How to manage Hashimoto's when you are a workaholic.

A listener writes in about her busy life and how to get help with fatigue, achiness, weight gain and menopause. 

Good Morning Stephanie,

Thank you very much for the ‘Guide’ and for all the information you provide.

I have a topic of interest that you may be able to address.

How to manage your Hashimoto’s when you are a workaholic.

Example: I have a full time job, Mon – Fri, 08:00 – 4:30

                            Part time job, Sat and/or Sun, 07:00a – 7:00p

                            Help husband with his job, about 10hrs week.

Plus all other items relating to running a home.

I don’t have kids but I do have 5 animals. I’m a fur mom. 😊

I usually only have 3, maybe 4 full days off a month.

And – no – scaling back on work is not an option at the moment.

All thyroid labs are good. Doctor says don’t worry about the Hashimoto’s. ☹

History of thyroid cancer, left side removed. Hashimoto’s, Chronic reactive Epstein Barr, risk for Rheumatoid arthritis, and…menopause, lol.

But still very tired, sore/achy, and weight gain after watching diet, trying to get exercise, and taking supplements.

So any insight you could give pertaining to this type of situation would be great.

I’m sure there are others in this same boat as I am.

Thank you again.

You’re wonderful.

Pam

Hi Pam,

Thanks for writing in. I really appreciate it.

Sounds like you have an extremely busy life and not sure how you power through with fatigue!

First thing I would say is, let’s have a look at your thyroid labs and see if they really are optimal. They may be optimal based on the lab values given but they may not be optimal based on what a healthy persons labs should look like.

Of course your doctor says don’t worry about the Hashimoto’s because standard of care in conventional medicine is not to treat it but to up your dose yearly as your thyroid tissue is destroyed. I’ve said that a million times on here so that is old news.

Next is to see if your medication is at the right dose and kind. Many people do fine on T4 only meds like Synthroid or Levothyroxine but a lot of people don’t. It’s clear you will need thyroid meds lifelong based on the fact that you are missing half your thyroid.

Chronic reactive EBV could very well be due to stress or overworking. In this case with the very busy life you have, some adaptogenic herbs might be called for. Potentially Rhodiola, Schisandra, Ashwagandha, Holy Basil or Maca. Don’t just go throwing these in your regime though. It really depends on what is going on and starting slow with one of these like Ashwagandha or Maca first, see how you feel after a couple weeks of taking it and then add in some others. You can order these through my dispensary at https://us.fullscript.com/welcome/hfh

When you have Hashimoto’s your risk for other autoimmune disease raises by about 30% so I will say, not slowing down a bit or at the very least making sure your diet is dialed in pretty much perfectly means your Rheumatoid Arthritis risk is probably higher than most.

Having a history of thyroid cancer is a big deal as well. Make sure you are having tumor markers tested regularly - I would guess this is being monitored but you never know. It should be if it isn’t.

I’m going to do an episode on cancer in general but to make sure your cancer does not come back into the other half of your thyroid OR appear somewhere else, there is a lot you can do in your diet and your lifestyle.

I want to say that I don’t think being busy is bad, especially if you are happy and you have good relationships, especially with your husband and those close to you. Sometimes this matters more than anything else. So if you feel great, have a sense of purpose and community and are truly happy, you are one step ahead of many people in your same situation healthwise.

It would be good to know what supplements you are taking. With cancer being in your past. L-glutamine is a popular supplement but there is some risk it might feed cancer so be aware of that.

Avoiding sugar as much as possible is a good idea - sugar is the main fuel for cancer cells. Your diet should be from the cleanest sources of food that you can afford. Here is where organic matters most. Lots and lots of fresh veggies, dark leafy greens, fermented foods such as sauerkraut and kimchi, bone broth, berries (keep other fruits to a minimum), locally raised organic meats if you can do it. I know this seems ridiculous given the cost of groceries but these are ideal for preventing a recurrence. I can provide meal plans and do so for my clients when they want them so that finding food to cook becomes much easier. Also, given your busy life, some non starchy carbs are probably needed daily to help maintain your energy.

You stated you are still very tired, sore/achy and dealing with weight gain and the most lovely menopause. The weight gain could be menopause related or it could be inflammation. It could be both. Hard to say without looking at your diet and some labs. Feeling very tired could be due to a need for T3 meds or an upping of your dose- again, those normal lab ranges may not be normal. Menopause can also cause joint pain.

If it is your joints that are sore and achy, this can be due to higher levels of inflammation and with menopause we lose some stability from decreased strength and tension in our tendons. If it is muscle soreness and aches then it could be a mitochondrial issue so we would need to look at what nutrients your body might be in need of.

A good fish oil may be in order for you and possibly a broad spectrum one that has omega 3,6,7 and 9. Designs For Health makes one called OmegAvail Synergy which again, you can get by going to us.fullscript.com/welcome/hfh which is my dispensary and gives you a 10% discount. Clients get 20% discount.

If you are not strictly gluten free, I would start with that and see if it improves any soreness you have. If not, try avoiding nightshades like tomato, potato, peppers, eggplant, etc. A quick google search of nightshade foods will help you find a whole list.

If none of this helps the soreness and aches then I would suggest and elimination diet.

You may also want to support your immune system. Looking for nutrient deficiencies is a good first step so that we can identify what your body needs. Things like vitamin A, C, D, or zinc. Maybe you need nutrients to support your mitochondria like B vitamins or maybe you are anemic? There might be more questions than answers here but it gives you something to think about. Here is also where being gluten free will be helpful along with figuring out if there are other food sensitivities. An elimination diet is the best way to know if you have a sensitivity as there is not one really good blood test for allergies or sensitivities.

You stated you are trying to get exercise. What does that look like? I imagine if you are fatigued that exercising is the last thing you want to do. When you have Hashimoto’s or any autoimmune disease, exercising can cause more fatigue if not done right. We have to not over do it. In your case, you might be working so much that exercise of any kind will send you over the edge. I would try for some restorative yoga if that is the case. It is the most amazing kind of yoga where you lie down in specific poses made to help restore your body and energy. And it is worth doing if you can do nothing else.

If you are doing a lot of sitting at your day job or the weekend job then I would make a plan to do some standing when you can. Get a standing desk to do some work at. Walk at lunch during a couple days a week. When you go to the store, park far away and walk from the back of the parking lot. Take the stairs when you can. All of this adds up and is a great first start to exercising when you can.

I hope this helps a bit. I can’t give specific details about what you should be taking as far as supplements go because that would be irresponsible.

Thanks for sending in your question. I love when you guys do that.

I created a new guide for you all called the definitive guide to Hashimoto’s which you can get by signing up for my newsletter. Use the pop up form on my website to be sure you get access. I am not sure the other sign ups on my site have it attached. If you sign up for my email list and it doesn’t show up, email me and I’ll send it to you!

Thanks so much for listening AND for tuning in! I am so so grateful to all of you.

Please share this with anyone you know who is dealing with Hashimoto’s and if you could be so kind to leave a rating and review, it helps more people find the podcast in the sea of millions of podcasts out there.

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.

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. 

Why are my hands and feet so cold? Episode 35.

Welcome to Episode 35. I’m coming to you from the frozen Tundra of MN where schools are closed and the high temps for the day will be around -15 and the low -31 with windchills reaching -50. When I got up the outdoor temp was -26.

 It is cold here and when you have thyroid problems and you are already cold, this can be an issue for you. Cold hands and feet can’t get warm and sometimes you might even be cold to the bone. 

A few years ago there were nights where I could not get warm enough to fall asleep without a heating blanket, wool socks, a sweatshirt and flannel pajama bottoms with at least 3 blankets on top of me, one of which was down. 

The struggle is real my friends. If you feel like this, you are not alone- cold weather or not.  

I got a question in my inbox about this very issue. Here it is: 

I was diagnosed with Hashimoto in 99, but given no info beyond that.  Had many problems with medication so ended up not using RX but went to Thyrophin PMG but always being ill.  Have been gluten and corn free, low dairy for years.

The past few weeks my feet have felt like they are in ice water, and my temperature has often been 95 degrees, with a hot home and heating pads and baths I can sometimes get up to 97.2 degrees.

I had been forgetting the Thyrophin frequently.

I did get a chill New Years Day.

Do you think the Hashimoto could be why I am so cold?

Unfortunately my MD moved away and there will not be a replacement for some time and I am in a remote area without much for functional medicine.

I will listen to more podcasts tomorrow.

I am taking undenatured whey to reduce hydrogen peroxide,  but can’t get catalase where I am, have upped the Thyrophin and drinking lots of ginger tea,  and bone broth and wondering what else I can do.

Thanks for any advice you can give me,

Sandy 

Thanks for your question Sandy. No doubt you will be helping many people by having wrote in and asked me this. It is a common problem. 

I would like to know what kind of problems you had on your medication. Perhaps you just didn’t feel great? Maybe you had heart palpitations? Maybe it made you feel worse?

The possible scenario here is that your adrenal health or HPA axis is not functioning properly which is leading to adrenal issues and if you have adrenal issues you may not feel well on medication. I discuss this in Episode 34 but the idea is that your adrenal health affects your thyroid health and vice versa so if you are not dealing with stress well, not sleeping well, having blood sugar issues, then your adrenals are working overtime and you are either in a state of hypoadrenia (things are working slower) or hyperadrenia (things are in overdrive) and your thyroid along with TSH and Free T3 and Free T4 output are also being affected. 

Thyrotrophin PMG is a supplement from Standard Process that is similar to the GTA from Biotics except it has magnesium citrate and bovine thyroid extract that has been processed to remove thyroxine or what we call T4. GTA  Forte II which is what I take has zinc, selenium, copper, rubidium, porcine glandular concentrate and some enzymes. 

Natural Desiccated Thyroid Hormone prescription pills are made from porcine or pig glandulars and the Thyrotrophin is made from bovine or cow thyroid glands so maybe this is partly why you are not feeling well. 

I am assuming you needed medication because you were on it but didn’t feel well on it so it might be time to have your labs done again at a doctors office or order them yourself through someone like Direct Labs, depending on where you live. Some states don’t allow consumers to order lab work. 

You probably need T3. Denis Wilson, MD has coined the term Wilson’s Temperature Syndrome which means that you can have a low body temperature and other symptoms that will respond to T3 therapy. 

I found this to be the case for me. I still have a lower body temperature but once I started on GTA, I no longer have frigid hands and feet. My hands are still a little cool but I am no longer freezing before bed and my overall comfort is much better. This, I believe is attributed to the T3 in GTA. 

It is almost like your body is able to reset itself and you may find that even after stopping a T3 treatment that you will remain more temperature stable. 

Symptoms of Wilson Temperature Syndrome (WTS) include typical hypothyroid symptoms and things like asthma, hives and migraines along with a lower body temperature. You may also have fatigue that lasts and stays, anxiety, depression, headaches, insomnia, muscle aches, brain fog, carpal tunnel syndrome, overall lack of well being. 

Low body temperature is the main symptom and is easily measured because as a whole, our body temp needs to be within a certain range to properly function. If you don’t have low iron or iron deficiency anemia, kidney disease or liver disease, and you have all these other symptoms, you might want to check in to Wilson Temperature Syndrome. 

Don’t expect to go to your regular doctor and expect them to even know what this is. You can learn more by googling Wilson’s Temperature Syndrome. 

I would make a plan to remember to take your Thyrotrophin. Find a time of day to take it where you can make it a habit. Also, don’t buy it off Amazon. Find a practitioner to buy it from. 

It is definitely you thyroid issues as to why you are so cold. 

You say you are taking undenatured whey to reduce hydrogen peroxide. 

Undenatured whey is whey that has not been heated enough to denature it or basically kill all the enzymes and good stuff that might be in it. Heat will destroy the immunoglobulins and break the peptide bond (broken down protein). It has glutyl-cysteine which is a peptide. Your cells use it to make glutathione which is our big antioxidant. From what I understand undenatured whey is supposed to raise glutathione levels and fix anemia. 

If your thyroid issues are due to a mercury toxicity from environment, amalgam fillings or anything else, you may not want to be taking this type of whey. Too much cysteine can suppress your thyroids ability to function so there may be a possibility of consuming too much undenatured whey that could be making you feel worse. 

The other issue I have with whey in any form is that the proteins in dairy products are similar to protein structure in your thyroid which can be an issue for your immune system. It can get confused and attack your thyroid tissue which can create more problems like hyper thyroid symptoms and tissue or cell death. 

Hydrogen peroxide is naturally produced by the body when we convert iodine in the thyroid. When TSH rises, more TPO or thyroid peroxidase enzyme is released which then releases hydrogen peroxide. This will cause damage to the cells in the thyroid if there is not enough selenium and glutathione. If you have Hashimoto’s you may have had a TPO antibody test done. The more peroxide in the body the more TPO antibodies may be created. The immune system may see the rise in TPO enzyme as the problem and so creates antibodies against it. 

The more iodine in your diet, the more it will need to be converted, the more hydrogen peroxide there will be which can decrease how much selenium and glutathione you have to deal with it. 

You might likely be deficient if you are eating more processed foods rather than real whole foods as well. 

You also said that you can’t get catalase where you are. I want to explain what that is for you guys. 

Catalase is an enzyme that will break down the hydrogen peroxide keeping it from damaging our cells much like glutathione does. You make catalase in your liver but maybe you are not making enough. 

Selenium also helps to form glutathione which will remove excess hydrogen peroxide. You can supplement with anywhere from 50mg to 200mg per day of selenium but no more. 

Before you do that though, look closely at your diet. Remove dairy completely for a couple of months to see if it is causing an immune response for you. Stay gluten free and find out what foods you are sensitive to. Sugar, alcohol, soy, caffeine, eggs and even other gluten free grains can be a problem for many of us. You may also want to consider if nightshades are a problem by eliminating them. They are quite anti-inflammatory for many people. 

Ginger is good for heating up the body so keep up with the ginger tea. Bone broth is excellent. Make sure you are eating enough. 

Eat foods that love the liver. Much of our T4 is converted to T3 in the liver. 

Foods with vitamin C like acerola cherries, greens, parsley, cruciferous veggies like cauliflower, broccoli, cabbages, brussel sprouts. Remember these are only a problem as a goitrogenic food if you are eating them raw in large quantities on a daily basis. 

Foods with vitamin E which will be protective to the liver and have antioxidant properties. Asparagus, Avocado, leafy greens. 

Zinc is an antioxidant and is in abundance in oysters, ginger root, many nuts and peas. 

Selenium works with vitamin E as an antioxidant. Molasses, brazil nuts, brown rice, turnips, garlic, red swiss chard, oranges and shellfish.

Most of us are deficient in magnesium and this is important for so many things in the body from helping cells to create energy to helping our liver detoxification pathways work properly.  It is found in a lot of grains and nuts but also coconut and brown rice. 

If you are following an elimination diet, this may not work for you and you might have to supplement with magnesium. My favorite is magnesium glycinate. 

There are many more things that are great for your liver- B vitamins, turmeric, milk thistle and amino acids. Remember that amino acids are coming from protein being broken down in our digestive tract. 

So eating and digesting protein is helpful as well. 

I would recommend you find a way to have your thyroid tested again and be diligent with taking the supplement for your thyroid. 

I hope this helps you Sandy. Thanks so much for writing in. 

I have had some people try to contact me about working with me one on one through DM’s on Instagram. It took me about a month to even notice they were there. I try to just pop on and off of my social media accounts so the best way to reach me is through my website www.helpforhashimotos.com by filling out the contact page there. 

Someone also asked me to talk about lunch ideas and I am going to put that in my newsletter along with a recipe for a pizza hotdish (as we call it here in MN)/casserole. So head on over to helpforhashimotos.com to sign up for that. 

You can find me on social media at out of the woods nutrition-help for hashimoto’s on facebook and @stephanieewalsntp on instagram. I have been less active there so again, the newsletter is the place to get the good information from me. There is also the help for hashimoto’s facebook support group so you can go ask to join that. 

Thanks so much for tuning in. Until next week! 

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! 

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

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. 

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

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.

Will going gluten free help Hashimoto’s? Episode 2.

In this second episode, we talk about how our immune system is affected by gluten and why it is important to avoid it to ensure our thyroid can stay healthy. We discuss how to go gluten free, how I went gluten free and where to find hidden sources of gluten. 

.

I have Hashimotos and I’m hypo. 

I’m tired of feeling bad everyday. I wake up and go to bed feeling bad. I have no energy throughout the day and I have 3 children to take care of. I’m unable to work due to my anxiety and depression. I have no support at home. 

I haven’t my house in 3 days. I feed my children whatever is quick and something I don’t have to stand over the stove and cook. I’m tired of being this way. I’m tired of being tired. It feels like I don’t belong here. I need help—-

LITTLE BY LITTLE, A LITTLE BECOMES A LOT.  I have been there. When I was first diagnosed I had a 2 year old and a baby. I remember my tongue feeling heavy and it felt really hard to talk. I remember writing a check and feeling like it was so much effort to move the pen across the paper. 

My first best guess is that you are either not on the right dose of medication or you are not able to convert the T4 in your medication to the form your cells need which is free t3. 

If you can, search for a doctor willing to test more than TSH which is a test looking at what your brain is telling your thyroid to do. Thyroid Stimulating Hormone is coming from the pituitary gland. When the amount of thyroid hormone in your blood is low, it is stimulated to send a message to the thyroid to make more hormone. When there is too much thyroid hormone in the blood it is stimulated to tell the thyroid to make less. So when you have a high TSH (mine was 150 when I was first diagnosed and then the doctor was happy with it around 5 despite the fact that I still felt terrible) it means you are in a hypothyroid state or your thyroid has been told to slow down. When your TSH is really low that means you are in a hyperthyroid state and your thyroid has been told to speed up. The reason why your number is what it is, is dependent upon your bioindividuality. TSH can vary from day to day as well so when you go in, you are getting a picture of how things are working at that moment. This is true of many blood tests.  The other problem here is the way the lab ranges were made. The “normal” range was set based on a group of healthy and sick patients. Some with thyroid conditions, and some without so the range is not necessarily based on healthy people. Most healthy folks have a range at or around 2.5. Personally, I am feeling much better at just below one. I am on compounded medication though and so that makes the TSH test result lower than normal. The problem is your doctor may have a lab range that shows 8 as normal which for most people will make you feel sluggish, tired when you wake up or need to sleep 10-12 hours or more, gain weight, lose hair, feel cold and generally not feel well. This is why it is so important to find a practitioner who will treat you based on your symptoms and not just on your labs. Take note that a normal or low TSH number doesn’t mean you don’t have low thyroid function. 

Free T3 and Free T4 measure the levels of the active hormone in your body. Free T3 is a more accurate indication that your thyroid is working properly. The free in these means they are available for your body to use. 

Depression is really common in people who are on T4 only medications. If that is the case for you, switching to a Natural Desiccated Thyroid Hormone Medication could help you out a lot. Before you even do that though, you really should take a look at your diet. If you body is not nourished it can’t do what it needs to do because certain biochemical processes in the body need certain nutrients to do their job. For example, the enzyme that makes T3 free for the cells to take up is very sensitive to things like malnutrition, inflammation and toxicity in the body and will not work as well. 

The major nutrients needed to make our thyroid work well are: iron, B12, vitamin A, vitamin D, magnesium, selenium, zinc and iodine. 

TPO Antibodies (Thyroid peroxidase)- this is an enzyme that is needed to produce thyroid hormone. 

TG Antibodies (antithyroglobulin)- this is a protein carrier for your thyroid hormone. 

These two mean your immune system has produced antibodies to attack because they perceive a problem. When these are present, it can make using the other labs useless because an unmanaged autoimmune condition can cause you to swing between hyper and hypo. 

What are your symptoms?

What I am seeing here for your symptoms are no energy, basically tired all the time, and anxiety and depression. You also state you have no support at home. I’m sorry. That makes it especially hard and I get how you feel. I didn’t have a lot of support in the beginning either. I suffered for years and my family suffered because I suffered. My kids, between toddler and early teenage years had a mom who had zero energy. who was angry all the time, who didn’t sleep at night and therefore was totally crabby. Everyone felt like they had to walk on eggshells around me and I have a lot of guilt over that. It took changing my diet without support for me to really see a change in my mood and my energy. Figuring out which foods were sucking the life out of me helped a lot. 

So, diet first. You can manage the autoimmune portion of the thyroid (the hashimoto’s) with nutrition. Start with gluten free, then dairy free and then you would want to consider an autoimmune protocol diet/elimination diet. You probably will find that the changes in diet will be life changing for you. 

You may need to take some supplements as well. Get your vitamin D checked to see if it is low and if you supplement with it, monitor your levels to make sure you don’t over do it. 

A lot of us will have iron deficiency as well. Get a full iron panel, especially ferritin. You need a ferritin level of around 75 for T4 to convert to T3. If you have a ton of inflammation you might have high levels of ferritin so as you change your diet, and reduce inflammation in the body, you should have this checked as well. 

Almost all of us are magnesium deficient. It does a lot of stuff in the body. 

We need selenium for enzyme systems in the body that help the thyroid work well. Chelated selenium is recommended at a dose of 100-200mcg a day. 

Zinc- important for us to make enough HCl to digest our food but also important in T4 to T3 conversion as well. 

It is also very important to manage your blood sugar. This can be done with diet and I often find people need support to do this but if you can do it on your own, great. 

You may need fish oil and a B complex as well but I recommend working with someone to figure out just what your body needs. 

Best of luck to you on your journey. 

NEXT Q

Hi. My insomnia, fatigue, and short term memory problems have been really bad lately. I don't know what to do. My newest endo wants me to chase down a whole bunch of other possible reasons for my symptoms. I suppose there's always a possibility that I've developed another autoimmune disease that causes the same symptoms. But, I'm exhausted. I feel like I'm being sent down a rabbit trail that I'll never get off of. I need something that works. Tell me honestly, how much better did those symptoms in particular improve with diet and exercise? I hate always feeling this way.

Does anyone ever have issues controlling the temperature of your body? Like being too hot or too cold? Is this part of Hashi’s?

I was diagnosed with hashimotos after my daughter was born a little less than 3 years ago. My whole life I was a size 5 and now I’m a size 14 and can’t seem to lose weight. My levels seem to like to jump around a bit but currently are level.

What I want to know is what do you do about the lack of energy? I have no energy. I don’t even know where to start with diets or what to do. What are diets that have helped? Anything!!! My energy is so low that I can barely get up some days.  Also all I have currently is a family doctor. Should I be trying to get connected with another kind?

1. Diet- yes diet helps. AIP, Paleo, gf/df, sugar free, managing blood sugar. Find a practitioner to help you.

2. Diet will help with weight and energy

3. Temperature issues can be related to the kind of medication you are on. Natural Desiccated Thyroid hormone can help with this. Either way you are probably not on the right dose of medication and/or it can be that your have low iron. Eating meat and liver especially is a great way to get liver from diet. Low iron is a big deal for us. I said earlier that ferritin is super important here but a full iron panel is very helpful. TIBC or total iron binding capacity is measuring the ability of transferrin to bring iron to parts of your body. This will be high when your total iron stores are too low. Serum iron measures what is circulating in blood on transferrin. Next you want to look at the percent of saturation. If this is low, supplementation may be needed. If you need to take a supplement of iron you should be monitored by your doctor as you can get too much.

   1. Another option here is that you could have an issue with your hypothalamus/pituitary axis. Working on your thyroid and adrenal health will help this a lot. Our adrenals are directly related to the HPA axis, play a big role in managing our blood sugar and also help us respond to stress. If you have any amount of chronic stress at all and consume the standard american diet then you likely will have an issue with this. Diet, again is so important here.

I see so many people struggle with making diet changes and I just want to say that you can do it. YOu have to want to be well more than you want to be sick. You have to want to let go of what is a crutch for some of us- we are not our disease, it doesn’t have us. We can manage it. 

Pork Patties with sweet potatoes recipe

Chicken Hashbrown recipe from The Healing Kitchen

Hidden Sources of Gluten in The Paleo Approach

Introduction: Help For Hashimoto's Podcast. Episode 1.