The Promise of Health

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

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

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

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

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

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

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

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

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

Thyroid disease is complicated.

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

Some of you feel like a sloth at that number.

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

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

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

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

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

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

This is where the books promising health fail you.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I was repeating the familial cycle.

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

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

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

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

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

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

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

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

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

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

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

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

Upon completion of this program, you will...

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

• Propose how nutrition affects thyroid health

• Identify dietary considerations for taking thyroid medications

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

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

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

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

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

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

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

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

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

Until next time.

Losing weight after menopause

Hello

I just started listening to your podcast and love it! I heard you mention menopause and how you gained weight and lost it. I would love to hear you elaborate on this subject. Menopause and Hashimotos and weight gain and what to do. I feel desperate with trying to lose and so many different ideas out there from intermittent fasting to keto and I don’t know what to focus on that will work. Please consider doing a podcast show about this.

Thank you

Beth Axxxxxxxx

Thanks for this question Beth.

Weight loss in menopause while also having Hashimoto’s can be a bit challenging. There are a lot of things to consider.

It’s not about calories in and calories out. Calories do matter and what kind of calories you are eating matter but what matters more is what is gong on in your body hormonally.

If you are struggling with weight loss, you could be dealing with a hormonal imbalance of some kind. Maybe your thyroid medication isn’t optimized well. Maybe some other hormone is off, like cortisol, insulin and/or leptin.

Maybe you have estrogen dominance or low testosterone. These things will determine how fat you get from the calories you do consume.

Most of the time the weight loss struggle, when not thyroid hormones, might be an issue of cortisol. When cortisol is high over a period of time it can create lower levels of serotonin affecting mood (depression), keep you from sleeping well (increasing sugar cravings) and can cause you to store fat.

Too much cortisol can create that dreaded muffin top and this needs to be fixed before much of anything else can be taken care of. Higher cortisol can give you that wired but tired feeling, make you quick to anger and make you feel irritable. It also is a cause of fat gain. I spent years like this though the weight gain in my late 30’s and all of my 40’s was really minimal because I was still cycling so estrogen was helping to keep me thinner.

When dealing with low cortisol you can get tired easily or have poor stamina and low cortisol can cause you to look at things in more negative ways, you might find you get sick more often, and of course it contributes to thyroid dysfunction.

Cortisol is 100% related to stress and how you react to it which will sabotage your fat loss. When high, cortisol increases blood sugar which leads to higher insulin levels which can increase fat storage.

Remember stress can be mental/emotional, strained finances, toxic relationships, infections, poor or little sleep (even shift work), food allergies/sensitivities and over exercise.

Bottom line, working to lower stress and manage cortisol will help reduce body fat.

When cortisol is high it will also decrease conversion of T4 to T3 which causes a slowed metabolism which will probably lead to fat gain.

I mentioned leptin before. This hormone tells your body when you are full so if leptin is blocked, you don’t get the full signal and you may end up eating more calories than you need/want leading to poor blood sugar regulation, higher insulin, and fat storage.

Gut health is also important. Many of you know a large percentage of your immune system lies in your gut aka GI tract aka intestines. If your gut is unhealthy, so are you, and this includes your ability to lose fat.

GI dysfunction very simply can look like gas, bloating, undigested food in your stools, terrible smelling gas, constipation and/or diarrhea, bad breath, nausea.

If the bacteria in your gut are out of balance, this can affect the conversion of thyroid hormone from T4 to T3, slowing metabolism. It can also affect the body’s ability to excrete estrogen creating a recycling of the hormone and cause you to gain fat.

If you are not properly breaking down the foods you are eating then you are not absorbing nutrients either. You need adequate protein to be digested and absorbed in order to make neurotransmitters, repair tissues and build a healthy immune system. If you have poor digestion this can lead to anemia which causes muscles to fatigue easily and can make it difficult to exercise and will decrease your ability to lose fat.

Inflammation in the GI tract can cause a stress response in the body which will increase cortisol production which can cause immune system problems in the gut itself leaving you susceptible to infections which will cause more inflammation and more cortisol leaving your body in a cycle of inflammation.

Eating foods you are sensitive to can cause a stress response in the body leading to release of cortisol and, you guessed it, fat storage.

Now you all know that when your thyroid is sluggish it means difficulty losing weight and easy gain of weight. All the stuff I’ve talked about can affect thyroid function and poor thyroid function which can include being on medication that isn’t fully supporting optimal function can affect all the stuff I’ve already discussed.

Sex hormones like estrogen and progesterone, when out of balance, will definitely cause you to hold on to fat as well. These hormones impact your ability to feel emotionally well, have will power and have any kind of motivation. In order for your sex hormones to be in balance, you have to have balanced blood sugar, balanced adrenals, and a healthy GI tract. If your testosterone levels are high you will have trouble losing fat. In addition, if you are dealing with any kind of toxicity at all from xenoestrogens, fat loss will be difficult.

All of this needs to be corrected before fat loss happens and fat loss should not happen if you are not reasonably healthy because you don’t want to be losing fat tissue which will mobilize toxins from that fat tissue and if you are not eliminating them, they will redistribute in other tissue. Not good.

Think if you have some of this stuff going on and then you hit menopause. Our estradiol is lower in menopause and estradiol helps us be more sensitive to insulin. So now we are at higher risk for insulin resistance.

Insulin resistance means your blood sugar levels could be normal but you might have too much insulin in your blood. High insulin with no where to go means fat storage. This means that for some of you for the first time in your life, what you eat will greatly effect your weight. Sugar and anything that converts to sugar will be a problem for you in excess. This means less dessert, less treats, avoiding sugary drinks and for some of us it might mean quitting these things altogether. It just depends on how important getting rid of the belly fat is to you. And it isn’t forever. Just long enough to give your body a minute to get insulin levels regulated and then you can figure out what you can enjoy and how much of it. It’s called finding your carb tolerance. This doesn’t mean you need to go low carb either because that is a problem for hashimoto’s but you might need to reduce the amount of bread, white potatoes and rice until you get things regulated. This is something I can help you with and I recommend having some labs done to see just where your biggest problems lie with this. There are some extra markers you should ask your doctor for but before you do, I recommend meeting with me to figure out what might be going on, then you can go to your doctor and get your labs done with what ever add ons I think you need.

Now, a topic all on its own is detoxification and I’m giving a talk at an online summit in January. Sign up for my newsletter at outofthewoodsnutrition.com for info in that in the coming weeks. There is a fair amount of research tying pesticides to fat gain and to poor liver health. Some in the scientific community suggest that our body creates more fat to handle the load of toxins we get exposed to. I have a couple of different questionnaires you can take to asses your toxin level when you work with me. It is the best and cheapest way to determine toxic burden because most testing is not reliable.

There is an immune system marker called Interleukin-6 or IL-6 and when that is increased due to inflammation of some kind, it can make it difficult to lose weight and keep it off and it may be a trigger for fat gain. Fat tissue is now considered to be an organ in the endocrine system and it likely causes inflammation while inflammation causes us to store body fat. Another vicious cycle.

Decreasing inflammation through diet is a great first step in beginning to lose fat. Cutting sugar, processed foods and eating real whole foods is important. If you need meal plans, I can help you with that. If you are a client in my 6 month package, you get meal plans for free. If you just want a meal plan consult, we can work something out.

All of this is tied to your brain health which I won’t go into detail here but what’s going on in your brain physiology impacts sex hormones, thyroid hormone, neurotransmitters like dopamine, serotonin, GABA and more.

Dopamine helps to keep our metabolism going and when we have low dopamine we have low energy and the worst part- sugar and junk food binges. Don’t let anyone tell you this is about will power. They can seriously suck it if they do. If you are low on GABA, it can also cause cravings for fat and carbs. This is not to say you should supplement with GABA because you can do that but that won’t fix why you are low on it in the first place.

I’m not about bandaids for problems unless they are needed to get your body on the right track while we figure out what problems you are dealing with.

Most of this info really applies to anyone but this question was about dealing with menopause. I went in early. I think I was 46 or 47. Either way I was super happy to not have a period anymore because my periods were horrible my whole entire life. I’m reading a book about hypothyroidism that was written at least 40 years ago and thinking back on my childhood and my first periods- I had so so many signs that my thyroid might not be functioning well all the way back to 13 years old. Sometimes this makes me so mad because I feel like a huge part of my life was just subpar. It’s really why I worked so hard to get my masters and my nutritionist license. I have so much to offer you guys in the way of experience and knowledge around these topics so that you don’t have to suffer like I did. It’s the only way I can not just sit and wallow in losing so many years of well being. I’m so glad I woke up and fought for better health. Some days are still a struggle but those are fewer and farther in between as long as I manage my stress and diet. In all honesty, I’ve gone off the rails a bit with my diet. Sometimes eating super healthy all the time just gets old. And, I’m paying for it a bit. My digestion sucks right now and today my energy level is in the tank but I think that is mostly due to getting up too early, working out too hard and a couple crappy things in my personal life.

I really need to start meditating and journaling again. I have a locked document on my computer where I write out things I would never say out loud or want anyone else to read. It’s where I get all the anger off my chest and just let it go. I highly recommend it for a release, especially if you don’t have anyone you can talk to regularly or you don’t want to always be complaining about certain people.

Anyway, back to menopause. As I said, I was around 46 when it hit for me. The average age is around 51. And let me just tell you- life is not over once you hit menopause. Before you hit it though, you might be having some crazy symptoms- even if you are fit and your diet is dialed.

Anxiety, racing thoughts, heart palpitations, hot flashes, insomnia, depression and so on. You can even have these symptoms in your thirties if your body is going to go into early menopause. If you are fit, these may be milder than someone who isn’t but very few of us make it through perimenopause without some symptoms. Peri-menopause occurs because your hormones, estrogen and progesterone, are all over the place.

Abdominal fat gain in menopause is real and so is loss of lean muscle. This is due to decreased sensitivity to insulin as I mentioned earlier. Your blood sugar is likely higher and there is likely some insulin resistance which lead to fat storage.

Any high cortisol, again, also leads to fat storage. We also become less able to build muscle and you are losing bone mineral density. It becomes pretty imperative at this stage in life to start exercising if you don’t already, and lifting weights is the most beneficial.

Let’s talk estrogen, specifically estradiol or E2. This form of estrogen declines in menopause. It promotes muscle growth and muscle strength- you need to lift heavy weights to make up for loss of estradiol.

You have to watch inflammation and blood sugar too. When estradiol declines but estrone or E1 might be a little higher and progesterone is low, it can cause sore joints.

The average weight gain in menopause is 5-8 pounds. As I mentioned before it was 28 pounds over a couple of years for me. It didn’t help I was mostly sedentary for 2 ½ years sitting at my desk doing homework and not changing how I ate much at all. In fact, I probably ate more sugar and crap due to stress in school which contributed to my weight gain. The change in estrogen levels and cortisol make us gain fat in our stomach which puts us at higher risk for heart disease. If your fat is in your thighs however, you are less likely to be at risk for heart disease.

Exercise and a dialed diet are going to be key to fat loss in menopause. I’m not a trainer so I can’t speak well to exercise but Stacy Sims in her book Next Level recommends sprint interval training for fat loss along with lifting heavy.

Her book gives you plenty of ideas on what kinds of exercise you can do but if you are new to exercising, buy the book and ask a trainer to help you work out based on the principles in the book.

It might take you some time to find a trainer willing to do it- I hired a guy who agreed to read my copy of Next Level and he never did. He told me he knew enough that he didn’t need to after he had the book for a few months.

Then, when I got it back it looked like he spilled water or something all over it. I was slightly annoyed over the whole situation- also I didn’t speak up for myself- still a work in progress there!

Alright- so sprint training and lifting heavy. I use an airdyne bike at my gym and do 8 rounds of 20 seconds high intensity and then 10 seconds off. I also lift heavy using a program from the book Hangry by Sara Fragoso and Dr. Brook Kalinak. I’ve definitely gained muscle and lost some fat but the biggest change has been body composition. My thighs are smaller and the dimples on my behind are getting smaller.

This has been two years in the making for me. In order for this to be sustainable and enjoyable I go to the gym 3 days a week and I foam roll, warm up, lift heavy, sprint and then stretch. I hate working out but after 2 years, it feels good to go. I feel stronger and more confident and the weight is coming off slowly which in my opinion is the only way to do it.

I’ve been more mindful of what I eat but that needs to get more dialed in as well. Like I said, I’m kind of off the wagon which for me just means eating more gluten free bread and too many nuts. I’ve also cut back on chocolate and rarely drink coffee.

By the way, lifting heavy as defined by Stacy Sims is lifting six reps or less of the most weight you can of things like deadlifts, chest press and squats. Get the book, read the book and then find someone to help you write a program from the recommendations in the book. Don’t try to figure it out on your own unless you are well versed in the gym already.

Doing this will help increase your metabolism, help you lose fat, improve your stability so you don’t fall and break a hip and improve your body composition.

Let’s talk diets.

If you are exercising, it will be super important to fuel yourself before you exercise otherwise your body will be stressed which messes with your muscle gain and fat loss. Eat a little protein and a carb like banana and nut butter, toast and nut butter, or something like that.

I tend to forget to do a carb in the morning but I do cold brew and protein powder before I go to the gym and I eat as soon as I get home. Sims states in her book that women specifically need to eat within 30 minutes of a workout in order to build muscle and keep our body from further breaking muscle down.

If you don’t eat right after your workout, your body is in a stressed place, blood sugar is likely high and you are more likely to store body fat. So working out while intermittent fasting is a big big no no. Eat some protein- whey protein is ideal, animal protein is also good. Chicken, eggs, nuts, fish, greek yogurt, cottage cheese. Any of these before or after are good.

Then do your best to get around 100 grams of protein per day or around 30 per meal.

If you google Stacy Sims and Intermittent fasting you will find a good article on why you should not do it. A very brief summary of why you shouldn’t intermittent fast or the ketogenic diet is because both of these diets mess with a neuropeptide called kisspeptin which, when it is disrupted will make our brain think we are deficient in nutrients, especially carbs leading to increased appetite and increases insulin resistance which leads to fat storage.

Fasting and exercising leads to higher cortisol which leads to fat storage. Short term, the keto diet might be great- long term it can mess up your endocrine system and increase fat gain. The article is called Yes! You are an athlete. No! You shouldn’t practice intermittent fasting. It’s a quick read and pretty easy to understand.

Bottom line- no to dieting, yes to exercising. Yes to figuring out your carb tolerance. Yes to looking at your blood work. Yes to joining me for 6 months every other week to help you get and stay on track with all of this. If you are sick and tired of being sick and tired. If fatigue is winning at keeping you on the sidelines of life more than you are winning at having the life you really want, then we need to talk.

You can schedule a discovery call at outofthewoodsnutrition.com under the work with me tab. Let’s see if we are a good fit. I know I can help you get your life back! Let’s do this together! I am compassionate and I have a real passion for helping people just like you get rid of their fatigue!

If you haven’t signed up for my newsletter you can do so on my website as well and get 5 things your doctor won’t tell you about hypothyroidism. I send out recipes almost every week in my emails.

Thanks to Beth for sending in this question. I love when you guys do that. If you have a question, please email me at stephanie@outofthewoodsnutrition.com or fill out the contact form on my website. It’s so much more fun to answer your questions than come up with content or guess at what you might be interested in.

Thanks for tuning in. Until next time.

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.