Is stress the cause of hypothyroidism and Hashimoto’s?

Stress. We all have it. Every. Single. Day.

It’s inevitable. We can’t necessarily control how much stress comes our way but we surely can control how we perceive it, deal with it, and let it affect our lives and our health.

Over 50% of doctors visits are due to unmanaged stress.

Our brain can’t really perceive the difference between real or perceived stress. Your mind is a very powerful thing and you can stress yourself out just by the thoughts in your head. Ever have a fight with someone in your head? Do you notice how your body responds to that fight? Quite similar to how it would if the fight were actually happening. That is how powerful your brain is.

Stress disrupts homeostasis in the body which is our natural internal balance. The psychological, environmental, or physical stress we encounter causes a disruption in our body.

Someone coined the term allostasis as a way to describe how our body adapts to stress due to the numerous challenges we now face. The processes that take place physiologically are regulated through allostasis and include our body temp, blood sugar levels, blood pressure, our bodily pH, nutrient status, and our hormone balance.

Examples of this is when you sweat to cool down or shiver to get warm or fear that keeps you from falling off the edge of a cliff. A blood sugar spike due to eating something high in sugar is another example. Any of these is your body’s response to a type of stress.

Stress also can occur within your cells due to things like toxins that can damage the inner workings of the cells through things like free radicals.

There is good stress too - things like being excited to meet a new potential love, or a first day on a job, or a hard workout.

Short term or acute stress is much more manageable. It’s the long term or chronic stress that becomes an issue. Daily stress like the traffic you are in to get to and from work can lead to chronic stress but it doesn’t have to. Things like poverty, child abuse, spousal abuse, toxic relationships, poor food choices, and things of that nature are more chronic. Big life stress like a divorce or death in the family can be short term stressors but they can have a big impact on your health.

We have a healthy stress response when what happens to us doesn’t break us but increases our resilience. We learn from it and adapt accordingly. When something is chronic, our body remains in fight or flight- the stress response is turned on permanently. This is what leads to a breakdown in our health or dis-ease.

You cannot control that your body is attacking itself in autoimmune disease, but you may be able to control some of the factors causing that attack, especially the dietary ones. You can control how you see this need for a diet change. Do you tell yourself it is too hard to take gluten out of your diet or do you tell yourself it is a way to feel better and you are happy to try it and see how it goes?

You are in charge of your attitude about making diet and lifestyle changes and you are even able to control whether or not you make them. You are in control or how organized or disorganized you are, whether or not you take time to exercise or relax and whether or not you have any compassion for yourself.

You have less control over how close the nearest grocery store is or whether or not you can afford to eat or pay for the gas to get there.  Your socioeconomic life is what is called a social determinant of health. If you have little control of your income, support system, community, etc, my job is to help you figure out how to make the best out of this situation.

The goal of this episode is to help you understand how to support your brain and body when it is stressed so let’s talk about what happens in your body when you are stressed.

Your nervous system and your brain are the two main players in the stress response. When exposed to some kind of stressor- physical, emotional, or environmental the brain will activate the fight or flight response in your nervous system. Epinephrine or adrenaline and norepinephrine are released raising your blood sugar and your heart rate to give you the energy you need to fight or flee the stressor.

Very soon after, the hypothalamus, adrenals, and the pituitary gland are signaled to release their stress hormones. If they are busy doing this all the time, the signal to release thyroid hormone may be missed….  The adrenals release cortisol increasing your blood pressure, and increasing heart rate so more blood is shuttled to the muscles and away from other places. Blood also flows through the thyroid so if less blood is shuttled to the thyroid… less thyroid hormone may be circulating.

Cortisol tells your liver to make more sugar so your blood sugar also increases- if there’s too much sugar in the blood it eventually gets converted to fat and stored as such in the body. Usually your mid section.

When this happens chronically, meaning regularly or more often than not, it takes a toll on your health and wellness. You lose the ability to respond to stress in a healthy way, as it was meant to be and that fight or flight mechanism is on all the time.

Your fast paced life, horrible boss, bad relationships, poor finances, the cost of gas and groceries, the doomsday thoughts of potential nuclear war with Russia, politics, crappy diet, chemical exposure, little work-life balance- all of this play a role in chronic stress if not addressed or dealt with.

Over ¾ of chronic health conditions have a connection to our inability to deal with stress and your doctor just isn’t trained to help you with that and they don’t have the time to do it either.

Stress is not the only cause of the breakdown of your body. It is one of many factors involved. That is why whole person healthcare is so important. You cannot just put a bandaid on the stress in your life.

What happens when your blood sugar is raised in response to stress?

I mentioned it before a bit- while in fight or flight, sugar is created by the liver for energy which increases insulin. Insulin is supposed to shuttle sugar out of the blood and into the cells. The liver and muscle are resistant to insulin so the brain can use it to function better to deal with the stress response. This is supposed to happen in the event of a quick need to manage an acute stressor- something happening in the moment like a car accident.

The problem with this occurs when there is a stress response happening all day every day for months or weeks at a time. Blood sugar levels stay higher in the blood leading to insulin resistance which over time can lead to pre-diabetes or type 2 diabetes, and fat gain.

Stress aids in those cravings, overeating, and fat gain you can’t seem to control or figure out why it is happening. Add that to a slow thyroid and you’ve got weight that won’t come off!

Any kind of acute stress like a phone call that turns your world upside down or a car accident or something like that can actually suppress your appetite, the opposite is true for the chronic life type stress because it increases the hormone ghrelin that tells you you are hungry. The release of cortisol will increase ghrelin so those cravings you have may be controlled by fixing your stress response. Ghrelin also lowers your cells sensitivity to insulin aiding in that fat storage and risk of type 2 diabetes.

When adrenaline and norepinephrine are released, your blood vessels narrow and blood pressure increases so extra oxygen can be delivered to your muscles. This is supposed to stop happening after the stressor leaves. Chronic stress can cause this to happen daily leading to an increased risk of cardiovascular issue such as heart disease and stroke. In addition, the stress from childhood trauma, social isolation (think lockdowns), and marriage problems also negatively affect the cardiovascular system.

Your parasympathetic nervous system or rest and digest mode is what the body uses to recover after a stressor has diminished. It is supposed to help your body get itself back to normal function after the HPA axis was activated.

Oxytocin, the feel good hormone is also released by the parasympathetic system which causes you to seek out help or support when you are dealing with stress. It is protective of your heart and cardiovascular system and so could be thought of as an anti-inflammatory hormone. It is said to help keep your heart strong and regenerate cells there that my have been damaged by stress. Your blood vessels also relax instead of constrict when stressed.

What happens when you stay in sympathetic stress more than parasympathetic?

This is the case in chronic stress and it causes the suppression of your immune system and makes it difficult for your body to produce a healthy response to those short term stressors.  It also can cause your body to keep the stress response on even after the short term stress is gone. When this happens, body systems don’t function well creating digestive issues, endocrine problems, and more.

So many people use the analogy of running from a tiger to explain the sympathetic stress response. It is an easy one to understand so let’s think about if you had to spend an entire day, week, month or year constantly evading a tiger to keep yourself alive. You have to be on alert 24/7 in order to save yourself. This, in your brain and body, is not unlike consuming a crap diet loaded with sugar and caffeine, living in poverty, having horrible relationships, staying up half the night, getting little to no exercise and never going outside.

Just imagine a scenario where that is your life and how you might feel. You probably don’t feel very good. Real or imagined stress is the same to your brain and causes the breakdown of many body systems over time.

Weight gain. Overeating. Increased appetite. Blood sugar roller coaster ride. Poor immune system function. Inflammation. Oxidative stress. Imbalanced hormones. Poor digestion. Mental health issues. Imbalanced gut bacteria/microbiome. High blood pressure.

No breakdown in your body systems is because of one single cause. Take the example of type 2 diabetes which is extremely prevalent in the US even for people who are not overweight.  We may think the cause is over consumption of sugary foods like cakes, cookies, pop, and all the refined carbohydrates but things like poor sleep, chronic stress, toxins, no exercise, and bad gut health all can play a role in the onset of it.

Same thing goes with thyroid health. All of the things I just mentioned can contribute to hypothyroidism and Hashimoto’s.

Let’s first dive in to how chronic stress affects your blood sugar.

When the body is in high alert/sympathetic mode/fight or flight cortisol is released to give the body the energy it needs to ‘run from the tiger’ by creating sugar that will enter the blood stream. In fight or flight, cells in the liver and muscle tissue won’t accept glucose for storage so the sugar remains in the blood to be used for energy and to go directly to the brain so it can function better/make the right decisions to flee the tiger. But we don’t actually need to run from a tiger so we have all the sugar in the blood topped off by our bad diet and this leads us to insulin resistance, prediabetes and eventually type 2 diabetes as well as fat storage/weight gain.

Stress contributes to blood sugar issues.

How about appetite, cravings, and weight gain?

Acute stress will actually suppress your appetite but at some point if the stress becomes chronic, ghrelin increases your appetite which would have been for food that was more energy dense but now we gravitate towards comfort foods that are usually refined type carbs. If you can get a test for grhelin, it is an indicator for elevated stress. Stress and high cortisol create high levels of ghrelin and it is thought the increase in ghrelin is to help the body cope with stress by causing a response that is to help prevent the depression and anxiety that can come with chronic stress.

Studies show that mental stress is associated with higher weight and if you stress about your weight or see yourself as fat, you struggle the most with losing the fat. If you are dealing with chronic stress of any kind, the last thing you need to be doing is putting pressure on yourself to go on a diet, start an exercise program, and have to worry about meal prep and planning. Don’t you think that might stress you out even more?

Stress and heart health.

Chronic stress can keep your heart rate and blood pressure a bit higher. It might not be enough for you to notice at first but overtime the blood vessels will narrow enough in response to adrenaline being released which in turn causes your heart to have to beat more to pump blood through your vessels better. This can contribute to plaque forming in your vessels and more cardiovascular issues.

I’m not talking major stress here either, a study of over a half million people who reported just general stress like longer work hours had a higher risk of having heart disease or a stroke.

How does stress affect your immune system?

Chronic stress causes your body to make fewer immune cells that are going to be on the lookout for invaders. You have many immune cells but the ones who are defending your body are things like T Cells, neutrophils ( a type of white blood cell), and cytokines (the ones you heard about in response to covid) which keep pathogens, infections, and bacteria at bay are suppressed leaving you more susceptible to infections and even cancer.

Inflammation increases with chronic stress too which is supposed to happen in response by the immune system to some kind of injury or infection. It helps your body repair injury but inflammation occurring constantly over time is said to cause damage to tissues in the body leading to chronic health problems. A good example of this is when the thyroid tissue is damaged by the immune system in Hashimoto’s.

What about oxidative stress?

This type of stress causes damage to our cells with the production of free radicals. It contributes to us aging too fast and causes the development of chronic health problems. It does happen naturally as the result of chemical reactions happening in the body but it needs to be kept in balance just like everything else. Too much is harmful to our cells and that can cause tissue damage.

Things that cause oxidative stress in the body are alcohol, mold, cigarette smoke, air pollution, that charbroil on your meat, eating too much sugar, inflammation in the body. All of this contributes to autoimmune disease, cancer, type 2 diabetes, cardiovascular disease, arthritis, and more.

Free radicals are formed in grilling or cooking meat at high temps, in the production of certain oils for cooking like canola oil and when those oils are used over and over to cook things like fried foods. Think about how often the same oil is used in a restaurant to cook anything fried. How often do you think most restaurants change out their fry oils? This type of stuff contributes to oxidative stress and cell damage. Cell damage causes inflammation. Inflammation activates the immune system.

Oxidative stress doesn’t start with symptoms or signs that you would notice. Not until damage has occurred. The best thing you can do to get control over oxidative stress is to eat real food. Lots and lots of colorful fruits and veggies, legumes, nuts, seeds, etc.

What about your digestion and gut health?

Chronic stress contributes to a change in the bugs in your gut, causes leaky gut, slow motility and can result in IBS and other GI tract disorders. That stress in the body shuttles blood away from your GI tract which is what causes things to move slower through your gut and can cause constipation and/or diarrhea. Changes in the microbiome will cause inflammation, an increase in bad gut bacteria and leaky gut.

Other things affected by chronic stress are fertility, bone loss, mental health issues like anxiety, depression and eating disorders.

Chronic stress is not our friend. We must get a handle on it if we want to be healthy, live well and long with a high quality of life. It’s time to get clear about your health.

How to fix your sleep habits.

You know you need a minimum of 7 hours of sleep but how do you make sure you get them? I know staying off a screen will help me sleep better but I don’t always stay off or wear my blue blocking glasses once the sun goes down. We don’t have to be perfect, we just have to progress. Maybe you get 3 nights of better sleep and you notice how good it feels to be well rested and you decide to go for more good nights. Maybe you don’t care. That’s okay too but if you don’t care you probably are not listening to this.

Just know, the more and better sleep you get before your coach turns back into a pumpkin is that much more sleep that provides you with physical rejuvenation and that increase in growth hormone which happens until around 2 am.

First up- schedule your sleep- shoot for going to bed around the same time every night. My goal is to be ready and in bed by 9 am in the summer because daylight starts around 5:30am.

Next, we want to start to tune ourselves into the diurnal rhythm, the rhythm of night and day. It isn’t the same thing as the circadian rhythm which occurs within your body naturally. Diurnal rhythms need the rising and setting of the sun to do their job. So you have to expose your eyes to the light, both morning light and sunset and avoiding the blue light and artificial light in general.

Staying up past sunset messes up both circadian and diurnal rhythms telling the body that it still needs energy to survive. This will then affect your blood sugar levels, ghrelin will increase telling your body you are hungry resulting in over eating or eating way past dinner time.

Have you heard of sleep debt? It is when you spend too much time awake, not sleeping when you should be and creating a debt of sleep time. A couple nights here and there are not so harmful but long term lack of sleep will result in long term health effects. You are more susceptible to autoimmune disease, heart disease, diabetes, cancer, and other chronic health problems when your sleep regularly suffers.

You can’t catch up on your sleep on the weekends either. You may feel rested after a weekend of sleeping better but your body has suffered the hormonal consequences that won’t right themselves after a couple of days of ‘being good’.  Your brain may feel better but your body on a metabolic level has not recovered.

You have to play the long game to fix this chronic damage. You can end up with an elevated HbA1c which is really a marker of inflammation and cardiovascular issues more than one of blood sugar dysregulation. If you don’t fix the chronic damage, you are at higher risk for high blood pressure, stroke, heart disease, obesity, and depression.

If you regularly feel groggy in the morning, you likely have a disrupted circadian rhythm likely due to lower cortisol levels in the morning. If you generally get enough sleep, you will find the groggy feeling going away within 10-15 minutes of waking, if not, it can last for hours. The best and cheapest way to fix that is to get that morning light exposure and have a consistent bedtime and awakening time.

Quality of sleep also needs to be focused on. If you go to bed after midnight on a regular basis you are missing out on growth hormone secretion so you will feel less rested than someone who went to bed by 10pm or earlier. Many people get a second wind if they force themselves to stay up when they are tired. You then miss that healing time window that occurs between 11pm and 2am and likely it is more difficult for you to fall asleep.

We don’t need to be so strict with our bedtime that we just don’t enjoy life anymore and you might even stress out about it. That is not the point of me giving you this information. I truly believe that knowledge is power and when we know better we can do better. So you now know better about how to make sleep a priority. If it doesn’t happen every night, it isn’t the end of the world.

Do you have to completely avoid coffee or caffeine in order to sleep your best? No. We all process caffeine at a different rate so you may tolerate it more than someone else and you might be able to have a cup of coffee after 3pm and be able to fall asleep no problem. One time I ate too much dark chocolate after dinner and had a really issue falling asleep because of it. Learn how your body responds and then act accordingly.  It can take anywhere from 2 hours to 12 hours to metabolize caffeine - it just depends on how your body processes it.

If you get jittery or anxious from caffeine, or if you have trouble falling asleep at night you might process it more slowly than someone who doesn’t. If so, avoid caffeine in any form, including dark chocolate around 6 hours before you plan to go to bed.

What else affects sleep negatively?

Cannabis, alcohol, and nicotine are all depressant substances that are often used as sleep aids because they cause you to feel relaxed or drowsy. The real effect is a sedative effect and not a support of your internal clock. These substances disrupt the normal homeostatic sleep cycle and the hormonal shifts that should be occurring. This results in less sleep at a poor quality. Avoid these substances 3 or more hours before sleep.

Shift workers really get the shaft when it comes to quality sleep. It is well known that people who do shift work are more susceptible to cancers, diabetes and other health issues because that circadian and diurnal rhythm is effected when one must be awake all night long. One way to mitigate the potential health issues from shift work is to prioritize that sleep schedule to be as consistent as possible- trying not to flip flop your sleep when on a week of nights and just stick to a night work sleep schedule the whole week.

What kinds of things can you do to promote a healthy sleep cycle?

A good diet- nutrient dense with a balance of carbs, protein and fats. This will not only keep you healthy, keep your weight managed, allow for better stress management, better physicality, disease prevention, and help us sleep well.

Avoid large meals right before bed. Remember if the body has to digest a big meal before you sleep, it keeps your body temp from dropping like it should and will get in the way of all the things your body is supposed to be doing, like repairing tissues, while it sleeps.

Avoid going to bed hungry so your blood sugar doesn’t get disrupted. This can make it harder to fall asleep and stay asleep.

Find out if you are deficient in Magnesium. This mineral promotes good sleep. Foods with magnesium include banana, nuts, seeds, leafy green veggies and dark chocolate though I’d probably just go for cacao beans over dark chocolate to avoid the sugar and don’t eat them at night so they don’t keep you up. Tart cherry juice is often recommended for a food source of melatonin and it is also a gate keeper of inflammation so it is a win win.

That warm glass of milk your grandma might have told you to drink before bed is also good for supporting good sleep so if you can tolerate milk, casein in particular, then you can also try that. It is actually hydrolyzed casein in supplement form that is the optimal thing to consume here.

Apples and nut butter, a sweet potato with butter and cinnamon or a banana with some honey or cheese and nuts are good combos of a complex carbohydrate eaten with a protein and/or fat food that can help keep blood sugar balanced before bed so you sleep better and longer.

Do you eat anything in particular at lunch time that helps you avoid that afternoon crash? Think about that and try it in the evening to prevent blood sugar crashes in the middle of the night. As long as it isn’t coffee!

I already mentioned to stop eating 2-3 hours before bedtime which will begin our fast overnight that we break with breakfast. We are not fasting into the late morning or afternoon, just overnight which should be 12 or so hours. No intermittent fasting- it isn’t the best type of thing for women and most definitely not women over 50.

Alcohol feels sedative at first but it increases glutamate which is stimulating so we might end up tossing and turning all night long keeping us from getting to REM sleep. No REM sleep means our brain isn’t securing those memories, repairing tissue or removing waste from our cells. This is why we feel the way we do the next morning when we drink.

You can drink mineral water between drinks and then have some kind of tea that will support your liver such as dandelion root or milk thistle or even nettle tea. This can help reduce the effects of too much alcohol.

Practicing good sleep hygiene will help you get better sleep.

If you can’t get morning light, try a light therapy box. I use the Bright Minds Therapy Lamp by BrainMD which you can get on Fullscript using the account you have set up through my link and you will get a discount on it. These light boxes expose your skin and eyes to light that mimics the effects of natural light. Try using it at the same time every day for a bit longer than you would normally be exposed to light outside. It is a really nice thing to have in the winter when the sun doesn’t shine much.

You can sign up for a fullscript account at https://us.fullscript.com/welcome/hfh

Next up- work on a routine at night where you can wind down and can really be anything you want that helps you relax. I’m not a bath person but if you like baths, try a bath with epsom salts and lavender oil, maybe restorative yoga, reading something that is not stimulating or anything that will anger you. I bought the book by RFK Jr. called The Real Anthony Fauci which I cannot bring myself to read because I have heard it has some really disturbing things in it about science experiments done on foster kids in New York and so it isn’t something I’d want to read at night which is what I do to wind down. Side note- didn’t bring that up to be polarizing in any way. If the stuff in that book was not true, RFK Jr. would have been sued. He has not.

You can try meditation which will put you into para sympathetic mode or rest and digest mode as long as you don’t stress out about whether or not you are doing it right. Just breath and notice your thoughts but let them pass by.

Exercising in the morning hours can help regulate your cortisol better but don’t sacrifice your sleep to get it in if you don’t have to. That kind of defeats the purpose.

The one we all know to do is to manage stress. Not always that easy but it is important to work on that so you get better sleep.

What is your bed like? What position do you sleep in? These things can impact flow of blood and oxygen, stability of your spine, and even your digestion.

While sleeping on your side may not be good for wrinkles it is better for your body. If you need pillow supports between your knees or for your lower back, give that a try.

Keep your room at around 65 degrees if you can. Warmer temps make it hard to fall and stay asleep because your body can’t cool down. You can get black out curtains or wear and eye mask. For years I had to wear ear plugs to quiet the snoring going on next to me. Now I sleep in a different room because it became life changing for me. I got great sleep and my thyroid labs improved that year and they have been great ever since. I can’t wear ear plugs anymore because the ringing in my ears has gotten so much louder that I have to do a white noise machine to drown out the tinnitus.

If you can’t fall asleep or stay asleep and you are laying in bed for hours, wide awake- get out of bed and change rooms. Avoid watching tv to distract you- write out what is on your mind keeping you awake, do something relaxing.

During the lockdowns, my daughter was doing school work and everything else in her bedroom and she got depressed. Dont’ do your work and sleep in the same place if you can help it.

Some supplements can be stimulating too so they should be avoided after 1 or 2 pm. B vitamins for sure should not be taken before bed, vitamin C and some of the adaptogens like ashwagandha, ginseng, rhodiola, and mushrooms like cordyceps can be stimulating so be mindful of these.

You can take some supplements to help sleep too. The sleepytime teas are good options. I will make a concentrated shot of the sleepytime tea if I am too stimulated to fall asleep. That way I’m not drinking a cup of tea and having to go to the bathroom 3 hours later. Try passionflower, lemon balm, chamomile, lavender and essential oils of ylang ylang, bergamot, sandalwood, vetiver, and copaiba for help in relaxing and promoting sleep.

Magnesium in the form of magnesium glycinate would be my first recommendation. Many people are in need of it though you can have a blood test to know for sure. It is needed for so many processes in the body that most people need it. It won’t hurt you to take it.

Chamomile helps relax the central nervous system by helping GABA. You can grow it in a pot or garden and eat the flowers or make tea from them. Or you can just buy tea.

L-theanine is a common sleep aid that is found in tea leaves and helps calm the CNS.

Vitamin B 6 also calms the CNS but avoid the B vitamins later in the day so take this one in the morning or by noon or 1pm.

Tart Cherry Juice was mentioned already as a way to boost melatonin. Try this before taking a melatonin supplement.  Melatonin is a hormone so you want to avoid taking it regularly unless doing so for other purposes. It has been found to be helpful in covid and in improving heartburn due to sphincter issues between esophagus and stomach.

Phosphatidylserine helps improve cortisol or right its secretion so it isn’t too high at night. You can also get it from fish, eggs, and organ meats.

Skullcap is an herb that you can take but it takes time for it to work.

Valerian root is more powerful than skullcap as a sedative but it can stimulate some people.

5HTP is made from tryptophan and is a precursor to serotonin and can have a sedative effect and can increase REM sleep. This is not one you should take without working with a practitioner. Long term side effects are not well known.

GABA is likely a waste of money as it is thought the supplement does not cross the blood brain barrier where it would have the best effect.

What does getting good sleep mean? How do I fix it?

Starting in your early 20’s, the average person needs around 7-9 hours of sleep and if you are over 65, you need around 7-8 hours. As we age we get less non REM sleep in stages 1-3 (see episode 143) and is because our brain changes as we age in the areas that affect sleep. Men tend to wake more throughout the night than women in this older age group and it is only because our brain is changing and we become less able to meet our requirement for sleep.

Things like high blood pressure, heart disease, mental health issues, medications and lack of exercise all contribute to the amount and quality of sleep we are getting.

As mentioned in the last episode, our heart rate falls when we are asleep. Ever heard of your resting heart rate? It is referring to the rate your heart beats at rest or while asleep and should range between 50-90 beats per minute with an ideal number being on the lower end of this. It isn’t set in stone though and is very dependent on your overall health, diet, exercise etc. It is bio-individual.

During deep sleep (stage 3) your heart rate and blood pressure lower, body temp drops and you are breathing deeper. All of this helps restore your cells function and keeps your blood vessels healthy. Keeping your room too warm at night will keep this process from happening well and will lead to poor or disrupted sleep. This is also why it is recommended to avoid exercise right before bed- it can make it harder to sleep and will delay melatonin production.

Body temp stays low all night until cortisol starts releasing to wake you so by the time you are awake and moving your body temp should be back to normal. This is why, if you are taking your temperature in the morning to see if your thyroid is working properly, you need to take it immediately without moving too much. You need that basal body temp to track thyroid. Check out episode 108 for more info on testing your thyroid using basal body temp.

Thyroid is part of the endocrine system. Another hormone part of the endocrine system affected by sleep is growth hormone. This is secreted to aid in tissue recovery and helps decrease abdominal fat. Insulin is also affected by sleep. One night of poor sleep can put you on a blood sugar roller coaster and impede any fat loss you might be trying to achieve. Getting good sleep means your body can use the insulin secreted during the day and leads to better blood sugar balance.

If you have Hashimoto’s, you have an immune system ready to attack your thyroid or actively attacking your thyroid. Sleep helps your immune system work better. Various immune cells, neurotransmitters, and proteins are made and then move throughout the body to give your immune system a boost. When we are not sleeping well, we can be more susceptible to getting an infection or becoming sick because our immune systems reaction time to an invader is slowed. Remember that a large portion of our immune system functions through the gut and when our GI tract is a mess whether from lack of sleep or something else, our immune defenses are also affected.

Our digestion is working at its best in the morning when we wake up and our metabolism slows down as the day goes on which makes an argument for a bigger breakfast or lunch and a lighter dinner. It is also ideal to give yourself 2-3 hours before bed without eating anything- unless you are working on bringing blood sugar back into balance, then you might need to have a snack before bed for awhile, until things normalize.

The reason for avoiding food before bed is to focus energy on recovery rather than digesting a meal during sleep. If you snack before bed or after dinner while watching tv, this may be a habit you want to consider changing.

Having good sleep also can ensure your microbiome is balanced. Keeping that circadian rhythm in proper working order means a healthy gut flora since stress and even jet lag can change the microbiome for a period of time until sleep gets back on track. This shift in bugs goes to one that encourages obesity and diabetes but the good news is you can get it back on track by getting back in sync with the sunrise and sunset.

Over ⅓ of people in the US are not getting the amount of sleep they should be which puts us at risk for chronic health issues, including Hashimoto’s. If you are burning the candle at both ends because you have no choice, you are in a tough situation. Your brain is suffering, your weight is suffering, your health is suffering. If you can make it a priority to get more and better sleep, I encourage you to do it.

You can not just sit and relax and get the same effects on your body as you can with sleep. Your body needs sleep to repair itself. Some big clues that you are not getting enough sleep are things like hormone issues which can be caused by no sleep but can also cause you to not get good sleep.

Not only can your hormones get screwed up but your cognition, your judgement and your control are not good. Brain fog, short tempers, generally unstable emotions and that groggy feeling we sometimes get with little sleep are all signs your sleep is disrupted in the middle of a sleep cycle. If you need an alarm clock to wake you in the morning, you are likely messing with a sleep cycle. I use an alarm to make sure I get to the airport on time when I have an early flight. That is it.

Not getting good sleep will cause poor grades in school, trouble deciding between right and wrong, and trouble completing tasks. Your metabolism is slowed even further by lack of sleep, and you are living in a survival or sympathetic state rather than rest and digest mode or parasympathetic. Mental health suffers with an increase in anxiety and depression.

Chronic stress can change the function of your brain and makes us easily startled with a poor response to stress in general- meaning every little thing stresses you out. It also can keep you locked in to that state of a sympathetic nervous system which causes difficulties in digestion, detoxification, you have more stress hormones and you cannot rest which all lead to even worse sleep and less healing.

Your body cannot heal if you are not getting good sleep.

Being in a state of chronic stress means your digestion suffers so you may not break down and assimilate the nutrients in your food as well, this can also inflame your intestines, cause leaky gut which will lead to food proteins being released into your blood stream and alerting your immune system so you end up with food sensitivities. Again, your microbiome is affected which leads to more inflammation, anxiety and depression.

Remember from last episode that ghrelin increases and leptin decreases making you hungrier causing over eating and overwhelming your digestion even more which can cause digestive upset.

Poor sleep causes a rise in immune cells that are inflammatory and increases oxidative stress because your cells are not being repaired like they should and waste is not being removed. It also slows down the natural healing process of the body and we can get sick easier.

Do you have trouble recovering from a busy or full day? It could be lack of sleep causing it. Things like tight muscles, sore or stiff muscles, poor flexibility or coordination are all related to poor sleep in all people, not just people who are physically active.

Being in a constant state of fight or flight causes dysfunction of thyroid hormones because your hypothalamus in the brain isn’t working right.

Depriving your body of good sleep also plays a role in clogged arteries and high blood pressure, and even your heart rate. When the cardiovascular system is affected, it can cause you to pee more in the night because we excrete more water and salt- when your heart rate and blood pressure are increased your kidneys are affected making you have to use the bathroom in the middle of the night which disrupts your sleep cycle even more. Most people don’t really need electrolytes on a daily basis unless they are sweating a lot but I do find they help me not have to wake up and pee in the middle of the night.

Adrenal fatigue is not a real thing. Your adrenals cannot get fatigued. The proper term is HPA axis dysfunction and stands for hypothalamic pituitary adrenal axis dysfunction. It can be off when we are not sleeping well with signals just not getting where they need to go. When this is at play, your cortisol will often be low in the morning and higher at night. Melatonin is higher in the morning and lower at night. If you need many cups of coffee in the the day to just make it through, this might be an issue for you. You basic blood work from your doctor can help determine if cortisol is low for you. You don’t need to do a cortisol test - they are not super reliable anyway.

The fatigue that results from HPA axis dysfunction leads to blood sugar regulation issues, fat gain around your middle, thyroid problems, and metabolic dysfunction such as type 2 diabetes.

These problems arise from chronic sleep issues, not just one or two nights of poor sleep.

Why does hypothyroidism make me so tired?

You sleep a lot. Why do you still feel tired when you wake up?

Hypothyroidism causes your metabolism and everything else slow down. This means that you are not making enough of the energy currency of the body or ATP. You need proper thyroid hormone balance for ATP to increase and then your energy will increase.

On the other side of that, you need quality sleep for your body to function properly. The amount and quality you get can make or break your health. Sleep quality plays a role in weight gain, weight loss, cancer risk or cancer prevention and everything in between. We need quality sleep for things like good bone density, lower inflammation, improve your mood and ability to manage your emotions and thinking, healthy skin, and most importantly, balancing hormones. Thyroid hormones are hormones just like your sex hormones.

You need quality sleep to balance your hormones.

It also improves your immune system and your ability to resist infection, decrease your risk for dementia, heart disease and improves your overall quality of life.

We all need about 7 or 8 hours per night for the best possible benefits.

You may remember the stages of sleep from science class - I personally don’t remember so let’s dig into this.

Stage one- the lightest phase. You are not completely unconscious but you are also not totally aware of your surroundings and you can be woken up easily by any noise. Your brain waves are shifting from alpha to theta waves.

Stage two- this is where we spend about half our sleep. Our heart rate slows, body temp drops just a bit to get us ready for REM sleep. Our brain waves fluctuate here from decreased activity to more burst of active waves which is how we retain our memories. This is the rest and recovery stage.

Stage 3- our deep sleep stage. We have trouble waking up from this one and our brain is having delta waves so we are basically unconscious and this is also a restorative stage for our brain. This stage is what helps us physically recover from the days activities. Our brain actually shrinks at this stage so it can detoxify itself. We also have increased blood flow and muscle and tissues repair themselves and/or grow.

We don’t usually wake out of a stage 3 sleep on our own but if someone or something wakes us from this stage, we may find ourselves tired and even feeling groggy which is because this period of rest carries over into our morning because we were interrupted. This is what can cause us to have brain fog as well. Ideally we should be sleeping in stage 3 for around 2 hours per night. As we age, this time is shortened.

The fourth stage is the REM or rapid eye movement that happens for a short time after stage 3 and this is where we find ourself dreaming and this is also where our memories become implanted in our memory? In this stage we are unable to move except for our eyes and breath. Our heart rate and brain activity can increase here and is why our dreams sometimes feel so real. I’m curious if this heart rate increase happens around 2-3am when many of you are also dealing with low blood sugar and that increased heart rate can wake you up.

After we go through all four stages, we come back to stage one and do it all over again. During the transition from REM to stage one, you can easily wake. It is said that this sleep cycle of stage one through 4 between 4 and 6 times.You spend ¾ of your time in stages 1-3 but as the night progresses you spend more time in REM and less time in stage 3.

So you may do stage one for 5-10 minutes, stage 2 for up to 25 minutes, stage 3 up to 4o minutes and REM about 10 for that first cycle, then as the night goes on you spend up to an hour in REM.

We need all these stages to be fully rested and to have that repair process happen. When we are sleeping well and going through all the stages, we have better production of cortisol and melatonin to keep our circadian rhythms working properly. Not only do cortisol and melatonin operate on a circadian rhythm but your thyroid hormones do as well so it would seem that good quality sleep patterns will improve thyroid function as well.

Keeping your circadian rhythm working well means not having exposure to unnatural light sources like devices give off when the sun goes down.

A portion of gene expression and biochemical processes are affected by how well your circadian rhythm works. Tissue repair and restoration happens better when this is functioning properly.  You may have heard of the HPA axis or hypothalamic pituitary adrenal axis. This is how cortisol is managed, most hormones are managed by the hypothalamus in the brain.

Again, cortisol and melatonin are controlled by the circadian rhythm with melatonin being secreted from the pineal gland and your gut. This is what makes you tired at night and is turned off by blue lights. Melatonin also acts as an antioxidant and was suggested for use in higher amounts of around 3-7milligrams for help in covid cases. It isn’t a trigger for a sleep state but gets your body ready for sleep. It is kind of a powerhouse of a hormone with aid in cancer prevention, helping keep your blood pressure under control and keep estrogen from getting too high. It can also help you with jet lag.

The best way to improve your circadian rhythm and melatonin and cortisol regulation it to get good exposure to sunlight during the day. Get outside and get some sun - it is how we are meant to be.  Melatonin should be high at night and cortisol should be high in the morning. If you drag in the morning and you felt like you slept enough, and your thyroid hormones are regulated well, then it could be your cortisol is not high in the morning. You can test for this with a salvia test but it isn’t super accurate unless you test it for a whole month and most people are not going to do that.

Cortisol is the waking hormone and is said to be high in stress responses. It is helpful in giving our strength a boost and improve our ability to focus. Avoiding chronic stress is going to be something you may need to work on if these hormones are out of whack.

How does our gut health play a role in all of this? Our gut is said to be the second brain and has a lot of neurotransmitters in it that contribute to our cognitive abilities, our mood and how well we sleep and is linked up with the vagus nerve. Much of our rest and digest or parasympathetic state occur with the help of the vagus nerve. Being in parasympathetic helps promote a resting state which we need for good sleep.

The neurotransmitters I’m about to discuss don’t work well if our gut is a mess which means that we need good gut health for good health and as the saying goes, all disease begins in the gut.

The neurotransmitter GABA is a calming nerve signal that helps us sleep but doesn’t work well if we are not getting good sleep.

Acetylcholine is a neurotransmitter that helps us in REM sleep and when we are dreaming to be wakeful but not awake.

Serotonin is a feel good hormone with most of it being found in the gut. We need a healthy gut and a functioning immune system to produce serotonin. When we get that exposure to the sunlight in the morning, the hypothalamus gets a signal that it is time to wake up and a signal is sent to the gut to start making serotonin. We need adequate production of serotonin to make melatonin for use when it is time for bed. it also helps produce vitamin D.

Most of you have heard of ATP- it is cellular energy and thyroid hormone helps produce it. Adenosine is the A in ATP and is a neurotransmitter (produced in the gut). It builds in the brain as the day goes on because most of us are alert and active. Have you ever really used your brain all day and just felt exhausted at the end of the day? This is because you used a ton of ATP and there is a build up of adenosine in the brain that gets cleared out while you sleep.

A note for the caffeine users- caffeine prevents us from being drowsy by blocking receptors for adenosine on our cells. That crash you feel when caffeine wears off is all those receptors becoming available for adenosine again which can cause you to just feel massively tired. Consuming a lot of caffeine can also cause cortisol and adrenaline to increase which keeps you awake longer and prevents the restoration our body needs when we sleep. If caffeine is increasing cortisol and adrenaline, those hormones come down eventually and often decrease too much causing further fatigue feelings. This can also mess with blood sugar, causing it to dip too low causing fatigue as well. That afternoon dip where you go for a coffee is not the answer long term.

Other things affected by sleep or lack of sleep- your metabolism. Not only does thyroid hormone affect your metabolism but how well you sleep does too. Our metabolism is slower at night and higher in the morning. What you eat for breakfast will determine whether you ride the blood sugar roller coaster all day long with dips in energy or whether your energy is steady the rest of the day.

The satiety hormone, leptin, tells you that you are full when the stomach is full and a signal is sent to the brain. Leptin is secreted and takes away our hunger. We feel content and full and satisfied. Leptin is not signaled well when we don’t get good sleep. We often look to refined carbs and sugar to fill us up when we are tired and it is probably because leptin is not being signaled. So lack of sleep can lead to weight gain or an increase in fat stores.

Ghrelin is the hormone that signals hunger and is raised when we get poor sleep. So it makes it kind of a challenge to make good food choices when leptin isn’t being received and we have too much ghrelin. Poor food choices can make it hard to fall asleep and get good sleep. it is another vicious cycle. We are craving sugar and fat and all the processed foods that keep us unhealthy. It is a survival mechanism that we have not evolved from yet. It is an evolutionary idea that we need to eat more to survive. In our hunter gatherer age this would not have been a problem because there was no ice cream or cookies or crackers to snack on back then. Unfortunately now we have access to so much crap and it is really just harming us and contributing to chronic illness.

Another problem that occurs when we are not sleeping well is we become less sensitive to insulin because our body is in fight or flight mode or sympathetic mode. Lack of sleep or poor quality sleep causes our body to shuttle glucose away from our cells and to places like the brain and muscle to be sure we can have a quick fuel source should we need to run from a predator. Darn evolution has not caught up with the industrial and agricultural revolutions.

The best and first thing we need to do is to give our eyes and our body exposure to sunlight in the morning when we wake up. Great to do in warm weather, not so fun in places that have a winter. It is more important to get natural light so it doesn’t have to be the sun. Sometimes in Minnesota where I live, we don’t see the actual sun shine for days- so natural light is okay. This will tell the hypothalamus that is daylight and sets the circadian rhythm on the right foot.

Getting your hypothalamus that signal will help all your hormones released by the hypothalamus to work properly. That includes the thyroid hormone production that starts in the brain. Natural light exposure will improve cortisol and melatonin production to help you get good sleep.

I’ve talked about blue light exposure before and that is the light that comes from tv, indoor lighting, devices and so on. Blue light is stimulatory and keeps us from making melatonin at night. Red light, much like the rays from a sunset. can promote rest and relaxation though I’m sure you are not going to put red lights in all your lamps at home. Not really that practical. Using night shift on apple devices can help but it is not enough to improve melatonin and sleep.

Sun exposure between 6 and 8am for 10 to 15 minutes is ideal. I’m up around that time but I’m not outside yet. it is important though because our skin has receptors for light exposure that are similar to those in the eyes. There is more natural blue light in the sky in the morning which helps to wake us up.

How to get more red light? Bonfires, candle light, dim your lights, avoid LED lights at home. How to improve your exposure? Get outside as much as possible, cover LED type indicator lights that might be on in your bedroom, keep your phone out of your room or at the very least on airplane mode. I used to use a white noise podcast on spotify on my phone to help me sleep but then I found myself scrolling before bed and then when I woke up. Such a waste of time so I bought a white noise machine. Keep your bedroom cool and dark too.

What does this sleep wake cycle look like?

Say you wake up at 6 am. Before 7 your blood pressure will increase from you resting state pressure which will help wake up your body and start the energy production process to be more than when you were sleeping. Cortisol has been gradually rising. Within an hour and a half of waking, melatonin production stops until evening.

If you have eaten within an hour or so of waking, your digestive tract has started working and you may have a bowel movement soon.

At around 10am is when you have the most energy and focus for the day due to your morning coffee and cortisol has risen.

There should be no afternoon slump between 2 and 5pm but your body should be feeling great and in peak physical performance.

Around 6-7, your body will have its highest body temperature and blood pressure and by around 8pm cortisol should be dipping and melatonin increasing so that you can go to sleep when the sun goes down.

By 10pm all the way through to 2am your digestion slows down and your body has done its repairing for the night and being asleep at this time frame is important because growth hormone is at its highest around 11pm. After 2 am melatonin slowly decreases while cortisol begins to rise to help you wake up in a few hours.

Next episode will talk about all the things that screw with this circadian rhythm like stress, poor blood sugar regulation, your diet, how hydrated you are, and more.

Thanks for listening. I hope you found this interesting. Please reach out if you have any questions or you want to work with me to figure out your health.

What is the perfect diet for hypothyroidism?

Are you eating the perfect diet? Do you still feel terrible? That perfect diet might not be right for you then. Remember, you are a bio-individual. Your chemical make up is unique to you so that latest internet fad might not be right for you. You are the expert on your body. You are made to assimilate all the good stuff you eat and eliminate what you don’t need or what might be harmful. Our body is always rebuilding tissue which requires vitamins, minerals, and energy from our food.

Your body will tell you in some form of dis-ease when something isn’t right. If we don’t pay attention when those issues are seemingly small and insignificant, your body will eventually scream at you in the form of some kind of health dysfunction. All your body is trying to do on a daily basis is keep you alive. You need to give it the substrate it needs to do its job well. You don’t put diesel fuel in your gas powered car after all. You should not do the same thing to your body, no matter how delicious it is.

First and foremost as a thyroid patient, you need protein and you need the essential amino acids that are naturally found in meat, eggs and fish. They are the most bio-available way to get those amino acids and meat is an easier way to get your needed protein which for women in general is around 100grams.

Red meat won’t kill you and that saturated fat in it won’t kill you either. That said, a Mediterranean style diet is well studied, contains less red meat and more fish and is touted as a very heart healthy diet. I think you might see a rise in your cholesterol from a higher red meat diet but a diet rich in plants with red meat on the side is not a life killer.

There is a component to the inflammatory pathway of fats called arachadonic acid which is pro-inflammatory. It is said that this fatty acid is higher in grain fed cows than grass fed- so right there is one way to reduce levels. Arachadonic acid is more often made from Omega 6 fatty acids which are found in vegetable oils and grains, animal fats, dairy, and shellfish. If you have a good balance of fatty acids in your diet from cold water fish, flax, chia, hemp, walnuts, wild game, or fish oils, you will be fine.  We need arachaconic acid for cell membrane integrity so it isn’t just a bad thing.

Red meat is high in B vitamins, zinc, selenium, iron, and phosphorus. Having a varied diet is good for you too because pork is higher in B1 than beef and lamb is higher in zinc than the others. In poultry, particularly chicken, the dark meat is more nutrient dense than white meat. Chicken skin is a great source of oleic acid too which is also found in olive oil. I’m not a fan but you do you.

I’m also not a fan of anything that comes from the water whether river, lake, sea or ocean. I’d rather starve. You have to be mindful of mercury levels in fish and whether it is farmed or wild caught. Wild caught fish is always going to be the better option healthwise but maybe give the ocean a break and avoid some of those over fished products. Otherwise, if fish is your thing, go for canned sardines or canned tuna. Safe Catch is a good brand of tuna that tests its catch for mercury. It is said fish can be eaten 2-3 times per week to keep mercury levels low in yoru body. It is a great source of B12, selenium, other B vitamins in addition to protein. Sardines are a great source of vitamin D, B vitamins, and minerals as well. Can’t get myself to eat those though but if you like them- they are great option. The smell of fish is offensive to me for some reason but fish is a great source of omega 3 fatty acids. I get mine from fish oil capsules.

What about dairy products? Many with thyroid problems need to avoid them as it is said they cause molecular mimicry with thyroid tissue so if you have high antibodies you might want to avoid dairy until you get your antibodies to nothing. Dairy products are a great source of protein and nutrients if you tolerate them. I regularly consume grass fed butter and sparingly consume other dairy products. You do what works for you. Be sure to listen to your body- how does it respond to dairy products? Can you eat some and not others? Are you lactose intolerant?

If you spend money on one thing, make it eggs, again if you tolerate them. Eggs are a complete protein, they have omega 3’s and omega 6 & 9 fatty acids, they have all the fat soluble vitamins A,D,E, and K, and all the B vitamins as well as choline, and many minerals. Much of these nutrients are found in the yolk and the protein is in the white. 3-5 pastured eggs each day can give you the minimum omega-3 fatty acids your body needs. They are also quite versatile. I’ve seen vital farms organic pastured eggs at Target for $7.99 and I can buy from my farmer, a pastured egg for $4.00. Even the battery caged eggs are high in nutrients. If you tolerate eggs, make them part of your diet.

Plant foods in general are THE source of fiber- you need around 30 grams of fiber each day and most people are getting only 15 or less. So up your plant intake. Plants are a source of water too, especially when eaten raw- think cucumbers and watermelon which are both hydrating and delicious. Go for a variety of colors, and eat as many different kinds as possible. The ones that are the darkest in color are the most nutrient dense options - kale, blueberries, black rice, purple potatoes or purple sweet potatoes. Fruits can be high in sugar and I found myself replacing my sugar habit of junk food to lots of fruits. We need to be mindful of how our veggies and fruits are grown. Many crops are sprayed heavily with chemicals. At a minimum go to EWG.org to get the list of the dirty dozen and the clean 15 each year so you can see which fruits and veggies you should prioritize to organic.

Nuts and seeds are great in small amounts. Remember I talked about their packaging in nature? They are a great source of fiber and fats. Different varieties offer different omega fatty acid profiles. Eat a variety and don’t eat a bunch at one time. Thyroid patients have been told to eat Brazil nuts for the selenium. These have a nice omega 6 and omega 9 fatty acid profile as well as being a great source of minerals. They can have high selenium levels but it is said it really depends on the soil where they were grown. They are not consistent enough to recommend for thyroid health in my opinion and if you eat a varied and balanced diet you are getting enough selenium.

Seeds are a great source of omega 3 fatty acids, which is a different form of omega 3 than is found in fish but is still good for you, especially chia and flax. They are high in minerals as well. Seeds like flax need to be bought whole and stored in the fridge and ground as you need them. They are delicate and their oil spoils easily when exposed to heat or light or air. Note that canola oil is made from the rape seed and is as delicate as flax. No seeds should have its oil extracted using heat or chemicals so make sure you source your seed oils from a place that does a cold process to extract their oils. These oils should never be cooked with.

Peanuts, while in the nut aisle at the grocery store are actually a bean and are high in protein, fiber, vitamins and minerals. Peanut butter is not the devil as is touted by the Paleo world. They are a common allergen along with soybeans. Peanuts are said to be high in mold which creates something called an aflotoxin which affects some people. Buy organic peanut butter if you can and enjoy the heck out of it.

The Weston Price Foundation says soy is bad for you. Is it though? It is mostly genetically modified. It is said that it can affect estrogen levels due to its isoflavones. Historically it wasn’t consumed raw or as soy protein isolate which is found in a lot of protein bars. It was traditionally consumed as natto, miso, or bean curd or more to make it easier to digest. Natto has a ton of protein in it and is full of vitamins and minerals.

Grains are vilified by the Paleo community and they are not inherently bad. For thyroid patients, I do recommend avoiding gluten containing grains such as wheat, barley, and rye but for most people in the world, grains are not bad for them and won’t cause damage to their thyroid. Wheat is a heavily sprayed crop with roundup both at the beginning and end of the growing cycle so if it isn’t organic, it is a problem. Grains provide some protein and can be a great addition to your diet.

The whole idea is that you consume a nutrient dense diet that you take some time to put some thought into. Get a wide variety of all whole foods and do the best you can with what you have.

What to foods avoid for thyroid health. How to understand marketing terms on food labels.

Do you know what the marketing terms on the stuff you buy in the grocery store? What does natural or organic actually mean?

Today we are going to dive into what the most common terms mean so you are equipped with all the tools you need to make good decisions at the store or farmers market. Many of these terms on food labels are not even regulated so there is no actual law that defines them. There are some terms on labels that do require some kind of regulation so lets dive in.

First up is certified organic or organically grown. These labels mean foods are processed through standards of the National Organic Program which requires foods be grown without synthetic fertilizers, fungicides, pesticides, herbicides, insecticides, or food additives. Products with low or no human toxicity can be used on these crops. This label also means the foods are not genetically modified. If a farmer makes less than $5k per year can label things organically grown but can’t be certified organic.

Genetically modified organisms or GMOs are also called Bioengineered foods on food labels. You will often find this claim or disclaimer under the ingredients list. These types of foods are modified through bioengineering or biotechnology by changing the gene structure. This usually entails the splicing of the genes of one organism with the genes of another to make them resistant to herbicides like roundup, resist frost or leaves turning brown. They can even be changed genetically to prolong their shelf life. GMOs are not supposed to be allowed in organic farming. The most common GMO crops are soybeans, corn (not sweet corn but corn processed into other things like corn syrup, high fructose corn syrup), cottonseed (oil is in a lot of food), canola (aka rapeseed), and sugar beets which are used to make table sugar.

Non GMO/GMO free/Non-GMO Verified are foods that are not bioengineered which is most of the whole foods that are available. Where you have to watch for GMO foods is in processed foods. Those processed foods with the Non GMO Verified label have their whole supply chain audited to be sure there are no GMO foods in them.

Now on to eggs. There are two common labels on eggs these days. Cage-free and Free Range. What is the difference?  Traditionally, chickens in big factory type farms for egg production have had their beaks removed and they are in small cages stacked one on top of the other. Cage-free is not a regulated term but is put through inspection by the Food Safety and Inspection Service guidelines. This requires food producers to describe how they are using the Cage-free label in relationship to their production of eggs, the packaging or their website. Cage-free hens are not living in those battery cages stacked on top of one another but are more likely to living in a big barn and do not go outside. They are also fed feed instead of eating grass and bugs.

Free Range label is regulated by the USDA and means the hens are supposed to have access to the outdoors and food and water. They need to have access to the outdoors at all times during their laying cycle as well but the reality of it is that these hens are in a big barn and have a tiny door where they could leave but most of the hens do not. In addition, this label can be used on any meat or poultry food product and all the producer has to do is give the USDA a description of the housing conditions to get the approval to use the claim. The animal only needs to have free access to the outdoors for 51% or more of its life. Pasture raised/pasture grown/free roaming/meadow raised means there must be given continuous, free access to the outdoors for a significant portion of their lives.

Grass Fed and Grass Finished is a common term found on beef in the store. All cows are started on grass and then moved to a concentrated animal feeding operation to fatten up with grains  (mostly corn) and are given growth hormones, estradiol, androgens like testosterone propionate, and trenbolone acetate). When a cow is grass fed and grass finished it is supposed to be on pasture, eating grass for its entire life. These terms are not regulated by the USDA but are required to follow Food Safety and Inspection Service guidelines so when it is on the label, the producer has had to describe the living conditions of the animals. There is another term called American Grass Fed which is a 3rd party certification through the American GrassFed Association that makes sure animals are raised on foraged grasses, are not confined to a building and are not given growth hormones or antibiotics.

The term Humanely Raised is not defined by the USDA but allows the producer to define what this means. It should mean the animals were raised with care having access to their natural diet and given clean water and that they are managed well.

Back to chickens, you might see pastured or pasture raised for both eggs, birds, and pigs. You may even see this with other poultry. These terms are not regulated it should mean the animals are living outside where they can forage for food but they may be given access to feed as well.

Obviously it is ideal to buy locally. I am a huge advocate for this and if you can do this, be grateful. I am lucky to be able to source 90% of my meat locally and literally within 15 miles of my house. In summer, I try to buy most of my vegetable produce from farmers markets. This not only supports my local economy but it allows me to get veggies that have been picked usually within 24 hours. I believe the nutrient content is better too because the people I buy from are also stewards of the land. Also, the food lasts longer because it was fresh picked rather than having been picked and transported halfway across the country a couple days or weeks ago.

The average distance your fresh food travels is 1500 miles. These foods are picked before they are ripe. This can reduce nutrient value and even change its taste. They spoil quicker too.

If you don’t have access to farmers and farmers markets like I do, you might have more limited options for sourcing fresh food. Maybe your budget doesn’t allow for you to do it. What do you do then? I think most of my audience isn’t in a food desert which is where you don’t have really any access to fresh foods but you do have access to really crappy processed foods. Maybe you are on a budget though and if that is the case you have to make due with what you have to make ends meet.

When you are dealing with chronic health issues, you need to prioritize some things. One of those things is your food. But maybe it will be deciding if you need more protein and prioritizing that. Or trying to make sure you get a variety of veggies to improve your gut health. Maybe we look at what kinds of fats you are eating and trying to improve that. Maybe we look at what your pantry is like and start to make some changes there.

You can start with choosing more affordable cuts of meat. I say this all the time when I am teaching classes. Usually the more affordable cuts can be slow cooked. Buy a whole chicken instead of pieces of chicken and you can make broth with the bones. Buy produce when it is in season when it is more affordable. If you like organ meats and bone marrow, those are usually the cheapest cuts because no one buys them anymore. Personally, I don’t enjoy them. I will scrape marrow from bones into soup but I won’t eat it outright. I feed liver and heart to my dogs.

Focus on quality of food that is realistic for you. Everything doesn’t have to be organic, pastured, grass fed or whatever. The important thing is that you just start eating real food. Shop the perimeter of your grocery store. Buy and try more vegetables. If you are feeding one or two people then maybe doing something like Hello Fresh or one of those types of meal services is cheaper than buying groceries.

Now let’s shift gears to talk about some of those compounds or chemicals in foods that you may have heard you should avoid. Like phytates, oxylates, etc. It is said that you should avoid these things because they can keep you from digesting the minerals and vitamins in them. It is also said that eating large amounts of some of these plant chemicals can be bad for you. Certain cooking methods can protect you from any dangers or damage of these things. For whatever reason, mother nature puts things into plants that we should not be consuming. After all we avoid poisonous mushrooms so, there is that.

So what is a phytate? It is also known as phytic acid and is basically how phosphorus is stored in plants. Think whole grains, nuts, seed, legumes. Side note on nuts and seeds- their natural packaging isn’t all that easy to get in to so we probably were not meant to consume them in large amounts like in the form of almond flour and things like that.

Our body makes enzymes to help us break down our food. We lack the phytase enzyme which would be needed to break down phytic acid or phytates so instead of breaking it down and digesting it, it travels through our digestive tract unharmed and it can bind up other minerals keeping us from absorbing them. If you find you are low in iron, magnesium, zinc, and/or calcium, have a look at your diet and see if you are eating something preventing absorption. This might be a bigger problem for someone on a plant based diet who eats a lot of veggies. You can mitigate any potential issues with phytates - soaking grains, beans, nuts, and seeds before cooking/consuming will help reduce the phytate content. Soaking grains is really only an option if you are grinding your own wheat or something like that and most of us are not doing that.

Oxalates are another plant compound that can be problematic for some that is found in greater amounts in almonds, spinach, rhubarb, radish, potato, buckwheat, and beets. I really believe for the general population these compounds are an issue when consumed in large amounts. No one is eating beets twice a day everyday, are they? Oxalates bind mostly to calcium which will prevent absorption in the small intestines so the best thing to do here is to not eat calcium rich foods when you are consuming a higher oxalate food. I used to eat rhubarb sauce with cream at my grandmas house every summer and it didn’t interfere with my calcium status. Anyone with kidney stones can have an issue with oxalates - kidney stones are mostly made from calcium oxalate. This means if oxalates are preventing calcium from being absorbed in the small intestine, the calcium is being shuttled to the kidneys where a stone can form.

Lectins have been sold as bad for you in the paleo community for years. Ten years later many of those paleo internet stars have completely abandoned their paleo diet ideals which is super interesting to me. I definitely wasn’t a paleo internet person 10 years ago but I fell for the diet dogma hook line and sinker. This little chemical is in all plants and in higher amounts in uncooked legumes and whole grains. They can survive the trip through your acidic stomach and keep your body from absorbing minerals in your food. It is also said that they can damage the gut and bind to the cells in your small intestine keeping you from digesting more nutrients. Aside from uncooked beans and grains, you can also find them in the nightshade family which consists of peppers, eggplant, potatoes, tomatoes, and I feel like I might be missing something else there. The autoimmune protocol when it came out over ten years ago really made me afraid of eating potatoes- how terrible is that. In fact, this whole movement caused some orthorexia in me and probably a ton of other people too.

Now the big one for us thyroid people is glucosinolates which we more commonly know to be goitrogens. The Brassica family of plants which is largely made up of cruciferous veggies are sulfur rich which is great for your detoxification system but many on the internet say they can be bad for you if you have a thyroid problem because it can keep your thyroid tissue from taking up iodine. You can cook your veggies to reduce goitrogens in them and just don’t eat piles and piles at each meal and you will be fine. Don’t be scared of your food.

Lastly, I just have a note about tannins which is found in black tea, coffee, chocolate, and wine. These can inhibit iron absorption so don’t take iron containing supplements or eat iron rich foods with your coffee.

I want to be clear that none of these are bad for all of us. Some of us may need to watch how much of them we consume, that is it. If you are super sensitive to one of these, you may need to consider elimination until you can heal your gut.

Some symptoms of consuming too much of one of these plant compounds can be things like bloating, gas, diarrhea, cramping, acid reflux, nausea, joint pain, etc. Depends on the bio-individual how the symptoms present. You can eat less of something, or change the way you cook it.

Again, soaking things will reduce lectins, oxalates, goitrogens, tannins and phytates and they are reduced even more when cooked after soaking. This process can increase nutrient availability of minerals like iron. Soaking grains in an acidic mixture reduces phytates as well. People used to soak grains in whey which they may have naturally found a way to make the nutrients more available just by trying to preserve things. Or think of making overnight oats where you are now soaking a grain to reduce is phytate and make it easier on your digestion.

Soaking and sprouting nuts is a common practice to make nuts more digestable. It is best to do with raw nuts and then you can dehydrate them which makes them super crunchy and delicious. Sometimes you can find already sprouted nuts in the store but they are quite pricey. It does seem to improve the bioavailability of nutrients in whatever you have sprouted.

Fermenting which is one of my favorite past times is a great and delicious way to reduce these compounds that inhibit nutrients and make them really good for your gut and easy on your digestive tract. There are a lot of great books on fermentation with one of my favorites being Fermented Vegetables. I forget the author but it is a great starter book for anyone diving into fermentation. You can ferment meat too but I’ve not dove down that road. Fermented foods are higher in histamine so if you have a histamine issue, you might need to avoid these.

You can cure meat too- I’ve made bacon in the past and it was a fun experiment. Curing meats was a method of storing meat to keep it from spoiling in the past. Thankfully we have refrigeration now. You can also cure fruits and veggies- sun dried tomatoes, raisins, prunes- sometimes these have more nutrient content than the fresh versions.

What to eat for thyroid health?

The definition of a nutrient diet can vary a bit depending on who you talk to. Here is what I consider to be a good definition.

a food with high vitamin and mineral content relative to its caloric value is nutrient dense.

Less calories and the more vitamins and minerals a food has, the more nutrient dense. A good example of this is a dark leafy green or blueberries.

We really want to try to get in as many foods that are rich in V and M as possible in the best possible way. We need calories as they provide the energy for our body to do what it needs to do on a daily basis and we need a good diverse diet rather than focusing on just what v & m are in each food. That is important but it isn’t the only thing we need to consider.

We want to maximize nutrient content in our meals and we want to maximize flavor.

I have spoke about consuming a whole foods diet before and again, this is not the store, it is the kind of food we should prioritize daily. Whole foods are foods that are unprocessed with nothing added to it and nothing has been taken away. Wheat flour is an example of a food that has had something taken away. Whole wheat is processed to remove the outer layer or the germ. This is where all the vitamins and minerals are stored so when we consume white wheat flour, the vitamins have been stripped away and synthetic ones are added back in. It is not a nutrient dense food compared to whole wheat.

Obviously if you are here, you have thyroid issues so wheat isn’t something we are consuming anyway. At least most of us. Whole foods are found in the perimeter of your grocery store in the produce and meat departments. Dairy too if you do it but conventional dairy is not a great thing to consume either. Focus on veggies, fruits, beans, legumes, whole grains, lentils, eggs, animal dairy products, meats, organ meats, and fish. A combo of these daily adds up to a nutrient dense diet.

Not all of the whole foods at the store are equal in nutrient density. You can make a meal of a boneless, skinless chicken breast, white rice, iceberg lettuce with some basic veggies and a store bought basic salad dressing and you have a whole food based dinner but the nutrient density is not so great. It’s still better than a fast food meal but it could be made better by switching the chicken breast for a thigh and leg seasoned with some fresh herbs and you could do brown rice or black rice instead of white rice cooked in bone broth and topped with grass fed butter and make a salad dressing of olive oil and lemon or get a good quality salad dressing such as primal kitchen salad dressings.

How diverse is your diet?

This is super important because what we put in our mouth feeds our gut bacteria. We can begin a healthy diet with eating simple things like chicken, broccoli and rice but if that is all we ever eat, we will end up deficient in many vitamins and minerals. We need a variety of foods to build a healthy microbiome aka healthy gut and get a variety of micronutrients and plant nutrients or phytonutrients. Those fibers in plants feed all the various types of bacteria in your gut so the more of them you eat, the better off you are for building a strong and diverse and healthy microbiome.

Our needs change daily depending on how busy we are, the stress we have that day, and how active or inactive we are. We can’t anticipate what we need from day to day as far as micronutrients go so we have to provide our body with a wide variety of foods and let the body do its magic. Your body will tell you if it’s needing something through cravings but sometimes we are fooled about what we really need by sugar, caffeine, stress, and alcohol. Those 4 things will trick you into thinking you need something adjacent to what your body really is needing. If you are needing chromium, you might crave sweets. If you are needing phosphorus you might crave coffee, if you need protein you might crave alcohol. I’ll be honest, the last thing I want when I don’t eat enough protein is alcohol but you never know. My biggest cravings when lacking protein is just food in general.

Our ancestral brain is probably more familiar with eating seasonally as we come from hunter gatherers so we hunted, fished, foraged for what we needed. This, of course, varied based on where in the world our ancestors were. Now we live in a global economy and we can get pretty much anything we want at one grocery store, maybe a couple specialty stores.  Most produce is picked and shipped before it is ripe and shipped across the country.

I live in Minnesota and we can’t grow citrus here, except indoors- I actually have a lemon tree that gives me about 7 lemons a year - we can grow apples, pears, squash and basic garden produce during the growing season from May to August. We are meat and potatoes people but my friend in Arizona has citrus trees on her property and she can harvest bushels of lemons. My daughter is in california where avocados are plentiful. You get the idea. Where we live matters in the type of foods readily available to us and having access to all these different foods is kind of cool. It provides even greater variety to what we might normally have access to.

Where does your food come from? If you live in a food desert, it’s coming from the convenience store maybe. If you can grow your own - ideal. I am lucky to know where 90% of what I eat comes from, especially in summer. I buy most of my meat local. I shop farmers markets in summer. There are some big issues with factory farmed meat and dairy products and monocrop farming is terrible for the top soil. The factory farming industry uses more antibiotics that the medical industry. That can’t be good for us, or our guts. Milk cows are separated from their calves so the milk can be used and sold.

The chemicals sprayed on crops is destroying the topsoil as I mentioned and killing off the bees. All the chemicals in our food, our body has to detoxify and get rid of. Not an easy feat when it is constantly bombarded. Monocrop farming also depletes nutrients in the soil which depletes nutrients in our food.

This is so very doom and gloom, I realize, but it is what we are faced with but the good news is that many of you have a choice in where you buy your food so shop with your dollars. Support those small local farmers when you can. It turns out, in todays economy, it might even be cheaper to buy local. I paid $4.50 per pound for grass fed beef last year. Not too bad.

Rather than spending a boat load of time binging your favorite show on whatever your streaming service of choice is, cook a nice meal and enjoy it with people you enjoy rather than plopping down in front of the television. Making a meal with love and some thought is nutritious, really good, and can even be healing to your body.

You don’t have to radically change your diet to start cooking more. Just start doing it. There are a million and one websites dedicated to cooking food and plenty of shows on tv or the internet to help you learn how to cook if you don’t know how. There used to be a show on the food network called How To Boil Water and my favorite cooking show of all time was called Cooking Live. I learned how to cook from that show in particular. It was the greatest. Anyway, you can learn how to cook something pretty easily now is the point.

Start by adding in some new recipe or a new veggie rather than cutting out all the crap you might be eating right now. Focus on the add and don’t judge yourself for what your current diet is. I think people think I judge them because of what they are eating because I’m a nutritionist. I don’t judge anyone. I don’t eat perfectly every day. No one does. But if you have a food sensitivity then you obviously need to remove some foods, and I do recommend thyroid patients avoid gluten to start with. Other than that, focus on getting in some good food and the bad stuff will eventually be edged out.

Eating real whole foods means your body can assimilate the nutrients better that those foods hold compared to synthetic nutrients often added to processed foods. Whole foods are mostly lower in calories than processed foods and you get more nutrient bang for your buck. The body knows how to use protein, carbs and fats from whole foods better than it does junk fats and it can get overwhelmed by our consumption of refined carbs and I don’t even want to talk about fake meat.

Some processed foods have their place. We can’t eat pasta without processing some kind of flour whether it is wheat or chickpea or rice flour. I like the occasional cracker which is processed. You get the idea. We are going to eat processed foods- they just should not make up the bulk of our diet.

We want to try to avoid those seed oils and hydrogenated oils and trans fats as much as possible. They are bad for us, they age us faster and they damage our cells.

A calorie is not a calorie. 100 calories of broccoli is vastly different than 100 calories of oreos. When you go from the standard american diet to a whole foods diet/lifestlye the food is more satiating so you end up eating less calories but feeling full and in the long run feeling better. Protein in particular is very filling and keeps you full for a long time. The general healthy recommendation for protein intake for women in particular is around 100grams per day or around 30 grams per meal. 30 grams of protein is about 1 4oz piece of chicken breast.

I don’t recommend focusing on calories in and calories out. Focus on eating some good food. Focus on protein at breakfast, lunch and dinner and just see how you feel. Pay attention to whether or not you have cravings anymore. Don’t restrict calories. Eat until you are slightly full and make sure you are chewing each bite of food really really well. By taking time to chew well before swallowing, you will be able to notice when you start to feel full. If you shove down half a frozen pizza in about 5 minutes, your brain doesn’t have time to catch up with your body and you find yourself feeling miserably stuffed.

Eating a diverse, nutrient dense diet not only makes sure we are eating enough food to sustain our energy but it also provides the building blocks and energy needed to make healthy tissue. Your thyroid is made up of tissue and if you are not building healthy tissue, you will not be building a healthy thyroid gland. See, there is a point to all this. Our body is constantly rebuilding bone, muscle, connective tissue and on and on. We must provide it with what it needs to do that.

Protein is great for making us feel full or satiated but fiber from plants and good healthy fats also help make us feel full for longer periods which keeps us from feeling the need to graze for energy at 2pm. Soluble fibers and certain fats can slow the emptying of the stomach. Fat in our food signals the release of a chemical from the body to help keep us full longer too. When we are full on these kinds of foods, we don’t over eat refined processed foods because we are full. We can’t physically do it. If you do, you are overeating and taking in too many calories which leads to fat gain.

Eating this way also improves your blood sugar regulation keeping you off the blood sugar roller coaster. You will snack less and improve your body’s ability to use insulin properly. Feel guilty about overindulging ever? Consuming adequate protein, carbs and fats from real whole foods will also stop the guilt of indulgence.

What is the point of this? Well, eating real whole, nutrient dense foods most of the time will help you avoid being deficient in nutrients, and helps you avoid a body with dis-ease. So we need our essential amino acids, essential fatty acids, and vitamins and minerals that we need to get from our diet to thrive and be well. These all are broken down by our digestive system into chemicals our body can use to build healthy cells, tissues, and organs. Our health is dependent on cells that can function properly. Our cells thrive when they are provided the proper nutrients. We really are only as healthy as our cells are.

What is your cell blueprint? If you want to learn more about where your cells are lacking, go to my website www.helpforhashimotos.com and click on the get help tab and then click on work with me to schedule a 15 minute call to see if we are a good fit. I’ll listen to your story, I’ll tell you how I operate my practice and you can decide if I’m someone you want to work with. No hard sales, no convincing you to put my package on your credit card. I only want to work with people who are ready to do the work it takes to get better. I’ll never try to convince you I can fix you and you must do it now.

Anyway, on to how we cook our food and how that affects nutrient density.

Different nutrients survive the cooking process where others do not. Vitamin C, for example, does not survive cooking. It is best when you can eat a C containing food in its raw state right after you picked it. It is water soluble so it is lost in the cooking process into whatever liquid you cooked it in. It is also destroyed by high heat.

The good news is that fruits and vegetables have many vitamins and minerals in them, not just one. Tomatoes have lycopene and C and while cooking destroys the C, it enhances lycopene. So the bottom line here is along with variety, eat both cooked and raw to make the most of the nutrients. Or you can just eat sun dried tomatoes which preserves the C and boots lycopene so it is a win win!

Start your whole foods diet by again, adding in some good foods rather than taking away stuff. Take a meal you know how to cook and add some extra stuff to it. Then take that meal the next week and try make each aspect of the meal in a different way with a few more ingredients. Take a Kevin’s brand meal for example. It is meat and a sauce packet. How about adding in some chopped veggies to the pan before you saute the meat up? I eat these meals all the time because they are quick and easy. You don’t have to think about them at all. I will buy pre chopped broccoli or if I am on a good week, I will have chopped some up myself. I add some good olive oil to the pan, saute the broccoli for a few minutes until it starts to turn bright green and then I add in the meat and brown that up for a few minutes with the broccoli and then add the sauce. If I have time or take the time I will add rice as a side dish. And if I’m honest it is usually white rice but I do venture into brown and even black rice when I’m in the mood for a complaint by my husband.

Remind yourself that cheap food comes at a health cost. It never will nourish you like real whole foods will. Cheap is easy for us as the consumer and for the manufacturer but it will always be less nutritious than homemade.

Next episode will talk about understanding food label terms like organic, bioengineered, cage free etc.

Why is gut health important?

Will Iodine Help My Thyroid?

Episode 85 also covers this topic though in less detail and not as well researched

The biggest need for iodine is for thyroid hormone production.  Deficiency would look like hypothyroid symptoms such as fatigue, brain fog/poor memory, hair loss (including eyelashes), puffiness, cold hands/feet etc. The other reason we need it is to prevent fibrocystic breast disease and as an antimicrobial.

RDA for adults is 150 micrograms per day and is based on studies looking at how much the thyroid gland uses and how much is lost in urine.

It is difficult to get enough iodine from foods because the soil content varies but the most reliable sources of foods are:

• milk (20 mcg), yogurt(20mcg), cheese (40mcg per 100g of food).

• fish and shellfish have anywhere from 20-100 mcg per 100g of food

• Mortons iodized salt has 150mcg in 3.3 grams of salt which is just over ½ tsp of salt.

• kelp has 3000 micrograms of iodine per gram

The most reliable way to get enough iodine is to include seaweed in your diet. You can eat things like the sea snacks once per week OR you can use a shaker of Main Coast Sea Seasonings which you can sprinkle on your food and use it like a spice/seasoning daily.

Avoid consuming more than 1000 mcg in one day but up to this amount might make you feel great. You do want to be mindful of causing thyroid antibodies to rise.   In some individuals when given microgram amounts you do “stoke the fire” and cause an increase in antibody attack on the thyroid gland.

Eating more than 3 servings per day of cruciferous veggies can interfere with your thyroid being able to use iodine.

Avoid drinking city water that is fluoridated and other fluoride products such as toothpaste and mouthwash.

Avoid bromides- brominated flours from store bought baked goods, vegetable oil, mountain dew and other citrus based sodas, gatorades, conventionally grown strawberries (sprayed with methyl bromide).

Iodine patch test is not valid and there is no scientific research to back up the claims.

Dr. Brownstein suggests

• taking in enough iodine to provide enough for thyroid hormone to be made.

• Take B2 (riboflavin) and B3 (niacin) to stimulate biochemical processes needed to make thyroid hormone.

• take anti-oxidants

• get enough magnesium

• minimize oxidative stress in the body

If you are wondering about your levels, you can do a 24-hour urine iodine test from LabCorp or Quest which will tell you your status for the day of and the day before the test. It only tests your intake and not whether things like fluoride or bromide are preventing the thyroid from taking it in.

In the early 1900’s there was an issue around the states that border the Great Lakes with people suffering with goiter which is an enlarged thyroid. It was thought that giving these people iodine would decrease the incidence of goiter. Around 1923 iodine was given to kids with goiter and over 4 years of supplementation they saw a 75% improvement.

From what I understand about goiter, it appears that the thyroid enlarges itself to capture as much iodine as possible coming through the blood. The thyroid is the major organ in the body using iodine because you need it to make thyroid hormone. It is actually the only mineral that becomes part of thyroid hormone. T4 or thyroxine is thyroid hormone with 4 iodines attached to it. T3 has 3 iodine molecules attached.

What does deficiency look like?  Pretty much hypothyroidism. It is detrimental to babies in the womb and in the first year of life if they are deficient as it can decrease IQ and result in cretinism which is stunted mental and physical growth. If you have hypothyroidism due to iodine deficiency you may also have a goiter which might just feel like a lump in the throat.

Interestingly, because iodine is antimicrobial and hypothyroidism can result from lack of iodine and will cause compromised immune system function, either of these things can increase the risk of infection.

The other big problem for people deficient in iodine is fibrocystic breast disease.

The biggest risk factors for iodine deficiency are eating foods grown in soil deficient in iodine. Soil near the ocean usually is not deficient in iodine because it is in the air, evaporates and lands in the soil. The midwest has soil that is deficient in iodine so it is commonly called the ‘goiter belt’. There is no ocean near the midwest and soil erosion from conventional farming practices will increase the deficiency.

The RDA for iodine is 150 micrograms per day. Just like most RDA levels for vitamins and minerals it is set to the minimum- enough to prevent goiter but maybe not enough to prevent other issues. It is unclear whether the amount consumed in iodized salt is enough or even getting absorbed.

It is thought that 150 micrograms is not enough iodine to make the function of your endocrine and immune systems optimal. One study has shown that the levels of iodine in the general population are deficient and iodized salt does not seem to be doing the trick. It is thought that iodine in salt is not as bioavailable as other kinds.

Getting iodine from food is ideal but like I said, soils where foods are grown can be deficient. Eating fish from oceans and shellfish or seaweed is a good source. Not eating iodized salt (it is better than nothing) and eating a lot of processed flour products that have bromide in them will lead to deficiency. Bromide competes with iodine for entry into the cells. Vegan and vegetarian diets are also lower in iodine. In fact, the bromine that is commonly in baked goods from the store is considered a goitrogen - so it promotes a goiter in the thyroid.

It is said the best way to test for iodine deficiency or iodine status is to do an iodine loading test which is said to provide a picture of what is in the whole body.  In this test you take 50mg of iodine and then 24 ours later you pee out what your body can’t use or doesn’t need. You can do the test without taking iodine and it will reflect what was in your diet the day before the test. You can do a 24 our urine test through LabCorp or Quest Diagnostics. This test just shows whether you are getting enough but doesn’t show what is getting into the cells so if you have a diet high in bromine then you may be spilling out more iodine than you should be.

Aside from the thyroid, our breast tissue uses iodine and deficiency is thought to play a role in some breast cancer. Iodine rather than iodide (from salt) is better at reversing pre-cancer cells in animal studies. It is also thought to decrease cellular damage from chemical reactions that damage fats called lipoperoxidation.

I’ll dive a bit deeper into the thyroid and the role iodine plays in its function now.

Thyroxine or T4 has 4 atoms of iodine which is why it is called T4. When you have a medication called levothyroxine that means it is hormone replacement of T4 only. Triiodothyronine is T3 which has 3 atoms of iodine attached to it. If you are deficient in iodine, you cannot make thyroid hormone in amounts needed for it to function well.

I mentioned goiter before which is the swelling of your thyroid and is generally a sign your body needs iodine. Deficiency also leads to hypothyroidism not caused by Hashimoto’s. Some experts believe deficiency also causes the autoimmune attack that happens in both Hashi’s and Graves disease as well as thyroid cancer.

What I am understanding is that your thyroid holds around 20 mg of iodine but can hold up to 50mg.  There is a transportation system in the body called the sodium iodide symporter that transports iodine into cells in tissues. It is important for your body to have optimal thyroid function because every cell in the body has receptors for thyroid hormone.

Lugols iodine is a very popular form of iodine and in my nutrition certification I was taught that painting a patch of this on your skin and seeing how long it took for it to disappear was an indication of iodine deficiency. I’ve since found out that this test has zero validity and isn’t telling you anything about your cellular iodine status. Lugol’s is named after Jean Lugol, a French doctor who studied iodine and its effects in 1829. He found that adding potassium iodide to water allowed for iodine to become soluble in water and he treated all kinds of infections with this solution. Just 2 drops of his 5% solution provides enough for the body to have sufficient iodine status which is greater than the RDA of 150mcg. The thyroid uses iodide and breast tissue uses iodine so having this combo is ideal.

Dr. Brownstein claims that you can take higher doses of iodine with Hashimoto’s and Grave’s if monitored well. His clinical experience has had him checking every patient he has for autoimmune thyroid conditions which he finds in many of his patients so he believes its prevalence is much higher than the statistics given by various organizations. He says low iodine levels is the reason for increased autoimmunity.

The National Health and Nutrition Examination Survey (NHANES) shows deficiency in iodine is rising. He claims the hypothesis that giving iodine to people induces autoimmune thyroid conditions. If iodine deficiency is more prevalent, why is autoimmunity increasing? The World Health Organization says iodide excretion below 50 micrograms per liter equals a moderate to severe iodide deficiency. A study out of Denmark shows that lower iodine levels are associated with a huge increase in hyperthyroidism in one town compared to lower incidence of hyperthyroidism in a town with higher iodine levels in patients.

Medical schools are teaching that you should not supplement with iodine and that we all get enough from iodized salt. The original treatment for Grave’s disease was iodine in the 1800’s and doctors were having success. Brownstein does say that iodine supplementation can raise TSH but if you have normal T4 and T3 lab results, this doesn’t mean you have made yourself hypothyroid. TSH is expected to fall back to normal ranges after a certain amount of time.

The complete opposite side of this topic is coming from several internet health practitioners that say you should not ever take iodine if you are dealing with autoimmune thyroid issues. One practitioner is adamant that you must not treat one thing in a thyroid patient. For example, you should not be given one single nutrient such as iodine or an herb to see if it makes a difference for the client. You must take a whole body approach. I do agree with this and Dr. Brownstein is not just supplementing his patients with iodine. He does also take a whole body approach.

Dr. Kharrazian firmly believes that it is dangerous to use iodine in thyroid conditions. He believes it is an outdated form of therapy. He says iodine is not caused by an iodine deficiency and that all the things that cause Hashimoto’s in a person are affected in a positive way by iodine supplementation. He says iodine supplementation will flare up someone with Hashimoto’s causing further destruction of the thyroid gland. He also says that doctors prescribing iodine are on the verge of malpractice. So he’s pretty confident in his stance.

Some of the research shows that supplementing with iodine triggers autoimmunity and activation of TPO antibodies. This causes destruction of the thyroid gland. He explains that when iodine is supplemented, it goes to the thyroid gland and the oxidative reactions take place which is normal and which is why we need selenium because it neutralizes the hydrogen peroxide that is formed during this chemical reaction. So you have the oxidation, damage to the thyroid cells, destruction of thyroid peroxidase, and thyroglobulin (the protein used to make T4 and T3). The supplemental iodine causes further damage to the thyroid gland.

He claims through research he has read that iodine supplementation causes TSH to be lower, not higher as Brownstein claims.  And Kharrazian is saying iodine will just increase inflammation throughout the body. He says you can have normal labs but antibodies will increase and you won’t even realize it. Dr. Brownstein doesn’t discuss antibody testing in his book.

Kharrazian offers multiple studies in the course I took from him on how iodine supplementation is just bad for the thyroid. One study took 40 patients with high TPO antibodies with normal TSH and no symptoms and gave them 250 micrograms of iodine where 1 tsp of salt provides around the same amount or a little more. They took the iodine for 4 months and after that time period, 6 of the 40 ended up with subclinical hypothyroidism and 1 patient ended up with hypothyroidism.  Another study found that iodine supplementation resulted in quicker profression to hypothyroidism. Dr. Brownstein’s argument is that you need to take higher doses in the milligrams and not micrograms but he doesn’t offer much in the way of papers to back that up.  Kharrazian offers enough evidence to keep me from trying it on myself because I’m in a good place aside from a little struggle with energy but I honestly think it is a genetic thing in my family because my brother, niece and one of my kids really struggle with energy levels.

So, I leave you informed, maybe confused. I’m going to keep looking for info on this topic and hopefully you have some information that can help you make an informed decision.

If you want to test your iodine status, the best test is a urine test and you can order it from Ulta Labs - the 24 hour urine test for iodine. You have to go to the draw center to get a container and then you just pee in it for a day and bring it in. Kind of gross but at least you can do it at home. Then you can tell if there is a deficiency. You can try the loading test as described earlier too. I’m doing the urine test on my daughter who does have slight elevations in thyroid antibodies to see her iodine status. I’ll keep you updated.

How to make your new years resolutions stick.

This time of year, after all the indulgences of at least three holiday’s within 5 weeks is a lot. I know I have eaten my share of Christmas cookies this year. And I did it with no guilt BUT I know I need to get back on the healthy eating train.

How about you?

If you said a resounding yes to that question then my FREE 30 day Clean Slate Cleanse is for you.

There are no tricks to this.

It is just straight up high quality information backed by scientific research to help you understand how your body naturally detoxifies itself and what you can do to help it do that.

No powders, no supplements, no starving or depriving yourself.

This 30 day challenge shows you how to ADD in some really great foods to feed your body what it needs to work properly all on its own.

NO ONE should embark on a detoxification program requiring only juicing, fasting or whatever the latest trend is unless they are healthy to begin with.

This FREE 30 day challenge is a great way to ease into eating better in the new year.

Another great way to kickstart your healthy eating is by ordering from Misfits Market where you can get fresh organic vegetables and fruits and you don’t have to go to the grocery store. They have just about everything your grocery store has plus they have some great premade meals from Snap Kitchen that I’ve been using to eat for breakfast and lunch making eating healthier even easier.

Check them out here and get $15 off your first order until January 15th. (this is a referral link, and I only refer people to places/things I use myself)

Will I see you in the 30 day Clean Slate Cleanse? Sign up here

How to fix heart burn.

heartburn link https://us.fullscript.com/plans/hfh-heartburn

Listener questions about fatigue, celiac disease and subclinical hypothyroidism

This episode has listener questions about thyroid symptoms like fatigue, celiac disease and subclinical hypothyroidism.

I have had thyroid issue for years and was diagnosed with hashis about 3 years ago. I spent thousands of dollars on a naturopath and she ended up caving and told me to go ahead and just start taking thyroid medication.

I have had pretty awful symptoms over the years, all of which still constantly come and go. Some of the most bothersome include extreme sudden fatigue (I feel like I have been drugged), chills, facial flushing and intense night sweats. Are these normal symptoms? Specifically night sweats? I have talked to my doctors and no one seems to understand why I might be having night sweats.

I have had full metabolic panel blood tests done, and a stomach biopsy confirming that I do NOT have celiac.

Name withheld.

It sounds like your naturopath and you may have been trying to avoid medication which I totally understand. If she caved and told you to start taking medication, was that because your TSH stayed high? I can guess without knowing what your labs said and I would guess that maybe TSH did stay high and maybe T4 was low and T3 was normal. There may have just been a defect in your gland. This type of scenario is primary hypothyroidism where the gland just can’t produce enough hormone for the body and it is likely due to an autoimmune or Hashimoto’s issue.

Symptoms can come and go and that is just because your body is different everyday. Your extreme sudden fatigue could be due to a food allergy or sensitivity. People present with symptoms of food sensitivity differently and extreme sudden fatigue could be one. Another reason for that could be really messed up blood sugar regulation. Facial flushing can be food sensitivities or it could be peri menopause. Night sweats could be food sensitivity or perimenopause as well. I had terrible night sweats for many years and when I went gluten free, they went away completely.

I also wonder if you had a positive blood test first for celiac disease and then they did a biopsy to rule it out. The biopsy would be in the small intestine and not the stomach so I am assuming that is what you meant. It could be that you are just sensitive to gluten which is different than celiac disease and both of these things are very real with real consequences to the body.

Non Celiac Gluten Sensitivity doesn’t really have any biomarkers related to its diagnosis that are super reliable because the research on it is not that old. You can check for antibodies to gliadin which is a protein so you may have an IgG test done for anti Gliadin Antibodies and that test is positive in a little over 50% of non celiac gluten sensitive adults. Anti Gliadin Antibodies are also present in people with connective tissue disorders, IBS without a gluten sensitivity, autoimmune liver diseases and even in around 2% of healthy people. This test does not have high specificity or sensitivity but it is still used in diagnosing NCGS.

The HLADQ 2 and 8 genes which are markers for celiac disease are not an indication that you are also susceptible to NCGS.

There is a difference between a sensitivity to gluten and a wheat allergy. I had a food sensitivity test done when I first started to find a better way to live with hypothyroidism and my naturopath ran a food sensitivity panel and it showed that I was more sensitive to wheat than to gluten. I react to wheat with immediate brain fog, huge welts on my face and neck and a general terrible feeling. I ate spelt in the midst of me healing myself about 11 years ago and had zero physical reactions to it. Spelt is one of those things they say you should avoid if you avoid gluten. Just because you don’t have physical reactions doesn’t mean it isn’t causing some damage in your body. Keep that in mind.  If you have an allergy you will have IgE antibodies to whatever it is that you are allergic to with symptoms of that allergy happening from within minutes to hours. For wheat, symptoms can be any of the following: wheezing, trouble breathing, cramps, nausea, vomiting, bloating diarrhea, gas, itchy skin, hives, and of course the most severe which is anaphylaxis. A wheat allergy would be more common in an infant or toddler but can happen any time. With a wheat allergy you only have to avoid wheat. If  you are avoiding gluten you will also avoid barley, rye, spelt and a few others.

If you have celiac disease, you have an autoimmune disease, commonly occurring alongside Hashimoto’s but not always. Then you avoid all gluten. Celiac also has a high genetic predisposition with the HLA-DQ2 gene which is in 95% of Celiacs. This disease is rising in prevalence over the last 30ish years. This is not because we can diagnose it better but potentially because of things like formula use, or an introduction to gluten before 4 months of age which results in a 500% increased risk. C-sections cause an altered gut microbiome for the baby so that is also thought to be a problem. Then there are the changes in how wheat is grown. So many possibilities and no definitive answers.

The biggest symptoms to celiac disease are diarrhea, fatigue, gurgling, pain, weight loss, distended belly, gas. Less common symptoms are bone loss, poor liver function, vomiting, iron deficiency anemia, constipation, nausea and dermatitis herpetiformis which is a rash appearing typically on elbows, knees, back and butt. Some people will have no symptoms at all.

The autoimmune damage occurring with this disease is damage to the lining of your small intestines. Those little microvilli that absorb your nutrients should be like a shag carpet and in determining CD there are different stages of damage to the villi.

A small bowel biopsy, which is what I think you meant by stomach biopsy is the gold standard for diagnosis both while consuming gluten and then again while on a gluten free diet and improvement in the biopsy tissue is seen. These changes in microvilli length are graded by something called the Marsh criteria. It grades damage from 1, 2, 3a, 3b, 3c with 3c having the most damage and the most severe symptoms. Gluten should be eaten daily at least 6 weeks before doing this kind of test.

There is another test called the Biocard Celiac Test from labsystems diagnostics that is a finger prick and is pretty accurate but it looks like a doctor has to order it and it is not available in the US from what I can tell. The antigliadin antibody test is better to be done with other celiac testing as it isn’t as good on it’s own as a diagnostic tool.

Nutrient deficiencies are common in celiac because the damaged microvilli just can’t take up nutrients so you end up with protein deficiencies as well as vitamin and mineral deficiencies. To be on the safe side I would make sure you are not eating gluten at all and you should see some improvements.

Without knowing more about your labs it is hard to say much more but I hope this was helpful.

Next question.

Hi, I have hashimotos and “sub clinical hypothyroidism” my symptoms seem to be getting better with the elimination of gluten and dairy but i have since found out via my Elisa 96 food panel(from alletess labs) that I am only mildly sensitive to beef and green peas among other things. My question is can I not have any protein powder in any form? Most protein powders are made with whey or pea protein or some beef version...if you u can help thanks

Marcie

A food sensitivity panel can often pick up foods that you are eating a lot of during the test. If you are only mildly sensitive to beef and peas I would say, work on healing your gut for a couple of months and then you can reintroduce those foods and see if you have any physical reaction of any kind. Wait at least 4 days in between reintroductions to give your body time to react. That said, if everything on the test was coming up mildly sensitive and you still eat those things minus gluten and dairy, just be mindful of not eating the same things all the time.

Let’s dive in to why you feel you need a protein powder. Do you rely on them for a meal replacement? Do you use one to make sure you are getting enough protein in each day? A few weeks ago I shared a graphic with my newsletter subscribers on ways to get more protein in. I would try for food first and then powders if you are struggling. And once your gut is healed you can reintroduce and retest. And again, the more varied your diet is the better - it helps you avoid food sensitivities.

Another question from an unnamed person.

I wondered if you could explain why someone would have high TPO Antibodies but normal thyroid hormones? And why is thyroid medication prescribed in this situation if hormones are normal? 

High antibodies with all normal thyroid hormones probably means there is some autoimmunity and potential destruction of thyroid gland tissue but it just has not yet affected the glands ability to put out enough hormone. The destruction usually starts before symptoms are felt and can take years before symptoms appear and at this point it would be too late to fix the gland and then medication is needed. There really should be no reason that I know of to be on medication with normal labs and high antibodies. Your body doesn’t need hormone, it needs your immune system to calm down and that starts with diet and lifestyle changes and having a look at your blood work to see what is deficient. So a complete blood count with a differential, a lipid panel, full iron panel with reticulocytes, inflammatory markers, LDH, GGT, a comprehensive metabolic panel  and I think that is a good place to start. That will give us a lot of information and then after getting to know you and your health and life history a bit we can work on making some changes to diet and lifestyle. Then if you still don’t improve, further testing may be needed.

Okay. That is it for this episode.

Why am I Not Getting Better Part 2

When I was working on my final capstone paper for my masters degree I went to the bookstore fishing for potential references and I was just looking at 100’s of books selling a promise of feeling better. I probably have had 30 or more of those kinds of books over the years- selling health and happiness.

Even cookbooks, especially the paleo ones. They say I found health through food. Food is medicine… etc. I certainly don’t disagree that food is medicine and that it can heal but what do you do when the food you eat isn’t enough?  You turn to supplements because they too offer a promise of feeling better and sometimes they do help you feel better because your body is deficient in something and giving it that particular nutrient helps it work better. Sometimes they work. Even the title for my final paper discussed how nutrients can help the thyroid.

I get an email almost daily from a company selling gut health supplements. That is all they do- they tell a story in their emails and then sell you a $60 bottle of digestive enzymes because that will cure it all. And they probably work for some people or they wouldn’t keep selling them. But what happens when you do all the things and you still don’t feel better?

Do you start to feel bad and blame yourself? Do you double down and work harder and buy more supplements? Curcumin maybe because everyone says that is going to help everything? But as one of my professors from school says, “You can’t have a curcumin deficiency” meaning there are no biochemical processes in the body that require curcumin to function.

It is a bandaid, which may be needed, but it isn’t a cure all. I think I had an epiphany in the bookstore just staring at all those books promising a better life. We can read all the books in the world and take all the supplements but if we are not doing the inner work that also got us sick and is keeping us unwell, then we will only get so far.

This is your friendly reminder to give yourself some grace when you are doing all the things right, even when you are not. Thyroid disease is complicated. There is a lot of research on this disease but sometimes I don’t think the right things are being studied- like finding a way to measure how we feel or recognize that lab values are sooo wrong when the upper limit of a normal TSH is 10.

Some of you feel like a sloth at that number. Remember that you are a cellular being- you are made up of cells the basics of which are carbon, nitrogen, and hydrogen and a few other elements in smaller amounts. Those are atoms. When you put some atoms together you get a molecule. Glucose or sugar is a molecule, amino acids are molecules that make proteins (the kind you eat and the kind you are made of), B vitamins are molecules.

I mentioned protein- when you put a bunch of molecules of amino acids together you get a protein which is a macromolecule (macro meaning big). If you hear a nutritionist talk about macros, they are talking about macronutrients which means big nutrients (protein, fat, carbohydrates).

So further on down the road, macromolecules eventually come together to make a cell and cells come together to make tissue like skin, vessels, your gastrointestinal tract, muscle and more. Those tissues will come together to form organs like your stomach, pancreas, liver, heart and organs make systems like the cardiovascular system, endocrine system etc. All of this comes together to make an organism, us.

This is where the books promising health fail you. They are not digging deep enough, partially because it is a lot of work and has to be done one on one but also because it doesn’t sell a lot of books. And the problem with figuring out what is causing your thyroid to not work is there are a lot of things that can go wrong.

It regulates your metabolism which is involved in weight but it regulates the metabolism of everything else in the body too which affects energy levels and everything else.

If you are not losing weight with hypothyroidism, it is because of this metabolic function not working.  Even after doing all the things, you might still be struggling with this and those books don’t know why or they place the blame on you.

You didn’t follow the program close enough, you missed a step, you didn’t do this or that.

I paid over $1000 to a chiropractor one time who had the answers and they said they had a doctor on staff but never offered me to see him for my medication (and I never asked because I was too scared) but they had a protocol that they used on everyone. They hooked my fingers and toes up to a machine that read something- I can’t even remember. They put me on the RepairVite diet for 3 weeks (which I followed strictly because I am a good patient), they had me on oxygen while I used a hand bike to exercise and increase my oxygen) and when after going there weekly for 12 weeks I still didn’t feel better he told me I should go have my thyroid levels checked again, he just didn’t know what to do.

I paid thousands to a naturopath who sold me hundreds of dollars in supplements each time I saw her and told me to lay off the sugar, eat flax seeds and coconut oil and my energy still suffered. To be fair, I desperately needed many of the supplements she suggested because I was extremely nutrient deficient and my gut was a mess. The supplements helped me get to a certain point. She then tried to get at my emotional well being and that is when I ran for the hills. She knew my energy levels went beyond physiology and I wasn’t ready to deal with that. I searched for a different practitioner that would keep throwing supplements at me and I would keep throwing money at them.

I think the big problem with how we are treated by doctors is that science can only take you so far - at least the physiology part of it. Some of us who have struggled to feel better have some emotional work to do. Maybe even, if you dare go there, some past life stuff. This is woo woo and not for everyone and I recognize you may think it is all BS. I respect that and I hope you can hear me out. I’m sure I spoke of this before. Therapy never got me where I needed to be and I’m game for trying anything except eating organ meats and fish.

Before I get to the woo woo I want to tell you about this idea called psychoneuroimmunology that I read about in the Epoch Times paper, which can be found in scientific papers and is all about taking care of your mental and emotional well-being. If you don’t care for your emotional and mental health, you may not ever fully put your condition into remission.

I hired someone to help me with this emotional stuff. I’ve discussed before that my mothers side of the family all has one form or another of thyroid disease. I’m positive they are all autoimmune but my mother and grandmother were only ever diagnosed with hypothyroidism. My one aunt has Graves for sure, my other aunt has Hashimoto’s I believe, my uncle has Graves, but my grandfather had no thyroid disease. He was domineering and emotionally abusive to his family - they didn’t have a voice.

Looking back on my life I grew up without a voice- very shy, very quiet, very afraid to speak up because I was afraid of being seen and made fun of. I looked so different from everyone else growing up (at least in my childs mind) because I was taller than everyone, I was pale as a ghost and I had red hair. I just felt like a weirdo so I’m sure that didn’t help my self confidence growing up.

I kept my circle of friends small. When I did speak up as a kid it seemed to backfire and I was very sensitive, still am, to other peoples energy. I never felt good enough. I never felt smart enough, I was never brave enough to speak up. That carried over in to my young adult life and I made decisions that were safe, that kept me small and silent. I let fear keep me small with no voice. That eventually led to, you guessed it, hypothyroidism.

I was repeating the familial cycle.

I had some hole in me I was trying to fill with food, people, things and that wasn’t working. I worked with someone doing some visualizations and was able to fill that hole with what was missing and I can’t articulate in to words what that is exactly but for the first time in my life I felt like a whole person. That little child that felt awkward and shy was no longer there.

I still take supplements, I am less crazy about my diet (but when I go too far off the rails, my body reminds me to get back on), and more sure than ever of myself and my ability to help others.

You see rather than covering up why I can’t help you get further, I refer out to others who can fill in those missing pieces and let you get there when you are ready. And that is just it- you have to be ready to do the emotional work that can be tied to thyroid disease.

It is okay if you are not ready, you will do it when the time is right. It is a big step to take because it means being vulnerable. The books don’t talk about that and the supplements don’t fix emotional vulnerability. You have to be willing to go after that for full health and well being to be a part of your life.

There is research on this but not in relationship to thyroid disease. Bottom line is that if you are still not feeling well after doing all the things the books and programs and functional medicine superstars are telling you to do then you may just have to dig a little deeper because as I say time and time again, there is no one size fits all protocol for everyone.

Do you have support? We don’t usually look sick so people might see us as lazy when the reality is we are just so tired all the time we have a hard time getting off the couch. Maybe you have relationships in your life that are toxic. This alone causes stress and inflammation.

Maybe you hate your job or people you work with. This also causes chronic stress and inflammation that can keep your body from healing properly.  Maybe you are lonely or isolated and just don’t interact with other people that often. Having in person interaction on a regular basis has been shown to be good for our health.

Are you in a hole of negative thinking or around people that only spew something negative? The less optimism in your life, the harder it is to heal. You can make a new habit of changing these negative patterns in your life. What you think about you perpetuate. Retrain your brain to think more positively.

We also need to challenge our brains to help keep depression and inflammation at bay. Find ways to mentally stimulate your brain by reading, playing games, doing puzzles or whatever it is that you can find that you like to do. For me, it was getting my masters degree that really saved me. That was a huge workout for my brain. You and your brain can learn new things and you can change the plasticity of your brain by changing the way you think. Having gratitude is one way to do this. Write down 5 things you are grateful for in a notebook before you go to bed or do a little meditation- I’ve mentioned before I will say what I am grateful for on walks sometimes when I need a little pick me up.

Find ways to laugh. I try to watch or listen to comedy whenever I can to make me feel better. Find things that bring you joy, even if it is something small. Be social. This one is hard for me. I am not good at being in social settings, especially if I don’t know a lot of the people in the room but being with people is good for us. We are meant to engage in social activities.

Meditation is well studied and known for its positive health effects. Even if you can do it for 5 minutes a day to start. Just sit in a quiet place and breath for five minutes. Each time you notice your mind wondering, just bring it back to your breath. It will eventually help reduce your stress and improve your inflammation and your autoimmunity.

So, all that to say that those generic protocols will help a lot of you but for those of you that it doesn’t help, don’t fret. Your biochemical make up maybe needs a little more than a generic protocol. My goal is to be able to help you figure what is missing. I have the tools to do that. Healing your body from any chronic disease takes patience and time.  And you can work on the emotional stuff when you are ready.

I am here to help you before you are ready and after. I don’t push you to do anything you are not ready for. You got this. You can feel better. I will walk along side you as you do the work. If you need the hand holding, my 3 month package is for you. You get a ton of support there and biweekly appointments to discuss anything and everything. You can schedule your free call to see if it is a good fit on my website under the Work With Me Tab.

Thanks for listening.

Why am I not getting better?

Why are you not getting better?

Do you focus on your strengths or on your deficits? It is easy to get stuck in a negative mindset  about our health and our thyroid health in particular. When your thyroid is not working optimally, you are stuck in a bit of a depression already. You probably don’t look sick and you may feel like total garbage.

You might be critical of yourself or someone else is critical of you. Either way, it’s not good for your body or your mind. When we focus on the negative aspects of this disease too much, you probably will feel more pessimistic, lose confidence, motivation, and you may just walk around feeling just generally bad about everything in your life. This is no way to live.

It is hard to be sick and it is also hard to be well and you do have a choice. Both take work.

Women especially tend to be critical of themselves, their appearance, and their abilities. We live in a culture of body shaming and we have all been exposed to images while growing up of what society believes to be the standard of health and beauty and that is a woman who looks like a coat hanger. I’m not a fan of the body positivity around extremely overweight people at the moment. Being obese is not healthy and there is a lot of science to back that up so don’t come after me. If you want to be heavy, go for it. You don’t see a lot of obese people that are 80 or 90 years old.

Aside from that, what do you think would happen if you focused on your strengths? If you looked at yourself in the mirror and found something good to say about yourself? Having a positive attitude is important for happiness, for general well being, and also for health and fitness.

When we focus on our strengths, what we have, what we are already doing well, then it helps us choose healthier behaviors more often, we have better exercise habits, better eating habits, and we will feel better overall.  Self criticism is not a good motivator. Shaming, judging, and pointing out your flaws actually gives us a physiological stress response which makes us feel worse and we are generally less motivated. When we feel emotionally attacked either by ourselves or someone else, we are less able to solve problems, less willing to try new things, and less likely to stick to those things we need to do to get and feel better.  Self criticism also activates the inflammatory response.

If you are trying to get better and you are walking around with a negative attitude about your body, you are perpetuating inflammation that is keeping you sick. How crazy is that. Our minds are very powerful. The good news is, when you can begin to think differently, you feel inspired, empowered and motivated and you start to get better.

I’m not saying your Hashimoto’s is all in your head- not at all. I’ve been there with the doctor and it is super frustrating. What I am saying is ask yourself what the story in your head is. What do you say to yourself on a daily basis? How do you think all day? Are you focusing on the negative of everything? Catch yourself doing it- hit the stop button and eject that negative tape and start to work on putting in a positive tape.

Instead of ‘I hate my body’ try ‘My body gets me where I need to go’. Instead of ‘why can’t I get better’ try ‘what is my body asking for?’. You get the idea. Just try to reframe what is going on in your head and little by little you will make new pathways in your brain and the positive thinking will get easier and easier.

When you work with me, we focus on fixing the problems of nutrient deficiencies, dietary needs, inflammation reduction but we also focus on developing your strengths and successes because you can do the hard work it takes to be well.

Doing this will allow for more happiness, more confidence and you may even feel more powerful and you will become more resilient. We have to unlearn all those negative messages we have been given throughout our lives whether from people we know or from the media. This takes time and it takes persistence because your brain is going to fight you on this tooth and nail.

If you are not aware of what your strengths are you can find assessments online such as the strengths finder to start with a list of your strength of character. You can just journal what you are good at. It feels weird at first but soon enough the good will start flowing. You can even just ask people you know what traits you have that they find positive. This one is hard for a lot of people, including myself, but I once did this as an anonymous survey so people who responded didn’t have to say who they were, and it was the best thing ever. I felt so loved and so good after reading all the responses. You can ask things like “what do you think I am good at?’ or ‘how am I most reliable?’

Once you find those strengths, then we need to ask how we can use them to get to my health goals. This will make getting better more enjoyable and your progress towards health moves forward instead of staying stagnant or moving backwards.

We all know the typical symptoms of hypothyroidism- low energy, cold hands and feet, fatigue, high cholesterol, muscle pain, depression, brain fog, memory issues, etc. Thinking positive can be hard when you feel this way. Start by thinking of something to be grateful for. When I am feeling really down, I will go for a walk and just start saying to myself “I am grateful for eyes that can see the blue sky, I am grateful for ears that hear the birds, I am grateful for feet that I can walk on, I am grateful for legs that take me where I want to go, I am grateful for a house that is warm and cozy….” and on it goes until I feel better and the things I am grateful for get a little deeper. It works.

In order to age well and be healthy in to old age, we need good thyroid function. Lower antibodies to your thyroid means a longer, healthier life. And you can reduce those antibodies. One of my current clients told me her endocrinologist told her high antibodies is just a fact of the disease and they will always be there. We have reduced her antibodies in half over a 4 month time period. She looks happier, her skin looks beautiful and she is doing the hard work it takes to get those antibodies down.

When you have hypothyroidism and hashimoto’s we need to not first say that you need medication. You may, but if your labs indicate your thyroid is working and it might be an issue in your brain, then taking a functional medicine perspective can prevent damage to your thyroid and keep you from needing medication.  We want to look at what FM calls your antecedants and your triggers that are causing a high TSH. What is going on in your hypothalamus or your pituitary? Those to are paramount to getting your thyroid to produce thyroid hormone and remember that TSH is a hormone put out by the brain to tell the thyroid to make more hormone. If that signal is off, we need to ask why.

In particular, these symptoms are associated with a dysfunction at the hypothalamus and pituitary glands:

• fatigue that is always there, especially when waking

• depression or melancholy

• extreme cold feeling

• high LDL cholesterol

• muscle cramps, pain in calves, thighs, upper arms

• constipation

• joint pain, arthritis like

• prolonged achilles tendon reflex time

• easy bruising

In order to assess what is going on here, we need some basic tests like blood chemistry from your doctors office. I would usually add a bit more on to what your doctor would order as they would not consider it relevant. In addition, what is your cortisol doing? Are you stressed? Stress increases glucagon levels and lowers T3 while increasing RT3. Glucagon is a hormone that raises blood sugar (read higher blood sugar, more insulin, cell resistance, fat storage). T3 is the thyroid hormone that your cells use and RT3 binds that T3 so the cells can’t use it.  This will create hypothyroidism that doesn’t need medication. I discuss what your labs mean in pretty good detail as a bonus lecture in my Nutrition for Thyroid course offered on my website.

When you are dealing with chronic stress such as what I have talked about here today with the negative thinking cycle, your cortisol can rise and that will inhibit the pituitary’s ability to produce TSH while also keeping the thyroid hormone you do have from being transported through your blood. So thyroid hormone is becoming depleted but your TSH may read as normal. This is when your doctor says you are fine and you definitely don’t feel fine.

That chronic stress not only suppresses the brain from releasing hormones that tell the thyroid to produce hormones, it increases inflammation that blocks the conversion of T4 to T3 or prevents T4 from being made at all. It promotes an overactive immune system resulting in more antibodies to your thyroid being made. It can bind up the free hormone so it doesn’t get to your cells. Chronic stress also depletes your magnesium levels which will lessen your body’s ability to relax and get that deep sleep your body needs to repair itself. Taking thyroid hormone replacement therapy when this is the issue will make you feel better for a week or two and then you will feel worse.

A normal functioning cortisol response is needed so the liver and kidneys can convert T4 to T3. Low cortisol levels will result in less cortisol available for that conversion to happen leading to higher T4 and lower T3 and excess cortisol will cause more T3 to be converted to RT3. If you become anxious when you get your blood drawn, that alone can cause a temporary increase in thyroid hormone levels.

If you have a story in your head about not being able to change your diet, you may be missing critical nutrients needed for good thyroid function. You need all the B vitamins, vitamin A and E, iodine, zinc, selenium, vitamin C. This is not to say you need to supplement- you need them from your food first and foremost because all of those nutrients also supply other processes in your body and when you get them from food you get them in the proper ratios. These nutrients complement one another and supplementing with a mineral like selenium or zinc can throw off other things. And it is really quite rare to be selenium deficient. Food first.

If you have a story in your head about why you can’t exercise know that exercise stimulates your thyroid to produce thyroid hormone. It increases your cells sensitivity to thyroid hormone meaning your cells will take it in and use it. It relieves stress which would be caused by the negative tape in your head.

We all need community, support and most of all love and the love part starts with us. We need to learn to love ourselves if we don’t already. Look in the mirror and smile at yourself. If you have the type of family that is supportive of you, put little post it notes around the house to remind yourself what kind of wonderful human you are and that you deserve to feel not just good, but great!  Chronic stress, if unmitigated by an inner spiritual harmony that assigns a positive meaning will disrupt your thyroid function at every physiological level.

From the textbook of functional medicine: “A 2002 review of celiac disease in The New England Journal of Medicine showed that gluten sensitivity can cause anemia, osteoporosis, autoimmune diseases, thyroid dysfunction, schizophrenia, psoriasis.

Our daily behaviors are fundamental to the production of our internal and external environments, they represent the most powerful influences upon our physiology. Our daily choices directly affect the chemicals in our body and how they function which includes: the kind of diet we eat, how much exercise we get, how the HPA- Adrenal and thyroid axis work, toxic or infectious exposures, emotional experiences of joy, fear, hostility, connection, etc. Negative influences include using chemicals on our lawns, consuming poor quality fats (trans fats), skipping meals, chronic stress. Positive influences are the opposite.”

You can do this. I can help you.

Thank you for showing up for yourself by listening. We all want to do better and when we know better we can start to do better. It just takes one healthy choice at a time whether it be a food or a new thought.

Sign up for my newsletter on my website and get The Definitive Guide to Hashimoto’s. You can also get your free 3 day anti-inflammatory meal plan when you go to my site and click on the meal plans tab.

If you are ready to start tackling your thyroid health, schedule your discovery call on the work with me tab on my website and if you want to just start on your own you can start with my Nutrition for Thyroid course available on my site under work with me, then choose programs.

Thanks for being here. I appreciate each and every one of you!

Think Critically and Question Everything

The Promise of Health

I was in the book store the other day with my daughter. While she was looking around I was in the health section. I was just looking at 100’s of books selling a promise of feeling better. I probably have had 30 or more of those kinds of books- selling health and happiness. Even cookbooks, especially the paleo ones. They say I found health through food. Food is medicine… etc.

I certainly don’t disagree that food is medicine and that it can heal but what do you do when the food you eat isn’t enough. You turn to supplements because they too offer a promise of feeling better and sometimes they do help you feel better because your body is deficient in something and giving it that particular nutrient helps it work better. Sometimes they work.

I get an email almost daily from a company selling gut health supplements. That is all they do- they tell a story in their emails and then sell you a $60 bottle of digestive enzymes because they will cure it all. They probably work for some people or they wouldn’t keep selling them.

But what happens when you do all the things and you still don’t feel better?

Do you start to feel bad and blame yourself? Do you double down and work harder and buy more supplements?

Curcumin maybe, because everyone says that is going to help everything? But as one of my professors from school has said,  “You can’t have a curcumin deficiency” meaning there are no biochemical processes in the body that require curcumin to function.

It does help inflammation but it is a bandaid, which may be needed, but it isn’t a cure all. I think I had an epiphany in the bookstore just staring at all those books promising a better life.

We can read all the books in the world and take all the supplements but if we are not doing the work to fix what got us sick in the first place then we will only get so far.

This is your friendly reminder to give yourself some grace when you are doing all the things right, or even when you are not.

Thyroid disease is complicated.

There is a lot of research on this disease but sometimes I don’t think the right things are being studied- like finding a way to measure how we feel or recognize that lab values are sooo wrong when the upper limit of a normal TSH is 10 and should be 2.5.

Some of you feel like a sloth at that number.

Remember that you are a cellular being- you are made up of cells the basics of which are carbon, nitrogen, and hydrogen and a few other elements in smaller amounts. Those are atoms.

When you put some atoms together you get a molecule. Glucose or sugar is a molecule, amino acids are molecules that make proteins (the kind you eat and the kind you are made of), B vitamins are molecules.

I mentioned protein- when you put a bunch of molecules of amino acids together you get a protein which is a macromolecule (macro meaning big). If you hear a nutritionist talk about macros, they are talking about macronutrients which means big nutrients (protein, fat, carbohydrates).

So further on down the road, macromolecules eventually come together to make a cell and cells come together to make tissues like skin, vessels, your gastrointestinal tract, muscle and more.

Those tissues will come together to form organs like your stomach, pancreas, liver, heart and organs make systems like the cardiovascular system, endocrine system etc.

All of this comes together to make an organism like a human.

This is where the books promising health fail you.

They are not digging deep enough, partially because it is a lot of work and has to be done one on one but also because it doesn’t sell a lot of books. And the problem with figuring out what is causing your Hashimoto’s or hypothyroidism,  is there are a lot of things that can cause it to go wrong.

The thyroid regulates your metabolism which is involved in weight but it regulates the metabolism of everything else in the body too which affects energy levels and everything else.

If you are not losing weight with hypothyroidism, it is because of this metabolic function not working but even after doing all the things you might still be struggling with this and those books don’t know why.

The blame might even be placed on you. You didn’t follow the program close enough, you missed a step, you didn’t do this or that. I paid over $1000 to a chiropractor one time who said they had the answers and they said they had a doctor on staff but never offered me to see him for my medication (and I never asked because I was too scared) but they had a protocol that they used on everyone.

They hooked my fingers and toes up to a machine that read something- I can’t even remember. They put me on the RepairVite diet for 3 weeks (which I followed strictly because I am a good patient), they had me on oxygen while I used a hand bike to exercise and increase my oxygen) and when after going there weekly for 12 weeks I still didn’t feel better he told me I should go have my thyroid levels checked again, he just didn’t know what to do.

I paid thousands to a naturopath who sold me hundreds of dollars in supplements each time I saw her and told me to lay off the sugar, eat flax seeds and coconut oil and my energy still suffered.

To be fair, I desperately needed many of the supplements she suggested because I was deficient in a bunch and my gut was a mess and those supplements helped me get to a certain point. She then tried to get at my emotional well being and that is when I ran for the hills. She knew my energy levels went beyond physiology and I wasn’t ready to deal with that. I searched for a practitioner that didn’t know I was so screwed up emotionally that they would keep throwing supplements at me and I would keep throwing money at them.

I think the big problem with how we are treated by doctors is the science can only take you so far - at least the physiology part of it. Some of us who have struggled to feel better have some emotional work to do.

Maybe even, if you dare go there, some past life stuff. This is woo woo and not for everyone and I recognize you may think it is all BS. I respect that and I hope you can hear me out. I’m sure I spoke of this before. Therapy never got me where I needed to be and I’m game for trying anything except eating organ meats and fish.

I hired someone to help me with this emotional stuff and the work we did together has helped me tremendously. I’ve seen another energy healer of sorts that came to the same conclusions as her so I felt it had to be legit.

I’ve discussed before that my mothers side of the family all has one form or another of thyroid disease. I’m positive they all have some kind of autoimmune thyroidits but my mother and grandmother were only ever diagnosed with hypothyroidism.

My one aunt has Graves for sure, my other aunt has Hashimoto’s I believe, my uncle has Graves, but my grandfather had no thyroid disease. He was domineering and emotionally abusive to his family - they didn’t have a voice. I don’t want to get too personal with this because there are people involved that deserve to have their privacy.

I will say, looking back on my life I grew up without a voice- very shy, very quiet, very afraid to speak up because I was afraid of being seen and made fun of or something. I kept my circle of friends small. When I did speak up as a kid it seemed to backfire and I was very sensitive, still am, to other peoples energy.

I never felt good enough. I never felt smart enough, I was never brave enough to speak up. That carried over in to my young adult life and I made life decisions that were safe that kept me small and silent. I let fear keep me small with no voice. That eventually led to, you guessed it, hypothyroidism.

I was repeating the familial cycle.

These two energy workers dug deeper than that and found there was some really dark stuff keeping my energy levels low. My first energy person tried to fix it but he missed something and this darkness came back. The other energy worker described the darkness as chords attached to me that were dragging me down. She cut them and sealed them and she had to do it twice because they kept wanting to come back.

We did some other work on my inner self too that changed the game for me. I had some hole in me I was trying to fill with food, people, things and that wasn’t working. She was able to help me fill that hole with what was missing and I can’t articulate in to words what that is exactly but for the first time in my life I feel like a whole person.

I still take supplements, I am less crazy about my diet (but when I go too far off the rails, my body reminds me to get back on), and more sure than ever of myself and my ability to help others.

You see rather than covering up why I can’t help you get further, I refer out to others who can fill in those missing pieces and let you get there when you are ready. And that is just it- you have to be ready to do the emotional work that may be tied to thyroid disease.

It is okay if you are not ready, you will do it when the time is right. It is a big step to take because it means being vulnerable.

The books don’t talk about that and the supplements don’t fix emotional vulnerability. You have to be willing to go after that for full health and well being to be a part of your life. There is research on this but not in relationship to thyroid disease. Bottom line is that if you are still not feeling well after doing all the things the books and programs and functional medicine superstars are telling you to do then you may just have to dig a little deeper because as I say time and time again.

There is no one size fits all protocol for everyone. Those generic protocols will help a lot of you but for those of you that it doesn’t help, don’t fret. Your biochemical make up needs a little more than a generic protocol.

My goal is to be able to help you figure what is missing. I have the tools to do that, It just takes time. You didn’t get thyroid disease overnight and it won’t get better overnight either.

I am here to help you before you are ready and after. I don’t push you to do anything you are not ready for. You got this. You can feel better. I will walk along side you as you do the work.

Thanks for listening and being patient as the episodes have been few and far between.

If working with me one on one is not something you can do or are ready for, you can take my Nutrition for Hypothyroidism course. It is a 4 week self paced course diving into the basics of thyroid health that gives you ideas on how to support your thyroid, recipes and cooking demos, access to my meal planning software for 75 days and a bonus lecture on understanding what your thyroid labs mean.  You can check it out at helpforhashimotos.com and then look for the GET HELP tab and then programs.

The Nutrition for Hypothyroidism program gives you access to a library of 4 culinary nutrition lessons to gain knowledge and confidence in preparing simple, delicious meals and snacks you can count on to deliver big health benefits.

Upon completion of this program, you will...

• Evaluate hypothyroidism within the context of common conditions associated with thyroid function

• Propose how nutrition affects thyroid health

• Identify dietary considerations for taking thyroid medications

• Learn how to prepare nutrient dense meals and snacks that support thyroid health

👉 Access to 4 lessons that you can complete at your own pace. 

📚 Nutrition lessons to learn about different foods and their health benefits

🔪 Culinary lessons to learn about key kitchen tools and how to use them to create simple, delicious meals and snacks

🧑‍🍳 Cooking demonstrations that illustrate nutrition and culinary lessons learned  [no cooking skills required - just the basics here!]

📝 Lesson-specific materials and guides to support you in applying what you have learned

🍽 Access to 1,000s of recipes so you can practice weekly skills with recipes that meet your preferences

👉 Resources to support you in building a kitchen with tools and ingredients you need to get nourishing, delicious meals to the table fast

Thanks for joining me. Please leave me a rating or review on apple podcasts so more people can find the show and if you have not already, please sign up for my newsletter and get The Definitive Guide to Hashimoto’s.

Until next time.

Why am I fat? High cortisol from calorie restriction.

I came across a study called Low Calorie Dieting Increases Cortisol by Yomiyama and colleagues 2010 in the journal of the American Psychosomatic Society.

The study was looking at dieting and the effect is has on psychological and physical stress so not immediately related to Hashimoto’s but if you are struggling with your weight at all because of hypothyroidism and you are restricting calories in hopes of losing weight, this is why this study is important.

Aside from that, most of us have been on a diet at one point in time. My mind is way too obsessive to make long term caloric restriction work for me so I never dieted much. I tried once before a friends wedding to fit in to a bridesmaid dress. Other than that if I tell myself not to eat something, that is all I think about. I did do well when I did AIP but my body didn’t really give me much of a choice and I probably felt my best physically and mentally when I was eating as clean as that diet calls for.

The hypothesis of this study is that diets fail because they increase stress and stress can increase weight through the HPA axis which also affects energy metabolism.

They were looking to measure cortisol in dieters and also noted that it has been documented that dieting produces negative emotions like depression, anxiety, low self esteem, nervousness and irritability.

This study was only 3 weeks long so it isn’t a great representation of how much a diet would effect cortisol long term and whether that long term stress would impede weight loss or even cause weight gain. The participants were either monitoring their diet or not OR restricting their diet or not.

Salivary cortisol was measured at the beginning for a baseline measurement and then at the end of the 3 week study. Each time they were measured for two days and 3x each day. First thing in the morning, 45 minutes after waking and 12 hours after waking.

Questionnaires were given asking about potential activities that would affect cortisol such as exercise, caffeine, alcohol, pain, stressful events etc.

Participants in the diet restriction group were told to follow a diet of 1200 calories a day with 50% of that coming from carbs, 30% from fat and 20% from protein. They also completed a food journal to be sure they monitored their intake.

Participants who were just monitoring their diet didn’t restrict calories and just used a food journal. The restricting food only (not monitoring) were given all of their food for the study. The control group didn’t do any of this and just ate their normal diet.

Part of what they were measuring was the cortisol awakening response which is the time between when you wake up and 30-45 minutes later. Psychological stress was also measured by questionnaire. Perceived stress was increased in those who monitored their caloric intake. Just restricting diet and not monitoring did not increase perceived stress but it did increase the amount of cortisol in the body in the evening but not in the morning (so no effect on the cortisol awakening response).

This info is important because one of the main jobs of cortisol is to increase energy via glucose which would also increase insulin. The authors do indicate that their study did not relate the release of cortisol to weight gain and they could not find studies on this in humans but there are mouse model studies showing a relationship between cortisol output and weight gain.

When cortisol is high, we know it increases the body’s own production of glucose as I said. It also decreases the body’s ability to use the glucose it makes or the glucose you take in through your diet which will in turn increase your blood sugar levels.

High cortisol breaks down protein and keeps your body from making it.  This translates to high cortisol breaks down your muscle and can affect your immune system response to offenders or potentially to your antibodies against your thyroid.

High cortisol decreases the immune systems Th1 response and increases Th2 response- these need to be in balance. Having either one high causes inflammation in the body which further increases stress biochemically.

High cortisol also plays a role in bone and collagen loss as well as decreasing absorption of amino acids from the protein we eat.

Signs and symptoms of high cortisol include:

• insomnia or poor sleep

• brain fog, poor memory

• depression, anxiety, irritability

• high blood sugar, high insulin

• craving for sugar

• weight gain, especially around belly

• fatigue

• poor digestion and absorption due to your central nervous system being is sympathetic mode

• night sweats

• high blood pressure

• poor immune system function

• low sex hormones

• bone loss or osteopenia/osteoporosis

• easy bruising, poor wound healing

• weakened muscles

You can test for cortisol via a salivary panel or a Dutch test but the research shows that a single day test is not accurate enough to make any conclusions about someone’s cortisol levels because our cortisol levels vary so much throughout the day. A serum cortisol test done in the morning may be a more cost effective way to see if you are dealing with high or low cortisol at least in the morning. It is more accurate than saliva but you don’t get the cortisol rhythm throughout the day.

Working with someone like myself to see where your body is at, what your diet is like, what your cells need is a great first step to improving your cortisol levels and the only time I have clients do caloric restriction is during a period where we are working on their body’s detoxification and even at that it isn’t for long.

That’s it for this episode. Thanks for listening. Download your free definitive guide to hashimoto’s on my website when you sign up for my newsletter. You can sign up for a free discovery call on my website too under the work with me tab. And if you want your free 3 day meal plan you can get that on the meal plans tab on my website as well. That is help for hashimoto’s dot com.

I created a do it yourself program called Nutrition for Thyroid focusing on hypothyroidism and how to support your body for healthy thyroid function. This is an ideal way to get started on feeling better. Here is what is included:

The Nutrition for Thyroid program gives you access to a library of 4 culinary nutrition lessons to gain knowledge and confidence in preparing simple, delicious meals and snacks you can count on to deliver big health benefits.

Upon completion of this program, you will...

• Evaluate hypothyroidism within the context of common conditions associated with thyroid function

• Propose how nutrition affects thyroid health

• Identify dietary considerations for taking thyroid medications

• Learn how to prepare nutrient dense meals and snacks that support thyroid health

• Understand what your thyroid labs mean

👉 Access to 4 lessons that you can complete at your own pace. 

📚 Nutrition lessons to learn about different foods and their health benefits

🔪 Culinary lessons to learn about key kitchen tools and how to use them to create simple, delicious meals and snacks

🧑‍🍳 Cooking demonstrations that illustrate nutrition and culinary lessons learned  [no cooking skills required - just the basics here!]

📝 Lesson-specific materials and guides to support you in applying what you have learned

🍽 Access to 1,000s of recipes so you can practice weekly skills with recipes that meet your preferences

👉 Resources to support you in building a kitchen with tools and ingredients you need to get nourishing, delicious meals to the table fast

Please leave a rating or review on apple podcasts so other people can find the show. I’d really appreciate it.

Is an elimination diet necessary for healing Hashimoto’s?

The internet says so. I say, maybe.

Functional medicine and functional nutrition look at foods differently than conventional medicine. We look at foods that are causing inflammation or are creating a toxic burden especially when it comes to autoimmune disease. What I’m looking for in having my clients change their diet is to see if there are foods that are contributing to immune system dysfunction.

The most common diet for doing this is the elimination diet and the various versions of it from the autoimmune protocol to the IFM elimination diet. The AIP diet is really strict. No grains, beans, nuts, seeds, nightshades, dairy, and eggs. Many spices are also included if they fall into any of these categories. Let’s not forget the sugar, caffeine, processed foods, trans fats, alcohol and GMO foods. Some people may need to remove citrus as well but I don’t usually go that far. Removing these foods should improve gut health and bring down inflammation so the body has time to respond properly to things going on. With removing foods, you want to add in healing foods.

One of the most healing foods you can eat is bone broth. It’s so simple to make too. Take your chicken bones after a meal and put them in a pot, add water and cook for 4-5 hours. You can make it even better by adding in onion, carrot, celery, garlic, a little ACV. The last batch I made I used carrot tops from the farmers market, celery, and I always save onion peels from when I use onions for other things and freeze them to use in making broth. I cook mine in the instant pot for 90 minutes so if you have one, that is the quicker way to get broth. I drink it occasionally when I’m just needing a little comfort or feel like my gut just needs some help. I add ginger and mint and salt to taste and then a little coconut milk if I think of it. It’s so filling and feel good and healing.

Also, eating a rainbow. Eat vegetables. More vegetables than fruit. You will get anti-oxidants, phytonutrients. You will get fiber. You need fiber!

You need protein. Your immune system needs protein to work properly and for cellular health.

It is usually recommended that these types of diets are done for a minimum of 2 weeks but ideally for around 6 weeks so that the body has proper time to calm down and heal again. Doing an elimination diet takes a shift in your mindset and it is really helpful to have some support. Some would say you will need a version of this diet for the rest of your life. To this I say, it really depends on your situation and how sick you are, how far your disease has progressed whether it is Hashimoto’s or something else.

Doing this diet can be overwhelming so you can do it in phases. Someone created a program where they walked you through doing it over 6 weeks time which you can do or you can start by removing the most inflammatory foods or the ones we would suspect are the most inflammatory with gluten being at the top of the list. Then maybe remove dairy the next week and then eggs the week after that. Try to get your family on board with this- that will be super helpful.

You will definitely need to do some meal planning, shopping and probably even list making. Thankfully the internet is full of websites that are dedicated to the AIP or elimination diet so you will not have a shortage of ideas for what to cook. There are several cookbooks out there too.

Sourcing the best quality food is ideal but not necessary. If you can find local farmers to buy from you may find that you are getting it for cheaper than in the grocery store these days but truthfully, I have not shopped for meat in the grocery store in years so I could be wrong. I paid $4.00 per pound for ½ a cow last year and that means $4.00 per pound for T-bone steaks and ground beef.

If you find it to be easier to stick to the elimination diet, you may want to clean out your cupboards so that when you go into your kitchen, you have options that will improve your health rather than impede it. And if who ever lives in your household with you can get on board and start eating the same way then that will just set you up for success. When I started to change my diet I cooked separate things for awhile but that did not last long. I got some pushback from my family, especially my husband when I made diet changes. It’s a little embarrassing to admit but when I was toying around with diet changes, I told my husband I was thinking about going gluten free to see if it would help me and he laughed at me. It’s not really ever been an emotionally safe thing to be vulnerable with him so I was pretty hurt by his reaction. I say this because if you are not supported, I want you to know it’s okay- you can still make changes and recover your health and when you get strong enough and healthy enough you can take steps to fix the relationship stuff too. We have to find our voices to be healthy too.

Having your family join you in diet changes is nice because they may have susceptibility to autoimmune disease too so getting them a head start on keeping some of those triggers under control will only benefit them for the rest of their life. But you do what you have to do - you can’t be good to them if you are not good to yourself.

For support you can look for a community but you have to be really careful of these online message board or facebook groups or whatever. Many of them are loaded with people who are not taking a functional medicine approach and they are complaining about symptoms and medications and things like that. They are not uplifting and supportive unless you are wanting to get support for feeling terrible and not fixing why you feel terrible.

You may have been told if you are a vegan or vegetarian that you will not heal an autoimmune condition eating that way. I’ve been to a couple conferences that really just hated on the vegan diet and lifestyle. I am not a vegan and I never will be a vegan but I respect your desire to be vegan or vegetarian. I do think you have to be really really mindful of what you eat when you are eliminating a whole food group. I think that is true for any type of diet- even the paleo diet because that eliminated quite a bit of stuff. With a vegetarian or vegan you have to be really mindful of getting in real whole foods and really good proteins - you can’t be vegan and do AIP- that would be way too restrictive. You may have to use protein powders to get enough protein but try not to make them a part of your everyday diet.

Making all these diet changes might feel tricky, especially breakfast. I remember really worrying about what I was going to eat when I just went gluten free. It was a big deal. I couldn’t do peanut butter toast anymore or most cereals- none of what I ate for breakfast helped my blood sugar ever. At the time I wasn’t a huge fan of eggs and if you are doing AIP you can’t have eggs to start with anyway so what do you have for breakfast?

Sweet potato hash (https://www.outofthewoodsnutrition.com/help-for-hashimotos-blog/2020/4/23/breakfast-hash) , breakfast sausage, coconut milk yogurt, leftovers. I started out eating a lot of leftovers and made what I called breakfast soup which was a basic soup - chopped onion, celery, carrot sauteed in olive oil in a dutch oven, then I added locally made breakfast ground breakfast sausage or made my own with ground pork and seasonings- I think maybe this recipe came out in my newsletter long ago. I’ll put it out again soon so sign up for my newsletter if you want the recipe. Then I added bone broth- about 4 cups and would add zucchini at the end so it didn’t get too mushy. You can do a hash of grass fed beef, zucchini, summer squash, onions and top it with an avocado. You’re not doing grains on AIP so gluten free toast is out of the question. Leftovers, as I said is always a good option.

Other options for the rest of the day might be soup for lunch or a really big salad with a good sized amount of protein- 4 oz at a minimum.  On the weekends, I make one or two chickens and then use that meat all week long. I buy chickens locally too and my last order was for like 15 or something like that- I was buying for 4 people and now we are down to three and one of those three is not always home for dinner so I need to learn to cook for two people. Even my husband isn’t home a lot for dinner so what’s the fun in cooking when no one is there. So I will throw two chickens in a dutch oven and cook at 300 for 4 hours or so and then all that meat just falls off those bones. Then I use the bones, liver, heart, gizzard, neck bones and make broth. I freeze the broth either in freezer bags or in jars- gotta be careful with the jars though or they can crack open.

You can do cauliflower rice and avocado and spices, then you can grill some meat and veggies for dinner and do some berries for dessert.

Finding the time for this takes some effort. Dedicate a day to prepping for at least the first half of the week and then maybe mid week you prep for the rest. You can get great meal prep containers at Target now. Batch cook. If you are making burgers, double what you need so you have leftovers. If you are making fish- same - just double it so you can have leftovers.  Use a crockpot, instant pot, air fryer- whatever makes life easy for you. Cook double the veggies so you can throw some of them into a salad the next day.

You have to make an effort to be prepared too for things like travel- plan around flight departures and arrivals and can you stop at a store on your way to your hotel, what kind of food is in the airport? I live in Minneapolis and our airport is really great. I always know I have great food options when I am traveling at least from my home town- other airports, not so much. Bring food with you if needed. Things like meat sticks, jerky, Epic bars, apples. All great travel options in a pinch. Even now you can get prepackaged olives and green beans in little snack packs.

Getting on this diet or just cleaning up your eating you may see joint pain disappear, your digestion can improve, pain may lessen or go away, thyroid antibodies may go down over time (they actually probably will go down but I don’t want to make promises), psoriasis goes away all with just diet changes. If things don’t get better then you can start thinking about testing for things like inflammation and other stuff that might just be in the way of making you feel better.

So start with diet, then we maybe look at gut health, healing the gut, looking at stress, lifestyle factors and kind of go from there. You may need to do some stool testing and maybe we find overgrowth in small intestinal bacteria or parasites or maybe your body just needs more gut healing foods or we need to figure out the right ratio of macronutrients for your body. It’s all a big puzzle that we need to figure out. Maybe you should not be eating a ton of fermented foods. If you don’t get better on an elimination diet, it could be that you are just feeding a beast in your belly with ferments and so we can do some testing to see if that is a problem.

Another thing to address might be your toxic load/burden and again the stress and how connected you might or might not be to other people, how happy you are. It all plays a role.

Working with me looks like this:

We are going to talk about your medical history, we will discuss any recent labs or labs can be ordered, we will talk about medical nutrition therapy and we will talk about any questions you have- things as simple as what you can eat for breakfast if that is what you need help with. We can do a 3 month package where we meet biweekly if you need that type of support or we can just meet one time or three times. Whatever works for you.

What does your cholesterol panel mean?

Do you ever fell frustrated by the complacency of people you care about?

I’ve always been one to fight for my health and for almost anything really. I question everything, especially narratives that come from the mainstream. I could have been complacent, and probably would be if it were not for my thyroid causing me to lose my child witnessing how the way I lived my life affected my kids.

After a family member came home from surgery all they wanted was fast food so someone brought it to them.  I have other family members who are sick. One has a major issue with their foot- no feeling in their feet and has a huge sore- they are not diabetic but have a rare condition and they just can’t seem to make any diet and lifestyle changes to try to help their condition.

I was telling my brother that I have small dense lipoproteins and he may as well if he wants to get it checked out. He just shrugged his shoulders.

I don’t want to change them. I do WISH they would change, but I’m not out to force my beliefs and lifestyle on them- I tried that, even before I was a nutritionist and believe me it never works. All I am saying is it hard to watch people you care about care so little about fixing their own health problems. As the saying goes, you can lead a horse to water, but you can’t make them drink.

It makes me sad, but I know that all I can do is lead by example and live my best life. So that is what I am doing.

I am very proactive when it comes to my health and since my last labs, I have gotten pretty serious about making sure I don’t have some sort of coronary event if I can help it.

I had basic labs done, a complete metabolic panel, complete blood count, thyroid panel, iron panel, and an advanced lipid panel called the CardioIQ through Quest Diagnostics which looks at lipoproteins in more depth.

I’ll kind of summarize what my nurse practitioner said in the visit summary about the labs and then I’ll talk a bit more about them.

She says my iron markers look fine but ferritin is slightly low. She didn’t think this was related to my fatigue which waxes and wanes. I have to agree because my fatigue is always better if I eat a ton of veggies.

My thyroid labs were stable so I am continuing on my current dose of medications. I have been taking Ashwagandha and Maca and it lowered by TSH and Free T4 but kept my Free T3 in the normal range. Reverse T3 is at 10 with a range of 8-25 through Quest Diagnostics.

My insulin resistance had improved quite a bit. This is looking at insulin, C-peptide and a calculation called insulin resistance score. This is good news because insulin resistance is one thing that will cause you to hold on to and create fat tissue which gets worse as we age. It looks like it is exercise for the win here!

My basic lipid panel or cholesterol panel had improved from the last one but I think it was off because I had a matcha latte on the way to the lab draw without even thinking and these are supposed to be fasted lab draws. The  one thing she noted was the low HDL at 43 and should be between 65-85 for a woman my age and physical activity. In the last 2 years there has not been much time I have missed a workout lifting a minimum of 2 days a week but for much of the last 2 years, it was 3 days a week plus some other kind of activity 2 other days in the week. Prior to my foot problem, I was walking almost daily and swimming laps here and there and doing things like elliptical and sprints or high intensity intervals. Exercise should help raise HDL so given mine is staying low she thinks there might be a genetic component to it. The Cardio IQ panel reveals a high Lp (a) [Lp little a] but my vascular specific marker is in normal range. The lipoprotein fractionation is all abnormal with a pattern B overall.

I will explain what these markers are and what they mean as best I can for the layperson to better understand.

Let’s first understand what cholesterol is.

Every cell in your body makes cholesterol because cells need it - it’s part of their make up. Cholesterol is the reason why your cells are fluid meaning things are allowed to cross the cell membrane both in and out. That is how sugar gets in to your cells as well as hormones and other things. It’s also how things that are no longer needed leave the cell.

Your body needs cholesterol to make all the hormones from vitamin D to sex hormones to thyroid hormone.

We need it to make bile. Bile helps break down fats and it helps remove toxins from the body. Bile is what makes your stool dark brown.

Not every part of the body makes all the cholesterol it needs so we need lipoproteins to carry it through the blood. This is where HDL and LDL come in.

HDL is made of apolipoprotein(a) or apo(a). LDL is an apoB. According to Peter Attia MD there is no difference between HDL and LDL cholesterol so calling one good and one bad is not correct. The reason LDL is called bad is because it is the one that infiltrates the wall of an artery and becomes oxidized or damaged. This oxidized cholesterol molecule enters the tissue of the artery which activates your immune system and other things to help with that inflammation and this is what leads to ‘hardening of the arteries’ or atherosclerosis.

Knowing your apoB separately from your LDL will give you a better idea what kind of cardiovascular disease risk you have. ApoB actually causes damage to your arteries years before you would even notice. ApoB actually rises in menopause too.

My  Cardio IQ test showed apoB was in the normal range at 82 with optimal being below 90. Others believe a healthy range is around 60 mg/dL so if I follow that, then mine is high.

The test also went over particle size such as VLDL or very low density cholesterol. The VLDL is the type that causes atherosclerosis so you want to know what that is. These particles are what infiltrate the wall of your artery or vessel. This is not good.

The Lp(a) is part of apolipoprotein(a) which is bound to apo(B). Lp(a) plays a role in repairing things, rises in inflammation, scavenging. When high it gives an increased risk of cardiovascular events. This is as deep as I am going with this explanation because it is very very complicated to explain and if you want a deep dive follow Peter Attia MD’s podcast The Drive.

What can you do to help improve your cardiovascular health?

First of all, it has been said that hypothyroid patients tend to have higher cholesterol. I could be completely wrong about this but I think it is because T4 only medications are keeping many patients at suboptimal health.

Getting your thyroid in it’s sweet spot will be good. You also want to avoid smoking. It is one of the biggest risk factors for cardiovascular disease and it’s just gross. I’m married to a smoker and grew up with smokers.

There are pharmaceutical drugs you can take such as statins but I’m not a fan of pharmaceuticals unless absolutely necessary.

Avoiding type 2 diabetes is preventative. You can take my Nutrition and LIfestyle for PreDiabetes course on my website to get a start on simple diet and lifestyle changes you can make to prevent yourself from becoming a type 2 diabetic.

Keep your blood pressure in check.

Know your calcium score if you are over 50 so you know your risk for CVD.

Get your weight in check. Easier said than done with hypothyroidism and even with inflammation. But things like diet changes, knowing what is causing the inflammation and even exercise are very helpful in getting your weight down if you need to.

The quality of the food you eat is important as well. I’ve talked about this a lot so if this is your first episode, you will learn more about this as you listen to other episodes.

Get your sex hormones balanced. Know that your cholesterol levels are different depending on what phase of your cycle you are in. HDL is highest at ovulation, Total and LDL cholesterol both rise after your period starts and peak in the follicular phase. Getting your cholesterol checked during your period is the most ideal time to do it.

Know if you have PCOS.

Focus on healthy fats such as olive oil, coconut oil, grass fed butter. Fiber consumption through vegetables and fruits should be around 30g per day. Most people don’t get half that. It’s okay to include whole grains such as brown rice and quionoa. Avoid processed foods as much as possible. Don’t over eat.

Exercise as I said before. The more fit you are the better off you are. It will lower your CVD risk.

Manage both physical and psychological stressors.

Niacin can reduce Lp(a) in the amount of 1-3grams of niacin- the kind that causes flushing. I took 500mg my first round and I had terrible flushing in my face for a few hours. It wasn’t uncomfortable but my face was really hot!

Hormone therapy for menopausal women can help as well but if you are more than 5 years post menopause, I don't recommend that. Also, Lp(a) doesn’t go up significantly so likely not anything to worry about.

Consume more monounsaturated fatty acids like avocados, olive oil, almonds, pecans, cashews, and peanuts. In general, consume a Mediterranean style diet as it is the most well studied in cardiovascular disease prevention. Be sure you are getting a minimum of 30g of fiber per day. This has been shown in the research to improve cardiovascular risk factors.

I’ll keep you posted on the results of my supplement and diet regimen and whether or not they are helping. I am taking fish oil, time released niacin, pantethinic acid, and curcumin.

If you need supplements, this is a friendly reminder that you can get them 10% off from my dispensary at https://us.fullscript.com/welcome/hfh

You can sign up for my newsletter on my website and when you do you get the definitive guide to Hashimotos  https://mailchi.mp/0e5555d60258/the-definitive-guide-to-hashimotos

Please leave a review on the apple podcasts so other people can find the show, if you don’t like something let me know so I can fix it.

Thanks for listening. Bye everybody.

Feeding your microbiome. What to eat for a healthy gut.

Gut bacteria and your gut microbiome is talked about a lot these days. Gut bacteria changes daily based on what you are eating because what you eat feeds the bacteria in your gut.

These bacteria affect not only our immune system but our central nervous system and how your appetite is controlled. They affect your blood sugar, your parasympathetic and sympathetic drive as well.

Gut function and the bacteria in your gut are pretty important.

Having a diverse microbiome, a variety of bugs, helps us achieve better health

When you hit menopause (this is important for all women to know because all women will eventually hit menopause) your risk factors of cardiovascular disease, type 2 diabetes, high blood pressure, obesity, etc. increase significantly.  You can see a decrease in fine motor skills, cognition, increased depression and anxiety and a greater risk for Alzheimer’s disease.

This is true even if you are physically active.

What is the best way to improve your gut bacteria?

It is NOT a probiotic.

Probiotics have their place for sure. Scientists are able to study specific strains of probiotics for  specific conditions.

The thing that improves your microbiome is fiber.

When the fiber we eat from vegetables and fruits gets to our colon, it ferments producing short chain fatty acids like butyrate, acetate, and propionate.

These short chain fatty acids prevent the bad bacteria from making their home in your gut. They also help you produce neurotransmitters like serotonin, dopamine and norepinephrine.

Having good gut bacteria also helps improve our bone mineral density by influencing the production and recruitment of immune cells that produce inflammation that causes bone turnover (how we build bone).

Premenopausal women have a different microbiome than men and post menopausal women have a similar microbiome to men. This is thought to be because of the change in sex hormone levels as we (women) age.

There are bacteria in the gut that are responsible for helping get estrogen into our cells and when you hit menopause you need less of those bugs so they die off. So we have less of these bugs available to help us use the estrogen we still make.

Estrogen also helps prevent leaky gut.

Less estrogen (estradiol) = more inflammation, increased leaky gut, decreased gut bacteria diversity.

All of this plays a role in increasing fat storage.

Eating well, increasing the diversity of bugs in your gut, having a healthy gut = lower inflammation, better energy, less fatigue, less fat storage, increase in neurotransmitters and growth of brain tissue and better bone density.

Poor diversity in gut bacteria pre-menopause can trigger autoimmune diseases post menopause along with the CVD, diabetes and the other stuff mentioned before.

A gut that has a healthy microbiome has approximately 90% Bacteroidetes and Firmicutes family and having a lower Firmicutes to Bacteroidetes ratio means a leaner body, better blood sugar regulation, immune and brain health.

Menopause encourages the growth of Firmicutes. We want to encourage the growth of Bacteroidetes.

We do this with moderate exercise and fiber. A wide variety of vegetables, fruits and whole grains. The daily recommendation for fiber is 30g per day. Most people don’t even get 15g per day. If you are not eating ½ a plate of plants at every meal you likely are not even close to the recommended amount.

Getting a variety can be a challenge but if you put some thought into it, you can get up to 20 or more different plant foods a day. It doesn’t have to be 20 servings, just 20 different plants which would include herbs, nuts, seeds, spices, and maybe even juice.

Here is what that would look like:

Breakfast: Overnight oats using dairy free yogurt like coconut yogurt, banana, blueberries, cinnamon, almonds, pecans, cashews, and a teaspoon each of hemp and chia seeds and maybe some diary free milk to make it less thick.  That is about 10 different plant foods right there.

Lunch: 4 oz protein of choice, 4 cups ripped mixed greens which might have 4 different kinds of greens in it, tomatoes, carrots, radish, cucumber, microgreens, primal kitchen salad dressing (likely has at least one herb in it). That might be around 13 different plant foods if the microgreens have multiple plants in it.

Dinner: Some kind of protein cooked with olive oil and sprinkled with an herb blend of 4 herbs with brown rice, onions, a bean and a side of stir fried zucchini, mushrooms, garlic and shallot. That is about 12 different plant foods.

Dessert could be berries with coconut cream and any snacks you need throughout the day can be protein and veggie or fruit such as nut butter and apple or celery and nut butter.

The more plants you get in the better.

I’ve been meal prepping these types of things, especially the breakfast and lunch examples for a couple weeks now and it makes life so much easier. I’m the type of person who won’t eat if there is nothing prepared in the fridge so this helps me a lot. I’d also rather snack on a snack bar or a cookie than veggies so having less of that kind of stuff in my house and giving me veggie and fruit options is just better for my personality.

Using my meal planner can help you get ideas of how to get more plant foods in. You can sign up for a free 3 day anti-inflammatory meal plan and I think monthly plans run $9.99 per month to $14.99 per month so it’s quite affordable. I also us the Feel Better App that used to be called Deliciously Ella. It is an app that has exercise, meditation, and recipes which are all plant based. I like using it because it helps me get more plant based foods into my diet. You don’t have to be a vegan to enjoy a plant based app. Another thing I have been using to ensure I get my veggies in is Imperfect Produce. I had a weekly plan where I could order organic veggies weekly which helped me eat more produce in general because I wouldn’t want to waste it before the next shipment came. I have paused it for the summer because i’m now buying from  farmers markets which is slightly more expensive but I love supporting local farms.

You don’t have to buy organic but if you are dealing with autoimmune disease, it is ideal because the less chemicals and toxins you put into your body, the better.

Thanks for tuning in. Sign up for my newsletter and get The Definitive Guide to Hashimoto’s. Please leave me a rating or review on apple podcasts too if you don’t mind. The more reviews the more people can find the show. If you don’t like something about the show, reach out and tell me so I can make it better. You can fill out the contact form on my site. I appreciate constructive criticism.