In this interview, Dave talks to Philippa about her hypothesis that the Lean Mass Hyper-responder phenotype may be described by an underlying thyroid dysfunction. They deep dive into the idea to discuss the relevant research, and compare it to Dave’s lipid energy model.
0:00 Intro and brief overview of Lean Mass Hyper-responders
Site mentioned: Lean Mass Hyper-responders facebook group
1:30 How does Philippa’s view on Lean Mass Hyper-responders differ from Dave’s?
3:11 How Philippa found the Lean Mass Hyper-responders facebook group
6:39 Philippa’s history with Hashimotos and perspective on thyroid function in LMHRs
Producer note: Hashimotos Thyroiditis is an autoimmune condition affecting the thyroid often resulting in an underactive thyroid
7:52 Does Philippa feel Lean Mass Hyper-responders have a thyroid dysfunction?
11:05 In accordance with the lipid energy model, wouldn’t you need lower T3 in order for higher levels of lipolysis to take place?
13:43 Does higher relative delivery of Free Fatty Acids to the liver result in higher production of VLDL? Does it depend on context?
17:31 What is futile cycling of fatty acids? Does it make sense?
21:18 The distributed object network model of energy potential trafficking, and how VLDL and fat tissue repletion, may play a key role.
26:58 Is it possible for someone who has never had hypothyroidism symptoms who went on a low carb diet and developed a Lean Mass Hyper-responder profile to completely erase the profile with medication?
30:35 Example of a Lean Mass Hyper-responder reversing the profile from diet
Producer note: To provide a little additional information, having been in close communication with the LMHR in question, the drop of LDL to 140 mg/dL from 800 mg/dL+ was after increasing weight by ten pounds, increasing meal frequency from one meal a day to two meals a day, decreasing exercise intensity and frequency and including “carb ups”. So macronutrients did change as did multiple other factors. As Philippa said, these are consistent with the lipid energy model, and her thyroid/anabolic signaling model.
33:06 Is the loss of a menstrual cycle in female Lean Mass Hyper-responders a red flag, and/or common?
36:37 Review of triglyceride and fatty acid metabolism in adipose, skeletal muscle, and liver and how it relates to the lipid energy model.
Study mentioned: Fatty acid metabolism in adipose tissue, muscle and liver in health and disease – Keith N. Frayn, Peter Arner and Hannele Yki-Järvinen 2006
44:13 What are the commonalities and differences between lipid profiles in people with hypothyroidism and Lean Mass Hyper-responders?
Study mentioned: The effects of thyroid dysfunction on lipid profile – C.V. Rizos, M.S. Elisaf, and E.N. Liberopoulos 2011
47:50 Common reasons for high triglycerides in Lean Mass Hyper-responders, and generally for those on a low carb/carnivore diets.
Post mentioned: High triglycerides on low carb and what to do about it.
Producer note: Going by submitted data on CholesterolCode, triglyceride levels of 200+ are not that uncommon from coffee sensitivity. Although a pull of the data we have would be necessary to see exactly how frequent it is, anywhere between 150-250 is what I most commonly see, from memory.
51:05 HDL and triglyceride inverse correlation and relation to Lean Mass Hyper-responders and the thyroid dysfunction hypothesis
53:11 Are there other things to look out for that may help suggest a non-favorable situation relating to the Lean Mass Hyper-responder profile?
55:40 Dave’s data on IGF-1 and LDL-C compared to predicted correlation
58:27 Overview of thyroid markers, their structure, and function
1:02:33 Does Philippa have any additional thoughts to share before wrapping up?
Blood marker changes of interest in Lean Mass Hyper-responders mentioned: MCV (Mean Corpuscular Volume) in 90s-100s, RBC (Red Blood Cell count) decreasing slightly, RDW (Red Blood Cell Distribution Width) increasing slightly
1:05:05 Context of blood markers being studied and how correlation with pathological contexts may be relevant
1:07:29 Leptin levels in the context of low carb, the thyroid dysfunction hypothesis, and the lipid energy model
1:12:50 Will Lean Mass Hyper-responders show signs of insufficient anabolic signaling, such as low bone density, over time?
1:17:37 Dave’s thoughts on investigating potential downsides to the Lean Mass Hyper-responder profile.
Link Mentioned: Philippa’s google doc on the thyroid dysfunction hypothesis
1:23:08 Outro
Thanks for this great offering, Dave. Suggest you add Philippa’s last name at top.
I remember watching this session with Philippa some time although I didn’t understand the relevance for me. I am mainly carnivore although not exclusively. I am a LMHR and my last LDL test was 6.4 on a range of 0-3.4. Since having chymo for Throat cancer 6 years ago my Thyroid test have always shown a very low T4 and T3 levels but high TSH. As a result I was advised by my GP to try Levothyroxine about a year ago. Since that time my dose has increased and I am now on 120mg per day. My TSH has dropped and my T4 has risen but importantly my T3 has also dropped which seems to defeat the point with taking T4.
I have since done some further research and have discovered that often people have mentioned that HFLC diet can result in low T3. Can anyone help and advise me if this is common. Is a low T3 an issues on a low fat diet or a normal response from the body.
Thanks