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Case Study Issue 88: Metabolic Typing for Thyroid and Infertility

by Dr Khush Mark(more info)

listed in case studies, originally published in issue 88 - May 2003

A 31-year-old woman with Grave's disease (an autoimmune disorder in which antibodies stimulate overproduction of thyroid hormones) came to see me for nutritional advice on helping improve her health naturally. She was married and worked as a freelance graphic designer. She had been on Propylthiouracil (PTU) tablets for 18 months, but for the past four months her health had been deteriorating. She had the following symptoms:

  • Dizziness and poor sense of balance
  • Eczema;
  • Acne;
  • Greasy skin;
  • Poor hair condition;
  • Nervousness;
  • Anxiety and tension;
  • Depression;
  • Panic attacks;
  • Fatigue and exhaustion;
  • Poor memory;
  • PMS;
  • Excessive thirst;
  • Hyperactivity;
  • Muscle cramps
  • Irritability;
  • Drowsiness during the day;
  • Need for excessive sleep;
  • Cold hands and feet;
  • High blood lipids.

When I went through all her symptoms, it seemed as though her thyroid problem was swinging from over- to under- active. She had mentioned that sometimes she would feel so cold that she would have a hot bath and afterwards wrap herself in a duvet with a hot water bottle, whereas other times she was so hot that she wanted to sit in a cold room.

She quit her job as she was having panic attacks and suffering from depression. Her illness led her to believe that her work colleagues did not like her and were talking about her.

She was also hoping to have a baby in the next year and was concerned as her doctors had told her it was impossible with her health situation. She had been trying to conceive for a while by now without any success.

I carried out a complete health profile on her asking questions such as 'was she breast-fed' through to her present daily dietary habits. She was a vegetarian and a very unhealthy one. On top of that she was not taking any supplements and was definitely lacking in vital nutrients such as vitamin B12, zinc and iron, as well as various amino acids. She was not getting any essential fats from her diet either.

So the next step was to determine her metabolic type in order to put together a nutritional programme for her. She was evaluated to be a fast oxidizer. Fast oxidizers are overly reliant on carbohydrate metabolism (excess oxaloacetate from glycolysis) and poor at burning fats, not producing adequate amounts of acetyl CoA (from beta-oxidation). These individuals do better on a 'higher' protein and fat diet. For a fast oxidizer the source of proteins is also richer in purines.

I emphasized to her the importance of eating according to her metabolic type such that her cells will receive the right nutrients at the right time in the right amounts. I told her that without following this diet for her specific nutritional needs, her health would not improve and that she would be wasting her money and my time if she was not willing to follow her metabolic nutritional programme.

She was very reluctant to eat meat, (which is completely understandable as she had not eaten meat in 16 years) but was willing to incorporate fish into her diet. This was a great start. She immediately started eating according to her metabolic type and introduced a variety of foods into her diet, such as fish, quinoa, buckwheat, legumes, pulses, sugar-free muesli, nuts and seeds and so on.

She began to introduce protein into every meal as well removing all refined carbohydrates. More importantly we worked on her food group ratios for each meal such that she was not having any bad reactions (for example hunger, irritability, moodiness, low energy, fogginess of thought, tired, sleepy etc.) two hours after the meal. This was achieved by using diet record sheets and varying her protein, carbohydrate or fat percentage in the various meals. The ratios of the various food groups were either increased or lowered depending on what type of a reaction she had two hours after having had her meal. The thought of giving up sugar was daunting for her but as she started to eat the foods recommended for her type and in the right ratios she no longer craved/wanted sugar and furthermore found it extremely sweet! Once I was happy with her meals (i.e. nutrient-dense as well as metabolically correct) I introduced various nutritional supplements which included omega-3 and omega-6 oils, B vitamins, and a multivitamin and mineral as well as a supplement to balance her oxidative system - in other words supporting the slower oxidative system as she was a fast oxidizer - in order to bring balance to her underlying biochemical imbalances.

Within a week she was back at work and feeling on top of the world (in her words). She had not felt like this in a long time and doubted whether she was ever going to feel better again.

Her partner even noticed the change in her moods, energy and complexion. At our next consultation she was quite a different person. She was happy and excited about the future.

Once she had started eating according to her metabolic type she had a blood test to have her thyroid activity analysed. According to her doctor's report her thyroid had resumed 'normal' levels of activity and her lipid profile had improved. Her dose of PTU was reduced.

After changing her dietary lifestyle rather drastically to a healthier one, she fell pregnant and as you can imagine was elated.

She keeps up the great work and will have her metabolic type re-analysed, each semester of her pregnancy, just in case it shifts due to all the changes involved with a new being growing inside her.

She has just been through her second trimester and is doing very well. She did not experience any nausea, sickness etc.


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About Dr Khush Mark

Khush Mark (PhD MS, MSc, BSc), lecturer and consultant in nutrition and metabolic typing ran two nutrition practices in the USA (in New Jersey and New York City) before moving back to London. She now runs two private practices in London, specializing in metabolic typing, originally discovered by Donald Kelley and later further developed by William Wolcott. She is also a member of the British Association of Nutritional Therapists. She can be contacted on Tel: 0208 785 9553; Mob: 07734 115 657;;

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