Wednesday, June 15, 2011

Hypothyroid Face

The before and after pictures shared by Korg Kcuf in the last post on low-carb hypothyroidism reminded me of the stunning before and after hypothyroid treatment pictures I once came across.  Fortunately, I have found these photos online, and they do show some remarkable changes in facial appearance. 

You often hear this swollen facial appearance referred to as "carbo face," which is one of the more retarded things I've ever heard.  If anything, this should be called "Eskimo face," as the native Eskimo had perhaps the puffiest and roundest faces on earth. You can even see telltale signs of facial myxedema in this young Eskimo mother, with quite a bit of fluid gathering below and above the eyes.  And this is someone who is incredibly well-adapted and epigenetically-programmed to a diet high in meat and fat and low in carbohydrate. 

Anyway, Korg's development of increased abdominal fat, a posture more rounded in the shoulder area, facial puffiness, and a drooping chin among other changes are prominent signs of hypothyroidism, as well as hypercortisolism/Cushing's.  These two conditions tend to go together, overlap, and cause one another - so it's hard to separate one from the other.  There is no question though that these facial and physical changes can be used diagnostically to tell what, in general, is taking place in someone's body.  And sorry to pick on low-carb.  There are countless paths to hypothyroidism and/or hypercortisolism, such as calorie restriction, endurance exercise, stress, chronic inflammation, infection, winter, or allergy.    

I remember when I had just finished doing 5 months of intense physical exercise on a low-carb diet for the first time my body and face became very puffy.  My eyes started looking very swollen, especially first thing in the morning (interestingly, laying down for long periods allows gravity to bring the fluid back from the body and into the face - it's very common to have a puffy face in the morning that ends up in the "cankles" if you have spent a lot of time standing during the day).  This is not just from the low-carb diet alone though.  My face (and belly) got very swollen again during re-feeding after my most recent bout of overly-strenuous endurance exercise in 2009, and has since cleared out even though my weight has increased by 15 pounds (mostly lean tissue increase).  But enough about me.  Here are some before and after thyroid treatment photos featured at http://www.jcrows.com/hypothyroidism.html

Pay attention to the hypothyroid/hypercortisol affects, including swelling of the neck, swelling below the eyes and in the upper cheeks, swelling between the eyes and eyebrows (the fluid presses the brow upward), disappearance of the outer third of the eyebrow and hair in general, and subtle retraction of the nose.  Very fascinating.  If you're a nerd I guess.  Following a hypothyroid diet many notice steady improvement in these exact facial patterns, even if they gain body fat.  






56 comments:

  1. I find in my Health Counseling practice with women with Hashimoto's, and I also noticed this in myself when I was positive for Hashimoto's, that there is a redness and puffiness below the eyeball on the ridge of the cheeks. I believe this is a mark of autoimmune disease, the underlying issues of course being gut dysfunction, infection, food allergies, and inflammation. It is very interesting to note, as you did here Matt, that this does go away once working on diet and healing the gut. I am certainly a testament to that myself.

    Thanks for this post. :)

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  2. The treatment pics are fascinating, but I don't think the comparison with the Eskimo is fair. In order to properly compare, you'd need a picture of someone genetically similar without that look. In my experience, people of Native American stock have such faces regardless of diet.

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  3. Dang it, I wish that Armour helped me that much. I got all the way up to 3 grains but ended up overdosing. The doc and I adjusted my levels over 3 years but I never really got relief from symptoms. I also tried the Wilson t3 therapy for 4 rounds but my temp barely rose, never did get to 98.6. I am completely off Armour since mid-Ray May and my temps are up: morning 97.4 to 97.8 axillary AM, up to 98.3 axillary during the day with no cold hands or feet but I still have problems with swollen face and feet in the AM. Not bad swelling by any means, just a little. But never did I experience anything as dramatic as those pics.

    Thanks for the great pictures, it really illustrates the point you are trying to make :)

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  4. So fascinating - thanks for posting about this. The before and afters are amazing.

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  5. Interesting photos! Note that if you click the links (hint, Michelle) and read the notes associated - the follow-up photos were several months later. Don't give up.

    I have also reversed Hashimoto's (normal TSH and no antibodies) from first Hyper to Sub-Cl. Hypo and now NORMAL. My Dr. nearly had a fainting spell when she read my latest report. "No meds for you!"

    Also cleared up TMJ symptoms - How? ETF! ETF!

    ~Anna

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  6. Melissa-

    Ha, I wasn't trying to be fair, as calling someone with a swollen face a "carbo face" isn't fair either. Just being an immature jerk. It's fun. Pregnancy can cause hypothyroidism and those facial changes as well.

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  7. The naked lady grew some boobage! Wonder if this also helps transforms lady apple shapes to pear shapes.

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  8. Seeing these "clinical" photos now makes me look at people in public differently - wondering if they need some bananas and tater therapy.

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  9. Kelly-

    She grew breast tissue and lots of lean mass with no added body fat. Many underweight (and overweight) women who embark on RRARF have this experience, but for women it can be scary because the scale increases dramatically, and there often is some fat gain in the first 2-3 months.

    Most women will find that their ideal body weight is much higher than they thought it was. Like Amanda who is very lean and attractive at 165 pounds. Great post by the way Amanda (I assume you'll read this)...

    http://www.batty.us/2011/01/be-strong-not-skinny/

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  10. Cool photos... it strikes me that knowledge of hypothyroidism has back-slipped in modern medical times. As having been only recently diagnosed with Hashimoto's, after years of complaining about a puffy face, I think the medical establishment has some brushing up to do...but perhaps I am biased.

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  11. Hi Matt. Don't the Eskimo have extra subcutaneous fat due to the cold climate for insulation purposes rather than edema as you mention with myxedema? Hasn't this been demonstrated in swimmers at the English Channel who start to get the same thing since they're swimming in such cold waters?

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  12. Funny, I seem to have gone through some similar changes in the face (unfortunately in the reverse order). I can't believe how much these people have changed. Puts all those complete-makeover-shows to shame. Wished that would happen for me, too. I am still diligently eating the food but so far nothing much has changed. I think part of it is due to my sleeping disorder which may have evolved into a full-blown anxiety order by now: I hope I can sleep - why am I not sleeping - I can't sleep! - panic attack - no sleep at all.

    A question for Anna: You wrote you overcame Hashi's by eating the food. Did you avoid anything in order not to trigger an autoimmune response? If you didn't, did you avoid some foods before getting Hashimoto's?

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  13. Has anyone else noticed the hair change in these people? I've noticed over the years my hair is thicker, shinier, less greasy, and has gone from straight to slightly wavy. definitely meaningful.

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  14. Oh and is it just me or do some of these pictures show that the people grew hair back? (Maybe you could sell RRAARF as a re-fur-ing programm, Matt ;-) Wouldn't sound that different but would probably make you instantly rich.

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  15. What does the area above the eye correlate to, anyone? I know right below is kidneys, and right below that is ... I forget, but anyway, been looking for years but can't find a facial chart that says for above. Because want to know what it means when someone is super puffy above, despite it below always being 100% tight like a healthy child. Not that it means healthy, it doesn't, as there are major kidney issues in this case, but probably over-active kidneys, etc, while under-active [whatever above is], and thus the stagnation.

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  16. I am a before. I was LC for a long time then went HED, gained 20 unsightly pounds, and now I'm trying to do even higher carb with lower fat to maybe lose some of the gained fat. At no time have I ever felt real energy, not with LC, not with HED and not now. Which means I usually end up turning to caffeine, which makes sleep worse and it's a vicious cycle. I am on armour and have a normal complete thyroid panel, but no way do I FEEL normal. I am doing starch carbs by the way, because even one medium serving of fruit makes me insane, ravenous to the point of not being able to seel sated no matter what I do, and threatens my sobriety from alcohol and binging. And I have tried easing into it. It just doesn't ever change get better with the fruit. I want to be an after and actually feel some energy in my body? Any suggestions? ...S.

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  17. Armpit - I have yet to find specific food triggers - but I do know I am intolerant to caffeine and hard liquor (small glass of wine once a week is fine). Before I d'xd with Hashi, I went through tremendous amount of interpersonal stress, plus trying to hold down a part-time job, plus attend college FT, and learning a parent had a major illness. That is when the Hashi manifested as Hyper.

    I was misdiagnosed as just plain Hyper and given PTU (Still wish I could get personal or financial retribution on the Endocrinologist who did that to me...but I digress.) He was "shocked" that it worked within two months. Bang, I gained 20 pounds and felt miserable. Correct D'xd as Hashi a few months later. Never was on synthroid (Good Dr. that time!) but did struggle with symptoms of Hypo for a while. Got back my mojo within the last 18 months or so.

    Also - I have tried gluten removal and challenges to no difference whatsoever. Negative on all celiac testing.

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  18. Has anyone else grown breast tissue? I used to be puffy when I was recovering from an ED. Now my face looks normal, but unfortunately I lost breast tissue in the ED and it never regrew :-( I wish it would. I didn't think that ever actually happened. Matt, if you could develop that sort of Rrarf diet, I would be ever grateful!

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  19. I found these pics years ago researching my husbands health issues and it was because of them that I became convinced he was hypothyroid! We had to fight for the right treatment but his results were just as remarkable as these photos!!

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  20. Thanks, Anna. I suspect that something might be wrong with my thyroid (have been getting a hoarse voice quite often lately without being sick or having talked too much).

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  21. So at what point should a person get on meds for thyroid, or just keep working on diet/lifestyle?

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  22. of course i'm reading, matt. i'm all up in your shit like a probiotic. i had to do a doubletake there, though, cuz its been a while since someone used my real name :)

    i' actually at 175 now, but still wear size small tshirts, and i'm probably around an 8-10 in pants. although VLC eating lead me to gain about 3 inches in my hips, i'm currently sporting a pair of leggings i bought in the girls section of kmart.

    a lot of women out there do not realize that there gets to a point where can be a huge difference between getting smaller and getting leaner, and keep focusing on the former when they really should be doing the latter. it took me a good 4 years to figure that out.

    not to postjack, but hey, you started it.

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  23. Just a personal observation. I went to school with this girl who was always very pretty. The last time I saw her, her face didn't look right. It was like her eyebrows were lower, closer to her eyes. She is a physical therapist and now a personal trainer as well. I was IF'ing at the time and she was saying that most people probably don't need to eat more than 1 or 2 meals a day and I agreed, LOL! She seemed smaller too. She was never fat, but she seemed smaller all over, maybe shorter too.

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  24. Anonymous S-

    I hear you on the fruit. I know some can just start throwing some fruit into the diet and it's no big deal. But I have crazy things happen if I eat fruit in a certain context - like as a dessert for a heavy-ish mixed meal.

    If I eat fruit by itself I do fine. But if I don't I start to have runaway hunger that peaks in the evening with an insatiable desire to keep eating and eating, trouble falling asleep I'm so hungry, and waking up at 4am with hypoglycemia-like symptoms.

    Only when my fruit intake eclipses a very large portion of my total diet do the benefits start to take place without the drawbacks (like tooth pain, increased hunger, increased fat, lethargy, anxiety, sleep problems, bleeding gums, zits).

    If you want to try it, try eating only fruits, 50-50 diluted juices, and starches like rice, potatoes, beans with no added fat or meat until your hunger goes down. It might take a while, but within a week you'll probably start to lose the strong desire to eat something else. At that point you can start slowly working other things into your diet. To me, this is a much better approach than trying to slowly add fruit, which simply doesn't work for those who have this same kind of reaction. I can totally see how this could trigger a desire to binge on alcohol. It's a gnawing emotional sensation in search of satisfaction.

    But I think many won't be able to feel the best they are capable of feeling without simple sugars in the diet. Instead of eating fruit and seeing that it doesn't work and omitting the fruit, think of tweaking your diet in ways that make fruit work. For me, this only works when the total percentage of fruit in the diet becomes very high. But it's quite invigorating to eat fruit in such large quantities if you ask me. Certainly worth a trial run.

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  25. Kitchen Recovery-

    The important thing is to take action. If a person has puffiness in the face and a persistent low body temperature with lots of hypothyroid symptoms, it's important to try to tweak diet and lifestyle first - because odds are diet and lifestyle caused or is causing the problem, and fixing the root problem is always the smartest strategy.

    But not everyone can solve their problems this way. If body temperature and signs of hypothyroidism don't clear up after a couple years of experimentation, I would think that it's time to pursue desiccated thyroid supplementation. But note, this is not foolproof either.

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  26. Amy-

    Several people have regrown breast tissue. I know Hawaiigirl has mentioned this, but so have a few others.

    Left armpit-

    Yes. The shine, thickness, and texture of hair often changes radically when thyroid is returned to its ideal levels. Hair is a good monitor of overall health.

    Barbie-

    Nice work sleuth.

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  27. um is it just me or, fig 1 e is HOT!!!!

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  28. It should be noted fig. 1e was given estrogen in addition to thyroid and I'm sure that accounted for most of the breastage.

    Matt, I think I am too scared for the gonzo fuit experiment. It took me 30 years to get over alcoholism and bulimia, so that's a lot to put on the line. Maybe if others with similar histories reported results. Thanks....S.

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  29. what would you recommend for someone with cushings syndrome? This person had a tumor in their brain and then cortisol levels through the roof. They had surgery to remove the tumor but cortisol levels didn't drop and now tumor is coming back.

    Is hypothyroidism still apart of the picture?

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  30. Hello from my crazy ass vacation! Missed the riots in Vancouver but was there for games 5 &6, young male energy was through the roof!!!
    On topic , puffiness plauges me and I am puzzled by it. Could it be an aging thyroid / menpause deal combo platter? I have to say that I had no puffiness on raw vegan ever. High fruit is looking good and some of that thyroid shit. Also , my temps are high and I sweat every night but it is a leukemia/ menopause issue IMO. It is also fucking annoying.
    I know you missed me and my cougar talk!
    Xo. Hag

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  31. By the way, this is a different Anonymous, lol.

    Nuff said, I send a three flyin through the air, and you come out of nowhere and dunk my shot. I was bout to say:


    That third picture from the bottom is pretty sexy.

    lol, we can't all get a joke in I guess. At least I get to dunk all of Matt's 3's when he ain't suspectin it. (Insert 80's joke or Mike Tyson quote here)

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  32. Also, i want that pic from paleo fail on a poster and a t-shirt. Well matt? You gonna sell me some merchandise or what?

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  33. In your free ebook you say to consume refined coconut oil rather than extra virgin. Why so?

    Thanks.

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  34. MATT-

    I actually found these exact same pictures over a year and a half ago, when I was researching some of the symptoms I had. They were really a goldmine to me, back then. It made me start thinking (I know, craziness).
    I believe I have went through all the stages of puffiness. After years of low carb and a full year of VLC, my face got round and puffy, I actually developed a small buffalo hump (like the one you get with Cushing's). Started gaining weight around my midsection and lost muscle. I showed all the signs of high cortisol/hypothyroidism. It's actually quite fascinating how much it can change your appearance. I couldn't recognize myself anymore.

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  35. James, refined tastes better and is still intact as coconut oil is so saturated it isn't harmed by refining (at least cold-pressed)

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  36. Snip from Matt- "If you want to try it, try eating only fruits, 50-50 diluted juices, and starches like rice, potatoes, beans with no added fat or meat until your hunger goes down. It might take a while, but within a week you'll probably start to lose the strong desire to eat something else. At that point you can start slowly working other things into your diet."

    This is exactly the kind of advice I needed! Next week is the start of a religious fast in which I will participate the first time. Basic parameters are vegan with a few fish-allowed days thrown in. Oddly, seafood/shellfish are allowed on almost all days. [Orthodox Christians, for the curious.]

    Anyhow - I was really grooving on the high fruit idea just for the ease and simplicity of not having to worry about 1-2 meals of the day. Husband is on board with the fruit-for-breakfast idea. Bake taters or make simple dahl & rice for dinner. DONE!

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  37. Veiled Glory,

    For more info on fruit, check out the recent posts on castlegrok. He has the kind of pointers you're looking for. (It's not different from Matt's advice, just more of the same.)

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  38. Thanks, Jim! Good advice, good timing.

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  39. Hey Veiled Glory,

    You're an Orthodox Christian, eh?

    You need to check this out:

    http://nutrition-and-physical-regeneration.com/blog/4016/fasting/fast-lent/

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  40. Thanks Ivan :-) That was the best summation of the conclusions I have reached. I don't feel so alone now in saying no to the Cheez.

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  41. LOL. I love your nonsensical theories. RRARF has basically become "Eat whatever Matt thinks is cool this week." Should be called the EWMTICTW diet. What a joke, but certainly very entertaining. I read your blog faithfully just to see what junk you are promoting next. SKCUS TTAM!

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  42. KARN-

    “Once we accept that knowledge is tentative, and that we are probably going to improve our knowledge in important ways when we learn more about the world, we are less likely to reject new information that conflicts with our present ideas."

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  43. Anyone know if this is what powerlifters have? Or are they all puffed up because they're just fat?

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  44. The doc and I adjusted my levels over 3 years but I never really got relief from symptoms. I also tried the Wilson t3 therapy for 4 rounds but my temp barely rose, never did get to 98.6. I am completely off Armour since mid-Ray May and my temps are up: morning 97.4 to 97.8 axillary AM, up to 98.3 axillary during the day with no cold hands or feet but I still have problems with swollen face and feet in the AM. Not bad swelling by any means, just a little. But never did I experience anything as dramatic as those pics.

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  45. My bust has increased on RARRF :-) ("I must I must I must increase my bust"). I'm 5'6'' female, had baby #2 in Jan. 10. Stressful year, couldn't lose the baby weight, forced it down to 149 with all the usual cardio, weights, restricted calories, vegan, raw, paleo, etc. (it was like my whole dietary life on speed for a year) nothing worked. Then I found 180. Started RARRFing in May. Up to 159 now, but holding steady. Temps in the morning about 97.4, up to 98 in the afternoon (even during the first half of my cycle!). And, my bust went from 36'' to 37'' (plus they look better after bfing 2 babies). Thanks Matt! with A history of ED it is very hard for me to sit at a heavy weight, I feel so fat, but mentally I feel good (done with dieting) and hoping the weight will start coming off. I'm starting to feel more motivated and having the energy to start a bit of exercise again (leisure walking 2-3x week, weights or bodyweight circuit 2x week). Some supplemental aminos (via Julia ross) have really helped with my sleep and my obsessions, on top of the relief rarrf mentality had already given me. Now I'm tweaking further eliminating fructose and pufa, feeling much better (esp. sleep, waking more well rested). So, fingers crossed, and in the meantime enjoying eating the fucking food.

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  46. Karn-

    If you think my theories are nonsensical, just you wait until I start blogging about RBTI. Wow. You are gonna love it!!!

    Jessica-

    Nice.

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  47. JUst about to get kicked out of library, on the road...
    But Amy, I've definitely grown my breasts back. They tended to be full before the worst of my ED, so even at 75lbs I had 'something,' and now they're really bigger than I'd prefer them to be (I like small breasts)--but other people seem to think they look good.

    To anonymous with the fruit problems: I'm wondering whether there is something to that notion of flushing pufas first and then trying fruit? I used to eat all fruit, then went carbophobic for a few years. The last several months I did high starch and all my hypoglycemia went away. I used not to be able to eat an orange without instant reactive hypoglycemia. Now I've gone back to fruit, and I can drink a pint of OJ and feel great. I hope that maybe the same might hold for you with time?

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  48. Thanks for the fruit advice Ela. I doubt there is much pufa left in me as I have been a meat/veg/dairy paleo, actively avoiding PUFA for 10+ years. I had a small glass of OJ by itself today and got tremors from that even. I could hear Matt's voice saying, have 10 more glasses! But it took me forever to 'come down' from that, and the threat of a manic episode looms large. ....S.

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  49. Sheila,

    I agree fully,and well said. I am here for the entertainment, not knowledge. I do enjoy Matt's thoughts and willingness to test on himself, I just wouldn't base my eating decisions on his randomly shifting hypotheses.

    Matt,

    I can't wait for RRARFPEATRBTI, I'm sure it will be a hoot!

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  50. Can't keep up with all the acronyms, whats the latest one RBTI??

    thanks matt for the post through to batty's site. had a look round at the strong not skinny post and also the previous one with a pic of Gwyneth paltrow who I have always really liked, but followed a link to another post and saw her incredible diet and daily exercise routine and really felt pity for this very intelligent, beautiful and down to earth woman. She was eating no more than 950 cals a day and eating kale at every meal, mostly in the form of some kind of shake, and working out with 2 hours of cardio a day, holding 3 pound weights! then it said apparently she is in the initial stages of osteoporosis.

    The insanity of the thinness that woman have to achieve to make it into the likes of Iron man movie, where she teeters about on 6 inch heels and looks so thin you nearly miss her when she turns on the side.

    I am also inspired to try and start doing some push ups and pull ups now, as don't belong to a gym. I have found that I cannot even do a single push up, pretty lame, so have a long way to go. But am feeling lots of energy to burn from rrarf style eating for around 8 months now, after a bout of low carb that lasted no more than 6 months luckily before i found this site.

    enjoying the community here, long time lurker, infrequent poster.

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  51. This comment has been removed by the author.

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  52. This is a picture I found searching Google Images for "Eskimo" of an Eskimo family

    http://i.imgur.com/z5K0S.jpg

    Their faces aren't round at all.

    here's another photo of the Eskimo woman in the family photo

    http://i.imgur.com/MZzMgl.jpg

    Apparently her name was Ola, and this taken in 1929 by Edward S. Curtis.

    another version of the photo
    http://en.wikipedia.org/wiki/File:Edward_S._Curtis_Collection_People_005.jpg

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  53. Hi Matt, in the second half of this page there are some other interesting hypothyroid face:

    http://www.jcrows.com/hypothyroidism.html

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  54. I strongly believe that hypothyroidism can be overlooked but it is easy to treat with natural thyroid supplements .

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  55. I dont know if its been pointed out or not yet, but the woman who grew breasts and had a change in body shape was also on estrogen. This is explained on other websites where the picture was taken. They gave her estrogen to push her into puberty, which was stunted by the hypothyroidism.

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