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

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.