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Jenn R

CR with fiber sensitivity and Hashimotos/hypothyroidism

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Hi. I'm new to this forum. I’ve always wanted to live longer, ever since I was a kid. I'm still pretty young but I recently decided to go on a calorie restricted diet. The thing is that I’m not sure how to do that and I could really use some help. 

I’ve been relatively skinny most of my life. My BMI is around 19 and has been around that since I was a 15-16. I suffer from Hashimoto’s (autoimmune hypothyroidism) and have recently had to eat relatively little to maintain my weight and look and feel like my normal self. I work out 6-8 hours per week of relatively intense exercise and eat around 1600-1800 calories a day. I try to eat nutritious food.

I’m sensitive to fiber so I have to restrict my vegetable intake. Eating more than 20 g of fiber per day makes me very gassy and prevents nutrients from getting absorbed. I try to eat nutritious foods that are low in fiber. 

The way I understand this diet is that people cut calories to the point where their metabolism slows down and their bodies barely get enough calories to survive. But their diet is rich enough to provide all the necessary nutrients by eating lots of vegetables and fiber. What do I need to do if my metabolism is already crawling. I’m on medication so I’m not currently hypo but my metabolism is very slow compared to the way it was before I had thyroid issues. My thyroid hormones are currently in the normal range but they're very close to hypo (my FT3 is at the low end of the healthy range and my FT4 is not that far above it). Do I need to slow down my metabolism more? Do I need to eat less if my BMI is already relatively low? How can I do this diet if I can’t eat fiber.
 

Edited by Jenn R

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Jeen, first of all you should read Michael Rae's FAQ

Then, maybe your BMI value got erased, I can't see it.

Also, I think it's easy to design a 20g-fibre, CR diet, even on plant-based foods, but you need the cronometer app.

Edited by mccoy

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OK, then my reply would be: with a BMI of 19, regular exercise and 1700 kcals per day maybe you already are on CR, the Hashimoto is maybe just keeping your setpoint lower than the average. According to MR's guidelines, you might try and loose 15% bodyweight, but then you start navigating in dangerous waters, since too little a bodyweight may result in some problems and too little a caloric intake does not allow many nutrients to be ingested.

My personal suggestion would be that you keep your current weight if you are comfortable with that and adopt a training strategy which exercises both lower and upper body (plus core of course) and adopt a dietary regimen which is whole-food based, phytochemicals-dense, like all people do here,  regardless of calories.

Are you inclined to be omnivorous, vegetarian, pescetarian or vegan?

Edited by mccoy

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On 9/21/2019 at 2:10 AM, mccoy said:

OK, then my reply would be: with a BMI of 19, regular exercise and 1700 kcals per day maybe you already are on CR, the Hashimoto is maybe just keeping your setpoint lower than the average. According to MR's guidelines, you might try and loose 15% bodyweight, but then you start navigating in dangerous waters, since too little a bodyweight may result in some problems and too little a caloric intake does not allow many nutrients to be ingested.

Yeah, I don't know how safe that would be... My body weight tends to be around 18.5-19.5. A BMI under 18.5 is considered underweight right? I could try to keep it at 18.5-19. Do you think that would help?

If my setpoint is lower because of my thyroid am I still getting the same longevity benefits as other CRONIES?

On 9/21/2019 at 2:10 AM, mccoy said:

My personal suggestion would be that you keep your current weight if you are comfortable with that and adopt a training strategy which exercises both lower and upper body (plus core of course) and adopt a dietary regimen which is whole-food based, phytochemicals-dense, like all people do here,  regardless of calories.

I play volleyball and do gymnastics (bars and floor) and rock climbing. I also do pushups every day and pullups 1-3 days per week. These sports and exercises work my upper body, lower body and core, don't they? Do I need to add more upper body, lower body and core exercises on top of that?

On 9/21/2019 at 2:10 AM, mccoy said:

Are you inclined to be omnivorous, vegetarian, pescetarian or vegan?

I think I'm polo-vegetarian. I eat only chicken and turkey (I don't eat fish or red meat). 

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23 hours ago, Jenn R said:

Yeah, I don't know how safe that would be... My bodyweight tends to be around 18.5-19.5. A BMI under 18.5 is considered underweight right? I could try to keep it at 18.5-19. Do you think that would help?

If my setpoint is lower because of my thyroid am I still getting the same longevity benefits as other CRONIES?

From the posts of long-time cronies here it would seem that 18.5-19.5 is an optimum CRON target, someone went lower but it may be unsafe or unhealthy.

I really don't know about CR and hypothyroidism, if you're skinny though and your calories are low, it means that there is probably an actual CR state.

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23 hours ago, Jenn R said:

play volleyball and do gymnastics (bars and floor) and rock climbing. I also do pushups every day and pullups 1-3 days per week. These sports and exercises work my upper body, lower body and core, don't they? Do I need to add more upper body, lower body and core exercises on top of that?

I'd say your exercise regime is complete, maybe adding a modest abdominal routine might benefit, other than that I believe it's pretty much all right.

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23 hours ago, Jenn R said:

think I'm polo-vegetarian. I eat only chicken and turkey (I don't eat fish or red meat)

Mmmmm..., Unfortunately, I've not much time now, next week I may try and design an example of 20g fibers diet based on fowl and plant foods, I'm curious how limiting the fibers threshold may be.

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On 9/24/2019 at 6:12 PM, mccoy said:

I'd say your exercise regime is complete, maybe adding a modest abdominal routine might benefit, other than that I believe it's pretty much all right.

Rock climbing and gymnastics definitely work my abs. A strong core is an absolute must for both.

Edited by Jenn R

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Jenn, this is an example of a quick optimization of a daily regime (average) with the upper bound constraints of 20 grams fibers and 1700 kcals, relative to my present weight of about 68-69 kg).  It contains all basic fundamental nutrients with the exceptions of omega 3s and vitamin D, which can be easily ingested by supplements or sunrays. It is possible to fiddle around with it to meet  individual requirements but you need the cronometer app of course. Calories can be increased by increasing oil and honey, without affecting fibers significantly.

At the end, it may constitute a reasonably healthy, CRON regime, given the constraints. Of course this is only an example, I'm no MD nor nutritionist and  the general practitioner and endocrinologist must be consulted when changing diet and specific conditions are present.

image.png.7260440df60181bb376461bd38eae16c.png

image.png.177bf7baae8f8c874773ac518efcb275.png

image.png.7afc87b7bf2fe0940c93fb7a15322a4b.png

 

Edited by mccoy

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That adds up a further layer of complexity since even refined cereals do contain fiber. Good, I'll try some other design out.

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Substituting refined carbs, for example pasta to fruit and vegetables is a disaster form the point of view of an healthy diet, unless you drink plenty of green juices and fruit juices (at least one liter per day), which only contain a small amount of fiber. Besides, you may need some supplements since you'd risk some vitamins deficiencies, like retinol if the cronometer example is accurate.This is an example, but to meet the energy target you'd need to zero EVOO and you only get 150 of cooked white pasta.

To me, this would not improve at all training efficiency with respect to the previous design.

I'd be curious to see what you are eating now entered in cronometer, maybe you're eating more fiber than you believe if you did not verify with a dedicated app.

image.png.3b4e5e95d0d5dc6dbd4a2ded6a8910f2.png

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This is another example, with 350 g cooked pasta + 0.5 cups tomato sauce and a little spinach, no deficiencies except fatty acids (n3 and n6), 20 grams fibers,

image.png.820a38d412f167ae9bc3e29c5a55aabd.png

 

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Cornmeal (tortillas, polenta) and brown rice are whole grains that are pretty low in fiber. White potatoes would also be a good source of carbs, and you can remove the skin to lower the fiber further. Could also potentially eat purple potatoes as a source of anthocyanins that you probably won't get from berries, black beans or red cabbage. For nuts, walnuts and hulled hemp seeds are pretty low and both good sources of ALA. Tofu has basically no fiber and might be the only legume you can eat, so that would be good. It’s better to get calories from refined grains than a lot of animal foods in my opinion. And replacing some meat with mollusks (oysters, clams) would boost the nutrient density a lot. You probably don't need more than 70 grams of protein, the RDA is around 50.

However, if CR works by slowing the metabolism, then you may be already getting the benefits and there is no point in calorie restricting any further. In this study people with low-normal thyroid function lived 3 years longer than people on the high end of normal (just watch your cholesterol because hypo can raise it). It might be better to focus on quality of life and managing your symptoms. For example your digestive difficulties are likely related to your metabolism, because gut motility slows down along with everything else and this can easily lead to bloating and constipation. This chart has a list of vegetables that are low-FODMAP, maybe you would be able to tolerate them better than other vegetables. 

Edited by Mikii

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On 10/2/2019 at 3:24 AM, mccoy said:

That adds up a further layer of complexity since even refined cereals do contain fiber. Good, I'll try some other design out.

Yeah, that's why I hardly ever eat whole grain foods. I generally eat fiber free & gf free grits in the morning because everything else (e.g. cereal, protein bars, etc) contains fiber.

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On 10/2/2019 at 8:08 AM, mccoy said:

Substituting refined carbs, for example pasta to fruit and vegetables is a disaster form the point of view of an healthy diet, unless you drink plenty of green juices and fruit juices (at least one liter per day), which only contain a small amount of fiber. Besides, you may need some supplements since you'd risk some vitamins deficiencies, like retinol if the cronometer example is accurate.This is an example, but to meet the energy target you'd need to zero EVOO and you only get 150 of cooked white pasta.

To me, this would not improve at all training efficiency with respect to the previous design.

I'd be curious to see what you are eating now entered in cronometer, maybe you're eating more fiber than you believe if you did not verify with a dedicated app.

image.png.3b4e5e95d0d5dc6dbd4a2ded6a8910f2.png

Thank you. As far as carbs go I generally eat about 2 servings of white rice/white rice pasta, 1 medium potato without the skin (potato skins have too much fiber) and grits. I often add rice cakes with avocado or honey on days on which I work out. 

Here's an example:

Breakfast:

- Rice grits (no fiber) + skim milk + a little bit of sugar and salt. This is a relatively large meal.

 

Lunch:

- 1 medium potato, no skin

- Chicken breast (no skin) - no seasoning other than salt. Roughly 1 piece.

- Iceberg lettuce (2 ish cups)

- 4-5 cherry tomatoes,

- Avocado - 1 ts

- Olive oil  - 1 ts or 1 tsb

- Ketchup

 

Dinner:

- 1 egg + 3 oz egg whites + spinach + 3-4 cherry tomatoes

- White rice/white rice pasta - 2 servings (1 cup-ish cooked)

- Avocado - 1-2 ts

 

Snacks:

- 4 cups of Mott's apple sauce (or 2 cups + 1 peach or 2 cups + 1 orange). Mott's apple sauce contains 1g fiber per cup (I try to avoid eating real apples because they're relatively high in fiber).

- Lots if zucchini (zucchini is relatively low fiber and high in potassium and magnesium compared to other vegetables). Occasionally, I'll eat a little bit of broccoli or brussels sprouts (I love these vegetables but they're so high in fiber 😞 ).

- Chicken broth - 0-2 cups

- Herbal tea + sugar*

 

Workout day - additional snacks for days on which I work out:

- 3-5 rice cakes + 2 ts avocado + salt (sometimes I also add honey)

- Some days I also drink skim milk + whey powder (usually before or after relatively intense 2+ hr workouts)

 

*Note: I have to have at least a little bit of sugar every day otherwise I get really hypoglycemic (eating too much sugar also makes my sugar level drop so I have to balance it)

 

Sometimes I go over 20 grams of fiber because it's really hard to eat less than that and my body really doesn't like it. 

Edited by Jenn R

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On 10/2/2019 at 10:28 AM, Mikii said:

Cornmeal (tortillas, polenta) and brown rice are whole grains that are pretty low in fiber. White potatoes would also be a good source of carbs, and you can remove the skin to lower the fiber further. Could also potentially eat purple potatoes as a source of anthocyanins that you probably won't get from berries, black beans or red cabbage. For nuts, walnuts and hulled hemp seeds are pretty low and both good sources of ALA. Tofu has basically no fiber and might be the only legume you can eat, so that would be good. It’s better to get calories from refined grains than a lot of animal foods in my opinion. And replacing some meat with mollusks (oysters, clams) would boost the nutrient density a lot. You probably don't need more than 70 grams of protein, the RDA is around 50.

However, if CR works by slowing the metabolism, then you may be already getting the benefits and there is no point in calorie restricting any further. In this study people with low-normal thyroid function lived 3 years longer than people on the high end of normal (just watch your cholesterol because hypo can raise it). It might be better to focus on quality of life and managing your symptoms. For example your digestive difficulties are likely related to your metabolism, because gut motility slows down along with everything else and this can easily lead to bloating and constipation. This chart has a list of vegetables that are low-FODMAP, maybe you would be able to tolerate them better than other vegetables. 

Thank you for the suggestions. I tried eating corn, brown rice and black rice but they're relatively high in fiber compared to white rice and my body tends to react. I do eat white potatoes (occasionally also purple and brown) and remove the skin (I limit myself to 1 medium potato per day because even that's relatively high in fiber). Occasionally I eat raspberries, but I limit myself to 10 per day. I eat strawberries every few months but my body doesn't really tolerate them well because they're relatively high in fiber. My body absolutely can't tolerate tofu or beans (I love tofu and beans so 😞 ).

I need lots of protein because I work out a lot and the types of workouts I do build a lot of muscle and strength. I tried eating less protein but my body wasn't happy, especially after working out.

Most of my gut difficulties are caused by SIBO, which based on what I've been told could definitely be related to hypo/Hashimoto's. I was diagnosed with SIBO 5 years ago. It tends to go away when I take Xifaxan and then always comes back a month or two later. I tried going on a low fodmap diet but it did absolutely nothing for me. The only thing that's worked for me so far has been a low fiber diet (and/or SIBO antibiotics). I often take butyrate because I've heard that a long term low fiber diet can cause colon cancer and that butyrate can help reduce the risk. 

Edited by Jenn R

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Most of my gut difficulties are caused by SIBO, which based on what I've been told could definitely be related to hypo/Hashimoto's. I was diagnosed with SIBO 5 years ago. It tends to go away when I take Xifaxan and then always comes back a month or two later. I tried going on a low fodmap diet but it did absolutely nothing for me. The only thing that's worked for me so far has been a low fiber diet (and/or SIBO antibiotics). I often take butyrate because I've heard that a long term low fiber diet can cause colon cancer and that butyrate can help reduce the risk. 

SIBO caused by low gut motility won't go away forever unless the motility problem is addressed, unfortunately. Prokinetic drugs can fix it but you have to take them every day. They do work though. I think the most used are metoclopramide, domperidone, erythromycin, and prucalopride. There are also some supplements that have a weaker kinetic effect (iberogast, 5-HTP, maybe ginger).

Lowering your thyroid activity any more would likely make your motility worse. Increasing your thyroid medication might make it better, but I'm not sure. 

Is it possible to replace your iceberg lettuce with spinach or romaine? Even romaine has a lot more nutrients than iceberg. Nuts would also be a really good addition if you can handle them.

List of prokinetic drugs: https://sibosurvivor.com/prokinetic-agents/

This is a good explanation of how they work: https://medium.com/@stkirsch/insights-from-mark-pimentel-on-the-treatment-of-sibo-c091bb5aa00

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2 hours ago, Mikii said:

SIBO caused by low gut motility won't go away forever unless the motility problem is addressed, unfortunately. Prokinetic drugs can fix it but you have to take them every day. They do work though. I think the most used are metoclopramide, domperidone, erythromycin, and prucalopride. There are also some supplements that have a weaker kinetic effect (iberogast, 5-HTP, maybe ginger).

Lowering your thyroid activity any more would likely make your motility worse. Increasing your thyroid medication might make it better, but I'm not sure. 

Is it possible to replace your iceberg lettuce with spinach or romaine? Even romaine has a lot more nutrients than iceberg. Nuts would also be a really good addition if you can handle them.

List of prokinetic drugs: https://sibosurvivor.com/prokinetic-agents/

This is a good explanation of how they work: https://medium.com/@stkirsch/insights-from-mark-pimentel-on-the-treatment-of-sibo-c091bb5aa00

Thank you for your suggestions. I drink ginger tea almost every day and it helps a bit but not much. The thing is that I try to avoid medications that affect brain chemistry. But I have no problem trying natural supplements. I forgot to mention. I take garlic and it seems to help to some degree.

I do eat a fair amount of spinach. I tried eating more, but it made me nauseous. The reason why I eat iceberg lettuce instead of romaine is because it's lower in fiber. I try to eat the darker parts because they have more nutrients. Also, is romaine safe to eat? (wasn't there a recall because of an e coli outbreak or something?) I really don't like nuts, otherwise I would definitely add them to my diet. I just really don't like the way they taste.

My thyroid is slowly getting better. It's stable and I feel a lot better than I did before I was put on medication but my FT3 and FT4 are still very close to the bottom of the healthy range at this point.. My doctor says that overtime my thyroid hormones will get closer to the middle of the reference range, which is considered more optimal, but it's going to take some time. Hopefully this will fix my gut issues idk. 

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I do eat a fair amount of spinach. I tried eating more, but it made me nauseous. The reason why I eat iceberg lettuce instead of romaine is because it's lower in fiber. I try to eat the darker parts because they have more nutrients. Also, is romaine safe to eat? (wasn't there a recall because of an e coli outbreak or something?) I really don't like nuts, otherwise I would definitely add them to my diet. I just really don't like the way they taste.

I would bet that a smaller serving of romaine, kale, arugula, or another green or red leaf lettuce has more nutrients than iceberg, that is, they have more nutrients per gram of fiber. You would have to check cronometer for specific serving sizes. Unless there is an active recall, I don't usually worry about romaine, I just wash it thoroughly. It might be higher risk than other greens, so that's up to you.

Since you don't eat seafood or seeds, a little bit of flax oil every day would be good for getting omega-3. That or a fish/algae oil supplement. 

I checked and grapes have even less fiber than applesauce, with more polyphenols. Dates have more fiber than grapes but less than applesauce. Variety is good! 

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