Is Intermittent Fasting Good For Hypothyroidism?

Hi Stephanie, 

Hope this email finds you well 

This last email of yours got me thinking about how now a days everyone is promoting intermittent fasting, 16 hours or more of fasting, very early dinner and late breakfast or skipping breakfast to have lunch directly. 

I want to know what’s your take on this.  

Thank you for all the content you publish and all the effort you put into giving us updated information. 

Have a great  thanksgiving. 

Kindest regards,

Lucia 

A quick primer on what IF is. It is in the category of time restricted feeding, alternate day fasting, and just plain fasting. This just means that you eat your allotted calories for the day within a specific time frame or eating window. This can be four hours, eight hours, 12 hours- basically whatever you choose as long as you eat within that window.

The idea behind this is that restricting your eating window to a specific timeline causes your body to burn fat and it is said to be good for you, your cells, etc.

The caveat here, and this is the case with most research done on humans, is that the subjects of the research or more often than not, men. A woman's biochemistry and physiology is not the same as a mans so the research cannot always translate to what women should or could be doing for better health.

The second issue is that research on intermittent fasting and the benefits of it, is often done on obese and overweight subjects. Almost any dietary changes made to this category of people will indeed show that it can be helpful in improving health outcomes. Men, especially do fairly well on an intermittent fasting diet with improvements in fat loss, blood sugar and insulin levels. Women, however, show no improvements in blood sugar or insulin levels in some studies, according to researcher Dr. Stacy Sims.

Most review articles on intermittent fasting have looked at things like body weight, waist size, blood pressure, heart rate, blood sugar, cholesterol levels, etc.  There is little research on the effects that IF might have on circadian rhythms of hormones, including thyroid hormones.

A lot of studies of any kind are first done in a petri dish or in animals, usually rats. Sometimes this is all that is done, usually because it would be unethical to do certain research on humans.  These types of studies don’t always translate well to humans. It is something that should be in the back of your mind when you hear things like “Research shows that xyz…”. Always have that critical thinking hat on.

That said, in rat studies, 24 hour fasts lower blood levels of T3, thyrotropin releasing hormone and TSH. In humans, T3 falls pretty fast after a fast. A 3½ day fast in healthy people showed T3 and TSH both dropped within the first two days of the fast. Another study showed T3 dropping by half in 24 hours while TSH remained stable. This is significant for anyone who’s thyroid condition is not already properly managed. And, I’m not sure how long these studies were for. What’s to say that after a year doing this you might also see significant issues with TSH levels. This is the problem. We don’t know because as far as research studies are concerned, thyroid problems are well managed with levothyroxine.

For people doing alternate day fasts from 4 weeks to 6 months long, the amount of T3 in blood was lowered while TSH, again remained the same. Another study showed eight weeks of time restricted feedings for just 8 hours also caused low T3 and normal TSH.

One study in this review showed 6 months of alternate day fasting showed no effects on FT4 or TSH in those with subclinical hypothyroidism. For those that need a reminder, this is when you might be feeling like crap but your thyroid levels don’t present out of the standard lab range so they do nothing for you. This is also when working with a nutritionist is important. Another study though, showed that fasting during Ramadan caused subjects on thyroid meds to need their dose to be raised.

This information is from a review which is referenced on my website with the transcript of this episode in case you want to have a look for yourself. I did not look at the studies mentioned in this review at all. I’m just summarizing what the paper states. If I had a guess, I’d say the studies were not done on women for the most part.

In addition, according to Dr. Sims, intermittent fasting caused more oxidative stress in female subjects where the opposite was true for male subjects. It also slowed production of thyroid hormone and slowed metabolism. Slow thyroid and slow metabolism go hand in hand.

This is a problem for women because when we fast, our body hangs on to fat or tries to hang on to it by slowing things like thyroid and metabolism down. If you exercise and fast together, it makes this even worse. If you are overweight and sedentary, you may see a benefit for awhile at least on the outside but you could be really f-ing things up physiologically.

Same thing applies to the ketogenic diet, another very popular option for weight loss. According to Sims, women’s bodies use carbs to startt hefat burning process and women tend to already be physiologically set to burn fat for fuel but needs those carbs to get things going. She states in her book, Next Level, that the keto diet, even in the short term, may negatively affect bone health meaning causing bone loss which is not a good thing for those of us in post menopause. It might also mess with hunger signals making you feel more hungry and store more fat (another problem for menopause because our satiety signals are not as strong and we hang on to fat much easier). It can also increase cortisol levels which is closely tied to how well your thyroid works.

I hope you found this info helpful. The moral of the story here is not to jump on the latest and greatest health or diet bandwagon. Quick fixes are not long term fixes and they are not a magic pill. The best, most sustainable way to help your chronic health, your thyroid condition, is to make changes you can stick with for the rest of your life. That is what I am here for. You can schedule a discovery call on my website helpforhashimotos.com and we can chat and see if we are a good fit. You can also sign up for my newsletter and get Five Things Your Doctor Won’t Tell You About Hypothyroidism. I’ve been doing a series on mindful eating every Friday in my newsletter as well as a weekly recipe. I respect your inbox and strive to provide you with quality content.

Have a great week!

Welton S, Minty R, O'Driscoll T, Willms H, Poirier D, Madden S, Kelly L. Intermittent fasting and weight loss: Systematic review. Can Fam Physician. 2020 Feb;66(2):117-125. PMID: 32060194; PMCID: PMC7021351.

Kim BH, Joo Y, Kim MS, Choe HK, Tong Q, Kwon O. Effects of Intermittent Fasting on the Circulating Levels and Circadian Rhythms of Hormones. Endocrinol Metab (Seoul). 2021 Aug;36(4):745-756. doi: 10.3803/EnM.2021.405. Epub 2021 Aug 27. PMID: 34474513; PMCID: PMC8419605.

What do my labs mean?

Your lab tests are only as useful as their interpretation.  I may have told you to ask for certain labs or maybe you have read on the internet what the best labs to ask for are to figure out why your thyroid isn’t working well.

Maybe your doctor will order the labs you ask for but do they know how to interpret them beyond the standard lab ranges offered? Do you? Probably not. So you have all this information and no plan to get you feeling better.

I’ve even seen functional medicine lab ranges that are more narrow than the standard or conventional lab ranges not be good enough to figure out a problem. The reason behind that is that the functional lab companies are getting their ranges based on the people who are coming to them for tests.

What does this mean? It means that the sick people going to a functional medicine doctor to get their labs are the people who’s results are making the lab ranges. This is true for most labs.

Does that sound like a way to figure out whether or not YOUR labs are out of range or within range? They might be within range of a bunch of other people who feel like crap and don’t know why.

Basic blood chemistry labs like a CBC, CMP, lipid panel, iron panel, thyroid panel can be super helpful but also know that your symptoms matter regardless of what your labs say. The labs are a way to help put the pieces of the puzzle together.

Your symptoms are your body’s way of telling you something is up. They help gauge whether an intervention is working or not. I saw plenty of people who could not help my fatigue because they were not looking in the right place or they were trying to bandaid the symptoms without really getting at the root cause.

Today I wanted to share with you my old labs and how they were interpreted by my practitioners at the time and show you what was missed based on the scientific research based lab values I use.

I was looking in a file cabinet for some financial documents and then got side tracked with all the stuff that could be thrown out in the file cabinet and I came across a green folder with a hand written schedule of appointments for a plan I paid for through a certain chiropractic office. I dug into it and found so much stuff related to my health and trying to feel better over the years. I thought this would make a great podcast episode since many of you have been to multiple practitioners and still feel like crap.

I’m taking you back to 11/25/2011 which is the first wellness plan I found from the 1st holistic practitioner I saw. She was a naturopathic doctor and from what I can tell from my research on her, she was out of ND school/residency about a year or less when I saw her. She was a kind, passionate doctor. I saw her for a few years until it got to be too far of a drive and I still wasn’t feeling great. She was actually on to why I wasn’t feeling great and it was an emotional component I wasn’t dealing with and her suggesting we work on it scared me away. I quit working with her after that and kept looking for the magic pill with other practitioners and never ever felt quite right.

I remember one visit with her where I had brought her a list of supplements I was taking based on testing I had done in my nutritional therapy practitioner training and she said, “I don’t even know what to do with this.”. I could tell she was super annoyed and I get it now as a practitioner because when a client/patient is taking stuff outside of the protocol that was set for them it may or may not be detrimental to the outcome. Plus, you might also just be wasting your money.

Anyway, I went to her for fatigue, hypothyroidism, mood issues, blood sugar issues, and apparently heavy bleeding during my cycle- super heavy. I’m sure there was other stuff but I don’t have my intake form.

Any of this sound familiar to you?

She recommended to me before testing was done:

• Coconut oil for low blood sugar/shakiness

• Flax meal, 1-2 T daily (she suggested mixing in applesauce) all month

• Omega 3: super EFA liquid 1 tsp/day all month

• GLA: 1000mg flax and 1000mg EPO days 15-28

• Vitamin D3: start at 2000IU/day, get tested within 2 weeks

• Probiotics: HMF Neuro caps 1/day

• Acupuncture for mood support

• Labs to get: TPO Ab, Tg AB, FT3, FT4, TSH, rT3 ($155); 25 OH Vit. D, 22IgG Food intolerance test

• See a gynecologist to get pelvic/transnational ultrasound to rule out organic causes of heavy bleeding with menses

• Schedule next appointment in 6 weeks

I did some testing on 12/9/2011: Intestinal barrier assessment 22 IgG through Pharmasan Labs. Just for reference, I was 40 years old (I’m 51 now) and my kids were 11, 9, and 6. I was working as a social worker 20 hours a week and not a very happy person.

Results were:

• Intestinal barrier assessment showed a moderately leaky gut

• Food parameter summary/food sensitivities detected

  • Yogurt was high

  • Baker’s yeast, egg white, tuna, wheat were moderate

  • Cows milk, gluten, goats milk, oats, shrimp were low for presenting antibodies

• Vitamin D test was at 33.3 on 12/8/11 and she told me the range was 40-100

I saw her on 1/2/2012 to go over these test results.

The wellness plan was:

• Avoid yogurt, bakers yeast, egg white, wheat, milk, gluten, oats for at least 4 weeks. Then trial reintroduce the low foods one at a time in this order: oats, milk/cheese- wait at least 4 days in between reintroducing when not eating oats. So eat oats for 4 days, wait four days then reintroduce milk/cheese but don’t eat oats while doing that.

• Breakfast ideas: quinoa porridge, organic chicken sausage, avocado with sea salt, egg yolk

• Flax seeds 1-2 tablespoons/day all month

• Super EFA liquid 1 tsp/day all month

• GLA: 1000mg flax and 1000mg EPO days 15-25

• Vit. D: 10,000IU per day for one month, then reduce to 4,000IU/day

• B6 complex 1/day with breakfast

• Probiotics: HMF neurocaps 1/day

• Slow Flow- use day 1 of period 3 caps every 3-4 hours

• Progesterone cream: day 15-28, stop if period comes before day 28, 1 pump per day at bedtime

• Permeability complex II- 1 cap 2x/day with meals

• She will contact me with thyroid results

• Retest vitamin D in 3 months

• Pelvic/transvaginal ultrasound due to menorrhagia to rule out other causes before getting ablation

• Schedule next appointment in March.

• On the back of the plan was a drawing of leaky gut

The wellness plan for my next visit on 3/9/12 went like this:

• substitute sugar for yacon syrup, read labels and eat less than 20-30g of sugar per day and watch to see how skin reacts.

• Snack ideas: celery/nut butter, carrots/hummus

• Same supplements as before with addition of

  • orthothyroid 2 caps/day

• Remove IUD

• Next visit 8-10 weeks, discuss periods, skin

I’m missing a years worth of labs and wellness plans from her- I do remember her diagnosing me with Hashimoto’s after these thyroid labs were done so I was off to see about medication changes from my doctor because ND’s in MN cannot prescribe medication.

I got more labs done on 1/8/2013 from Pharmasan Labs. The panel was called the Endocrine Health Basic and it was a saliva test.

The cortisol test wasn’t horrible as far as results go- it was a little low in the morning and stayed below range until about 2 pm where it barely went within the range and then was a little high around 9pm. This is a typical pattern for someone with thyroid problems. According to the reference range, my cortisol was below reference range all day long- could be why I was so tired all the time and my blood pressure was super low (I was also freezing all the time).

DHEA was 274.5 with reference range for women at 57.0-615 so that was normal

Estradiol was off the charts low at <0.8 and it should have been between 1.0-14 according to the lab range.

Estrone was 0.8 and that was within the range for my age group.

Progesterone was 566 so high for the range of 38.0-462 but she had me on progesterone cream so I can only imagine that it was probably in range before that.

Testosterone was 26.2 which was also within this labs range.

I wrote her an email on 2/20/2013 saying i got a new presecription for thyroid meds with an increased dose. I got a referral to an endocrinologist which I did not use because I have not found them helpful in the past and they are more expensive to see. I was getting heart palpitations on my new medication so I was taking half a pill and working my way up to a full pill to let my body adjust. I told her I didn’t feel clear headed, probably brain fog, and I was super forgetful and having a hard time concentrating. I said, ‘my kids think I’m crazy’. I told her I was worried about taking a higher dose and asked if I should take it and see how it goes.

She replied that my thyroid needs more support so it might be worth trying to see how my body tolerates it. She wondered if there was something in the medication that my body didn’t like. I believe the real problem was that my cortisol was so off still, I didn’t handle stress well and my body was just responding to the T3 in the new medication. She suggested I ask my doctor for Westhroid or Naturethroid and to ask my pharmacist about the medication I was taking and why I might be having palpitations on it.

I do remember taking Westhroid and doing really well on it and then there was a shortage or whatever and I had to find something else. Story of my life!

On 10/25/13 I redid the Endocrine Health Basic lab panel

• cortisol was within normal range except at 8pm it was high at 3.3 and it should have been below 1.5. She told me to take magnesium at 7pm. I remember the first time I took a powdered magnesium in water. I felt a rush of calm over my whole body from top to bottom. That is the only supplement that has made me feel a physical difference.

• DHEA was at 58.6, remember last time it was in the 200’s. It was still within the normal lab range but much lower this time. My notes say DHEA is a counter balance for cortisol

• All the sex hormones were within the lab normal range. The healthy lab ranges I have are for blood and not saliva so I can’t compare the two. One thing to know is that even functional medicine labs are making their ‘normal’ lab ranges based on the results of people who use the lab. Who goes to practitioners who use ‘functional medicine’ labs? Sick people! I think my hormones were off because I was still a long ways from feeling good with severe mood swings, poor sleep, angry all the time, terrible blood sugar and more.

• I must have had a visit on or around December 4th 2013 because I got a wellness plan via email with 24 things on it

• Supplement protocol changed a bit- ground flax in applesauce was making me throw up shortly after taking it.

  • Floravital iron and herbs at 10ml per day to see if tolerated and reduce dose if it caused constipation

  • NO RAW brassica veggies or soy because they can interfere with thyroid function- we now know this not to be true unless all you ate was brassica veggies and nothing else in huge amounts every day.

  • Add a pinch of sea salt to my water

  • Cornus Sanguinea for autoimmune thyroid support 1 spoonful in the morning (I don’t remember taking this)

  • Adrenal support 2 caps with breakfast

  • EstroMend 2 caps with dinner for memory/estrogen support instead of Femmenesence Pro Peri

  • Take a break from Sepia 200ck for at least one month to see if PMS is manageable without it (she was throwing supplements at this mood problem and nothing was sticking)

  • Repeat thyroid labs in 5 weeks

  • Glutenzyme by Pharmax in case of accidental gluten exposure - at the time we were not sure if I had celiac disease because I never got tested. I felt so good off gluten I didn’t want to go back on to be retested. At this time I was very strict with avoiding gluten.

  • Exercise: do yoga and she wanted me to go to a Qoya class which was about a 40 minute drive for me from my house and I never went. I don’t like driving that far for a workout- even now, my gym is 5 minutes from my house.

  • Grounding/visualization: imagine roots growing from your feet that firmly connect you to the earth. I still do this when I feel stressed. She said the roots provide you with nourishment/energy and offer a way to release any unwanted energy back to the earth to transform it.

  • We discussed removing my mercury fillings from my teeth.

  • Return visit in 8 weeks.

The next set of labs is from 11/26/2014 so almost a year later. By this time I probably did have my fillings removed. I did 1/4 of my mouth at a time with a dentist who knew how to remove mercury safely.

By this time I had found an MD willing to treat my symptoms along with my labs and I don’t think I was seeing the ND anymore- she was too far away for me. That said, I was driving almost an hour to the MD but she took my insurance so the visits were way cheaper. I had also gotten my nutritional therapy practitioner certification by this time. The notes on the reason for the visit was that I was here to check on thyroid, I fell really good, not fatigued, sleeping 7-8 hours, feels well physically, stress is reduced, had heart palpitations when tried raising dose of thyroid meds last time. This doctor was the only doctor in her practice willing to use something other than levothyroxine to treat thyroid so I tread lightly with her in order to continue to get the meds that made me feel good. I’d also make a note that I was not feeling tired even though my iron levels were super low- I think this was attributed to being filled up with friends in a community of like minded people who I really enjoyed. I had previously lost a friend group in 2010 and had found friends through my certification program.

• FT3 2.0 (lab range 2.0-4.4) normal but low by my ranges

• FT4 0.74 (0.82-1.77) low by lab and my ranges

• TSH 5.070 (0.450-4.500) High by lab and my ranges

• TPO Ab 69 (0-34) high

• Tg Ab 1.0 (0.0-0.9) high

• RT3 11.4 (9.2-24.1) lab range only

Again, these are lab ranges here that are done on probably both healthy and sick people because it was the lab at the doctors office though some of this, like Reverse T3 and the antibodies may have been sent out to Quest diagnostics. Had my doctor used the ranges I have which are based on healthy people and from the research, it may have painted a different picture. Here I have low T3, low FT4 and High TSH which indicates I’m not making enough T4 and not converting it for whatever reason. My meds were raised.

Fatigue was back with a vengeance and by January 2015 I was going to a chiropractic office that had a medical doctor on staff. My hope was that I would be able to see the doctor and have him prescribe my meds. The funny thing is, I never asked the chiropractor if I could do that. I just assumed. When they presented their plan and the cost, there was no mention of the doctor. I figured out later, he was a place holder so they could do certain things in their clinic that needed an MD on staff. I don’t think he was ever there. I didn’t have my voice, I was too timid to ask about seeing the doctor.

So for this office, their treatment plan was for my complaints of low energy, anxiety, brain fog, constipation. Based on my history and his exams he recommended the Nutritional Function lab test, GI Effects Stool test, Cyrex Array 4 for food hypersensitivity with the knowledge that I may need further testing based on the results of these tests.

Their plan included 6 visits with the nutrition chiropractor and 16 visits doing oxygen therapy which was their fix for my fatigue. He put me on the Apex Energetics RepairVite Diet and their powder. I did feel really good after this diet but it was restrictive. They used the IFM MSQ each visit to see how things were either improving either for the better or worse. In 2015 this plan cost me $1235 after discounts.

They did a body composition by hooking me up to some electrodes and having me lay on my back for around 10 minutes or so. I got a super fancy report showing my BMI at the time was good. It also had something on it called phase angle and mine was low. This report indicated that that is consistent with cell death or cell breakdown which could very well have been the case. I was thin and tired and brain foggy. It is said to be a predictor of malnutrition and I do think at the time I was not absorbing nutrients really well. It also showed that I was about 31.4% body fat so likely losing muscle and what you might call skinny fat. All that from a really fancy nine page report.

I did have my blood drawn for a CBC at their clinic. They didn’t give me the actual results but a fancier paper with each marker, my lab value, functional ranges and laboratory ranges. The entire thing was highlighted line by line in green for normal, yellow for out of the functional range and red for out of the laboratory range.

This blood draw was from 2/24/2015 - I was originally going to go through each lab marker and tell you the differences between their lab range and my lab ranges but I think that is going to be too much so I’m going to skim over them. The point I’m trying to get across is that this chiropractor missed some things that I would catch with my lab ranges. These things would be minor for the most part and could be fixed with some diet changes and supplements.

They missed low albumin, high AST and ALT liver markers, low sodium, high CO2, high bilirubin, low glucose, high HBA1C, low HDL cholesterol, high iron, low ferritin, low neutrophils, and high lymphocytes. They had shown high monocytes and eosinophils where my ranges said they were normal.

When the lab ranges vary so crazily from lab to lab and practitioner to practitioner, things can get missed. The blood chemistry training I received from my former professor allowed me to get scientific research based lab values on healthy individuals that are sound with ranges tight enough that I’m able to catch things before they get bad so to speak. This lab also showed TSH was a little high and T4 was low which would indicate I was in need of an upped dose of medication which I could not get from them because their doctor on staff was not actually on staff.

I was more mad at myself about that whole doctor thing because I didn’t have the confidence to ask them about it. I was intimidated by the chiropractors for some stupid reason. Things would definitely be very different now- I have found my voice! I would have questioned them about seeing the doctor. I was just so desperate at the time.

They also had me do a Cyrex Labs Array 4 - Gluten Associated Cross Reactive Foods and Fodds Sensitivity which is for IgG and IgA antibodies. Nothing was out of range but soy and corn were considered to be just slightly out of the normal range. He put me on the RepairVite diet for 3 or 4 weeks then when my MSQ showed I felt really great he told me I could go back to my normal diet. That was it. According to him my gut was healed.

Next was a Genova Diagnostics GI Effects stool test. A huge fancy report with graphs and pictures in color on the first page that told me nothing. I had undigested fat in my stool and some species of bacteria were low. So the solution was to take HCL with meals.

They also did a comprehensive melatonin profile which came back normal. I think he did that one because I was so tired. Remember that they missed low ferritin which will make one tired so I think this test was a waste.

In April 2015 they had me to the Adrenocortex Stress Profile which is a saliva test. It showed my cortisol was high all morning and high normal in afternoon and normal at night. I think the stories in my head contributed to my stress levels. I was not a happy person and I was wound up pretty tight.

Once I was done with their program I told them I was still fatigued and they told me to go back to my doctor to have my thyroid checked. And that was it.

I was back at my doctor that took insurance in August 2015 and had a CBC done again. There was about a 5 months difference between the two labs and this one was showing anemia and likely micronutrient deficiencies. RBC, Hemoglobin and Hematocrit were all low and MCV was high by my ranges all of which indicated I needed some nutrients. I had my B12 tested too and it cam back normal by the lab range. I don’t have a different range for that but it would be interesting to dig through the research which I might do at some point. All of this would point to fatigue for sure but it was missed by my doctor.

Same doctor tested my thyroid on October 6, 2015. FT3 was normal (low by my range) at 2.0, FT4 was low by both ranges at 0.74, TSH was high by both ranges at 6.130. I was on naturethroid at the time and struggling with palpitations when the dose went up so this is when I started splitting the dose and taking it twice a day. When TSH and T4 are low it could mean an iodine deficiency (not likely though I was not eating a lot of processed foods and using sea salt), autoimmunity- so antibodies could be high, and there was likely less conversion of T4 to T3 because there was less T4. There was a definite thyroid gland dysfunction.

Fast forward to April 2017 when I had my blood and urine tested for life insurance.

By my ranges, glucose was low, BUN was low, Creatinine low, Uric acid low, bilirubin low, liver enzyme ALT high, AST high normal but better than the previous years labs, GGT low (indicated oxidative stress), protein low (low by their range too), albumin low, globulin low normal (low by their standards), calcium low, LDH low (indicative of glucose issues), HDL low (inflammation), cholesterol/HDL ratio leaning towards an increased risk of CVD. They missed a lot of stuff with their ranges and I got the best life insurance rating you can possibly get.

My latest labs were done at my last visit to get my prescription renewed. I’m grateful to have a quality nurse practitioner willing to work with me based on my symptoms. She is cash pay though so I do pay out of pocket every time I see her. She is also functional medicine trained. The first time I saw her, she had me do a Dutch test and a Cyrex leaky gut panel- that was around $1000 for the two tests. I didn’t learn much from either- stuff I kind of already knew. I also did a food sensitivity panel from Cyrex that came up positive for foods I had been eating a lot of and tuna and shrimp. Since those two were on that very first food sensitivity panel I did back in 2012 I wonder if there isn’t some significance to that.

I did a gut healing protocol- a mix of following her recommendations and my own gut healing protocol from my GI class. It worked. I have been able to reintroduce dairy on a limited basis, meaning I don’t eat it every day, and nuts.

Back to my latest labs- done in April 2022. I compared them to the labs I had done July 2020 which was fun for me given my blood chemistry background.

What was missed?

Everything came back normal according the the lab values from the lab which was Quest Diagnostics.

My lab ranges revealed some white blood cells were high indicating a potential for low cortisol, a virus, parasite, and general inflammation. My blood sugar was low at 70 but can be low if cortisol is low or in hypothyroidism. My HDL cholesterol was low indicating the need for gallbladder support and triglycerides were high which can be high if there is hypothyroidism or elevated estrogen. My cholesterol to HDL ratio was high which can indicate an increased risk for cardiovascular disease.

My calcium was low indicating potential need for getting more in my diet or poor absorption. It could also be a mineral deficiency but I can’t confirm that because the minerals were not measured.

Creatinine was low which would either be decreased muscle mass or poor protein intake. LDH was high which can be high with hypothyroidism and my TSH was 20.39, FT4 0.7, FT3 2.2.

Clearly my thyroid labs say I was hypothyroid which affected the results of my other labs.

Why was I so hypo? I forget to take my afternoon dose of NDT a lot. I retested in June of this year after being more diligent about taking that afternoon dose and my TSH was 0.44, FT4 1.1, and FT3 3.7.

Why did I share all of this with you?

So you know you are not alone on this journey. I get what it feels like to feel bad.

I’ve done the work to understand what your labs might be saying about what’s going on in your body and I can help you figure it out.

I also want to point out that a lot can change in a couple of months of giving your body what it needs or what it is asking for so one bad lab result does not mean you are doomed. That lab draw is just a picture in time of what is going on and retesting with the same labs after a couple months of changes can help me see if things are going in the right direction.

Let’s figure this out together. I am on your team.

Thanks for tuning in.

Should I take iodine to support my thyroid?

The short answer is no. Here’s why. 

It is considered a trigger for Hashimoto’s and for thyroid autoimmunity in general which would include Grave’s disease. There have been several large studies that show people consuming iodine have higher thyroglobulin antibodies. People who have iodine deficiency to begin with have a 4x higher chance of increasing their thyroglobulin antibodies when they take in more iodine. Just 500 mcg of iodine triggered or provoked autoimmunity in previously healthy people when iodine was added to the diet. 

If you have long term exposure to iodine, it can have long term effects on regulation of your immune system, again, triggering autoimmunity. 

Iodine increases oxidative stress and promotes inflammatory reactions. Oxidative stress and destruction of thyroid cells within the thyroid leads to your body’s inability to make thyroid hormones and leads to destruction of your thyroid gland over time. 

Some examples of what it looks like when you supplement with iodine are: 

1. You have high TSH and have hypothyroid symptoms so you supplement with iodine which causes destruction of the thyroid gland but will give you a normal TSH and improve your symptoms for a while. 

2. You have normal TSH and no thyroid symptoms but you are consuming a fair amount of iodine through your diet or supplementing (it’s in all processed foods). You get thyroid gland destruction which will raise your TSH and maybe cause you anxiety and insomnia. 

3. You have normal TSH (all of these normals are according to conventional medicine) and are on thyroid hormone replacement. You have no symptoms. You supplement iodine, you have destruction of the thyroid gland and you get depressed TSH (around 0.01), high T4 and T3 and you have hyperthyroid symptoms. 

4. You have normal TSH, no symptoms, positive TPO antibodies (called silent autoimmunity), you supplement iodine, thyroid is being destroyed, you end up with normal TSH, no symptoms and TPO antibodies become elevated. 

Iodine is a goldilocks nutrient. Your intake needs to be just right. According to Datis Kharrazian you need about a pin drops worth each day which amounts to about a tablespoon a year. That isn’t a lot. I guarantee you are getting much more than that in a year if you eat a standard American diet or take a thyroid supplement with iodine in it. So if you are taking a supplement with iodine, I might consider stopping it. If you are prescribed iodine by your doctor, I don’t even know if that is a thing, then I would not stop without talking to your doctor. 

Another study, “Effect of small doses of iodine on thyroid function in patients with Hashimoto’s thyroiditis residing in an area of mild iodine deficiency”, states that just 250 mcg of iodine to people with euthroid status (meaning their thyroid is working fine) but that had silent autoimmunity showed significant changes to their thyroid hormone function. One woman in this study had a TSH that went from 2.5 to 43.3 after supplementation. Most of the other people in the study saw their TSH double but antibodies were all over the place from a 900 point increase to very minimal proving that this disease and anything else in health and nutrition is very bio-individual or personalized. 

A study on salt content in Slovenia showed that when the iodine in regular table salt there was increase from 10mg to 25mg of potassium iodide per kilogram of salt their rates of Hashimoto’s more than doubled. 

It also has been shown to increase nodular goiter in people. 

Iodine restriction may be a way to combat some of the thyroid disease plaguing the world. One study on this topic showed that 78% of subjects had normal thyroid function with just restricting their iodine and had no need for thyroid hormone replacement in just 3 months. Restriction in this study was less than 100mcg per day. 

In subclinical hypothyroidism which is when you have high TSH but no symptoms, iodine restriction is thought to normalize or decrease TSH levels and these iodine levels are correlated with urine iodine concentrations. It is thought that iodine restriction could be a major or preferred treatment option for some people. 

Where do we get most of our iodine? 

• Iodized salt is probably the biggest and that is in every processed food that has salt as an ingredient unless it is specified. 

• Seasoning mixes made with salt or things like onion salt, celery salt etc. 

• Seaweed and the snacks made from seaweed

• Foods containing iodates, iodide, algin, alginates, carrageen, agar

• All processed bread products

• Milk (1 oz a day is allowed)

• Egg yolks

• Seafood minus freshwater fish

• Many supplements, especially multi vitamins and thyroid supplements

• Anything with Red Dye #3

• Most restaurant and processed foods

• Soy products: edamame, tofu, soy burgers

Goitrogens on the other hand, we have long been told to avoid and that may not need to be the case. 

A study on broccoli sprouts in thyroid patients found that it was completely safe for thyroid patients to consume. The thyroid was not negatively affected at all. In fact, in this study, the broccoli sprouts were shown to activate Nrf2 which protects us against toxins and oxidative stress related conditions. 

Bottom line for goitrogens from food are that they do not cause goiter or affect how much T3 or T4 is produced.  They actually increase our levels of glutathione, our major antioxidant and protect our thyroid from oxidative stress/damage. 

Goitrogens from chemicals do cause goiter and do negatively affect the thyroid and should be avoided when possible. These are things like PCB’s and Phthalates. So cleaning up your environment including getting rid of plastics might be helpful which I have talked about on the detox podcasts. 

So bottom line, consider how much iodine you are getting in your food. If you are not feeling well or you can’t get your antibodies down, you might consider a low iodine diet to see if it helps. We also need to remember that there is an ebb and flow to this disease. We will always have to mind things like stress and food in order to feel our best. If you are in a place where normal to you is tired, moody, stressed, irregular bowels please know that is not normal, that is your body telling you something is off. 

Did you know the average person sees a nutrition professional only 1.8 times? That statistic is very disheartening but I get it. Diet and lifestyle changes can be really challenging, especially right now. If you are the type of person who can take information and run with it, the Covid-19 special might be just what you are looking for. It is an exceptional value at $37. For that price, you get to take the state of the art Nutritional Assessment Questionnaire (NAQ) which will show me where your body is out of balance. This allows me to make a personalized protocol for you and your unique situation. 

This is for you if you need a boost in the right direction for your health, not if you are dealing with multiple chronic health conditions. Now more than ever, we need to take control of our health and well being and this is a great way to get started. Once you do, you will be invited to join Nutri-Q and take your assessment and fill out a health history. Then we will meet by phone or Zoom for 15 minutes to go over your results and discuss your plan. I look forward to working with you on your health journey. 

You can learn more at outofthewoodsnutrition.com and click on covid-19 special at the top. This deal is going away at the end of June so now is a great time to get a kickstart on your well being and feel your best. 

Take care. 

What do high TPO and TgAb antibodies mean when T3 and T4 are in range? Episode 47.

I was diagnosed with Hashimoto's Thyroiditis 2 years ago and I'm 26 years old, but I don't know how long I had it before it was detected. I found out by accident. I went in because I thought I had kidney problems, but the blood work came back it showed I had hypothyroidism. The TSH came back in the 400 range, but my T3 and T4 were in range. A dietitian came and told me that my condition could be "cured" through the AIP diet, so I gave it a shot. And then I gave up. I travel a lot and just moved to Japan (the move has been stressful and my hair has started falling out quite a lot). I also just discovered your podcast and it's blown my mind. I feel more motivated to try again, but it's difficult to communicate with Japanese doctors. I just got my most recent blood work back and my TSH is 9.413 (so the Dr increased my meds), the T3/T4 is still in range, but my TPO and Tg are super high. TPO is 198 and Tg is 954. My bf is super supportive and wants me to get into remission and I want to get off of the medication, but I'm not really sure how to start, especially since I'm a foodie and I'm in Japan with wonderful food available. I feel hopeful and discouraged all at the same time.

-Laura

TSH high

T3 in range

T4 in range

TPO and TgAb high

Thyroglobulin antibodies- TgAb: thyroglobulin is made in the thyroid and helps make thyroid hormone- a common trigger for Hashimoto’s. 

Thyroid peroxidase antibodies- TPO. This is an enzyme that is needed for the production of thyroid hormones and is often the first thing attacked in hashi’s. 

I found a paper (Woeber 2016) that said high thyroglobulin antibodies are used to diagnose cancer. These antibodies are found in blood tests in about 20% of patients with thyroid cancer that develops in the thyroid follicular cells.  Follicular cells use iodine in the blood to make thyroid hormones. 

Most thyroid cancer is what is called papillary cancer which grows slowly and develops in the lobe or one side of the thyroid.  Often the cells look normal.  

I might check with a doctor over there if possible to see if they can do some further testing just to be safe. 

A study in 2017  (Matana et al 2017)discussed diet and how it contributes to antibodies. They acknowledge that genetics play a pretty big role in thyroid autoimmune disease but environment also plays a role. 

What contributes to Hashimoto’s disease?

• Either too much or not enough iodine

• Smoking was a risk factor for Graves Disease but not Hashimoto’s.

• Selenium and Vitamin D intake or lack of intake

• Stress

• Nutrient deficiencies

• Infections/viruses

• Impaired gut function

• Low iron

• Adrenal fatigue

Being infected with enterovirus which is a common infection in babies and kids- runny nose, cough, feeling unwell, fever. 

The study pretty much bashes animal fats as something that increased antibodies but the study was done using a questionnaire- we don’t know the quality of the food and they are saying that it was an association and not a cause. 

The point of AIP is that it is anti-inflammatory and contains healthy fats. When I did AIP I didn’t eat enough veggies and sometimes I think that is where we go wrong with it. I think trying out AIP again would be good. 

I would not just go off your medication. There may be too much damage to your thyroid and you don’t want to end up with more damage to your body. I’m still recovering from going off my meds 4 or 5 months ago. I’m still really puffy and can’t get rid of the weight I gained from that. Plus it is dangerous. Your organs start to shut down. That is not good. 

So- do you know anyone in Japan? Having a support system will help. 

Start with one meal at a time. Avoid all the big inflammatory foods- I don’t know what the food is like over there. Maybe someone who is listening can help us out here. Send me an email if you know how you can help Laura navigate Japan. 

Take it one meal at a time. You need to get the inflammation down, calm down the immune system and figure out which foods, if any, are causing the antibodies to go up. 

You mentioned traveling a lot which makes me think maybe you got some kind of bug and that could be the trigger here. Until you can get to the root cause you need to calm down your immune system and the best and easiest way to do that is to remove those potentially inflammatory foods. 

Sometimes we need to take it one step at a time. Start by removing all grains and alcohol but add in some good healthy fats- coconut oil (not sure how easy that is to get there), olive oil, avocados, olives and if you like fish and get fish that is not contaminated from the radiation then eat fatty fish once a week. 

The next week remove legumes and nightshades and add in some soups and bone broth from pastured animals. 

The following week take out the dairy products if you have not already as well as coffee and chocolate. 

Then take out processed foods, refined sugar products, eggs and poor quality oils like vegetable oils and add in some fermented foods like sauerkraut or kimchi. 

Lastly, remove the nuts and seeds and add in nutrient dense meats like liver if you can tolerate it. 

Keep this up for at least a month and then see how you feel. You may want to continue eating this way for a couple months or more depending on how sick you are. 

You can begin to reintroduce foods when you feel like your body is ready. There are lots of resources online to know just how to do it, or in books but the basics look like this: 

Take just one food. Eat it 2-3 times in one day taking note of how you feel after you eat it up to an hour or two later. If you do okay- wait 4 days to a week before reintroducing another food and don’t eat any more of the reintro food for those 4-7 days. Be mindful of your well being during those days to see if you can attribute anything to the food. For example- I get pain in my right hip- almost like arthritis when I eat corn sometimes. But it is a trigger I can look for when eating something my body might not like- I think it is the oil the corn is cooked in rather than the corn itself but I’m not going to just eat a crappy oil to test it out. :) If you don’t have any symptoms, you can add that food back in to your diet and test out something else. If you have a reaction then don’t eat that food for awhile- like another month of healing and if you have a reaction give your body a good week or so to recover from it before you reintroduce anything else. 

Reactions to foods can come in many forms- your skin, your mood, your joints, headaches, digestion, poor sleep, extreme fatigue. Food journaling with your mood is a good way to track all of this.  

Some other things I would make sure you are working on are:

• sleep

• stress management- so meditation, connection, exercise (too much or not enough)

• spritual stuff- whatever that means for you

• get out in nature

I understand wanting to get off your medication. I wanted that so bad. You might be able to but if you can’t it doesn’t mean you are a failure. The medication we have to take is a hormone. We need it to survive. It is okay if you need it. 

If you want to go way out there though- check out the work of Dr. Joe Dispenza. He was in a terrible accident while biking and he crushed his spine. The doctors told him he would never walk again and he healed his injury with his mind. Now he travels around the world and teaches people how to use their mind to bring good into their life. That is some woo woo stuff but also pretty miraculous. 

And as far as I’m concerned, meditation of any kind is good for us and we really do become what we think. That is why I do this podcast. You don’t have to be victim to your disease. You have some choices in life and how you spend your time matters.

Thanks for writing in Laura, and if anyone out there can help Laura navigate through this while in Japan, please write to me and I will connect her with you. 

Until next week! 

Woeber, K. A. (2016). The Significance of Thyroglobulin Antibodies in Papillary Thyroid Cancer. Endocrine Practice: Official Journal Of The American College Of Endocrinology And The American Association Of Clinical Endocrinologists, 22(9), 1132–1133.

Matana, A., Torlak, V., Brdar, D., Popović, M., Lozić, B., Barbalić, M., … Zemunik, T. (2017). Dietary Factors Associated with Plasma Thyroid Peroxidase and Thyroglobulin Antibodies. Nutrients, 9(11).

Six types of thyroid dysfunction. Episode 39.

Welcome to Episode 39. I’m so happy you are here. 

I spend a good couple hours cooking several things last night so I would have food to eat over the next week or so. I’ve been trying to double up on meals when I cook so we have stuff to freeze for nights I don’t want to cook. 

I made two whole chickens on Sunday night so I had leftover meat for making soup and for putting on salads. I made a double batch of chili on Monday and Tuesday was a big batch of Thai Beef Stew, braised cabbage and I tried out a meatless dish of grape tomatoes, garlic, basil, chickpeas and spaghetti squash. If you tolerate legumes it was an okay dish. I was hoping for more flavor from the chickpeas. I just sautéed the tomatoes in olive oil, smashed them, added the garlic and chickpeas and sautéed a bit longer. Then I added the spaghetti squash and basil and mixed it through. 

We are having venison chops tonight with sautéed mushrooms and roasted cabbage. 

What are you making for dinner these days?  Head over to my website and comment on this post to let me know what your cooking. Look for Episode 39. 

Today we are talking about the six types of thyroid dysfunction that cause or result in hypothyroidism so let’s get started. 

The thyroid gland is super sensitive to any changes in the biochemistry in our body. It’s job is to perceive even the tiniest of changes in the body and make up for that by changing how much thyroid hormone is released in the body. 

This is one reason you can see such different lab values over time. 

When these changes in our biochemistry become something that is chronic or constantly happening in the body then there begins to be problems with the thyroid gland and the communication between the hypothalamus and the pituitary gland. 

Things like constant blood sugar dysregulation, constant or chronic inflammation in the body, deficiencies in nutrients, poor liver function, toxic burden, low stomach acid, intestinal permeability, poor eliminations and even the use of hormones including thyroid hormones can cause thyroid problems. 

Hypothyroidism or low thyroid function can fall into six different types. Some of these may occur at the same time, and it may be that only one of these will require permanent hormone replacement. 

1.Primary Hypothyroidism. 

This is when there is decreased hormone production by the thyroid gland. So it isn’t making enough T4 or T3. One cause and the most common cause in the US is Hashimoto’s. Worldwide the most common cause of Primary Hypothyroidism is iodine deficiency. (ref)  It is also caused by removal of the thyroid gland. 

This is a dysfunction of the thyroid gland and this is the one type of hypothyroidism that needs to be treated with thyroid hormone replacement. 

If you have Hashimoto’s, you may need medication due to the destruction of your thyroid gland but you also need to understand that this condition is an immune system issue first and a thyroid issue second. 

If you catch Hashimoto’s before too much damage is done, you might be able to support your thyroid nutritionally. Sadly, for me, I am still in need of medication.  If you do not have success bringing TSH down with diet and lifestyle changes, you will likely need hormone replacement. 

Your labs might look like this if you have primary hypothyroidism: 

• high TSH

• normal or low Total T4

• normal or low Free T4

• normal or low Free T3

• normal Reverse T3

2. Secondary Hypothyroidism

This deals with your thyroid not putting out enough thyroid hormone due to an issue in the pituitary gland. Remember that the thyroid is regulated by the pituitary gland and the hypothalamus. When these two glands are not communicating and the pituitary doesn’t secrete Thyroid Stimulating Hormone (TSH) like it is supposed to. You may find your TSH at or around 1.8 but still having symptoms of hypothyroidism. 

Chronic stress in the body is usually at the heart of this one. Stress fatigues the pituitary and it can cause a failure to signal the thyroid to produce thyroid hormone. 

Stress: too busy all the time, not enough sleep, living off of coffee and processed foods, inflammation, viral or bacterial infections. All of these will mess with your adrenal function and your thyroid function and remember those two go hand in hand.

You can also have low thyroid function after pregnancy. This is a stressful time for women who tend to be the ones suffering with most thyroid conditions. Pregnancy in and of itself will put a high demand on the pituitary gland. 

If your blood tests come out normal but your doctor puts you on thyroid medication anyway, it can help you feel better for a couple weeks but then you might start to feel worse. You can develop thyroid hormone resistance at your cells much like insulin resistance. 

So your cells are refusing thyroid hormone because there is too much in the blood and you might be given a higher dose making things even worse. You have all this hormone running through your blood so your pituitary gland gets a message it can stop making TSH or it just stops talking to the thyroid altogether. 

You might need medication after enough damage has been done between the communication of the pituitary and the thyroid.  

If you have Hashimoto’s but it doesn’t get addressed, this can become you.

Your labs might look like this: 

• 1.8 or less TSH

• 6 or less T4

• symptoms of hypothyroidism. 

3. Your T4 is not converting to T3

This happens when you have tons of chronic stress and high cortisol. So you are making T4 but your body isn’t converting it to T3 which is what your cells need. When cortisol is high, you will likely have some of this going on. 

If your body is dealing with infection or inflammation your cell walls can be damaged by that which also affects T4 to T3 conversion. 

You need to damper the inflammation or infection and support your body in dealing with cellular stress (free radicals). 

T3 levels won’t affect your TSH so your labs might look like this: 

• Normal TSH

• Normal Total T4

• Normal Free T4

• Low T3

• Low Free T3

• Low or normal Reverse T3

4. Your conversion of T4 to T3 is too high.

This would mean you have too much T3 being made and you also have less thyroid binding globulin (TBG). 

Too much T3 will overwhelm the cells and you find yourself in thyroid hormone resistance again. It is common in women with insulin resistance and PCOS. It is often caused by too much testosterone in the body.  If you have developed Type II Diabetes and are taking insulin for this, you may also find yourself in an over conversion of T4 to T3.

If you are using a testosterone cream you can over convert T4 and T3. 

You will have hypo symptoms with this one. 

A big help here will be to reverse the insulin resistance to reverse the thyroid hormone resistance and begin to feel better. 

You may have labs that look like this: 

• Normal TSH

• High or high normal Free T4

• High or high normal Free T3

• Normal Reverse T3

5. High Thyroid Binding Globulin

Thyroid Binding Globulin is a protein that carries thyroid hormones to the cells so they can use them.  You can develop antibodies to this protein in Hashimoto’s. 

You can find yourself in this situation if you take hormonal birth control or estrogen replacement therapy. 

If you are on birth control, you may have high levels of estrogen you will make too much TBG and thyroid hormones are carried to the cells on TBG so if you have too many TBG proteins in the blood bound to them, you can have less thyroid hormone getting to your cells. 

You have to work to get the excess estrogen out of the body. 

Your labs might look like this: 

• Normal TSH

• Low Free T4

• Low Free T3

• Normal Reverse T3

6. Thyroid Hormone Resistance

Again, similar to insulin resistance with a root cause being stress. Your pituitary gland and thyroid gland may be making just the right amount of hormone but it just isn’t getting into the cells. It feels like hypothyroidism to you and it is the high amount of cortisol in your body that is causing your cells to resist the thyroid hormone. 

You absolutely must manage your adrenals with this one. 

Your labs might look like this: 

• Normal TSH

• Normal Free T4

• Normal Free T3

• Normal Reverse T3

You have to make sure your labs are being tested regularly in all cases. 

Ok. That’s it for me. 

I want to remind you all that I have openings in my practice for a few more clients right now so if you are needing help navigating diet and lifestyle changes head over to Help For Hashimoto’s and fill out the contact form. You can also get my report on Five Things Your Doctor Won’t Tell You About Hypothyroidism. 

One last thing, part of the diet and lifestyle changes are to look at what you are putting on your skin. I found Beautycounter to be a trusted source for skin care and make up for me. They ban over 1300 chemicals in their products while the US only has a ban on around 30 ingredients. So, you don’t have to think about safety with their products and I really like that so I became a consultant last year. I don’t work too hard at selling it because my focus is really on nutrition but if you have any interest in checking them out go to beautycounter.com/stephanieewals to shop. I would sure appreciate your support. 

I’m still on a social media break and have no desire to get back on anytime soon. I’m checking the Help For Hashimoto’s facebook group once a day. You can join that if you would like but all the action is in the newsletter which you can sign up for on my website. 

I’m grateful to you all. Please leave me a rating and review on iTunes so more people can find the show and get help. 

Until next time. 

Your immune system and Hashimoto's; Adaptive vs. Innate immunity in Hashimoto’s. Episode 38.

Welcome to episode 38.

I am 3/4’s the way through a year of podcasting. Thanks for sticking with me and hanging out. I really appreciate it. My end goal is to help as many people as possible have a great quality of life with autoimmune disease.

You can help me with that by sharing this podcast with people you know dealing with thyroid issues and by leaving a rating or a review. I have enjoyed reading the reviews and honestly avoided them for awhile because I didn’t want to see if there were any bad ones. Thankfully there weren’t any. Anyway, I am grateful to those of you leaving reviews. 

Someone in Denver who rides the train to work listens and I want to thank you! I do this for you! So you can begin to feel your best. 

I’ve had a busy week and didn’t do so well with eating enough last week. I had not prepped any food which always makes for days where I just skip a meal which is so bad for my adrenals and my blood sugar. My blood sugar is so sensitive which I think is keeping me from losing the 5-10 pounds I have gained over the last year or two. I have not done anything different with my diet but menopause and insulin resistance have made of mess of my body. I have regularly done the autoimmune strong workouts over the last month- I’m getting them in at least three days a week. I hate working out but I want to be strong as I get older so I just do it anyway. 

I ate out a lot this past weekend but we are so fortunate to have some really cool restaurants that serve at least Paleo type foods. I had a green curry with pastured chicken and organic veggies twice in the last week from a great restaurant called French Meadow in Minneapolis. They have a lot of gluten free options which is so nice and the food is good. It tastes like it is made from scratch.  

I had a yucca crust pepperoni pizza with a cheese made from pumpkin seeds and a chicken curry dish to bring home from another place called Sassy Spoon. They are 100% gluten free which is nice. They are another from scratch type restaurant. 

This weekend I was at a party for a family member and there were gluten free cookies for dessert and I had at least one whole cookie if not a little more. I could feel the effects of that right away on my neck and my face began to itch like crazy. So, despite wanting to devour a ton of them, I didn’t. I didn’t want to suffer the physical consequences. That party had a taco bar with corn tortillas but I skipped the tortilla and just had the meat, lettuce and guacamole with a little salsa- so basically a taco salad. Pretty easy to modify that one if you can tolerate tomatoes. 

On Saturday morning I made my breakfast soup and chicken and veggie stir fry with lots of garlic to eat for the week. As long as I have food to eat during the week, every thing seems to go better for me. My moods are better, sleep is better, energy is better. It is just a matter of taking the time to make the food. 

Monday I ate at a place called Foxy Falafel which even has Autoimmune Protocol menu items. I tolerate chickpeas so I had their falafel which is such a treat. We even got their egg free, gluten free, dairy free brownie and chocolate chip cookie. I over indulged but I have not been to that restaurant in 2 ½ years so it was okay with me. They also sold Hu chocolate which is pretty darn good. 

After all that indulgence over the last week, I filled up on my green juice made in my vitamix which consists of a lemon, 2 stalks of celery, ¼ of an english cucumber, a handful of parsley, water and ice. I always feel really good after drinking that and it kickstarts my digestion for the day. 

Sauerkraut has been in regular rotation too. That helps my digestion work better as well. We have our old refrigerator full of it and everyone complains about the smell. It is sort of infiltrating the whole refrigerator. I love it! 

I’ve been doing hamburger patties on a bed of lettuce too. Quick and easy. 

Okay- let’s get started on todays subject. It is an important one to understand because it plays a big role in your autoimmune disease. 

Today we are talking about your immune system and Hashimoto’s. This episode has some scientific terms in it but I think I have broken it down to make it easier to understand. It is important for you to know how your body works and the immune system is a pretty big deal.

It is our biggest line of defense with many kinds of cells, antibodies, proteins and chemicals all working together like a country’s military defense system works to protect a nation. 

The immune system is divided in to the innate immune system aka the non-specific immune system. This side of the immune system is highly involved in inflammation- like when you hurt yourself and you get a bruise or a bump. When you cut yourself and the area gets all red and becomes scabbed. The job of the immune cells in innate is to keep pathogens out. It acts quickly and does not specify or target any one thing. For the most part, it cannot tell the difference between an invader, damaged cells or healthy cells so healthy tissue sometimes gets damaged. So if you have chronic stress causing inflammation or some kind of infection that won’t go away, this side of the immune system produces chronic inflammation. 

The other side of our immune system is the adaptive immune system which is very specific about the attacks it launches. We will talk a little more about this side in a minute. 

Your immune system needs to be regulated in order for your Hashimoto’s disease to be managed. 

Our immune system is on guard for antigens. Antigens are toxins or other foreign substance which causes an immune response in the body and can create antibodies against it. 

Things like a specific food, mold, bacteria, a chronic virus such as EBV or a parasite. These things irritate the immune system leading to an attack.  Now in Hashimoto’s, gluten is a big antigen which induces an attack on the thyroid gland every time you eat it. Remember that gluten is a protein found in all grains to some degree but the biggies that can be more of a problem for most people are wheat, barley and spelt. 

You can also have an immune response to environmental chemicals or heavy metals but not everyone will develop an immune response to these things.  You might be someone who doesn’t have a huge heavy metal burden or you just don’t react to foods. The exception would be gluten and possibly dairy because the proteins are similar to those of your thyroid so I always recommend people remove those two things from your diet. 

Your immune system might be reactive to bacteria. Many people with Hashimoto’s have antibodies to the bacteria Yersinia enterocolitica. 

Whatever your issue is you need to remove the antigen either by removing the offending food, detox the heavy metal or get rid of the bacteria to calm the immune system and manage Hashimoto’s. 

When dealing with autoimmune disease and specifically Hashimoto’s we want to look at TH-1 and TH-2 cytokines which can be high while T-suppressor cells will be low. 

A cytokine is a category of tiny proteins that work to signal cells of the immune system and are produced by cells in the immune system and a number of other places. They have many jobs in the body one of which is to work with the immune system to protect us. 

T-suppressor cells are also known as regulatory T cells which work to modulate or regulate the immune system and help us maintain tolerance to antigens against our self which helps prevent autoimmune disease. The T regulatory cells are immunosuppressive- they suppress the immune system. 

So, if we have high cytokines and low T-suppressor or T-regulatory cells then you have an immune system that is all out of balance and giving you symptoms of Hashimoto’s and maybe even causing destruction to your thyroid gland. 

Now let’s look at TH-1 and TH-2 cytokines specifically because most of us fall in to either TH-1 dominance or TH-2 dominance. 

TH-1 are T helper cells involved in an innate, or immediate immune system response. This is the adaptive immune system which is a part of the immune system that creates memory after dealing with an antigen. This means it will always remember that particular antigen whether it is a food, mold, heavy metal or parasite or bug. Every time that substance enters your body your innate/adaptive/acquired immune system will attack. It is very specific about what it reacts to. This is the part of our immune system that, once we have measles, will protect us from ever getting it again.  It is the line of defense against the pathogens.  

Sometimes it doesn’t distinguish the difference between an invader from non invader when it enters the body. It gets confused which can result in things like hay fever, asthma or an attack on the thyroid. 

When you have TH-1 dominance your immune system is overactive in the TH-1 pathway.  The majority of people with Hashimoto’s have TH-1 dominance but there are some Hashimoto’s patients with TH-2 dominance. 

You might also switch back and forth between the two depending on what your body is needing or getting too much of. Maybe you are deficient in some minerals or or getting too much of a mineral. These can trigger either TH-1 or TH-2 dominance. 

The best way to manage this is to focus on the whole body. Reduce inflammation throughout the body. Remove the triggers for your immune system. 

Once you have an autoimmune disease, you can put it in remission but you will have it forever and will have to work to manage your diet and lifestyle so your immune system can relax a bit. You must restore balance to the body. 

High TH-1 or TH-2 immune cells block thyroid receptors on your cells so your thyroid hormone cannot get in and do its job giving you symptoms of hypothyroid. 

Type 1 Diabetes, Hashimoto’s, MS and chronic viral infections are associated with TH-1 dominance. 

Lupus, dermatitis, asthma, and chemical sensitivities are mostly associated with TH-2 dominance. 

This is not always the case- remember that. As with everything there are exceptions. 

TH-2 are T helper cells involved in a delayed immune system response. Helper cells work to direct immune system activity as do the regulator cells and suppressor cells stop an immune reaction when needed. 
There are some different ways these immune cells could be affecting you. 

• You might not make enough of the T-suppressor cells that regulate your immune system and tolerate antigens. Not enough T-suppressor cells keeps the immune system on high alert and attacking self. Your thyroid gland can be a victim of this problem. 

• Maybe you make too much of the chemical messenger Interleukin-2 (IL-2) that tells other immune cells to attack and kill an invader. Too much of this one puts tissue not involved in the attack at risk of being an innocent bystander that gets attacked. 

• You might make too many Interleukin-4 (IL-4). This releases B cells that look for intruders and mark them for death. Again, here your thyroid tissue can be damaged. 

• Not managing your blood sugar or not being able to handle increases in insulin due to consuming sugar and refined carbs can send those B cells in to over production. 

• Having food sensitivities and eating those foods anyway or dealing with a parasite will increase Interleukin-4 and increase production of the B cells. 

• A chronic virus such as EBV will increase the Interleukin 2 creating more natural killer cells and cytotoxic T cells. 

Let’s get to know what these terms mean. 

Interleukin- these are a type of cytokine. Cytokines are chemical messengers within the immune system cells. Some cytokines kill pathogens on their own. 

B cells- a white blood cell that is circulating in the body and is on the lookout for for antigens that they have antibodies to. When these cells activate, they are quick to divide and grow. Some of these have memory and will forever recognize an antigen when it enters the body. 

Natural Killer cells- white blood cells that go to an infection site to destroy cells infected by a virus. They play a role in the adaptive immune system having a memory to viruses. They do not need to be activated to kill cells in the body. 

Cytotoxic cells- T cells that attack cells infected with a virus and certain bacteria. They release chemicals called cytotoxins which cause infected cells to die. 

Our ultimate goal here is to bring the immune system back in to balance. 

You need to support your immune system and you can start with Vitamin D in the form of cholecalciferol. This specifically supports the T regulatory cells so they can do their job right. Remember these are the ones that help regulate the immune system. 

Make sure you are taking an emulsified version which means it is mixed with some kind of oil so that your body can use it. Poor quality vitamin D supplements with be mixed with soybean oil or with canola oil. Look for one with MCT oil (a form of coconut oil) or I have seen them with olive oil too. Biotics makes a nice one called Bio-D Mulsion Forte. 

Fish oil will also support the T regulatory cells but taking any fish oil in large amounts isn’t a good idea. 

There are some studies to show that people with Hashimoto’s are not able to process vitamin D naturally so they may need higher amounts than the average person. If you have a Vitamin D test that shows normal levels yet your immune system is still struggling and you are doing everything else right to reduce inflammation and immune responses you may think about raising the amount you take. Having high normal levels is best for thyroid patients. 

You may need a therapeutic dose and should have your levels checked by your doctor once a year or more to make sure you don’t over do it. 

Excess vitamin D can cause calcification of the heart, kidneys or lungs and you can have too much calcium circulating in your blood. 

Glutathione (a big antioxidant in the body) in a cream form and superoxide dismutase (an enzyme that acts as an antioxidant to protect your cells). These will both help regulate the immune system. 

Don’t waste your money just trying these to see if they help. Work with someone who can first help you get your diet and lifestyle dialed in, get your digestion working well and making sure you are able to digest fats and absorb vitamins and minerals. 

Back to TH-1 and TH-2 Dominance. It is helpful to know which way you go here so you can know which things will continue to stimulate your TH-1 or TH-2 cells. 

Things that stimulate TH-1: Echinacea, Maitake mushrooms, glycyrrhiza from licorice (so if you take licorice for adrenal health and you feel worse because of it then it could indicate TH-1 dominance), lemon balm. 

Things that stimulate TH-2: caffeine, green tea extract, grape seed extract, pine bark extract, white willow bark, lycopene (found in tomatoes) , resveratrol. Taking any of these will stimulate the immune system further and cause you to feel worse. 

Again, work with someone who can help you with monitoring these things. 

Things that regulate TH-1 and TH-2:  probiotics, vitamin A, vitamin E and colostrum. 

Things that quiet interleukin one that would activate TH-1 or TH-2: Boswellia (frankincense is a species of the Boswellia species), pancreatic enzymes (often sold as digestive enzymes), Turmeric or its compound curcumin. 

It is probably best if you have some sort of immunologic testing done to find out if you are TH-1 or TH-2 dominant before messing around with the things mentioned, aside from Vitamin D. 

You also will want to work on diet, keeping your blood sugar stable, get your adrenal health dialed in and make sure your digestion is working top notch. 

After all of this is completed and you know where your body stands, where your immune system stands then you can work to find those specific antigens, the things triggering the immune response. A gluten free diet is very important because gluten is one of those foods that is inflammatory as I stated in the beginning. 

Healing leaky gut or intestinal permeability will be important too but we can discuss that in another podcast if I haven’t covered it. I don’t remember what I did yesterday hardly and being 38 episodes in, I cannot remember from week to week what I have covered. 

Thanks so much for listening. Again, if you could leave me a review on iTunes, I would really appreciate it. 

I am on a social media break and not sure when to return. I am checking the Help For Hashimoto’s facebook group once a day, otherwise I’m avoiding all social media.  

If you have a question, you can email helpforhashimotos@gmail.com or you can go to my website and fill out the contact form. 

Have a comment or question about this episode? Leave it on the blog post on my website helpforhashimotos.com under episode 38. I’d love to hear from you. You can also get my free ebook 5 Things Your Doctor Won’t Tell You About Hypothyroidism while you are there. You’ll get a weekly recipe and some nutritional nugget of information each week. 

I’m taking new clients right now so if you are in need of help navigating your autoimmune disease and especially Hashimoto’s, I am here to help. You can reach out to me on my website. You can make an appointment for a 15 minute free call to see if we are a good fit for working together. 

Until next week my friends. 

Can Hypothyroidism affect your heart? Episode 37.

Welcome to episode 37. Thanks for joining me. Today I am diving in to our heart health and what it means to our heart health when we are dealing with hypothyroidism. 

Do you have: 

High or low blood pressure?

Fast or slow pulse?

Irregular heartbeat?

Heart skips a beat?

Palpitations

High cholesterol?

Heart Disease, plaque buildup, heart attack?

These are all things that can be affected by thyroid disease. 

Our heart uses thyroid hormone. Our heart is affected by changes in our medication or by the amount of medication we are taking. It is affected by low levels of T3. How many of you have a doctor that will only test TSH? 

This could be affecting your heart. 

When you don’t have enough thyroid hormone your heart can beat too slow or it can beat irregularly meaning it can flutter or miss beats. Long term consequences of this is that your tissues don’t get enough oxygen or nutrients which will make you feel physically bad. Our heart and the entire cardiovascular system is dependent on adequate levels of T3 for proper function. T3 helps improve how the heart contracts so when you are low you will have less cardiac output. Cardiac output means the amount of blood the heart pumps through the circulatory system in one minute. 

You can also end up with plaques developing in your arteries and high blood pressure. Hypothyroidism can effect how blood is pumped in and out of the heart, how the lining of the arteries functions, cholesterol levels in the blood and more. Low T3 can increase the amount of cholesterol and fat circulating (technically called lipids) in the blood.

T3 is the main regulator of gene expression in the heart muscle. Gene expression means how genetic information is transferred in the cells of the body. It is the effect of a gene on the body.  It is thought that low T3 levels are associated with increased death in patients already dealing with heart disease. 

Hypothyroidism is associated with higher cardiovascular risk factors. This means that we have a higher chance of cardiovascular disease. The heart cells do not convert T4 in to T3 very well if at all so if T3 is low then the heart tissue feels the effects and doesn’t function as well as it should. 

Treatment with thyroid medications is supposed to improve all risk factors but the problem is if you are treated with T4 only medication and you are not converting T4 to T3 for whatever reason, you may be at higher risk for issues with your heart. 

There are not a lot of randomized controlled studies in this area but hopefully some will be done soon. 

Bottom Line:  Hypothyroidism affects the whole body. It has a negative impact on the heart and almost everything else when it isn’t treated. 

You might hear from your doctor that NDT like Armour or Westhroid etc will cause a high heart rate. If this is the case for you then you must look at your adrenal health and/or iron levels. If you have high reverse T3 which is usually the case with cortisol or iron problems or even chronic inflammation you can see an issue with your heart rate.  You could have a high heart rate if you are having a flare up of Hashimoto’s where tissue is being killed off and thyroid hormone is being released. 

If you think your medication is causing heart palpitations, discuss it with your doctor and you may also want to try to take it in smaller doses. I am currently on Armour which my body doesn’t love as much as the compounded thyroid powder so when I take one whole pill I get palpitations throughout the day. I have to take half a pill 4x a day to get my body used to it. I also have adrenal issues and low iron which is not super responsive to iron supplementation so once those things are fixed, I should be good. 

OK.  I want to explain more about heart disease so you know what you are dealing with and how you can optimize your life choices so you can give your heart a fighting chance. 

Heart Disease or Coronary Heart Disease are conditions that affect the heart muscle, valves or rhythm. 

Cardiovascular Disease are conditions that affect blood vessels- usually that they are narrowed or blocked which can lead to a heart attack. 

Heart disease is caused by atherosclerosis- a disease of the arterial wall that leads to the narrowing and obstruction of the artery. The narrowing is because of sclerotic deformation of the artery and the development of raised patches called atherosclerotic plaques in the inner lining of the arterial wall. Depending on which organ in the body the artery feeds, atherosclerosis in those arterial walls will impair blood flow to that organ. 

The two major types of Coronary Heart Disease are angina pectoris and myocardial infarction (heart attack). 

AP happens when the space inside the coronary artery is narrowed but not closed off completely.  At rest your body will be able to deal with less blood flow but any physical activity will cause the heart to have to work harder, the artery with the build up can’t supply enough blood to feed the heart muscle which can result in a gripping chest pain that can radiate to the neck and usually the left arm. 

Heart Attack or MI happens when the coronary artery closes up all the way and blood flow to the heart muscle stops. This causes a portion of the heart to die or causes death. 

About half the people who have a heart attack die in the first 2-3 hours and if you make it through a heart attack will take some time to recover and may suffer complications such as an abnormal heartbeat. 

How do we prevent these conditions?

We first prevent the build up in our arteries- the atherosclerosis. 

We avoid: smoking, obesity, diabetes, high blood pressure, physical inactivity, stress, anxiety, anger and the big ones- poor sleep and the standard American diet (SAD). 

For 60 years or more we have been told to avoid fat and cholesterol in our diet. To eat margarine and cook with vegetable oils. That we need to be on statin drugs to manage our cholesterol. 

We can thank the Diet Heart Hypothesis which states that dietary fats, including cholesterol, cause heart disease. A correlation was shown in a diagram of 6 countries (carefully selected out of 22 countries that had the same data available) that fat consumption and death from heart disease were related. When all 22 countries were put in the diagram the correlation between fat and heart disease wasn’t plausible. It actually shows there is no correlation at all between fat consumption and dying from heart disease. 

A lot of money was thrown at scientific research in the US to prove this correlation to be true. The data that did not support the hypothesis was thrown out and the data that did was promoted and advertised. Studies in other countries that were done were proving this hypothesis to be wrong. 

Many of the studies proving the correlation between dietary fat and increase in heart disease or death were funded by companies that proved to benefit from this idea that fat is killing us. We were being sold a false bill of goods and we have been believing it and paying for it with our health for years. 

Is cholesterol really a bad thing?

The short answer is no. 

The longer answer-  We will die without cholesterol. Our bodies are made of billions of cells and almost every one of those cells produces cholesterol all the time. Why is this? Every cell uses cholesterol for structural integrity. 

Saturated fats and cholesterol are used by our cells to make the cell walls firm. If they are flabby and fluid we would be structured like a worm. 

Cholesterol is needed in different amounts all over the body depending on the purpose or function of the cell in that area. 

Protective barriers like our skin will have much more cholesterol because we need a strong sturdy barrier to protect us from any invasion. If a cell needs to be softer and more fluid it will have less cholesterol. 

Our cells communicate with each other and and transport molecules in and out of the cells-they need cholesterol and fats to do that. 

Our brain uses about around 25% of all the cholesterol in our body. 

Most of the cholesterol in our body does not actually come from the food we eat. Many studies have been done to show that dietary cholesterol does not have a huge effect on the cholesterol in our blood. 

Our body was made to make it on its own. It makes about 85% of our cholesterol and the rest comes from food. When we eat more foods containing cholesterol our body makes less of it. We eat less of it, our body makes more. 

Low cholesterol has been shown to produce emotional instability,  problems with behavior, aggressiveness, violence, low self control and more.

Sex hormones are made from cholesterol too- low libido, adrenal issues, high or low estrogen etc. 

Our liver produces much of our cholesterol and regulates its levels. 

When our skin is exposed to sunlight, we make vitamin D from cholesterol. 

Why do some people have high cholesterol and others don’t? Why will it be higher when we are under stress or have surgery? Why is it higher in winter and lower in summer?

Cholesterol plays a healing role in our body. It goes up when we need something to be healed. It’s higher in the winter because we have less sun exposure. 

Damaging molecules end up in our blood stream and we have this layer of cells in our blood vessels that can be damaged by things going through our blood. These cells send a message to our liver that there is damage. The liver makes cholesterol and sends it to the damaged area in the form of LDL cholesterol to repair the damage. Once the damage is repaired/the wound is healed it goes back to the liver in the form of HDL.

If you have high LDL cholesterol you should be asking, what is causing damage in my body instead of how do I lower my cholesterol. Get to the root of the problem and the cholesterol will take care of itself. 

Atherosclerotic plaques in your body are sources of inflammation in the body. Inflammation is the way our body responds to any injury. It is there to get rid of whatever is causing the problem so the body can begin to repair itself. 

Plaques in your arteries are the body's attempt at dealing with chronic, never ending damage that has been done to the blood vessels. The body is basically forming scar tissue in your arteries. 

What causes all of this?

Processed foods is a big one, poorly managed blood sugar and sugar in the diet in large amounts. Remember that women should only have around 22grams of sugar per day and men should only have 24 grams per day. High blood sugar on a regular basis creates an inflammatory environment within the body. 

Really quickly- some other things that cause inflammation in the body are the chemicals in products we use everyday- personal care products, household products, prescription drugs, exposure to smoke and pollution, pesticides, chlorine, microbes and parasites and even disrupted gut bacteria. Certain nutrient deficiencies, lack of sun exposure, no exercise and high stress are also big problems for our health in general but also in managing inflammation in the body. 

How do we manage to have good heart health and good cholesterol?

Consuming high quality healthy fats: 

Note it is NOT any particular fat that is good or bad but the way it is processed that makes it bad for us. 

The types of fats we need to know and understand: 

Saturated fat: a stable fat, doesn’t go rancid easily and our body can make it so it is considered non- essential. It is usually solid or semi solid at room temperature. 

Monounsaturated fat: pretty stable fat, won’t go rancid easily, our body can make it so it is considered non essential. Liquid at room temperature but if refrigerated should become somewhat solid. Found in olive oil, olives and oils from almonds, pecans, cashews, peanuts and avocados. 

Polyunsaturated fat: very unstable, goes rancid easily, never heat them or cook with them. Always in a liquid state, even if refrigerated. Two of these are considered essential meaning we have to get them from the diet. Flax and other seeds, nuts and fish and fish oil. Omega 6 and 3 are from these types of fats. 

All fats and oils are a combination of these three types of fats. They are categorized by which fat is most prevalent. 

We need all three types of these fats in order to have proper function in the body and to make sure that we can manage any inflammation in the body. 

We must have good digestion, proper liver function, zinc, magnesium, vitamin B6, vitamin E and C in order to have proper repair of inflammation in the body. 

Consume a mixture of about 30% saturated fat, 10% polyunsaturated fats (Omega 3 and 6) and 60% monounsaturated fats like olive oil as a very general guideline: 

• Animal fats from pastured, well raised animals if possible

• High quality butter such as Kerry Gold, Organic Valley or a locally made butter

• Ghee which is the butter fat with the whey removed- used in Indian cooking a lot

• Coconut or Palm Oils

• Cold Pressed extra virgin olive oil

• Other cold pressed oils from nuts or seeds

Cold pressed oils are expensive and more difficult to make. They are the most fragile oils as they are easily damaged by light and heat. They are the seed oils and oils made from nuts. Canola oil is a seed oil and is processed with high heat, chemicals and is a rancid and damaged oil before it hits the grocery store shelves where it then sits on a shelf exposed to light all day long- remember seed oils are polyunsaturated and are damaged by light and heat. 

Avoid hydrogenated fats, partially hydrogenated fats and those highly processed “vegetable” oils and of course trans fats. 

Other things that can be helpful: 

Vitamin C can help the body repair itself when under stress or when other factors are present that might otherwise cause damage to the lining of the blood vessels. Best choice is whole foods that are high in vitamin C (listed in order from highest amount of vitamin C per serving to lowest) like papaya, bell peppers, broccoli, brussels sprouts, strawberries, pineapple, oranges, kiwi, cantaloupe and cauliflower. 

Staying well hydrated will keep your blood free flowing and thinner. The thicker and more viscous your blood is, the more damage can be done to the lining of your blood vessels because there is more friction. Aim for about half your body weight in ounces a day but no more than 100 oz a day. That is a lot of water and even I find it tough to get that much water in each day. 

Cardio Protective Nutrition: 

• Consuming and digesting animal proteins which are the best source of vitamins A, D and the B vitamins. 

• Again, vitamin C

• Potassium- helps us maintain healthy blood pressure. Fruits and veggies in general but Swiss Chard has 1000mg of potassium per serving. Recommended amount is 4700mg per day. 

• Fill your dinner plate (and lunch and breakfast plate) with vegetables, especially cruciferous veggies like broccoli, cauliflower, cabbage, brussels sprouts

• Consume wild caught fish, pastured eggs

• Fermented foods like sauerkraut, kimchi, fermented pickles, miso or natto

Lastly, high cholesterol in the elderly population is associated with longer life and life expectancy in general increases with higher cholesterol. Cholesterol is protective against infections, lower cholesterol levels associated with memory issues. 

Okay. That is it for today. Thanks for listening. Please leave me a rating and review on iTunes so more people can find the podcast. Let’s get as many people as possible the information they need to heal. 

Have a question or comment about today’s episode? Head on over to helpforhashimotos.com and ask it on this weeks episode blog post. Search for Episode 37 and you will find a transcript of todays episode. 

Need help figuring out how to navigate your thyroid condition? I am taking new clients right now and would love to help you out. Go to my website and fill out the contact form. 

I’m taking a facebook break. I will be checking in to see if anyone wants to join the Help For Hashimoto’s facebook group but beyond that I am trying to stay off it. I’m not a fan of putting out a bunch of content there when Facebook owns it all. 

I am focusing more of my energy on putting really good content out in my newsletter and here on the podcast so if you have a topic you want covered contact me through my website. 

I forgot again to send the lunch ideas in my newsletter. I’m so sorry about that. I was pretty stressed out last week with lack of sleep and worrying about passing the grad school entrance exam. I got a middle of the road score which is what my school was looking for so it looks like I’m going back to school at almost 48. Am I crazy? I don’t know. I am little scared though. it is kind of daunting to be a student at my age. I am also freaking excited to learn about functional medicine! More excited than scared the more I think about it. Maybe it will be fun for you all to learn along side me! 

Go sign up for my newsletter. For sure each week you will get a new recipe to try and so far the feedback on the recipes I’ve sent out has been really good. 

All right, see you next week! Take care! 

https://endocrinenews.endocrine.org/hypothyroidism-and-the-heart/

https://www.ncbi.nlm.nih.gov/pubmed/17923583

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512679/

https://www.ncbi.nlm.nih.gov/pubmed/17093250

Adrenals and your medication. Episode 34.

Welcome to Episode 34. I’m so glad you are here. Today we are talking about adrenal health and why it is soooo important to have healthy adrenal function when you have hashimoto’s or other thyroid conditions. 

The adrenal glands are little walnut sized glands that sit right on top of our kidneys. We would die without them, they are that important. These little glands help us deal with stress in our every day lives and with chronic stress which is a part of most people’s every day lives. 

Your ability to be resilient, have energy and endurance all depend on our adrenal glands ability to do their job. They secrete cortisol, adrenaline (epinephrine) and noradrenaline (norepinephrine) and impact how your body uses carbohydrates and fats, how well you convert your food into energy and if your body will store fat, how your blood sugar is managed, and helps your cardiovascular system and gastrointestinal system work as they should. 

The adrenal glands also make your sex hormones after menopause and andropause. They have anti-inflammatory properties and help to minimize the effects of alcohol, drugs, foods and toxins. 

All this said, they are pretty important and they manage a lot of stuff in our body which means they can “wear out” or become fatigued. This is what many now call HPA axis dysfunction or dysregulation. 

Basically this means that when our body perceives a stressful event our brain signals our adrenal glands to release cortisol, adrenaline or noradrenaline to deal with the stress. 

As this happens more often in our body due to chronic stress, food sensitivities/allergies, inflammation, mismanaged blood sugar etc., our adrenal glands become less able to recover and respond again and they become depleted. The adrenals are not able to respond and this affects all parts of our body in a physiological way. 

This disrupts how much cortisol is released and when it is released which will affect our sleep patterns as well as the production of some hormones and neurotransmitters but not necessarily the levels of cortisol put out by the adrenals. 

It is the brain that signals the adrenals to release their hormones, the adrenal glands don’t do it on their own, so it is believed that the problem is in the brain and the signaling in the nervous system. 

The package insert for your thyroid medication will specifically state that you should not use your medication. Here is what the package insert says for Synthroid (Armour says something similar)

• Do not use SYNTHROID if you have uncorrected adrenal problems.

• Taking too much levothyroxine has been associated with increased bone loss, especially in women after menopause.

• Once your doctor has found your specific SYNTHROID dose, it is important to have lab tests done, as ordered by your doctor, at least once a year.

• Foods like soybean flour, cottonseed meal, walnuts, and dietary fiber may cause your body to absorb less SYNTHROID from the gastrointestinal tract. Grapefruit juice may cause your body to absorb less levothyroxine and may reduce its effect. Let your doctor know if you eat these foods, as your dose of SYNTHROID may need to be adjusted.

• Use SYNTHROID only as ordered by your doctor. Take SYNTHROID as a single dose, preferably on an empty stomach, one-half to one hour before breakfast.

What does this mean for you?

Here is a list of symptoms that will tell you if you are having an issue with your adrenal health:

• You tend to be a night person

• You have a hard time falling asleep

• You are a slow starter in the morning

• You might feel keyed up and have trouble calming down

• Your blood pressure is higher than 120/80

• You get a headache after exercising

• You feel wired after drinking coffee

• You clench or grind your teeth

• You have chronic low back pain that gets worse when you are fatigued

• You get dizzy if you stand up too fast from sitting/lying 

• You crave salt

• You have afternoon yawning, afternoon headaches

• You have a tendency towards shin splints 

• You tend to need sunglasses outside even if it isn’t sunny

You may also see lab work that shows high T3 yet you are feeling like you are still hypo or if you are on a natural desiccated thyroid medication and just not feeling well or you’re having symptoms that make you feel hyper like heart palpitations, racing heart or even anxiety. 

This can be because the cells are not getting the T3 and it is just sitting in your blood stream which can cause the feeling of anxiety or a racing heart among other things. 

Your thyroid function often is affected by how well functioning your adrenal glands are. 

Chronic adrenal stress will affect how your brain is able to tell the adrenals to work so they will have extra output of adrenal hormones at certain times and at others you will have very little leading to the symptoms listed earlier. 

When your adrenals are not functioning well, aside from keeping T3 from getting in to the cells, you will also have trouble converting T4 into T3, your cells can become less sensitive to your thyroid hormones which is probably what is happening when your T3 is high yet you feel hypo. 

Hashimoto’s can be triggered by chronic adrenal stress because adrenal stress will wreak havoc on the immune system which can result in the antibodies against your thyroid being made. 

What causes adrenal stress? 

So much. 

Your diet- consuming too much processed food, too much sugar and having food intolerances or food allergies. Your adrenal glands, cortisol especially, play a major role in blood sugar management. Food intolerances cause inflammation and an immune system response so continually eating foods you “shouldn’t” will cause an issue for your adrenals and can raise reverse T3 which means your body is converting your needed free T3 into Reverse T3 leaving you feeling hypo. 

Your body makes less Progesterone which is needed to even out the effects of estrogen in our body when we are dealing with chronic stress. 

Too much estrogen in your body binds up your thyroid hormones in your blood. High cortisol contributes to estrogen dominance in your body. 

Your adrenal function is affected by your ability to deal with stress of all kinds. We turn on that stress response when we: 

Don’t get enough sleep. Sometimes we can’t control getting enough sleep if we work a night shift or we have young children or whatever. Being deprived of sleep is not good for your adrenal health which isn’t good for your thyroid health. 

Make sleep a priority. Sleep in a dark, cool room. Go to bed at the same time every night and wake up around the same time every morning. This will help to reset your internal clock and will help you sleep better and deeper in the long run. Also, keep electronics out of your room, wear the blue blocking glasses after the sun sets- this will help increase your melatonin production allowing you to feel tired but also fall asleep. 

Do something to help deal with mental and emotional stress. Therapy, meditation, journaling. Find what makes you feel better and do it. Lose the things in your life that are contributing to your stress. Sometimes we have to see less of those toxic people in our lives. Take care of you first. You are no good to anyone else if you are not well cared for first. 

Manage your blood sugar! So important. This is second in importance to sleep. If you want to see improvements in your hashimoto’s or adrenal issues then you have to manage your blood sugar. Consuming large amounts of sugary processed or high refined carbohydrate foods will affect your adrenal health for the worse. Even consuming too much fruit at one time can be hard on your blood sugar. If you get hangry then you have an issue with blood sugar. If you wake up between 1 and 3 am then you have an issue with blood sugar. 

Inflammation in any form will stress your adrenal glands but most especially the chronic inflammation that most of us with hashimoto’s are dealing with. Chronic inflammation is increased by all the things I have just talked about along with things like parasites or infections you might not be aware you have. 

Exercise, gently. Autoimmune Strong is a good place to start. They have the most gentle exercise program I know of for chronic illness and it won’t tax your adrenals. 

Your thyroid health and your adrenal health go hand in hand. If one is not working well, the other one won’t be either. 

You can have your cortisol levels tested by a salvia test that measures your levels throughout the day. It will give you a good picture of what time of day you are lacking or having too much cortisol and then you can make a plan with your practitioner to fix it. I don’t recommend doing this on your own.  You might not find a conventional doctor who would test this or even know what to do with it so it might be a good idea to find a functional medicine practitioner who can help you. 

Some things you can do on your own to help your adrenal function are: 

Eat protein and fat at every meal, including the first meal of the day and do so within an hour of waking. This will make your blood sugar stable and your adrenals won’t have to get busy raising your blood sugar right away in the morning. Eating protein and fat in the morning will also help keep your blood sugar stable all day. 

Until your body starts to get back on track, you may need to eat some protein every few hours to help stabilize your blood sugar. If you are dealing with insulin resistance or blood sugar issues, this will help your body adjust and remain in a stable state. If you tolerate a small amount of nuts, seeds or eggs or even a can of tuna or sardines. These would be great options for you. A protein shake made of just a single ingredient protein powder (I like Designs For Health Pure Paleo Protein Powder) or even high quality beef jerky. 

You will need to figure out how well your body tolerates the starchy or more sugary carbohydrates. As I have said before, I don’t tolerate starches well, especially at lunch time so I tend to have a small amount at dinner which helps me to sleep better. If you feel sleepy after eating you know you have eaten too many carbs. Avoid grains, potatoes, sweet potatoes, winter squashes, parsnips, beans and sugary things.

Avoid fruit juices and instead consume the whole fruit so the fiber keeps your blood sugar stable by slowing down how quickly your body absorbs the sugar. 

Avoid coffee or caffeinated teas, no decaf coffee either- it usually has some caffeine in it. These stimulate the adrenals- if you are dependent on caffeine to get you going in the morning, you likely have some adrenal issues. 

Eat lots and lots of vegetables, high quality protein and high quality fats. Stick to a palm sized portion of protein, a thumb sized portion of fat and fill the rest of your plate with veggies- greens, fibrous veggies like broccoli, cauliflower, cabbage, asparagus, brussels sprouts, carrots, celery, radish, onion, garlic and so on. 

Find out if you have sensitivities to foods and eliminate them. An elimination diet is particularly helpful and a cheap way to figure out which foods cause inflammation in your body. 

Don’t fast if you are dealing with any blood sugar dysregulation and/or adrenal stress. This will only make things worse. You may want to stick to a 12 hour window of opportunity for eating and make sure you are eating enough. You need more than 1200 calories to sustain yourself and to ensure your body can heal. Eat until you are full and satisfied- this will ensure you don’t have blood sugar issues as long as you are eating as suggested. 

You may want to supplement with magnesium. It is needed for so many biochemical reactions in the body and the adrenal glands are no exception. Magnesium can act like a spark plug in the body and stress depletes it. Magnesium citrate can be found in a product called Natural Calm which is readily available. It can loosen your stools though so be aware of that and back down how much you take if you need to. 

B vitamins are essential for your body and play a role in energy production. A high quality B complex is recommended. Know your source when you buy it. I don’t recommend Amazon as a place to buy supplements. 

Vitamin C is good for your adrenal glands but it also stimulates the immune system so if you are dealing with high or elevated antibodies for thyroid, you might want to be cautious. 

Licorice root is great for sluggish adrenals. It is stimulatory so don’t take it after 1 or 2 pm. It can increase energy and endurance and helps to manage low blood sugar issues. 

Ashwaganda is an herb that is known as an adaptogen which means it will help your body get or stay in a more balanced state and it can help stabilize your cortisol if it is either too high or too low. It is also a nightshade and can be inflammatory to some or stimulate your already overactive immune system. 

Ginger root also helps to keep your cortisol levels even and balanced. You can make a tea by grating 1 teaspoon of ginger and let it steep in hot water for about 10 minutes. You can strain it or just drink it. 

I think this is a good place to stop. Thanks for joining me. Have a question about your thyroid or how to manage it? Go to my website- helpforhashimotos.com and fill out the contact form. 

Please leave a rating and review on iTunes so other people can find the podcast and be helped. There are 14 million people just in the US that are diagnosed with Hashimoto’s. That is a lot of people. The more you share about the podcast, the more people that can be helped. I’d really appreciate your help on that. 

You can find me on social media at stephanieewalsntp on instagram and at Out of the Woods Nutrition-Help For Hashimoto’s on facebook. I also created a facebook group for the podcast called Help For Hashimoto’s which is a positive support group but all the action is happening in my newsletter where I send out recipes and tips for living well with Hashimoto’s. You can sign up on my website. I was thinking of making a grocery shopping list or a guide to understanding your thyroid labs to give you when you sign up for my newsletter. Will you let me know which one you prefer?

Talk to you soon! Have a great week! 

Perimenopause and menopause with thyroid issues. Episode 33.

I'd be interested in hearing you discuss hashimoto’s and thyroid medication during perimenopause and menopause, and/or how those hormones can affect your thyroid and the way your body absorbs thyroid medicine. I'm 51 with Hashimotos, Armour Thyroid (90mcg), with levels considered normal by the endocrinologist. 

I am gluten and dairy free and eating well. But I still struggle with constipation, weight gain, insomnia, facial puffiness etc--hypothyroid symptoms. In November I had the first period that I have had in about 8 months. In the weeks after that, everything seemed to be in good working order...lost the weight, digestion was great, puffiness went away. Now a few months later (with no periods), all those same symptoms are returning.

I had been on Armour from June until I saw the endo in November .  I saw the endo on 11/19 and my TSH was 4.6, Free T4 0.81 (those are the only ones they gave me and there isn't a patient portal where I can peek at others that might have been taken).  

They advised me to go up to 90mcg at that time as he likes the TSH lower.  The period that I had was on 11/13 and so when I saw him everything was going GREAT...had dropped 6 pounds without trying, sleeping well, digestion good.  Have been on 90mcg since November and am creeping steadily upwards, digestion sluggish, insomnia, etc.  Ahhh!

Michelle. 

Thanks for your question Michelle- it is quite likely there are hundreds of thousands of women in your shoes. Before I forget to mention it- work with your doctor to at minimum add in a Free T3 test. TPO and TgAb antibodies tests and Reverse T3 would also be helpful. 

This is a complicated issue and I can give you some good general information but as with everything- we are all bio individual so you will have to experiment to find what works for you. 

Women start to make less estrogen and progesterone as we near our 40’s. This alone can trigger our thyroid to slow down. It sounds like you might be on a hormonal roller coaster here which is totally possible as you approach menopause. 

I like seeing that your endocrinologist likes to see your TSH lower than 4.6. Ideally it should be around 1-2. But upping your medication might not be the solution. That is not to say you shouldn’t take it as prescribed- I’m just saying there might be things you can do that will allow you to take a dose and stay there without having these fluctuations like you are. 

You say you are eating clean and gluten and dairy free. That sounds good, but what does clean eating mean to you? 

How much sugar or starchy foods are you eating? Once we hit a certain age, those starchy carbohydrates can be a problem for some of us when we are looking to maintain or lose weight. 

Those of us with hypothyroidism whether caused by Hashimoto’s disease or not can encounter issues with insulin resistance. Our body cannot process and tolerate sugars like it used to- my body certainly can’t. This means that you will have to be very mindful of what you are putting in to your body and even what time of day you do it. 

Maybe you feel tired an hour after eating lunch- even a paleo style lunch. If it had some starches in it, and you are feeling tired- like a sugar crash- then you likely are not tolerating starchy carbs at that time of day. 

If you struggle with sleeping- falling asleep or staying asleep a bit of starch in the evening meal might help you sleep better. The only way to know is to try it for a couple of days. 

Let’s talk about what perimenopause and menopause are before we dive in to what might be happening with you. 

During perimenopause (the 2-12 years before you reach menopause) 

It can start in your late 30’s but is more commonly occurring in your 40’s. You can have hot flashes, sleep problems, mood swings, and heavier than normal periods (this part is the worst if you ask me) and these symptoms can wax and wane for a good 10 years. 

Your estrogen during perimenopause will be fluctuating significantly to the point that you will have more than you’ve ever had circulating through your body at some times and other times it might be low. It is much like the blood sugar roller coaster but is called the perimenopause roller coaster. 

Symptoms include: 

• heavy flow that is new to you or longer flow (high estrogen)

• cycles that are less than 25 days long

• changes in breast tissue: lumps, sore, swollen (high estrogen)

• waking in the middle of the night and you didn’t before

• worse or more cramping

• start of night sweats, especially before a period (low estrogen)

• migraines that are new to you or are worse

• mood swings before a period (high estrogen)

• gaining weight without changing what you are doing

You may have some or none of these symptoms. About 20% of us will have dramatic changes during perimenopause. The rest of us are lucky to have minor issues. 

Progesterone is gradually lost during this time which is kind of like a cruel joke from mother nature because it is the progesterone that helps counteract the affects of estrogen. 

It also helps us deal with stress and the loss of progesterone makes us feel more anxious, depressed and have poor quality sleep. 

Managing your diet and allowing some self care. 

• Don’t kill yourself in the gym- over exercising or doing too intense of a workout will affect your energy levels for days to come, especially if your adrenal glands are worn out or confused about what to do for you

• Learn to let stuff go- like dishes and cleaning the house. 

• Avoid alcohol- this alone can wreak havoc on your hormones at this stage in the game. It keeps us from getting rid of that excess estrogen AND lowers progesterone.

• Manage your blood sugar. Journal your food so you can see just how much starchy food and sugary foods you might be eating. 

• Take magnesium- it calms our brain, helps us sleep and regulates our brain communication with our body

• Exercise gently, especially if you are dealing with Hashimoto’s. Autoimmune Strong is a great place to start. 

If you are dealing with heavy bleeding, you need to avoid dairy which Michelle already is, avoid alcohol, eat fermented foods and lots of veggies to help keep your gut bacteria healthy. Gut bacteria clear estrogen from your body and so does fiber so eating more veggies than you already are can be really helpful. I also find my energy to be better when I eat more veggies- like 7-8 servings or more a day.  

If your hypothyroidism is not being managed well (meaning your TSH and free T3 are not optimal)  then you may have heavier periods as well. Work to get your TSH around 1-2 and some doctors think it is okay if it is a little below one (.3 to .5)— especially if you are on a natural desiccated thyroid hormone replacement- When T3 is optimal you might find a suppressed TSH. Finding a doctor that will allow your labs to look this way is another story. 

Also keep in mind that you might feel great at a TSH of 2 and someone else might feel good at .3. This is bio individuality. It is so important to know your body and learn how to tell when things are off. 

Your thyroid medication may need to be adjusted seasonally too. If you live in a climate with winter- even all for seasons then your TSH may rise in winter and fall during summer. Another reason to really be in tune with your body and its signals. 

Part of my job as a Nutritional Therapy Practitioner is to help you learn how to do this. 

Menopause starts one year after your last period and symptoms should be better. 

You will have much less estrogen and progesterone at this point. Your adrenal glands will be making estradiol in your cells and this is supposed to be enough to keep you feeling good. BUT- if your adrenals were taxed for years before this happens then you may have some issues. 

Your endocrine system is made up of the pineal and pituitary glands in your brain, the thyroid and parathyroid glands, the Thymus (works with the immune system), Adrenals glands, pancreas and your ovaries. All of these work synergistically together as a system and when one is off, they will all be off. 

You can’t just take a supplement for your adrenals and think that it will fix your issues. It will help in the short term but it is a band-aid and not getting at the root cause of your problem. 

If you have gained weight around your middle, you are more than likely dealing with insulin resistance. This means that your cells are not accepting glucose or sugar from insulin as it travels through your blood stream to bring your cells sugar. Your liver and your muscle cells are not accepting the sugar so it just stays in your blood stream and eventually gets transported to fat tissue for storage. This is why we gain weight.  

The best way to combat this is to quit sugar completely. No dessert, no sweet anything. Every time you eat sweets it makes your insulin resistance worse. Even fruit- so keep your natural sugars to below 25 grams of fructose

High fructose corn syrup in soft drinks is 55% fructose, sugar cane is 50% fructose and honey is 40% fructose. Eight ounces of orange juice has 18 grams of fructose.  So pay attention to what you are eating. If it is sweet tasting, it is likely contributing to your weight at this point. 

Starchy foods like potatoes and rice are mostly glucose and very little fructose but you might find you still have a problem with those as well and will need to test your carb tolerance with a glucose monitor. Start with sugar though. It is more important at this stage to remove sugar from your diet and then look at the starches. 

Hormone fluctuations during perimenopause and menopause can affect how your thyroid functions. 

You might end up with estrogen dominance (the highs on the rollercoaster) which can keep thyroid hormone from attaching or making their way into the receptors on your cells. This means your cells are not getting thyroid hormone creating hypothyroid symptoms. 

Thyroid hormones are similar in chemical make up to estrogen. Too much estrogen or eating too much soy can block the receptor sites as well leaving you with less thyroid hormone in your cells and hypothyroid symptoms. 

As we lose our progesterone, we may see or feel a need for more thyroid hormone. We need progesterone to get T3 which is what our cells use and need. 

Our thyroid naturally slows down as we get older and therefore will not be able to get enough hormone to our cells affecting not only our energy but creating all the other symptoms we have talked about before. 

If you are dealing with chronic stress, and most of us are, this will also affect our ability to make enough thyroid hormone. 

When your thyroid is not working optimally or you are not medicated optimally, all of your hormones will be disrupted. 

It will be important to know if you are in menopause or if you’re having a thyroid problem. If you take estrogen thinking you are in perimenopause or menopause and it is actually your thyroid causing the problems, you might end up feeling worse and the estrogen will affect your thyroid function. Vicious cycle as with so many things in our body. One can’t work well without the other. 

If you have crazy periods during your 30’s and 40’s it is more likely an issue with thyroid than perimenopause. Thyroid problems are often the cause of early perimenopause. I’m a textbook example of this. 

They make the symptoms of perimenopause and menopause worse, affect blood sugar, make you depressed, affect your ability to handle stress. 

You have options: 

• start with journaling your food to pinpoint

  • are you eating enough

  • are you eating too much sugar

  • is your ratio of protein fats and carbohydrates where it should be

  • are you eating a lot of processed foods or a whole foods diet?

• exercise

  • reduces hot flashes

  • better mood

  • lessens depression, less anxiety

  • higher sex drive

  • sleep is better

  • more energy

  • lowers insulin resistance

  • increases bone density

  • helps manage weight

• natural supplements- introduce 1 at a time and wait 2-3 weeks before adding another one

  • maca powder

    • will help your hormones adapt and balance as needed

    • can reduce hot flashes

    • supports the entire endocrine system, including adrenals and thyroid

    • can regulate menstrual cycles

    • can increase energy and stamina

    • don’t take it if you are on estrogen

  • soy- is supposed to be helpful as a phytoestrogen to help with menopausal symptoms. I’m not sure how I feel about this. Don’t supplement but get it in food form. I would go for tempeh and miso and NOT genetically modified. 

  • Black cohosh

    • helps to reduce hot flashes

    • helps insomnia, fatigue, anxiety, depression

    • helps with joint pain/body aches

  • Damiana- tea or tincture (2-3 ml 2 to 3x/day)

    • helpful for hot flashes, low sex drive and general well being

  • Dong Quai

    • hot flashes, insomnia, fatigue, anxiety

  • Vitamin D

    • helps regulate endocrine system

    • supports sleep

  • Chasteberry or Vitex

    • helpful for breast tenderness

    • balances progesterone

    • water retention

    • headaches, irritability, depression, fatigue

    • sleep issues

The Period Repair manual is a must read for every woman

Supplements suggested can be bought through this trusted source (my fullscript store)

Thyroid talk with Ginny and Danna from Thyroid Refresh. Episode 32.

In todays episode I am talking with Danna Bowman (Thyroid Nation) and Ginny Mahar (Hypothyroid Chef) who have teamed up to create a really cool interactive program on their Thyroid Refresh® website called Thyroid 30®. We talk about how they found each other to team up and create a positive space for thyroid patience to be supported, what some of the biggest mistakes thyroid patients make, how lifestyle choices make a difference in your recovery and more. Use code TryThy30 for $5 off their program starting January 13, 2019.

How does blood sugar dysregulation affect the thyroid? Episode 31.

Welcome to episode 31 and Happy New Year. 

I spend a lot of time between Christmas and New Years reflecting on my year and always being really hard on myself for not accomplishing more than I did. 

I had a great year, I have good relationships with people in my life that matter and while they are not perfect and not always great, I am working hard to show up better in those relationships. So here is to a new year full of health and great possibilities in all areas of my life and in yours too. 

I am really grateful you are here. 

I teach a class called The RESTART Program as a Nutritional Therapy Practitioner and it falls right in line with the subject matter of today’s podcast. I am discussing managing blood sugar in relation to thyroid health. They go hand in hand and one out of balance puts the other out of balance. 

My class is all about managing blood sugar and about Restarting with a new outlook on food and nutrition. It is a real food sugar detox where you learn how to eat real food to manage your blood sugar, you get nutrition education and you get support from me and from the members of the class. We have a private facebook group and we meet each week for five weeks with the detox starting on the second week.

There are no shakes, no pills- just real food. This class has been life changing for so many people and I really love teaching it. Learn more at www.outofthewoodsnutrition.com/restart 

Susan O.  “RESTART® gave me the tools to reverse pain, lose weight, increase energy, and best of all, the common sense of how we should be living and eating. Thank you for helping me make a difference in my life and my family.”

Tina T.  “I came to the RESTART® class just wanting to learn how sugar affects the body. I left class feeling better and with a ton of knowledge. It’s a lifestyle change I can do. Stick with this class, you won’t regret it.”

Melissa M.  “I now understand what I need to heal myself and my family. This class changed my attitude towards food and health. If you are sick and tired of being sick and tired all the time, I highly recommend taking RESTART®.”

You can register for class now at www.outofthewoodsnutrition.com/restart  Cost is $147 for the entire five weeks and will be taught via zoom which is free for you to download. 

Okay- on to the show. 

Why is maintaining healthy blood sugar levels or keeping your blood sugar balanced so important for your thyroid?

Most if not every organ and tissue in the body needs glucose or sugar. It is what helps us make energy in our cells so if you are lacking in sugar your cells are not getting the materials they need to produce energy so your cells will not have energy, your organs won’t and you definitely won’t have any energy. 

When you have a low level of glucose, your blood sugar is low and your thyroid won’t be getting enough energy or enough sugar to turn into energy to function. It will be sluggish and not able to produce enough hormone for you. 

When you have higher levels of glucose in the blood or high blood sugar on a regular basis, you end up with something called insulin resistance. Say you eat a meal that is pretty carbohydrate heavy of maybe pasta or bread or pizza and that gets broken down into little particles of sugar. It will cause your blood sugar to rise and your body says “I’ve got to get rid of this sugar in my blood. There is too much in here and it can damage my blood vessels. So it releases the hormone insulin which is supposed to lower blood sugar in the blood by bringing the sugar to the cells so it can use it for energy production. 

The problem when we eat all that refined carb garbage is that you are eating too many carbs for your body to handle so you are dealing with this higher blood sugar issue with the quick rise of insulin to help manage the levels of sugar in your body. It’s not good and your body- your cells eventually get tired of receiving the sugar from insulin so they become resistant to it. They are like- “No more. My cell door is closed. Go away!” 

So you have this sugar with no where to go because the cells don’t want it. It is just floating around in your blood stream. But it has to go somewhere so what does your body do?

It stores it in your fat tissue or creates fat tissue to store it. 

Now your thyroid is looking for nutrients but the cells are resistant because of the insulin resistance. The cells are refusing the sugar being transported by insulin.  No fuel for the thyroid means it isn’t going to produce enough hormone for you and you feel sluggish. You might have the TSH of 5 or 7 or 9 that your doctor says is fine when you know it isn’t fine because you feel like crap. 

Now keep in mind this is a very simplified explanation of things because I want you to be able to get the idea. 

When your blood sugar is high either from insulin resistance or because you are constantly eating all day long or because you eat the Standard American Diet then you probably are experiencing some inflammation.  We are all bio individuals- where you experience inflammation may be different than someone else.  If you have inflammation in your thyroid due to autoimmune attacks or because of something else- your thyroid cells are not able to take in the nutrients they need to function well. 

Two important nutrients are iodine and the amino acid tyrosine.  If you have an inflamed thyroid, that doesn’t mean you should supplement with these two nutrients. That is a band-aid. The root cause might be the mismanaged blood sugar and you should be able to get both of those nutrients from your diet.  

Missing these nutrients through mismanaged blood sugar is one way you can get  to an autoimmune diagnosis. 

Here is the kicker. People with high blood sugar levels in their blood and insulin resistance tend to have low thyroid hormone production which will increase your TSH. When TSH goes on the rise it can make insulin resistance worse. 

I think I can attest to this- when I experimentally went off my medication I felt and actually still am pretty puffy. I ate three cheesecake flavored M&M’s last Saturday and a couple hours later had a small patch of psoriasis on my palm and the back or nape of my neck is itchy. It can mess you up. It is a vicious cycle. 

When you have a high TSH because your body can’t make enough on it’s own, as your blood sugar lowers the cells in your thyroid are affected. We need the proper amount of T3 and T4 to maintain healthy blood sugar. The more out of control our blood sugar gets, the more our thyroid can’t function properly. It is sluggish and that contributes to insulin resistance even more. 

The best way to fix this is to fix your blood sugar balance. To keep it balanced and reset things. So obviously diet is a huge factor and that is what the RESTART Program is all about. There are other things you can do as well. 

Sleep is huge. One night of bad sleep, loss of sleep can create insulin resistance in a healthy person so for those of us suffering from insomnia, you are in that vicious cycle again and so having diet dialed in will be really important. We repair our body at night and cortisol is supposed to be low at night- if you are not sleeping both of those things are going to be messed up. No repairing of tissues, and cortisol can be high which means insulin resistance and fat storage/creation. 

Exercise. When your muscles are worked or exercised and trained, if you will, they become insulin sensitive which will lower your insulin resistance. For many of us with autoimmune disease we need to go slow and I can’t recommend enough the Get Autoimmune Strong Program. Please go to the show notes and use my link to check it out so I get credit for sending you. It helps me pay for the podcast. 

A lot of experts will recommend burst training where you do something intense for 30-60 seconds and then rest for a few minutes and do it again. I am not in the place where I can handle that so if you get exhausted from working out- autoimmune strong is for you. 

You can also use a standing desk instead of sitting desk. I got one on Amazon that sits on top of my cheap Craigslist desk for about $80-$90. It was a good investment. 

Manage stress. This along with sleep is sometimes more important than eating well. That’s not to say you shouldn’t eat well but these other two are really really important. When you are experiencing a lot of stress- mental/emotional or physical, your cortisol levels go up. When the cortisol is high, your liver will create sugar to increase your insulin and again we have a cycle we don’t want to be in. 

Cortisol is in our body to give us a burst of energy to escape danger. Our primitive mind doesn’t know the difference between actual physical danger and what goes on in our mind, or even between a close call on the road and running from a bear. It is all the same to our body. So chronic stress- not good for our body fat and our blood sugar. Unfortunately, our body prefers to get its energy or sugar from our muscle rather than our fat so we end up losing muscle and getting fatter in this scenario of unbalanced blood sugar.  

So we have this high blood sugar because of high cortisol and we have resistant cells, they don’t want any more sugar so more and more sugar gets released either through you eating something because your body has told you you need more energy so you crave some kind of sugary carb food or because you are stressed so the blood sugar levels are higher and higher- your body thinks there isn’t enough sugar because the cells are refusing it and so the levels get higher and higher in the blood and that gets shuttled to fat because it needs to get rid of it. 

When you eat matters and what you eat at night matters too. When you eat before bed, if it is a carb heavy food like a cookie or a bowl of cereal, your blood sugar will be high when you go to bed and you will have a crash around 1-3 am when cortisol is released to raise your blood sugar. Ever wake with a start or have heart palpitations at that time and then you can’t get back to sleep? That is a blood sugar issue. Then you pile on lack of sleep because you couldn’t fall asleep and you have more insulin resistance. 

Eating protein at breakfast or your first meal is important to keeping your blood sugar stable all day long. If you aren’t eating protein and you have insulin resistance and issues with cortisol, your body will take what it needs in the form of sugar from your muscles- creating less muscle and more fat. 

You may need to eat every 3 hours for a short time to get your blood sugar balanced, but don’t eat a bunch of carbs every 3 hours. Eat some healthy fats and proteins with veggies to keep your blood sugar stable and then eventually you will be able to make it from meal to meal without needing a snack. Eating all the time, snacking all the time will keep your insulin levels high all day long which means more fat storage, inflammation and stress on the body and on your thyroid. 

All this stress affects your pituitary gland and TSH is secreted from the pituitary gland. When your adrenals and cortisol are working hard to manage stress and blood sugar, there isn’t much room for your thyroid to be helped out so it takes a hit and becomes sluggish or you develop autoimmune disease.  Cortisol inhibits production of T4 and of TSH (will show up as a high TSH on a lab). 

So we have a thyroid that isn’t working. This causes a decrease in the rate the cells take in sugar (glucose). The receptors on your cells don’t know what is going on so they can’t take in the right amount of anything.  Your blood sugar is out of whack and T4 and T3 are not being secreted from the thyroid like they are supposed to either. You are dealing with inflammation because insulin overproduction will also produce inflammation. 

You are dealing with a blood sugar rollercoaster here. Sometimes too high blood sugar due to a meal you ate or stress or whatever and then low blood sugar because of the rise in insulin, too much insulin which causes a crash- when you get really tired after a meal or after a bunch of sugar. Cortisol gets involved to try to fix the problem and it starts all over again. Not good. You crave the sugar to get you out of the crash. 

The solution here- besides taking my class is to heal your gut, remove some of these foods that are causing your blood sugar to be so out of control. Figure out if certain foods are causing you inflammation, get some good nutrients in to your diet. Get some omega 3 fats, fiber and protein in your diet.  You might need chromium, magnesium, cinnamon can be really helpful in lowering your blood sugar and testing your blood sugar. I am working on getting someone on the podcast who is an expert in finding your carb tolerance. It involves pricking your finger- I’m not so good at that. I have to have my daughter do it for me so I don’t mess with it- I really need to do that though. I know there are certain foods that really spike my blood sugar and the thing of that is- it can be different for everyone. You might really react to an apple whereas someone else won’t be affected at all. I’ll work on getting a good guest to help us figure that out. 

Ideally you want your blood sugar levels to stay somewhere in between 80-100. This would be on a blood glucose monitor. You can get a good picture of your blood sugar from a Hemoglobin A1C test. This will measure the sticky proteins of sugar that are attached to your red blood cells. This causes your red blood cells to become brittle and cause damage to your blood vessels. This is how we end up with plaques in our veins. 

In The RESTART Program we don’t use any sweeteners on the sugar detox. Some safe alternatives if you are going to have sugar keeping in mind that sugar is sugar and will affect your blood sugar the same -are honey, maple syrup and maybe coconut sugar. Again- these all will do the same damage if you eat too much of it. You shouldn’t be having any more than 22-24 grams of sugar a day according to the world health organization. That is not a lot when you figure 4 grams of sugar is = to 1 teaspoon of sugar. 

Stay away from aspartame, splenda and other artificial sweeteners. Some people think stevia in green powder form or the liquid drop forms are okay- I don’t care for the taste and I don’t know that my body loves them either. Some people do okay with erythritol or xylitol- they can cause bloating and irritate your gut. Avoid agave as it is pure fructose. It will for sure spike your blood sugar. 

The bottom line here is that you cannot address your thyroid without addressing your blood sugar and your diet. 

Diet changes alone can result in weight loss, more energy, better sleep, lessened cravings, better skin, and a better functioning thyroid. 

I’d love to have you in my class. Learn more or register at www.outofthewoodsnutrition.com/restart

Check out autoimmune strong here. 

Thanks so much for joining me today.  I’m glad you are here. Please leave me a review on iTunes and share this podcast with anyone you know who might be helped by it. 

I’m sending out a recipe for breakfast soup in my newsletter next week so go sign up for the newsletter on my website if you want that. It is really good. You will also get an ebook called 5 things your doctor won’t tell you about hypothyroidism. 

Join the Help For Hashimoto’s facebook group to get ongoing support from other members and from me. 

You can find me on instagram at stephanieewalsntp but all the action will soon be in the newsletter. 

See you next week! 

Study on blood sugar and hypothyroidism

Oops! I forgot to take my medication. Plus, how’s your poop? Episode 17.

ITunes Review: 

Stephanie, Thank you so much for a wonderful podcast. I love that you keep it real while answering difficult questions for us. You have a very calming and peaceful voice and I am always so encouraged listening to your podcasts. Keep them coming. We are listening and learning. 

What do you do if you forget to take your medication? 

Half life- a half life in the world of medications means the amount of time it takes for the concentration of the medication in your blood plasma to reduce by half.  Said another way- it is how long a drug stays in your system or the amount of time it takes for the effectiveness of a drug to reduce by half. 

If you are taking levothyroxine, the half life is 6-7 days and up to 9 or 10 days if you are dealing with hypothyroid conditions. If you have hyperthyroid conditions then it can be as little as three days. Nothing seems to be easy with this disease. 

Levothyroixine is a common treatment and most likely what your doctor will prescribe unless you have a doctor open or more knowledgeable in thyroid health. 

For practical purposes we will go with a 7 day half life for levothyroxine. When you take this medication, around 80% of it goes through your system over a longer period of time, like several hours. 

According to the Williams Textbook of Endocrinology, missing a day shouldn’t have a big effect on you. They also say that T4 is absorbed very well by the body so waiting an hour to take your medication before eating might not necessarily be required. Taking it on an empty stomach will give you a more stable TSH reading though. But since we all know that TSH should not be the gold standard, that maybe shouldn’t matter. 

The reason you usually have to wait 6 weeks to have your labs tested is because of this long half life. It takes about 6 weeks before your body has adjusted to a dose. 

However, if your digestion is not working well and we are going to talk about that in a minute, then you may have issues with absorption and of creation of T3 from your T4 only medication. 

There can be an issue in concentration of medication between manufacturers which can mess with your body. So, be proactive and let your pharmacy know that you do not want them to switch your medication without your knowledge. Remember that getting this dose right is like goldilocks- it needs to be just right. 

This same textbook also says that NDT is not a good choice for treatment and that TSH is the gold standard so- take it for what it is worth. 

A NDT like Armour has a half life of 2-7 days with the T3 having a half life of 4-6 hours. So if you take your medication with T3 in it at 8am then sometime between 12pm and 2pm you have about half of the original dose of medication in your system. Your cells will have used the rest of it. But it should last you about a day. This means half is gone in 4-6 hours, another half of the half (a quarter more ) will be used in another 4-6 hours and so on. 

T3 is used up faster because your body doesn’t have to convert it like it does T4. This is why it is a good idea to take a partial dose in the morning and a partial dose in the afternoon. 

Now let’s talk about what happens when our digestion isn’t working well because this is very important for our thyroid to work well. 

Thyroid peroxidase is an enzyme. It makes thyroid hormones by cleaving off an iodine molecule and adding it to the amino acid tyrosine on thyroglobulin which then makes T4 and T3. In order for this to happen, we need to have available to us: selenium, copper, magnesium, B vitamins, zinc, vitamin A. 

You should not just go and willy nilly supplement with these vitamins and minerals. There are many factors involved here and supplementing with some of these may make things worse in the long run. So it is a good idea to either do a lot of your own research or work with someone who knows how to work with your condition. 

Our gut or gastro intestinal tract is an important factor in our thyroid health but even before that, what we eat and how we break it down in our stomach is a key factor. 

Before we even talk about what you are eating, let’s talk about how you are eating it. Are you running through the drive through before or after your kids activities? Are you eating in the car or eating while you are doing something else?  Are you relaxed or stressed while you are eating?

Any of those scenarios will mean you are going to struggle with breaking down your meal before it even gets to your small intestine where most of the nutrients are absorbed. 

Digestion actually starts in the brain. We smell our food cooking and our brain signals the production of saliva so we can break down some of that food in our mouth while chewing. Are you chewing your food well? Like 20-30 chews per bite? Really breaking it down so the enzymes in your saliva can begin digesting the carbohydrates in your meal?

Once you have chewed well, you swallow and that ball of food goes in to your stomach and stomach acid and pepsin get to work digesting or breaking down proteins. 

Do you have acid reflux after eating? (there is more about this in the audio)

Once it is broken down in the stomach and reaches the right pH then the valve between your stomach and your small intestine opens and fats are broken down by the release of bile and nutrients are extracted in the small intestine and absorbed in to the blood stream. 

Here is where your gut health comes in to play since leaky gut or Intestinal Permeability are what contributes to autoimmunity. 

We need a balance of gut bacteria in our intestines to help us convert T4 to T3 there. If we are not eating right or digesting well then we will have an imbalance of bacteria and intestinal permeability. 

We can end up with parasites, overgrowth of candida and constipation- all with their own contributions to our failing health. 

When we have hypothyroid- we have a sluggish gallbladder which means we might struggle to digest our dietary fats and then we are making thick and viscous bile which further messes up the gallbladder function. When this is not working well, we are not detoxifying as well either. so we can’t break down hormones or toxins from our environment. 

How are you pooping? No one wants to talk about it but you must be moving stool through your body and going every 16-24 hours. Your BM should be the size of your forearm from your wrist to your elbow, it should come out with ease and you should feel relieved when you are done and not like you still have to go. 

Being constipated further contributes to the “bad guys” overgrowing in your Small Intestine and causing bacterial infections, you may experience chronic pain, inflammation, digestive issues, food intolerances and Hashimoto’s. 

With all of this happening, we can also have issues dumping estrogen and so it can accumulate. This can cause hypothyroidism that you won’t see on a blood test according to Datis Kharrazian in Why Do I Still Have Thyroid Symptoms. This excess estrogen will keep the thyroid hormones from getting to the cells- causing hypothyroid symptoms. 

So you see, taking supplements without first healing the gut is pointless. It is a band aid at best. The only supplement you may need at this point is some stomach acid- Betaine HCl so you can start to break down your food and get those nutrients to your cells, kill off some of the bad guys and bring things back in balance. 

You will see improvement in chronic inflammation from changing what you eat and the way you eat it. Start with your plate. With breakfast. Make some bone broth. That is the next recipe to go out in my newsletter so sign up for that. 

So reduce inflammation by cutting out gluten, dairy products, eggs, most other grains, soy products and yeast. Yeast can feed an already out of control candida overgrowth. These are some of the big allergens, in other grains it is best to avoid corn for sure. 

This gives your body a chance to calm down so it can properly react to foods. 

You need to be on an elimination diet for 3 weeks to 3 months depending on how sick you are, how inflamed, or how long you went untreated for Hashimoto’s. In addition to this, you can do something called a FIT test

What can you eat?  There are no notes for this. It’s only on the audio. 

Why Do I Still Have Thyroid Symptoms?

Against All Grain

Meals Made Simple

Are you your diagnosis? A little bit about selenium. Episode 14.

I was on this facebook group today for people with Hashimoto’s and autoimmune disease. Someone newly diagnosed was wondering about fatigue and being completely drained after workouts and wanting to nap even after 9 hours of sleep. I responded with take the exercise down a notch by trying to just walk for now and google the Autoimmune Protocol. Someone else responded with how they can eat what they want and exercise and that they get down sometimes and maybe a little tired but doesn’t everyone. She said she chooses to live her life, not her diagnosis.   

Article on green med info talking about using selenium and Myo-Inositol being used to put hashimotos in to remission and euthroidism which means your thyroid is working on its own. 

Selenium:

Before 1970 it was considered toxic but has since been classified as an essential nutrient needed in small amounts. It functions as an antioxidant. 

It is hard to get from foods because soil levels are varying so you never really know what you are getting especially if you are not eating local produce that is harvested in soil that is being managed properly. In the US the western part of the country may have higher levels than the eastern part with South Dakota having the highest levels and Ohio the lowest (According to Staying Healthy with Nutrition by Elson Haas.

We have less than 1mg of this mineral in our body and most of it is stored in the liver, kidneys and pancreas. Men need it more than women due to it being in their testes so it may have a function in sperm production. 

We lose selenium through eliminations and we should be able to absorb it through our intestinal tract at a rate of about 60%. This, of course will be dependent on your ability to digest your food well and also whether or not your gut is healed. We absorb it better when it is combined with amino acids- this means you have to be eating protein and breaking it down. 

Most selenium in foods is lost when they are processed like in white rice or flour. Food sources are liver, butter, fish and lamb, whole grains (out for most of us dealing with autoimmune disease), nuts- especially brazil nuts, shellfish, salmon, garlic, onions, mushroom, broccoli, tomatoes, radishes and Swiss chard can have good amounts of selenium if the soil is good where they are grown.  Many experts believe that Brazil nuts have such a varied content of selenium that we can’t necessarily rely on them. If you supplement, selenomethionine is your best bet at around 100-200 micrograms a day. Some suggest 200 mg for about a month and then a maintenance dose of 100 mg. Learn to listen to your body and if you are interested in knowing your levels, getting the plasma selenium test is ideal. Serum and whole blood will work too so if your doctor is able to test it, have them do it. 

Toxicity and deficiency symptoms are similar. Liver damage, hair loss, brittle nails with white spots and streaks. They can even fall out. These would be due to high soil levels.  If the supplement you are taking is formulated wrong, you can have muscle cramps, nausea, diarrhea, irritability, fatigue, loss of the hair and nails, pain, numbness or tingling of the hands and feet.  Deficiency will make you more vulnerable to infections, toxins, and other nutrient imbalances- again- this is where good digestion is key.  If you are taking anything to reduce stomach acid you will be deficient in selenium as well as many other vitamins and minerals. Most birth control pills will also deplete you of it as well. 

When you are NOT deficient you may tolerate cigarette smoke better as well as alcohol and poor quality fats. 

How does this relate to the thyroid? We need selenium to convert T4 to T3 which is the usable form of thyroid hormone that our cells need. Also, when TSH is produced and released, your body gets a message to make more hydrogen peroxide. This is needed to help make thyroid hormone in a round about way. It is needed to make some things happen in your body so the hormone gets made. We need antioxidants to neutralize the hydrogen peroxide after it does its job. Selenium is part of the process of helping glutathione neutralize the peroxide. 

In Isabella Wentz’s first book, Hashimoto’s Thyroiditis, she explains that if you are taking in too much iodine, more hydrogen peroxide needs to be produced which will mean you need more selenium to neutralize it. When you are already deficient in Selenium, you can end up with too much hydrogen peroxide which can cause inflammation around your thyroid tissue which creates an immune response, antibodies are produced and you have autoimmune disease. 

She recommends taking a selenium supplement on an empty stomach with vitamin E which helps our body absorb selenium better. 

Inositol 

Myo-insoitol is the same thing as inositol and is found in lots of fresh fruits and veggies so supplementing with it may not be necessary. High amounts are found in oranges, grapefruit and limes with blackberries, kiwi, cherries, peaches, apples being up there too. You can get it from brussels sprouts, beans, artichokes, cabbage, asparagus, dark greens, zucchini, bell peppers. As long as your digestion is working well you should have no problem getting enough from your diet as long as you are eating real whole foods. 

It was once considered B8 but since our body can make it, that distinction was taken away. Some still consider it to be part of the family of B vitamins though. It actually can help your body break down fats for digestion. It helps keep our cells firm so nutrients can get in and wastes can get out. It also helps brain cells work better. 

Caffeine can produce deficiency which can look like constipation, hair loss, high cholesterol and even eczema. Again, you can get enough from your diet so you don’t need to supplement. 

Link to Green Med Info article

Learn more about the nutrients our body needs here.

How do you push through the fatigue? Episode 13.

Q.  How do you push through the fatigue? I just want to get my life back on track.

Q.  I’ve got hypothyroidism/Hashimotos. Around noon I start getting tired and it can get to the point of dozing off. I've had every thyroid level possible checked and it's within normal range. We've actually checked it numerous times. I've had my b12 and folic acid checked along with my hormone levels, vitamin levels, and had a CBC done. Everything is good. I'm wondering if maybe we are missing something. Could I have something that we haven't checked for yet. I've also got bipolar2, depression/anxiety and ptsd which I take Topamax for. I also take Levothyroxine for my hypothyroidism.

First let’s talk about Topamax. I want you to know what you are on.  Your doctor should be testing your kidney and liver function and your blood should be tested to be sure you are able to process the drug well. They can become toxic very quickly.  

You should not drink alcohol while on this medication as it interferes with the effectiveness and it can make you sleepy as well as slow your heart rate. 

Antacids will keep you from being able to absorb this medication as well as any nutrients from your food. 

Fiber supplements can reduce the effectiveness of this medication. 

This drug will cause you to be low in folate or deficient in it. 

It has not been approved to treat PTSD but is endorsed by the National Alliance on Mental Illness to treat bipolar disorder and other mood disorders. 

Common side effects: 

Diarrhea, Dizziness, Double vision, Fever, Hair loss, Loss of appetite, Mood changes, Nausea, Reduced perspiration, Sinusitis, Stomach upset, Taste changes, Tingling or prickly skin sensations, Tremors, Uncontrollable eye movements, Urinary tract infection, Weakness, Weight loss.

With that being said, let’s move on and talk about fatigue. 

This is a super common issue for those of us dealing with thyroid issues and there are a number of reasons why fatigue could be your issue. 

Anemia.

You can have anemia from a deficiency of B12, Iron or folic acid. Your doctor may check your iron levels but do they check B12, folic acid and ferritin? Any one of these can contribute to fatigue.  And just because your lab says you are in the normal range doesn’t mean you are in the optimal range. j

Normal ferritin levels are between 12 -150 ng/mL. Mine is currently at 17 and I struggle with energy often. Some thyroid experts would say that optimal ferritin levels should be at 90-110 ng/ml for good thyroid function.  If you are still losing your hair- it could be an iron deficiency. 

And B12 values from your doctors lab may include values from people who were deficient in B12 so you can’t always rely on the lab values. “normal” is between 200-900 pg/mL but under 350 can give you neurological symptoms.  

Food sensitivities, not food allergies which is when your immune system reacts to protect you like when someone’s throat closes off in a nut allergy.  This alerts the IgE part of your immune system and happens as soon as a food is ingested. The IgA and IgG sections of the immune system will react to foods in what I would call a sensitivity or intolerance. These can cause us to be fatigued. 

IgA reactions happen in the intestinal tract which can cause inflammation there each time we consume a particular food. This will damage the intestines and can cause us to be unable to absorb nutrients from our diet. You may have symptoms like diarrhea or looser stools, constipation, reflux or you may not have any symptoms at all. You can end up with conditions like IBS, gas, rashes on your skin, acne, asthma, headaches, irritability and fatigue.  Celiac disease is in this category. 

If your T3 is low and you have high Reverse T3, this will affect your energy. T3 helps our cells make more energy. Reverse T3 makes T3 ineffective so that we are slowed down a bit. If Reverse T3 is high, we will not have any energy and one of the biggest reasons this might be high is due to stress. Another problem could be that you are not converting T4 into T3. This can be due to stress, or even nutrient deficiencies either due to low stomach acid or a compromised gut. You might find you need to be on a medication that has T3 in it. 

If your TSH is high, you will not have energy. Not all lab values are created equal here. You need to make sure that you are in a good range. Lab values for TSH are made up from a population of all kinds of people- those who are seemingly healthy and those who have undiagnosed thyroid problems and even the elderly who often have lower functioning thyroids.  The best reference range for most people is to have a TSH around .5-2 uIU/L. Personally,  mine is lower than .5 and I feel pretty good on that.  If you are taking NDT you can have a TSH that might look hyper and if your T3 is in normal range you probably feel pretty good. This can cause alarm with your doctor but try to have a conversation with them about it. 

How is your blood sugar?

This is a really really big one because it affects our adrenal glands which also have a role in energy. The good old blood sugar roller coaster will cause your adrenals to become weaker or cause the signaling between your brain and your adrenals to not work well leading to what is called adrenal fatigue or HPA axis dysfunction. For people like us with Hashimoto’s we may not tolerate those refined carbohydrates very well at all. Sometimes we get a big release of insulin when we consume sugary or refined “white” foods that others might not. So our blood sugar goes up really fast and we may have too much insulin in our blood which causes us to crash with fatigue and even anxiety or nervousness. This stresses our adrenals and leads to more fatigue.

Adrenal health is important for energy. If you are suffering from Adrenal fatigue you likely don’t have much energy to speak of even if this is the only thing you are dealing with. This is such a big deal and it takes some time to bring your adrenal health back in good standing. You need to avoid caffeine, keep your blood sugar balanced, make sure you are sleeping well and resting when you can, managing stress and probably supplementing. You can listen to Episode 7 of this podcast for more on adrenals. 

Having good digestion is key to energy. 

Many of us will be nutrient deficient and usually deficient in those nutrients that help our thyroids to function well. Just having hypothyroidism makes it harder for us to get our nutrients out of the food we are eating. This means the digestive system has to work a little harder to break down our foods and this can cause a lot of fatigue. We often have lower levels of stomach acid and most of us don’t eat when we are relaxed and we certainly don’t take the time to chew our food well. Right there is three strikes against us in the energy department. 

When we are not relaxed when we eat, we are not in “rest and digest” mode or what is called parasympathetic mode. This means we are in fight or flight mode which is not a good environment for good digestion. We already are not making enough stomach acid because we have symptoms of hypothyroidism, then we are not relaxed so we make even less. Then we are not chewing our food well- like 20 chews per bite to break it down. So, we have all this food in our stomach, not enough stomach acid and it is not being broken down. Our digestive system is working extra hard to try to break this stuff down- using all kinds of extra energy and that makes us tired. Then you have undigested food going through your intestines. You have leaky gut or intestinal permeability and these undigested food particles are then getting in to your blood stream causing your immune system to go on alert and inflammation occurs in the body. Fatigue is going to be a factor here. 

If you have low vitamin D, you can have fatigue. Get some sun. Lay in the sun for 10-15 minutes or go for a walk on a sunny day and expose as much skin as possible. Take a supplement of D3 if needed and make sure to have your levels checked by your doctor. Low D is a factor in autoimmune diseases like Hashimoto’s. 

A good diet will go a long way to helping you with your energy problems. High quality proteins and veggies along with a small amount of fruit. The big foods to eliminate for us are going to be gluten, dairy, eggs, nuts and I would try to eliminate nightshades to see if you feel better. This is basically called an elimination diet and is important for you to start to feel better, have more energy and bring your body back in to balance. 

You can find Hydrozyme at www.getbiotics.com use code DFILC163 to access. 

High T3, low T4, recommendations on supplements to feel better. Episode 10.

Welcome to episode 10. I hope this day finds you well and that everyday in every way you are getting better and better. 

Let’s get started. I got a question from Jordan. 

Hello Stephanie,     

    I'm very intrigued by your podcasts and enjoyed the free EBook! I was diagnosed with hashimotos auto-immune 2 years ago I've been on levothyroxine and my t3 remains high my T4 remains low but my tsh is always within normal ranges! My hair is terribly dry, brittle and gray and at the ripe age of 30 I'm heading to being bald! My bowels are Terrible to the point I was believing I had Celiac's or a gluten or wheat allergy until I listen to the podcast! I'm extremely overweight and I'm working hard on that as I'm 60lbs down! I have several of the symptoms of the adrenal fatigue except once I fall asleep I stay asleep and want to sleep hours upon hours! I'm writing to you to see if you could recommend to me some vitamins or suggestions so I can feel better. I'm a single mother on a extremely tight budget!  Thank you for your time! 

        Jordan

In the early stages of hashimoto’s people can have symptoms of both hypothyroidsim and hyperthyroidism. You can have palpitations, tremors, be really thin and have anxiety. You can have the dry brittle hair that is falling out and you can feel like you are going crazy. 

In hashimoto’s, your immune system is attacking the thyroid gland causing bits of thyroid hormone to be released in to the blood stream making you feel like you are experiencing hyperthyroidism. 

So what is happening? What will the issues be that you may have?

• food sensitivities

• nutrient deficiencies

• adrenal fatigue

• possibly an infection in your gut

• poor detoxification- you are not able to clear out toxins

Any or all of these will keep your immune system on high alert and continue the attack on your thyroid. 

The high T3 is probably what is causing your hair to fall out. This can be indicative of high antibodies and since you have a diagnosis of hashimoto’s this could be what is going on here. You can ask to have your thyroglobulin antibodies along with the thyroid peroxidase antibodies tested. This should confirm why T3 is high. 

Low t4 can indicate disease in the thyroid or a problem with the pituitary gland or the signal that tells your thyroid to make more thyroid hormone. Your TSH is in the normal range, you said- I assume that is conventional range. If it is above three, functional medicine would consider that high. So, The pituitary gland would release TSH if t4 is low and a high TSH level would probably mean the thyroid itself isn’t working well and you would have hypothyroidism.  If t4 is low and TSH is not high then the pituitary gland is not signaling correctly. This is something you would want to discuss with your doctor. 

You also need to take a look at all of these things to bring down the inflammation and hopefully put your hashimoto’s in to remission. 

You may have deficiencies in the micro minerals like selenium, zinc, vitamin D, iron, B12 and B vitamins in general. First and foremost though you need to see if you have low stomach acid.     

Let’s start with Selenium: 

Many of us with hashimoto’s are deficient in this micro mineral which can be one of the things that causes us to get hashimoto’s. It helps to break down and make neutral the free radicals made during thyroid hormone production. If we are low on selenium, damage to the thyroid can occur and our ability to convert T4 to the T3 (which is what our cells take in) is affected. Take around 200 micrograms of this one. It has been shown to help reduce thyroid antibodies. 

Vitamin D:  

This helps to regulate our immune system and remember that hashimoto’s is an immune system problem first and foremost.  Your levels should be around 60-80 when you have it tested for optimal immune system regulation. 

D3 is the more absorbable form and you should make sure that it is in a capsule or liquid form with some kind of high quality fat like olive oil or MCT oil (a broken down portion of coconut oil). It is a fat soluble vitamin so you need to take it with fat for your body to use it. 

Good food sources for vitamin D are cod liver oil, fish, eggs and sunlight

B12-

If you have major fatigue, you should have your levels of B12 tested. It plays a role in digestion too so you want to make sure you are, again, making enough stomach acid. Most of us with hashimoto’s and hypothyroidism have low stomach acid. 

When you have low stomach acid, you don’t digest your food well which means your body has to work harder to break it down which requires energy. 

One of the possible causes for the low stomach acid is a B12 deficiency. And a B12 deficiency can cause low stomach acid. Vicious cycle. If you don’t have enough stomach acid you can’t get the nutrients including B12 and iron out of your food. You won’t be breaking down your meals as well and this can lead to food sensitivities. 

Betaine HCl with Pepsin. This is stomach acid in capsule or pill form. I recommend starting out with around 150mg pill to see where you are at. It will help you digest and break down your food better so you can use the nutrients in your food. 

Next, Probiotics. 

Intestinal permeability plays a pretty big role in autoimmune disease. One of the things linked to it is having your gut bacteria out of balance. Having more “bad guys” than “good guys” can cause gut issues and anxiety. You have about 100 trillion bacteria in your gut. 

Start with a 10 billion CFU per capsule and increase every couple of days until you see or feel die off symptoms. The die off is the bad guys dying out and the good guys taking over. The bad bacteria will release toxins that might make you feel bad for a couple of days. This can also exacerbate the inflammation and immune response so make sure  you have good eliminations and are drinking plenty of water. 

One of the best ways to get a lot of good bacteria in to your digestive tract is by consuming fermented foods like sauerkraut- not canned sauerkraut but the raw fermented kind found in the refrigerator sections of stores or find it at farmers markets. Or make it yourself. It is so easy to do and really inexpensive. 

Here is a good explanation of what leaky gut or intestinal permeability is and how it affects the immune system from Sean Croxton: 

“think of a window screen. And I say, “It’s a hot day. You open up the windows. And the good air comes through to cool the place off. And it feels nice and good and what not. But it keeps all the bugs, the flies, the gnats and the mosquitos out of the house. And that’s how the gut works. It’s very selective about what it allows through into the bloodstream or wherever.

“But if some kid came over to your house and started poking big holes in your window screen, then what happens is you open up the window. And gnats might come in. Flies might come in. What do you do? You start grabbing a magazine and like whacking away and stuff. And that’s what your immune system does, right? It says, “Wait. This isn’t supposed to be here. So let’s start whacking away.” And now we’ve got a problem. We’ve got an overactive immune system.”

Glutamine- 

This will help heal your small intestine where intestinal permeability happens. It helps to repair the lining of your small intestine where new cells are made every 3 or so days. 

Zinc can also be helpful in repairing leaky gut and in helping you make enough stomach acid. 

If you are dealing with any kind of adrenal fatigue: 

This would mean your brain is not communicating with the pituitary gland to help your adrenals manage stress. This is called the HPA axis and it also helps to regulate the immune system. When we are stressed, this system doesn’t work well. 

If you are dealing with adrenal fatigue you may feel: 

• overwhelmed

• tired even with 8 hours of sleep

• like staying in bed in the morning

• a craving for salty foods

• daily things are too much to handle

• brain fog

• little to no sex drive

• like you can’t make a decision

Adaptogenic herbs like American Ginseng, ashwagandha, Asian ginseng, Cordyceps and Chaga mushrooms, and/or holy basil and licorice root may be helpful. 

You should work with a practitioner to find out if you are in need of supplementation here. 

Some things that can help you manage your hashimoto’s is your diet. 

• Being gluten free, dairy free or try an elimination diet to help you figure out which foods you are sensitive to. This will also naturally help you balance your blood sugar which will also help give your adrenal glands a break.

• Make sure you are eating protein of some kind at every meal, including breakfast and eat breakfast within an hour of getting up. Don’t skip any meals and don’t do any fasting.

• Eat 4-5 meals per day for a week or so to give your blood sugar regulation system a break.

• Have a snack of protein and fat or a starch before bed. Make sure any carbs you are eating are eaten with protein.

• Avoid caffeine

A word of caution on supplements. Please don’t go buy them at your local big box store or the corner pharmacy store. Don’t buy them on Amazon either. I suggest at the very least to buy from Vitamin Shoppe or from your local food coop or even Whole Foods. You should work with a practitioner that can help you find just what you need though

The reason for this is there is no regulation on supplements. They don’t have rules in manufacturing or labeling. Some supplements won’ t even have the ingredients stated on their label or the dose can be way off. Some might have gluten or dairy in them and you might have a sensitivity to it. This is one case where quality really matters. 

A practitioner should be able to find what is most bioavailable for you since there are multiple chemical formulations of certain nutrients and some work better than others. Some are more expensive than others to manufacture. 

You also need to make sure you start with low doses so as not to over do it.  You just don’t know how your body will react to a new supplement. Starting slowly with lower doses will help you catch a reaction to it before it gets too bad. 

There is no magic supplement that will fix the hashimoto’s or anything for that matter. Some of these will definitely help you on your journey to healing or remission or whatever you want to call it. 

My top picks would be Hydrozyme from Biotics which is a lower dose stomach acid supplement and diet changes first and foremost. You can get that by going to www.getbiotics.com and using my practitioner code DFILC163. 

When starting a dose of stomach acid, remember to take a few bites of your protein based meal, take a pill, take a bite of food, take a pill and you do this until you feel a little burning sensation. Then you know to take one less than what gave you the burning sensation. 

Thanks so much for listening. Please tell anyone you know who has been diagnosed with Hashimoto’s to listen in and if you would be so kind as to leave a review on iTunes so more people can find this podcast that would be great too. My goal is to help as many people as possible to feel better and beat this disease. 

Got a question about your thyroid or hashimoto’s? Please send your questions to helpforhashimotos@gmail.com or head on over to my website and fill out the contact form there. 

You can find me at www.outofthewoodsnutrition.com or www.helpforhashimotos.com  I’m on Instagram at @Stephanieewalsntp which is where I post the most and on facebook at Out of The Woods Nutrition

See you next time. 

Endocrinologists, medication, and first steps to take when diagnosed. Episode 9.

So today I had my 3rd consultant appointment to tell me I have hashimotos disease. (I got told this by the doctor 3 months ago) all he said was, its fine, Nothing to worry about and its very common in women, thyroid is fine, no need for anything else other than ill see you in 9 months time......now i feel like an idiot for having bad days of constant tiredness and pain.

After receiving the results from my full thyroid panel that was ran by my gynecologist, she referred me back to my regular doctor. She spent 10 minutes confirming that I do have Hashimoto thyroiditis and hypothyroidism. She said that I need synthroid and I should follow-up in 3 months. Nothing was explained to me. No recommendations for supplements. No recommendations for diet. I had to request an endocrinologist referral, which will take weeks. So my question here is should I begin the synthroid, figure out what supplements I need, diet, etc or wait to start synthroid until I meet with endo? I’m lost. Also, the closest functional medicine doc is 2 hours from me and doesn’t take insurance.

It seems this is quite common for a lot of us. We go to the doctor and they tell us to take the medicine and come back in three months or so to be tested to see if we are at the right dosage.  I personally got nothing at all from an endocrinologist. I had to pay out of pocket to see him and he was worthless to me. Just because your thyroid is a part of the endocrine system does not mean you will get the proper care from an endocrinologist. I am sure there are great ones out there but I have found they are particularly difficult to work with you on treating symptoms and not just your labs. Plus they have a standard for their labs and they will go by that and nothing else. If you are lucky to find an endocrinologist who will work with, great. If not, fire them and keep looking. You are the customer in this situation. You have a right to find someone who will listen. Unfortunately I realize that some of you have horrible health insurance and don’t have the ability to look around much so I have a plan for you! 

First of all, you have to remove any triggers for the disease. This will be different for each of you. Once you find our what your triggers are then you will have to repair that which brought your body out of balance and led you to your autoimmune condition. Why is your immune system out of balance? Why did this happen. These are questions you need to ask yourself and do a little digging. 

Make a timeline of your health. Look back to as far as you can remember and write it all down in a timeline. Infections, times where you were severely stressed out, antibiotic use or other medications you took, were you on oral contraceptives? Any accidents? Have you ever been exposed to any toxins? How about heavy metals? Do you have amalgam fillings?  Once you make a timeline you can see where things might have started to go wrong and then how to fix them. Obviously you can’t do anything about an accident or the fact that you took antibiotics but you can manage stress, take probiotics and other nutrients such as b-vitamins. i strongly recommend working with a practitioner on this to get it right. You don’t and shouldn’t just take any old supplement just because someone says you should. Don’t waste your money on things you may not need. 

Next, know that synthetic T4 only medication is not the only one on the market and it doesn’t work well for some people. Ask your doctor to let you try natural desiccated thyroid hormone like Armour or WP thyroid or any one of the other ones on the market. 

Also, you must take a look at your diet. This is always the very first place you should start. What are you eating?

A gluten free diet is a must in my book. There is so much research now on the effects of gluten and what is now believed to be the glyphosate in the wheat products that is destroying our health. Gluten also affects our gut health in that it plays a role in leaky gut or intestinal permeability which allows undigested foods or proteins to exit our intestines and go in to our blood stream setting off an immune reaction which can lead to food allergies or sensitivities. 

You may have to eliminate other foods too. Most people also have to eliminate dairy products and some of us don’t tolerate a whole bunch of foods. An elimination diet is a good first step really but if that seems overwhelming to you then start with gluten free and work your way there. Removing these foods that are causing inflammation in your body will allow your body to calm down and begin to repair itself. It will also provide your body with a chance to properly react to a food that is harming you so when you reintroduce foods you should be able to tell if something is working well for you. Foods can affect our mood, our energy levels, our digestion, our skin, our brain and more. Keeping a food journal is a good way to really pinpoint what foods are not working for you when you reintroduce them. 

The quality of your food is also very important. People often say how expensive it is to eat healthy and I’m not gonna lie. It can be costly to eat all organic and shop only at food co-ops. I have been very fortunate to be able to do just this but I also don’t have a lot of extra money for anything else. I have made high quality foods a priority and will continue to do so because it is important to me. It may not be important to you and that is okay. You can do a lot of good for your health by shopping at a regular conventional grocery store. Just don’t shop the center aisles of the store. In other words, buy real whole foods and if you can, shop with the environmental working groups list of dirty dozen and clean fifteen. This is a list of produce that is recommended to be bought organic and a list of produce that is okay to buy conventionally grown. A big way to save money though is at farmers markets. I got a head of cauliflower for $1 and all kinds of things at much cheaper prices than were in the store. I also buy most of my meat from local farmers at a significant savings. So if you can do some of that kind of thing it is really helpful in saving money. 

Next, if your adrenal glands are not working properly, you will not see improvement in your thyroid health. When we are stressed our cortisol can be low or high or fluctuate between the two. Last weeks episode was about adrenals so you can give that a listen for more details. 

You also need to heal your gut where 80% of your immune system lies. Cleaning up your diet, making sure you digest your food well, maybe taking a stomach acid supplement. If your stomach is not acidic enough you will not digest your food which will start the cascade of inflammation through the digestive tract and the body. A good diet is essential here and probably some supplementation. You should work with a practitioner on this. 

Lastly, removing toxins. This is big. Maybe you have a heavy metal issue. Maybe you need to clean up your personal care products and your household products. Perfumes have too many chemicals in them to count so those should be avoided. Air fresheners are full of chemicals. Anything you put on your skin will be absorbed in to your blood stream so you need to be mindful of that. 

I could probably spend an hour on each of these subjects but I like to keep these episodes kind of short since many of us have brain fog and low energy.  

You should take the medication that your doctor prescribed and see how you feel. Some people are sensitive to fillers in some of the medications. Synthroid contains cornstarch. Some generic brands have blue food dye in them. Many people do better on natural thyroid hormone replacements like Nature thyroid and Armour but everyone is different.  It is common for people with Graves disease to do better on T4 only meds like Synthroid rather than meds with T3 in them because they will have developed antibodies to T3 and T4. Because T4 is synthetic in synthroid there is less of an autoimmune effect in those cases. 

If you are taking synthroid or other synthetic T4 only medication and you show a normal TSH lab test but dont’ feel any better this might be what is happening: 

If you have hashimoto’s, long term inflammation of any kind including stress you can end up not being able to convert T4 to T3. You pituitary gland wont’ communicate well with your thyroid gland and/or your cells won’t respond to the thyroid hormone that is brought to them.  You may also have issues with your blood sugar, a gut infection, food intolerances and so on. 

If you are taking or feel better on natural desiccated thyroid hormone then: 

you probably couldn’t convert t4 to t3, you were sensitive to something in the medication, you may need t3 because those cells of yours are not taking in the t3 brought to them or the cells just like t3 better. 

If you have high cortisol, low progesterone, inflammation, nutrient deficiencies- these all will play a role in your body’s ability to take in whatever medication you are taking. 

Something else to consider is that if your autoimmune condition is managed you might not need medication at all. When your thyroid gland is significantly damaged then you will probably be dependent on medication and not taking it can be life threatening. 

Either way, you have to manage the hashimoto’s with all that was mentioned today. It is a lifestyle folks, not a quick fix. Healing or recovering or putting hashimoto’s in to remission takes time. The better you do with diet and lifestyle the better your thyroid will perform for you. 

To me, it is all worth it. 

That’s it for today. Thanks for listening. Be sure to share this podcast with anyone you think could use it. My goal is to help as many of you with hashimoto’s and other autoimmune conditions as possible. 

Be sure to pick up my free ebook, 5 Things Your Doctor Won’t Tell You About Hypothyroidism on my website www.outofthewoodsnutrition.com or www.helpforhashimotos.com  

You can find me at Out of The Woods Nutrition on Facebook www.facebook.com/outofthewoodsnutrition and at @stephanieewalsntp on Instagram. 

Please send me your questions about thyroid and hashimoto's or anything autoimmune related to helpforhashimotos@gmail.com or fill out the contact form on my website. 

Again, you can get $15 off your first order with www.paleoonthego.com with the code GETCLEAR

Also, I would appreciate it if you left a review on Itunes for me so more people can find this podcast. It would really help me out! 

Thanks. 

Links (some are affiliate) to stuff I talked about: 

Eat Wild

Make-up and Skin Care

Mrs. Meyers

Branch Basics

Hot Logic

Acid blockers, digestion, and elimination. Episode 8.

Terrible heart burn !!What helps? Has anybody had any issues with Omeprazole or any acid reducer.

OMEPRAZOLE: aka Losec, Prilosec, Prilosec OTC and Zegerid

classified therapeutically as antiulcer agent and pharmacologically as a proton-pump inhibitor

Used for maintenance of healing in erosive esophagitis, duodenal ulcers with or without H.Pylori. Short term treatment of active benign gastric ulcer. The OTC or over the counter is for heart burn occurring more than or equal to 2x a week. 

What does it do?  it binds to an enzyme on gastric parietal cells in the presence of stomach acid. It diminishes the accumulation of acid in the gastric lumen with lessened gastroesophageal reflux and helps heal duodenal ulcers. 

Binds 95% of protein and is metabolized by the liver with a half life of 30 min to an hour. Half life means how long it takes for half of a medication to be eliminated from the blood stream.  

It says to use cautiously in liver disease, in geriatric patients due to increased risk of hip fractures in patients on high doses for longer than one year and in pregnancy, lactation or children. 

Acid blockers like the ones mentioned and also things like mylanta, maalox, tums alka-seltzer, tagamet, pepcid, zantac etc all will lessen the amount of stomach acid you have in your stomach. So how will you break down your food? That is what it is there for.  The acid blockers change the pH of your stomach which is supposed to be very acidic at around 3 I think. This low pH is how we break down our food, especially protein. Protein gets broken down in to amino acids which become neurotransmitter. Stomach acid breaks down our food so we can extract the nutrients we need from it. 

Low stomach acid, which happens naturally as we age and most of us with hypothyroidism don’t make enough of it can lead to anemia, candida, fatigue, constipation/diarrhea, tooth decay, hair loss, and a higher risk of developing food sensitivities. 

So you have less acid when you take an acid blocker but you also have a deficiency of good bacteria, calcium, coq10, folate, glutathione, iron, magnesium, melatonin, niacin, potassium, B vitamins, selenium, vitamin A, C, D and zinc. 

Hypothyroidism can lead to hypochlorhydria or too little stomach acid. This is what often causes acid reflux. When food is not digested well by the acid in your stomach it will putrefy, ferment and become rancid in the stomach. Our small intestine doesn’t like to let undigested or poorly digested food from the stomach enter there so it backs up in to the esophagus, irritating the tissue there and causing heart burn. 

Coffee and nicotine reduce the pressure on the esophageal sphincter so you end up with more reflux.

The food is not as acidic as it should be it doesn’t stimulate the gallbladder to secrete bile to emulsify fat and the pancreas doesn’t get signaled to release digestive enzymes to further digest the food. So you have this rotting food moving through the intestines which will eventually cause inflammation, maybe even an infection and likely leaky gut or intestinal permeability. 

The fat in the food isn’t being broken down by bile from the gallbladder so your cells are not getting any minerals. Zinc is a mineral which helps us produce enough stomach acid. Having hypothyroidism messes with our gallbladder function and it can cause it to become sluggish and it won’t release enough bile. Combine that with the SAD and you have the perfect storm for gallbladder attacks.  When the gallbladder isn’t working well, the liver also becomes sluggish and backed up so it can’t detoxify our hormones, toxins or other things. 

So as you can see, having less than good digestion is a real big problem for those of us with sluggish thyroids. Along with zinc, we end up depleted in tyrosine, selenium and vitamin A and D. When it is not working well it plays a role in autoimmune disease as well. Perfect. Look at all we have going for us!  We have a large amount of our immune system in our gut- around 60-80%. If our digestive tract is out of wack, inflamed, or if we are dealing with parasites then our adrenal glands will end up depleted. This will make your thyroid sluggish as well. 

It just keeps getting better for us. 

Ideal elimination from the time you eat a meal to the time it leaves you in the form of a bowel movement is between 16-24 hours. This is slower with hypothyroidism.  Constipation is anything longer than what your normal elimination would be. You can end up with malabsorption issues and toxins  and hormones get recycled which add fuel to the fire. There is a good chance you will be growing more of the harmful bacteria putting your good guys at risk for being taken over by the bad guys. Remember that we convert some T4 to T3 in the gut but we won’t do that as well when there is an imbalance of bad to good bacteria. 20% of thyroid function relies on the right balance of bacteria. 

Another biggie mentioned briefly earlier is the elimination of hormones, particularly estrogen. I am not a hormone expert but I do know that poor digestion means you can end up with higher amounts of estrogen that can lead to hypothyroidism that doesn’t show up on a blood test. This information came from Why Do I Still Have Thyroid Symptoms from Datis Kharrazian. He says that “excess estrogen binds the thyroid transport proteins so that thyroid hormones cannot get to the cells to do their jobs, causing hypothyroidism symptoms”

There are a lot of things you can do to eliminate acid reflux and keep things moving along smoothly. 

Food sensitivities or allergies can cause reflux or silent reflux which often has a cough with it. 

Look at your diet. As per usual, gluten free, dairy free and an elimination diet are the first place to start.  Remove also, eggs, corn, soy and yeast. This will give your immune system a break. A chance to calm down and your gut can repair itself.  These foods should be eliminated for 3-4 weeks. The longer the better.  Typical food reactions can look like skin rashes, eczema, acne, fatigue, joint pain, bloating, gas, heartburn, constipation, diarrhea and even nasal congestion. You can have anxiety, irritability, headaches and more. 

Manage your blood sugar. 

Stress. Don’t eat when you are stressed, take a minute to calm down, sit at the table without a phone, book or anything else. Take a few deep breaths, say grace if you like or whatever. Then take a bite of your food and chew it really well. Like 20-30 times per bite. 

Don’t drink a lot of water and avoid anything bubbly with dinner. The phosphorus in pop can put you in to sympathetic or fight or flight which will automatically turn off stomach acid production. 

You can take digestive bitters about 20 minutes before dinner and if that is not enough you may need to supplement with stomach acid. Something called Betaine HCl. I like a product called Hydrozyme from Biotics Research. I recommend buying it from a practitioner, not off of Amazon. 

To find out how much you need you take a bite of food, chew it well, swallow it and then take an HCl supplement with a small amount of water. Take another bite of food, chew it well and take another pill. Keep doing this until you feel a little burn, kind of like heartburn or like you just took a shot of alcohol. If you felt the burn at 3 pills then you know you only need 2 at each meal. Eventually you can get enough healing of your body done that you will start to make more stomach acid and you won’t need to take as much of the supplement. 

You can check in on your digestion by keeping a food journal. Write down everything you eat and drink and how you feel afterward. Keep track of your bowel movements. Look at them. Do you see undigested food in your stools?  What shape are they?  You can google the Bristol Stool Chart and see where you are at and where you need to be. Your eliminations should be solid, about the length of your forearm from your elbow to your wrist. It should come out with no straining, you should not feel like your elimination wasn’t complete and you should not have much on the toilet paper after you wipe. 

If you want to test your transit time you can take some activated charcoal pills, like 5 of them or you can eat about a cup of beets, or take 2 tablespoons of sesame seeds. Take them first thing in the morning, don’t chew the seeds if you use them, just swallow them. You want to be able to see them when they come out.  Write down what time you take them and what day you take them. Then keep track of your bowel movements. Write down the first time you see the seeds, beets or charcoal (your stool will be black with charcoal and reddish with beets) and write down the last time you saw them in your stool. The difference between the time you swallowed them and the last time you saw them is your transit time. Remember we are looking for anywhere from 16-24 hours.  Also, ideally you might go two times a day. 

That is it for me today. If you have any questions about this episode or you would like to submit a question for the podcast, please feel free to leave a comment on my website, www.outofthewoodsnutrition.com or www.helpforhashimotos.com or email me at helpforhashimotos@gmail.com

You can find me on facebook at www.facebook.com/outofthewoodsnutrition or on instagram at stephanieewalsntp. 

Thanks so much for listening. I really appreciate it. If you enjoy listening to this and want others to have access to it, I would appreciate it if you left a review on iTunes for me. My goal is to help as many people with thyroid problems and Hashimoto’s or other autoimmune diseases and I can’t do that without your help. Please help spread the word.

The first step to getting your life back is believing that you can!

Thanks again. See you next time. 

Do you have symptoms of worn out Adrenal glands? Episode 7.

Today we are going to be talking about the adrenal glands. I had a question from someone asking me what the adrenal glands were so here you go! 

Adrenal fatigue symptoms: 

Being a night person, hard time falling asleep, slow starter in the morning: 

All signs that your cortisol rhythm is out of balance causing cortisol to be high at night and low in the morning. It should be the opposite. 

Do you tend to be keyed up and have trouble calming down?

This is a sign of increased adrenal output or hyperadrenalism. Having high cortisol with low DHEA can cause this. In the beginning stages of adrenal breakdown, the body’s response to stress is to increase the cortisol output from the adrenal glands. If the stress never stops, this process doesn’t stop and you will eventually have adrenal fatigue. 

Do you get a headache after exercising?

This means your adrenals are slow to put out cortisol. Chronic stress will cause the cortisol levels to drop leading to a decreased ability to control blood sugar and eventually low blood sugar, irritability, headaches and so on. Exercise can cause your blood sugar to drop and if cortisol output isn’t there then blood sugar won’t be regulated properly leading to symptoms of low blood sugar. 

Do you feel wired or jittery after drinking coffee?

This may mean you have issues with high cortisol output, you need liver support or you just have a sensitivity to coffee. Caffeine is an adrenal stimulant though and it can contribute to excess cortisol output. 

Do you clench or grind your teeth? This is a classic sign of increased stress and high stress levels lead to an increase in your sympathetic nervous system or the fight or flight response. This will increase your total cortisol output. If the stress isn’t resolved, adrenals will start to break down and adrenal fatigue comes to visit. 

How about chronic low back pain that gets worse when you are tired? Our pelvic supportive muscles are neurologically related to the adrenal glands. You maybe need some connective tissue support. 

Do you get dizzy when you stand up quickly or feel dizzy in general?

This is a sign of low adrenal function. Our adrenal glands are responsible for keeping blood pressure in the normal range for those few seconds it takes us to go from lying down to standing up. Having a drop in blood pressure by 10 or more indicates a need for adrenal support. 

Do you have arthritic tendencies? Achy joints and there is no sign of arthritis? Consider your adrenal health and your gut health. Both can be responsible. 

Do you crave salty foods or do you salt your food before tasting it?

You may have a possible need for electrolytes. Our adrenal glands help manage stress but they also help keep our minerals balanced. Aldosterone is a mineral corticoid which causes our body to reabsorb sodium and chloride. When aldosterone levels are compromised, we excrete more sodium and chloride than is needed giving us a salt craving. I often tell my clients to salt their water if they are having adrenal issues. 

How about afternoon yawning? This can mean adrenal insufficiency, and slow or hypo functioning adrenals glands. It is also a sign you need B1 or thiamine and an indication of low thyroid function. 

Pain on the inner side of your knee? Tendency to have shin splints or sprained ankles? Adrenal dysfunction causes weak ligaments in the body. Ankles are most affected in a lot of us. 

Do you need to wear sunglasses even when it is cloudy outside? The ability of our pupils to constrict in bright light is partially related to adrenal functioning. When the adrenals are tired, they won’t constrict easily or at all. 

The purpose of the adrenals is to help us cope with all kinds of stress including the stress caused by blood sugar dysregulation.

The hormones secreted by your adrenals affect the way our body uses carbohydrates and fats, the conversion of fats and proteins in to energy and how fat is distributed in our body (especially around our waist and the sides of our face). They play a role in heart health and in digestive function. Adrenal hormones are anti-inflammatory and anti-oxidant which helps minimize reactions to things we are allergic to from things in food to our environment.  After menopause they make our sex hormones. 

How is your ability to respond to chronic illness? Adrenals have a hand in that too. 

Again, blood sugar dysregulation/erratic blood sugar levels is closely related with low adrenal function. You might have a tendency towards allergies, that arthritic pain and get sick more often.  You might even find yourself with fears you can’t explain, anxiety and depression, inability to concentrate and tougher time recalling memories.  Find yourself less tolerant of things or get frustrated easily? Insomnia? 

Things that affect the adrenals: 

• Financial problems, loss of job

  1. Death of loved one

  2. Stress, chronic, repeated, psychological, fear

  3. Poor food choices, SAD diet

  4. Perpetual negative thinking loop running in your head

  5. No relaxation time

  6. Lack of sleep

  7. Chronic or acute infections

  8. Allergies, environmental or food (do you eat something you are sensitive to?)

  9. Lack of exercise OR too much of it

  10. Caffeine

More signs and symptoms of adrenal fatigue: 

• Hard time getting up in the morning

  1. Fatigue not relieved by sleep

  2. Lethargy or lack of energy

  3. Everyday tasks take a lot of effort

  4. Low sex drive

  5. Can’t handle stress well

     • road rage, anxiety all the time, yelling at your kids for no reason, compulsive eating, smoking, drug use

  6. Takes you longer to recover from being sick, injured or going through a traumatic event.

  7. Mild depression- seems pointless to make an effort at anything

  8. Less happiness or feelings of enjoyment

     • you don’t feel interested in much, don’t do much for fun

  9. Worse than bad PMS

  10. You cannot skip a meal, need snacks all the time

  11. Less tolerant of others

  12. Slow to wake in the morning- by 10am or so you feel better, slow down around 3pm and feel alive after 6pm

  13. You are not very productive

You have to look at these symptoms together. You probably have more than one which will suggest you are dealing with adrenal dysfunction. Having more than three of these is indicative of a problem. 

How do you recover?

Take a look at these symptoms on my website under this podcast and see where you can make some changes. You absolutely will have to make some changes in your life if you want to recover from adrenal fatigue. Supplements can help and you may need to supplement to kick start your adrenal recovery but they will only be a bandaid if that is all you plan to do. 

We all have stress and those of us with chronic illness have that on top of our every day stress. Remember that chronic illness, autoimmune disease, with an overactive immune system is stressful in and of itself to our adrenals. Then add on the standard American diet and you have more stress in the form of blood sugar dysregulation and digestive distress. Do you have food allergies or sensitivities? Probably if you have autoimmune disease. 

Look at your lifestyle: 

Remove the stressors: 

• What robs you of energy? People in your life, food sensitivities, no sleep

  1. Are you getting fresh air?

  2. Do you drink alcohol? Eat junk food? Smoke? Caffeine/coffee?

  3. Chemicals in your environment?

     • laundry

       1. skin care

       2. household cleaners

       3. clean water

Learn some deep breathing techniques, meditation and just do it. Even one minute a day to start will be helpful. Notice the stories you tell yourself in your head. Are you having an argument with your spouse or friend in your head? Your stress response will be the same whether it is in your head or actually happening. 

Sleep- the big big issue us Hashimoto’s sufferers deal with. We need to sleep to recover our adrenals. If you want to heal your adrenals, you need to go to bed and be asleep before 11:00 hits. Go to bed or start getting ready for bed at 9:00. No joke. Let the dishes go, let everything go and just work on healing your body for a while. If you can, sleep until 8:00 or 9:00. This is not always possible but do the best you can.  Normal adrenal function allows for cortisol to rise from 6:00-8:00 in the morning. With adrenal fatigue the rise isn’t as high and the drop in cortisol is faster. Lower cortisol means it takes longer to really feel awake. 

If you can’t sleep and are waking up between 1:00 and 3:00 in the morning, then you have a blood sugar issue. Your adrenals have kicked in to raise your blood sugar which causes you to wake up and it takes awhile for you to get back to sleep. 

Eating a protein/fat and unrefined carb type snack before bed can help you to stay asleep. You can also include some starchy carbs in your evening meal which should help you to fall asleep and stay asleep. 

Get some exercise. Low intensity to start. Walk for an hour as many days a week as you can. Yoga, especially restorative yoga can be very helpful. Wear the blue blocking glasses at night starting around 7pm. This will block the blue lights from TV and other screens which will aid in melatonin production. 

Eating: You must eat within an hour of waking up in order to prevent the adrenals from getting involved in raising your blood sugar. Even if you don’t feel like eating, eat something. Protein, fat and a small amount of starchy carb will help significantly. Maybe something like some chicken or turkey, a couple slices of avocado and a couple bites of sweet potato and maybe a small pile of veggies like cucumbers or carrots. 

Supplements that might be helpful in recovering your adrenal health. Remember, if you are only doing supplements they will be a band aid. You need to change your diet and lifestyle and use supplementation to help you along the way. 

• Vitamin C- very essential nutrient to the whole adrenal process. Ascorbic acid along with bioflavonoids. Look for a C complex. Go for highest quality of any supplement that you can afford. Buy from a reputable source.

• B Vitamins- A B complex with methylated folate- important in energy production

• Magnesium Glycinate- is like a spark plug for the adrenals. Very helpful with energy production.

• Trace Minerals and Electrolytes

• Essential Fatty Acids- fish and fish oils.

• Adaptogenic herbs and other herbs-

• Licorice Root- anti-stress, increases energy. Very helpful in many ways to the adrenals. Avoid in the late afternoon and evening.

  1. Ashwaganda- a nightshade but a great adaptogen. It will help the body function more in the normal range no matter if you have high cortisol or low cortisol. Can be stimulating for some people.

  2. Korean Ginseng- helps with energy.

  3. Siberian Ginseng- take no later than lunchtime- is stimulating

  4. Rhodiola- prevents stress induced adrenaline activity

  5. Holy Basil- gives us a sense of well being, helps normalize blood sugar

This is not an overnight fix. It didn’t take you overnight to tax your adrenals. Plan on 6 months to 2 years of recovery. You will see improvement over time unless you don’t change things in your life that got you here in the first place. You can get your life back but you have to put in a little work to get there. 

What does all of this have to do with the thyroid?

Chronic immune stimulation as in the case of unmanaged Hashimoto’s causes long term high cortisol (stress). You have to manage the autoimmune disease in order to also manage the adrenal gland stressors.  Low thyroid function or hypothyroidism is often the after affect of adrenal stress. Chronic adrenal stress will affect the communication between the brain and the adrenal glands. They hypothalamus and the pituitary gland are less effective with chronic adrenal stress and therefore cannot communicate with the thyroid as well.  The thyroid hormone also won’t be able to get the cells like they need to to do their job. T4 will not convert to T3 as well. The cells won’t be as sensitive to the thyroid hormone when it reaches them and the immune system cannot regulate itself as well. 

Obviously diet is a big part of this. You have to be eating high quality protein, fat and carbs in the form of veggies and a small amount of fruit. There are blog posts on my website for each of those topics as related to health in general so you can go over there to read more. Just search protein, fat, or carbohydrate. You have to keep your blood sugar stable and eat every 3 hours or so if you need to until your adrenals and blood sugar become more stable. Have protein and fat based snacks and avoid all juices for now. Don’t eat any higher glycemic foods/ food higher in sugar without eating protein or fat with them. Avoid artificial sweeteners, partially hydrogenated fats, any foods you are sensitive to, refined sugar and the other things mentioned earlier like alcohol, smoking/nicotine and caffeine. 

This week, tell yourself each day: “everyday in every way, I am getting better and better”.  You have got this and I have got your back. 

Thank you so much for listening. Your support means a lot. Please share this podcast with anyone you know dealing with thyroid problems, autoimmune issues or chronic illness. Much of the information here can help more than just those of us with Hashimoto’s. 

If you haven’t already, you can get my free ebook, 5 Things Your Doctor Won’t Tell You About Hashimoto’s on my website. You can also find me on Facebook at www.outofthewoodsnutrition.com or helpforhashimotos.com and on instagram at stephaniewalsntp.  

I would love to answer your questions about Hashimoto’s or other chronic conditions. Please send your questions to helpforhashimotos@gmail.com or go to my website and fill out the contact form and put podcast in the subject line. 

Thanks for joining me, see you next week. 

Natural desiccated thyroid hormone vs. synthetic, dry brittle hair, and having invisible illness. Episode 6.

I have Hashimotos and recently my hair has turned extremely dry and brittle. My doctor increased my medication a month ago, but still no change in my hair. I definitely feel as though it’s caused by something with in me as opposed to any products I may be using on my hair since those have not changed. Any suggestions would be sincerely appreciated!

Jody

Losing your hair and or having dry brittle hair are common symptoms in hypothyroidism. Some things that might be causing this for you are: 

1. is your thyroid medication/treatment optimal?

   1. all the cells in our body need thyroid hormones to function properly. T4 only medications like levothyroxine and synthroid might not be working well for you. Maybe your body doesn’t do well converting t4 to t3 which is what your cells use. You might need a T4/T3 combo medication.

   2. Make sure your doctor is testing TSH, Free T3, Free T4, Reverse T3 and the antibodies- TPO and TgAb. Functional medicine lab ranges according to Datis Kharrazian for TSH are 1.8-3.0 mU/L (milliunits per liter). Personally, I have felt best when mine is a bit below 1.0 which is common for those of us on Natural desiccated thyroid hormone. Free T3 functional range is 1.2-4.9 mg per deciliter, free t4 functional range is 1.0-1.5 ng/dL (nanograms per deciliter. If you lab results are not in these measurements, you can google how to convert them in to these numbers. Don’t worry about taking notes on this either, all of this will be on my website at out of the woods nutrition dot com. The antibodies should be at zero but that doesn’t mean you don’t have the autoimmune thyroid conditions of hashimoto’s or graves disease. Our immune systems fluctuate- when you have your blood test they might be considered within range- so don’t rely on antibodies testing alone to mean you do or do not have the disease.

   3. What are your iron levels like? Ferritin is our storage iron. If that is low it can result in hair loss and probably are related to dry hair too but more so hair that is falling out. Having good ferritin levels encourages hair growth and having low levels means your body will put hair and nail health on the back burner to ensure that the tissues that really need iron get it first. Liver is a great way to get your iron. Personally I can’t stand liver in the form of pate or cooked so I take either an iron supplement occasionally or I take Vital Proteins liver capsules which are not cheap. I have liver in my freezer and have not taken the time to dehydrate it and put it in capsules which would be way more cost effective.

   4. If you are not making enough stomach acid, you will not be breaking down your food, protein in particular, so you will not be getting all the nutrients you need from your diet which will affect how supple your hair is. Are you eating enough protein? Hair and nails are made of protein. If you are deficient either because you are not eating enough or because you are not breaking down your food well enough you will be deficient and your hair will pay the price. I recommend starting out on a low dose of HCl aka Betaine Hydrochloric Acid with Pepsin to help you break down your food. Something like 150mg to start with and go up from there………..

   5. Something your pharmacist won’t tell you- some thyroid medications can cause hair loss. So, the very thing you are depending on to feel well is causing your hair to fall out. The package insert for your medication will also tell you that you should not be taking it if you are suffering with adrenal insufficiency- adrenal fatigue.

   6. If you have hashimoto’s you have an autoimmune disease and that means you are likely susceptible to having more than one autoimmune disease- most commonly 3 AID and the likelihood of having a total of 7 over your lifetime. These things don’t happen overnight either. Your body suffers internally for years before another disease becomes symptomatic. This is why it is soooo important to address diet and lifestyle issues. We don’t just all of a sudden get sick overnight. Our body is like a car- pick your dream car or even the one you are driving now. How you care for that car today and for the time you drive it will determine just how long that car runs well for you. You have to put the right kind of fuel in to it. You have to change the oil and have other fluids checked. Your car wants to run well for you but it will break down if you don’t give it what it needs to run properly. Our bodies are the same. You only get this one chance to be here now. Your body does what it can daily to maintain homeostasis or balance. It works really hard to keep us alive and running well. What we fuel it with really does matter. A calorie is not just a calorie. You will get so much more out of 100 calories of veggies vs. 100 calories of cookies.

   7. Speaking of fuel- how is your blood sugar? According to Izabella Wentz: Blood sugar swings- due to high refined carbohydrates and not enough good quality protein and fats will cause T4 to be converted to Reverse T3 which keeps T3 bound up so the body and the cells can’t use it. This can cause us to lose hair too. Again, I know you were more concerned about dry brittle hair but the two go together.

   8. Are you digesting your fat well? Are you eating a good balance of omega 3 and omega 6 fats? Get a high quality fish oil and eat some healthy fats like olive oil, avocados and coconut oil to get a good mix of omega 3 and omega 6. The ratio of those should be around 1:1 and most of us get about 1:20 with omega 6 being the 20 because it is in a lot of processed foods and restaurant foods in the form of canola oil and soybean oil.

   9. Some people believe that supplementing with collagen can help your hair. We make less of this protein as we get older so you can try it to see if it helps. I would give it about a month.

   10. I would lastly look at your hair products. It doesn’t sound like this is an issue for you as you said you didn’t have a problem before and you had not switched products. My favorite hair products are Intelligent Nutrients- they are good for your hair and for the environment. I do think you are right though, your hair problem is internal. I would encourage you to use a food journal to keep track of what you are eating and how you feel and you may notice that you might need to change some things.

Good luck Jody, and please let me know if any of these suggestions helped you! 

Hi! Your podcasts have been great so far...thank you, thank you, thank you. I have been diagnosed with hashimotos for the past two years. I am 34 years old.

I decided to visit the doctor two years ago when I started having body aches and unusually dry skin. I was extremely tired all the time, however I thought that was natural due to having a newborn. I soon realized it was much more than being a “tired mom”.

I was put on levothyroxin. Seemed to even my levels out until recently. Started having stronger symptoms again and revisited the doctor. Taken off of levothyroxin (synthetic thyroid medication) and placed on nature throid (natural thyroid medication). What do you believe are major differences in a synthetic vs natural thyroid prescription?

Thank you again for all of your honest, transparent, and giving information.

CM

We have a similar story. I was diagnosed after my second child was born. I went in for a literal pain in my behind which turned out to be sciatica and when the doctor asked me if I needed anything else I told him I felt extra tired but thought it was because I had a toddler and an infant. He did a TSH test- standard for conventional medicine and my TSH was at 150- so clearly I had an issue with hypothyroidism. He put me on levothyroxine and I never felt good after that. My periods were heavy, I was cold all the time- like chilled to the bone and my adrenals were shot. 

Your question is about the differences between synthetic medication like levothyroxine and natural desiccated thyroid hormones like Naturethroid. I will get to that but I want to first address why things leveled off for awhile but got worse and your medication had to be adjusted. 

1. You were diagnosed with hashimoto’s which is first an issue with your immune system and second and issue with your thyroid- likely hypothyroid symtoms. When the autoimmune disease is not treated with diet and lifestyle modifications, your immune system can remain on high alert and can continue to attack your thyroid tissue killing it off. This often gives us the feeling of going between hypo and hyper symptoms. Maybe this has happened to you, maybe not. Anyway- one of the reasons for needing your dose to be increased is because more of your thyroid has been killed off. I guess you never said that your dose was increased but just changed to a different medication. Still, this is something to be mindful of.

2. Now, on to the differences between synthetic and natural hormone medications.

   1. NDT was used in the 1800’s to treat patients with hypothyroid symptoms. The medication is made from pig thyroid glands and this is why it is called natural. It also contains all the thyroid hormones present in our own thyroid tissue. Desiccated means that the pigs are bred for the purpose of getting the thyroid. It is removed with a specific protocol, frozen, minced, dried and made into a fine powder. It is defatted and batches are combined to get a uniform mixture of T4 and T3. The benefit of the natural desiccated medications is that you get what your body would have normally provided for you had your own thyroid stopped working properly. This means the right ratios of T4 and T3, and T2, T1 and T0. There is not a lot of research on T2,1 and 0 but they are obviously there for a reason so this might be why some people really feel so much better on NDT. The dosages are often referred to as grains. One grain equals 60 mg of NDT In Armour which is made up of 38mcg of T4 and 9mcg of T3. You can find conversion charts from manufacturers for most of the NDT medications on the market.

      1. Armour, NatureThroid and Westhroid are the most common prescriptions. My favorite was WP thyroid until I couldn’t get it anymore but have found great success using a compounded thyroid medication which is just the thyroid powder and cellulose which I open the capsule and put under my tongue. This is called taking the medication sublingually. It bypasses your stomach, gut and liver and goes right in to the bloodstream. This works for me, but doesn’t mean it will work for you. You can try it and see how you feel after a week on it. I take my meds in divided doses. Half in the morning when I wake up and half in the late afternoon. Western Research Labs or RLC labs is the manufacturer of your medication. You may be able to get all the ingredients of your medication on their site. Also be aware that your pharmacy can switch your medication without telling you if they run out of what is prescribed. You can ask your doctor to write your prescription to be dispensed as subscribed or you can let your pharmacist know that you do not want them to switch your meds. The main reason NDT meds are different is because they contain more than just T4. T3 plays a big role in cognitive abilities in the brain and how the brain functions. Got brain fog? Maybe you are not converting T4 to T3 or maybe you are lacking in T3. NDT might be what is the key to your brain fog, depression and mood problems for us. If you don’t feel any changes in those things, maybe you are not on a high enough dose or your body isn’t using it well. This is where diet changes can help. T3 is supposed to be better absorbed by the gut than T4. Studies show that 95% of T3 is absorbed within the first 4 hours of taking it and will happen even faster on an empty stomach. Back when Armour was first being used, they were making doses of medication based on symptoms and relief of those symptoms. Novel idea huh!?

      2. In 1926 synthetic thyroxine was created. Synthroid was made. To market this great money making drug- the maufacturer sold physicians on the idea that it was better than NDT. Research was funded to prove it was better than NDT. Unfortunately the study didn’t show Synthroid to be better than NDT. The research study was not published and the Dr. performing the research was discredited. A journalist caught on and broke the story and there was a lot of trouble for the manufacturer in the 90’s. The FDA pulled the medication due to irregularities in formulation. It was even marketed and sold in the US without formal FDA approval. In 2013 28,000 bottles of 150 mcg of Synthroid were recalled due to being a lower dose than stated on the bottle. Your doctor likely is just used to prescribing this medication because that is what they are taught. They have been told that NDT causes heart problems which is really a load of crap. Too much can lead to atrial fibrillation, osteoporosis, insomnia, heat intolerance, tremors, and more. My body takes awhile to get used to a NDT Medication change and that is why dosing it twice a day is recommended. Fight for the chance to try this kind of medication if you don’t feel well on synthetic only medications. The synthetic medications are really about money. Synthroid is the 4th most prescribed medication in the US at 70 million prescriptions a year. The profit from Abbott Labs funds endocrinology groups and their meetings as well as clinical research grants. Do you think they are going to publish studies that show their medication doesn’t work as well? Probably not. Pharmaceutical companies have more to gain by you being on a synthetic medication that keeps you sick vs. the Natural medication that makes you feel better.

I want to also talk about how it feels to have a disease that isn’t visible. I was talking with my niece and her husband last weekend about thyroid. Somehow the subject came up and my nieces husband said something about if your thyroid isn’t working right you are basically screwed or something like that. I had to laugh because he is so right. We don’t look sick but some days we just feel terrible. It is hard on us and hard on our families. My parents don’t understand, especially my dietary restrictions. They quit inviting my family over for dinner. My mom never makes an effort to understand how this has affected me. I don’t hold that against her- she is doing the best she can with the tools she has. So she says things like, let’s go out for pizza- you can eat a salad. Oh that sounds like so much fun to eat a salad while everyone else is enjoying pizza. It’s never- “let’s go to a restaurant where you can really enjoy the food”. She has thyroid problems too but all I ever hear is “I am so glad I feel so good”- what is normal for her is to feel tired and have a headache or just say she doesn’t feel good. She lays on the couch most afternoons and she had a headache everyday of my life in the morning. Sometimes we think we feel good because normal is to feel bad. 

Here are what some people are saying about what they want people to know about hashimoto’s. 

BA says:  In my case support... You don't "look" sick... My husband truly truly is trying to understand it all. He sees what it does to me but doesn't understand why. Thinks with diet and exercise I'll be just fine...

LH says:  Digestive issues, fatigue, stress,

GH says:  That everything can be great and you look and feel wonderful then you suddenly crash and feel like death. For weeks.

TF says:  Like one minute I lost 60 pounds, was working out every day at the age of 50 and living my best life and out of nowhere this monster hits me and now it’s horrible. I don’t know from one day to the next what is coming. I don’t even understand most of it. this disease is so extensive and complicated

TC says:  Why food makes us sick? Hurt? Not sleep?

KT says:  Always test your thyroid ANTIBODIES! All my “usual” thyroid labs were in the normal range, but antibodies off the charts... so grateful I finally had a doc test them!

TW says:  The fatigue is real, I’m not lazy. I don’t “want” to take a nap, I have no choice. What is needed? Research. Education of MDs and endocrinologists.

SJ says:  Extreme fatigue, and excessive weight gain ! 100 lbs, which I've been unable to loose for 20 years. Insomnia as well , and digestive issues ( gluten intolerant ). HASHIMOTO'S IS A BEAST !

TB says:  Research to determine which diet is the best for Hashimoto's. Extreme fatigue and brain fog are real!

SD says:  Educating MD's who are still treating all of our symptoms seperately, telling patients they are overweight because they eat too much and don’t exercise enough, and prescribing thyroid replacement that is man made instead of natural desiccated thyroid (NDT). Quit my doctor of 21 years 8 years ago and found a naturopath. Best decision of my life!!!

MH says:  More education, more testing. Doctors to understand test results vs symptoms and please don’t say” well you are  borderline even though you have these symptoms, so we will not treat you.”

TM says: Our tired is not their tired , it’s not even in the same realm . Our weight gain is not our fault . We are not lazy, we’re tired.

CE says:  Our inflammation is unlike others due to the constant aches we endure along with insomnia, depletion of vital nutrients, and gut problems.

AO says:  It may seem invisible but our body is having a nuclear war. New symptoms and concurrent disorders are constantly showing up, that don't seem to be related sometimes, and there hasn't been enough research to do anything but regulate diet and control some symptoms. It IS disabling for a large amount of people. With mine I had to quit work and can only last 2-4 hours of any type of work before I am too exhausted/weak/ill to function.

RS says:  More knowledge/awareness for everyone...So doctors stop running basic labs, so that people are more aware of symptoms and can ask for the correct labs, so loved ones can be more supportive of those with AI diseases, and so everyone realizes how vastly important our diets effect our health. The majority of people who find out I have Hashi’s have no clue what it is. I don’t look sick, so they don’t understand how I can go from 100 to bed ridden for days, or understand why I eat the way I do if I don’t have “food allergies.” People just don’t understand any of it, even my family and closest friends.

Weight gain with diet changes, exhausted after exercise, nightshades, and AIP. Episode 3.

I have been eating nothing but raw vegetables and water for 6 days. I have gained 3 pounds. I am at a loss. I have taken more D3 and B12. I have added magnesium to my diet. I am exercising even though I am exhausted all the time. I have resorted to taking sudafed because it makes me have energy.......please help. I have been to 2 different endocrinologists and they refuse to help. I have been gluten free for 6 weeks. What else can I do?

1. with raw veggies only for 6 days…. How much were you eating. It could be that you were not eating enough and your body was starving and holding on to weight.

   1. If you were not eating enough it could deplete the adrenals and then you have an issue with cortisol. This is our main stress hormone and when it is working normally it can be anti-inflammatory and key for fat burning. It also helps keep our blood sugar and our blood pressure up. So, if you were not eating enough, your blood sugar would be low and cortisol would be released to save the day. This can be a problem if it is constantly working to help manage your blood sugar whether too high or too low. Cortisol is supposed to be low in the evening to get us ready for sleeping and higher in the morning so when we wake up we feel ready for the day. If this is not you, then you probably have an issue with your cortisol being out of balance. When cortisol is low it can affect your ability to tolerate your workouts, meaning you are exhausted after a work out. Exercising too hard can wear out your adrenals and to work on healing them and getting them working properly again you need to slow down the workouts to basically just walking up to five days a week for an hour.

      1. If you have low cortisol you will have symptoms like:

         1. needing a pick me up in the morning or afternoon to keep you going such as coffee or in your case, sudafed to ramp you up.

         2. cravings for salt in general, or sugar or starches between meals

         3. you feel burnt out or don’t handle stress well

         4. you feel like you need sunglasses even on a cloudy day

         5. Your blood pressure is low or you get dizzy when you stand up quickly from a sitting position

         1. If you have high cortisol

            1. you might have extra fat around your mid section

            2. you feel tired even after sleeping a full night

            3. you have poor digestion

            4. you might wake up tired and achy

            5. you have trouble falling asleep

      2. High cortisol issues and low cortisol issues can happen at the same time. They can sort of wax and wane. It is higher when we are dealing with chronic stress which can be physical or emotional and physical stress can include what is going in internally with your body and thyroid issues. When stress is chronic (and the diet and exercise you describe would be very stressful for you right now) you can get puffy, wired and tired, and you may gain weight.

   2. This could have been detoxifying to your body and released something that your body couldn’t get rid of so you gained weight because we store toxins in our fat tissue.

      1. If your detoxification pathways are not open (liver, skin, lungs, eliminations) and this diet of raw veggies over the last 6 days really cleaned things up internally but those toxins had nowhere to go then your body could have shuttled them in to your fat tissue.

      2. All raw veggies can be hard on our digestive tract too. You might consider starting with some bone broth and cooked veggies before continuing with all raw veggies. You can steam veggies, cook them in broth (the most soothing to our digestive system), roast them, grill them or satue them in some healthy fats like coconut oil or olive oil. Broth will have minerals and collagen that are soothing and even healing to your digestive tract, especially the small intestine.

   3. Were you avoiding fat because you were worried it will make you fatter? This is not always true and consuming a small amount of healthy fats everyday is necessary for our cells to be healthy. Each cell is made of a layer of fat and we need healthy fats to make up the building blocks of our cells. This helps waste be removed from our cells and get nutrition in to our cells.

2. It would be nice to know amounts of D3 and B12 you are taking.

   1. Vitamin D is a fat soluble vitamin with defieciency being a contributor to autoimmune disease. We make vitamin d from cholesterol in our skin cells when we absorb UVB radiation from the sun. We need vitamin d for many processes in the body including the regulation and absorption of calcium, phosphorus and magnesium and for our bones to mineralize and grow. It plays a role in regulating the release of serotonin which we need for our mental/emotional health and for good digestion. It also helps us heal and helps to regulate our immune system but it doesn’t work on it’s own and supplementation with a high dose is not in and of itself a solution. WE need to take it with other fat soluble vitamins (A, E, K —-D protects against A toxicity and A protects against D toxicity and large amounts of A&D increase the need for K—-consuming liver is a great way to get all of these from food.) and we can’t use or assimilate our fat soluble vitamins with out taking them with fat. There was a study done around 1980 with Wheat Bran showing the possibility that it can prevent us from absorbing vitamin d, creating a possible deficiency.

      1. food sources of vitamin d besides liver are:

         1. salmon

         2. sardines

         3. tuna

         4. eggs (if you tolerate them)

         5. shiitake mushrooms

   2. B12

      1. we need this to help with the metabolism of carbs, proteins and fats in our cells and it is really important in making and regulating DNA, making fatty acids and in energy production.

      2. We need good gut bacteria to be able to use most of the B12 we take in so getting it from food is always best. Also, you can only get B12 from animals (unless you supplement) like shellfish, and meat products and it is produced by the animals gut bacteria.

         1. sardines have the highest amount of B12 per serving

         2. then salmon, tuna, cod, lamb, scallops, shrimp, beef

3. Exercise- if you are exhausted, then don’t exercise. Go for a walk. This will help your adrenals heal. Anything you do while working on healing your adrenals should not be debilitating, grueling or super competitive. Yoga, tai chi, kick boxing, swimming, walking, even dancing. Do something enjoyable and start slow and work your way in to it. Most important is to do it at your own pace. You might be overexercising.

   1. Again, when the adrenals are off this can lead to weight gain.

4. You have been gluten free for 6 weeks. This is great. Gluten is not the friend of someone with Hashimoto’s or thyroid issues so staying off it is a good first step. What else can you do, you ask?

   1. you can eat at least one pound of veggies, cooked and raw, remember I said cooked will be gentler on your digestion. Eat a wide variety keeping in mind the autoimmune protocol and nightshades (peppers, potatoes, tomatoes, eggplant, etc) being inflammatory for some of us with thyroid issues.

   2. consume about 25 grams of protein each meal for four meals or work in 100 grams of protein in a day.

      1. one serving of salmon should have around 22 grams of protein and a small chicken breast should have around 28grams

   3. Get some healthy fats in your diet

      1. avocado, avocado oil, olive oil, olives, coconut oil, coconut milk, nuts if you tolerate them, ghee if you tolerate it.

   4. Fruits in small amounts and stick to berries mostly but get a variety.

   5. Spices and herbs are also great. Be mindful of pepper and seed based spices if you are doing the autoimmune protocol.

5. Avoid

   1. gluten and grains

   2. dairy

   3. sugar

   4. alcohol

   5. Coffee won’t help your adrenals

I’m trying to find the limits/dimensions of my food sensitivities and figure out how to navigate eating out and would like to start introducing nightshades but am a little confused because my dietician says if you’re sensitive to one nightshade, you’re sensitive to them all. (I am gluten, dairy and sugar-free. I was full AIP for months, but have started reintroducing foods.)

For context, my three exposures:

1st and 2nd - I ate 1/4 of a fresh tomato and about 20 hours later felt extremely anxious (8 or 9 out of 10) and one of those times I had heart palpitations.
3rd - I took a chance and ate meat marinated with bell peppers. No reaction, which was great. Maybe being in the marinade isn’t enough exposure? Or maybe because the meat was cooked? Curious what is going on. 

1. Nightshades:

   1. contain a couple thousand different species of plants, most are inedible and poisonous. Eating too many of these can kill off our cells and contribute to a leaky gut and really eating too many can actually be poisonous. It is thought that low level exposure can contribute to health problems over time.

   2. Which foods are considered nightshades?

      1. bell peppers, hot peppers and spices made from them

      2. tomatoes

      3. ground cherries/gooseberries

      4. eggplant

      5. goji berries

      6. pimentos

      7. potatoes

      8. tomatillos

      9. ashwaganda (a popular herbal adaptogen for adrenals)

2. Reintroducing foods.

   1. How many months did you do full AIP?

   2. Waiting until you are in feeling your best and your labs look good to do reintroductions is ideal. This gives your gut a chance to heal and bring down any lingering inflammation.

      1. also making sure stress is well managed is important. Don’t do reintroductions during a stressful time in your life. It can likely set your recovery/remission back quite a bit.

      2. If you have been aip for a month or longer you can consider reintroductions if you have good digestion, you are not getting worse rather than better and you can manage your hashi’s/thyroid problems well. You may still need medication and that is okay.

      3. Don’t start with foods you know you have an allergy to.

      4. If you have a reaction to something, it is likely you need to work on healing your gut more.

   3. How to reintroduce a food

      1. Start with one food, you pick it but here is a suggestion of where to start:

         1. egg yolks

         2. legumes (green beans and peas)

         3. spices

         4. oils made from nuts or seeds

         5. ghee

      2. Eat the food you pick 2-3 times in one day and then don’t reintroduce another food for about a week.

         1. start with less than a teaspoon or so of the food you picked and then wait for about 15 minutes. If you notice any symptoms immediately, stop and wait a week or so to try again.

         2. no reaction, have a small bite, wait 15 more minutes, then a slightly bigger bite, wait for a couple of hours and pay close attention to how you feel.

            1. symptoms can be digestive, changes in energy, cravings, sleeping issues, headaches, dizzy feeling, runny nose, more phlegm coughing, clearing your throat, itching, aches, skin rashes, mood issues.

            2. you can eat a bigger portion at a meal on the day you reintroduced it if this reintro went well.

         3. wait 4-7 days before introducing another food if that went well.

         4. If reintroducing a spice, you can reintro it in smaller amounts than I just suggested as it is consumed in small amounts.

      3. You might find that you can tolerate a food on a rotation type basis or just every once in awhile but not everyday. This is okay- it helps ensure you get some variety in your diet.

      4. Keeping a food journal can be very helpful to try and pinpoint where something went wrong.

3. I have not read anywhere about all or nothing with nightshades. Based on the way reintroductions are suggested in the autoimmune protocol community though, it looks like sweet peppers and paprika are introduced in stage three and the rest of them in stage four.