a healthier body.
CarbSane said…
These might seem out of order, etc. Galina's "missed the heavy cream" comment went to spam and I just now published it.
CarbSane said…
@Galina: If I were to try it , I would do it 3 - 5 days in a row, eat my usual LC till the rest of month, then repeat. Sounds easier that Jemmy Moor's 6 days of water fast. At least it is something that I never tried.

I "accidentally" did a rather high fat diet when I began IF. I couldn't eat that much protein in a 5 hr window. But ... I was eating like 600 cal and forcing around 3-400 more to keep from going too low cal at the time.

Don't get me started on Jimmy and his fasting. He's taken to censoring my comments on his blogs. Now he's trying to convince people that he's testing Kurt Harris' and Paul Jaminet's theories on eating more carbs by eating unspecified quantities of sweet potato FRIES (no doubt prepped with veggie oil) and wheat bread. *SIGH*
Anonymous said…
Carbsane, have you seen this:

Think it might interest you.
Galina L. said…
Carbsane, could you, please, tell me more about your experience with IF? Did you try a long fast?Did it make any difference regarding your body composition? I jumped when I saw that post - fat distribution influenced by diet is not typically discussed in details, while there is much more in a weight loss than just getting the scale number smaller(although, Dr. Davice just tried to do something about it in a weird fashion). There are individual differences, of course.I guess, my body works slightly differently than yours (for example, I can't loose weight quickly).
Sanjeev said…
I'm not CS but I'll try to contribute:

I'm currently doing the "do not eat until after 3pm (1500)" form - occasionally I don't eat until 1800, and most days I finish eating just before bed, 2300 to midnight.

I doubt there is any metabolic advantage over an equal-calorie, multiple-meal diet.

The best that thing that I can say about it is, it makes sticking to any diet easier in several ways. First, it removes many decision points - breakfast, lunch and all snacks until at least 1500.

Also, hunger is restricted to the early day, when I can deal with it easier for some reason. Overeating and "going hog wild" for me was largely a night-time thing, so eating no calories until then is "working with the system", or some kind of "dietary Aikido" - don't eat when I can prevent it, eat when I can't.

As to the other question - the "extreme" diet that makes the most sense to me is to overload the most satiating macro nutrient, protein, not the fat. The ideal thing would probably be a SLOW digesting protein (cottage cheese) with some fat to further slow digestion.
Galina L. said…
Thank you, Sanjeeve. I though before that late night eating was fattening. I new some fat people who never eat and not being hungry till the middle of the day.Not so for you.
I try to move around my eating window, but almost never eat after 7 pm. I also have a day a week,when I eat 3 times or more relaxed with food choices - "Control cheating" (I started to do it after Carbsane's interview with Jemmy Moor), and one day I eat once a day. Today I was surprised when I found out(after I found misplaced measuring tape) that IF regiment caused more weight lost around my waist then previous just VLC diet. In mine case meal spacing made the difference not the food composition.I have no idea why. I am afraid my posts are getting tedious.
Sanjeev said…
> people who never eat and not being hungry
> till the middle of the day. Not so for you

Nope, morning has always been my absolute hungriest time (this may be changing as I get used to IF), but I've always given in to the high-fat, high-calorie munchies at night, when I'm usually not that hungry.

This has made sense to me lately after reading about "executive function", which decreases the more stress you're under, and typically is low late at night.

Some further reading on executive function, if you're interested :

Wang and Aamodt
David Rock

> I am afraid my posts are getting tedious
Not at all. This is the internet though - you may not get an answer for a couple of days then get 10 replies as people get some free time ...
Galina L. said…
Never heard before about the executive function,time to investigate. Well, not long time ago I was puzzled by the abbreviation IF. I mostly appreciate about the IF the fact that it provides an optimal control over hunger. First step for me was LC. Before that I had to eat every two hours, or be ravenously hungry. It is so nice to be free at last.
CarbSane said…
@Galina: I did Fast 5 (5 hour eating window) from early June 2009 to late September. I think I only deviated one day when I had breakfast. I started with the 5-10pm window but that drifted earlier as I'm not really a night eater so ended up being 3-4 to 8-9. I experimented with various eating plans in that time. VHF w/lots of CO, every 4th day being a carb day, a variation on Primal, etc. Summers are a time for socializing/traveling for me so there were drinking days in there too. It truly helped me by letting me recognize REAL hunger vs. phantom hunger - the urge to eat just because it's mealtime! Nowadays I don't watch the clock to break my fast, but I don't eat until I get hungry, and I often do ignore the first hunger pang - if it persists I eat, if it goes away I'll answer the next call hours later.

Like I said, I felt leaner in my torso but this didn't translate to any size difference. FWIW in 2010 I weighed rock solid between 197-202 for most of the year, and really that was the case except for vaca blips back to June 2009. I definitely have recomposed in that time and lost size but not weight. That seems to have stopped now.

Gearing for another push. Just too many life distractions to focus on me.
Galina L. said…
Good Luck, Carbsane! I truly wish you to succeed! Thank you for providing more details about your experience. After trying to figure out what would work for me, I am curious about other people experience.You said about no difference in size.I notice that a measuring tape could give more information. In my past I have a 2 year long weight plateau after initial 20lb loss on Atkins(like most LCarbers), it was frustrating, but after it moved, it continues slowly moving . Sometimes weight loss just stops for a while. Do you think about introducing longer fasts once or twice a week after your summer is over? Who knows, may be your 2 cups of coffee on the morning provide enough interference.I hope you are not taking offense in my advice.Summer time is challenging for me too - I plan to spent 2 months in Russia visiting my mother and friends. Even without travel my Florida garden with blueberries , figs, peaches, pomegranates would be working against LC way of eating. There is more in life than dieting.
Anonymous said…
I did Fast 5 for a while (maybe a month?) and while I liked how it removed a lot of "food drama" for me, I was cold to the bone all the time. I am hypothyroid anyway, and after my last blood test the doctor upped my meds again, which I can't know was due to IFbut I'm suspecting. Just my own experience...

CS is Jimmy Moore really censoring you? That's so disappointing.
Anonymous said…
Also, I wonder whether years of LC/VLC led to the hypothyroid in the first place...
Sanjeev said…
> whether years of LC/VLC led to the hypothyroid

did you ever have low iron at the same time as LC/VLC?

The liver needs iron to convert inactive versions of thyroid hormone to active. I don't know if having low iron at the same time as a very low calorie diet leads to permanent thyroid insufficiency, but definitely in the short term it does.
Anonymous said…
I don't know, Sanjeev, but I'd be surprised as I tended to do VLC with lots of meat. But it's certainly possible.

I read over on 180 Health recently that Atkins himself talked about VLC shutting down thyroid function, but I haven't poked around myself to see if this is so, and if so, why.
Sanjeev said…
thyroid hormone levels fall on all low and very low calorie diets.

I haven't researched whether low carbohydrate is especially bad for thyroid or if its effects are longer term than very-low-calorie-high-carbohydrate.
Galina L. said…
Again, it is just my personal experience, I am hypo-thyroidal myself , diagnosed 15 years ado, it is a Hashimodo disease - autoimmune in origin. I continued to have symptoms while on Synthroid, after switching on Armour thyroid(lastNovember), I am cold no more,energy level is much better . In my case, going LC and then IF didn't affect thyroid problem one way or another. My other autoimmune diseases got better - no need in asthma inhaler, eczema almost gone, allergy on fish less prominent. Actually, I think that not rigid IF is a way to reintroduce previously forbidden food back and be more flexible with food choices . It is not about self-deprivation.I like the advice of Todd Becker on the subject
CarbSane said…
@Steph: Yes, unfortunately tis true. He once stated to me in an email that he never censors comments unless they are abusive/profane, etc. He's also made this claim on his various venues publicly. It's simply not true.

Regarding thyroid and everyone contributing on that front: I've always been "cold" - since well before my days of dieting or anything else. Hypo? I'll never know. I was an extremely active, healthy and - if I should say so myself - physically rather exceptional person until I frigged it all up with dieting and whatnot in my late teens.

@Galina: I realize I forgot to answer to your query about extended fasting. Like I cautioned Jimmy - it's not advisable for anyone with weight issues and/or eating disorders. Going on his cruise now, he's back to pre-fast (before the pre-fast binge that is) weight, no doubt it will climb, and he'll have a new plan to tackle it when he returns. I really feel for this man, but his antics are less than conducive to empathy as time wears on.
Sanjeev said…
Steph wrote: I'd be surprised as I tended to do VLC with lots of meat

lots of meat helps but doesn't guarantee good iron status. I once ended up with very low ferritin and transferritin (but high hemoglobin) despite eating 4 meat meals a day.

Granted I had been donating blood for several years at the maximum allowed frequency, but the amount of iron I was eating (steak and the even higher in iron liver) was supposed to cover that loss easily. My doc told me it was one of the lowest ferritin readings he'd ever seen.
Galina L. said…
Thank you, Carbsane. I am sorry to hear about J.M. regaining his fast lost weight. I feel for him too. Six days fast sounds rather desperate.
Flavia said…
@Gallina, yes it does. And yes he does censor. If you notice his latest menu posts, there are zero comments- which is fishy as this is when he has been changing his diet most and gaining weight. Thats when people usually comment.
RRX said…
Man. I clearly came to this one too late.

Regarding all of the comments about using fasting and lowering calories to very low levels, I stopped worrying about that last year. Studies such as these, (I have the full paper if anyone wants a copy, as it's behind a pay wall),,, and now this one, put that whole fear to bed for me. I used IF very successfully to both lean out a little bit AND to balance out any high consumption days. I no longer fear big social meals because of this. I don't worry about restricting myself in any way or having to plan out how to manage it. If I have one, then I just skip breakfast the next morning and essentially have a ~18 hour fast. It's kept me weight-stable for months now, and with very little psychological effort. If it feels fine and you don't already have a diagnosed health issue, then I say people should feel free to try out fasting.