Why am I fat? High cortisol from calorie restriction.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Signs and symptoms of high cortisol include:

• insomnia or poor sleep

• brain fog, poor memory

• depression, anxiety, irritability

• high blood sugar, high insulin

• craving for sugar

• weight gain, especially around belly

• fatigue

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

• night sweats

• high blood pressure

• poor immune system function

• low sex hormones

• bone loss or osteopenia/osteoporosis

• easy bruising, poor wound healing

• weakened muscles

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

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

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

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

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

Upon completion of this program, you will...

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

• Propose how nutrition affects thyroid health

• Identify dietary considerations for taking thyroid medications

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

• Understand what your thyroid labs mean

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

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

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

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

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

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

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

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

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

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

Eat Wild

Make-up and Skin Care

Mrs. Meyers

Branch Basics

Hot Logic