Food Sensitivity Testing and more with Reed Davis of FDN

Food Sensitivity Testing and more with Reed Davis of FDN

Stephanie Ewals, NTP

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AIP diet and vacation; feeling apathetic and tired all the time.

AIP diet and vacation; feeling apathetic and tired all the time.

Stephanie Ewals, NTP

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Hi, 

I am two weeks in to the AIP diet and am planning a vacation in December to an all inclusive resort. Will I undo all my hard work on this diet if I go off plan for a week? What if I have a glass of wine? How much damage will it do? 

Sarah,

Hi Sarah. Thanks for your question. You will be three months in to AIP which is a good amount of time on the diet. Some people only need that long to see a real benefit. The trick will be reintroducing foods while you are there. Your body will have had a good amount of time to heal which means your body will have the ability to give you a proper response to your reintroductions while on vacation. OR you could do a few reintro’s a week before you go in case you have some major digestive, skin or emotional reaction. This way you will be able to deal with it before your trip. Otherwise I would not really stress out too much about it because you want to enjoy your trip and sometimes stressing about what to eat is worse than eating the actual foods you want to. I would be mindful of not eating gluten and dairy since they are often a problem for autoimmune thyroid patients and if your symptoms before the diet change were not too terrible then you might be just fine. Just take it one meal at a time and play it by ear while on vacation. Make sure you are eating a lot of vegetables and fruits and enjoy an occasional glass of wine.  Have a great vacation. 

How do you know if your Hashimoto’s is the cause of your apathy (lack of interest, enthusiasm, or concern) and fatigue?  I know others who do not have any problem. My husbands wife has it as well and is thin, walks, does yoga, stays up past 10, etc. I am getting worse. I am tired and now apathetic about not getting anything done. I am eating anything because no matter what, I will gain weight. Is it hashimoto’s or something else? My doctor can't find any reason for me to be so tired. I just want to do nothing all day. I do work, so Monday-Friday I have to get up to the alarm, and then plant myself on the couch when I get home. This is existing, not a life.

I found a study linking major depressive disorder (depressed mood, low self esteem, loss of interest or pleasure in activities you used to find enjoyable) and the hypthalamic-pituitary-thyroid (HPT) axis. The amount of dysfunction in the HPT axis was related to how severe the depression was. Lower T3 and TSH was an indication of thyroid dysfunction in major depressive disorder. This study found a correlation, not causation but is still something to consider (1). 

Some other things to consider with apathy are your hormones. If you have an imbalance of estrogen, progesterone, or testosterone this can affect the neurotransmitters in your brain. Estrogen imbalances will have an effect on serotonin receptors in the brain. Serotonin is a neurotransmitter that gives you a feeling of well being and happiness as well as helping you learn, have memory and more. Estrogen imbalances will mess with dopamine too (a hormone and neurotransmitter related to motivation in reward-motivation behavior) and thyroid hormone is needed for all neurotransmitter receptors in the brain. 

Some questions you should be asking yourself and your doctor: 

• Is my medication doing it’s job?

• Do I need more T3, am I converting enough T3?

• What is my diet like?

  • Are you on a gluten free, dairy free diet?

  • Are you sensitive to any other foods?

• Is my cortisol high in the evening and low in the morning?

• How is my stress level?

• How is my sleep?

• Am I on a blood sugar roller coaster?

Something is not right, obviously you know that- the way you feel is no way to live and let me say to you that it is not your fault, you cannot just push through it and I hope you have some good support. You don’t deserve to feel this way. I have been there. My first inclination is to ask if you are on natural desiccated thyroid hormone like Armour or if it is a T4 only medication like levothyroxine because it sounds like you need T3 and if you are not eating a healthy diet, that needs to change. 

(1) Jia Y, Zhong S, Wang Y, Liu T, Liao X, Huang L. The correlation between biochemical abnormalities in frontal white matter, hippocampus and serum thyroid hormone levels in first-episode patients with major depressive disorder. Journal of Affective Disorders. 2015;180:162-169.

Are heavy periods and hypothyroidism related?

Are heavy periods and hypothyroidism related?

Stephanie Ewals, NTP

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If I take Armour Thyroid will it interfere with drinking celery juice everyday?   Julie

Hi Julie, 

First of all, it depends on how you are taking your meds and when you are taking them. Do you take it first thing in the morning with water? Or do you take it sublingually (under your tongue)? Most thyroid meds need to have time to absorb when taken orally so I wouldn’t drink your celery juice and then take your pill. Personally I take my Armour by chewing it up and putting it under my tongue and letting it dissolve directly in to my blood stream. Then you don’t have to wait to eat. I can’t speak to how this works with T4 only medications though. 

Celery in general is really good for us. It has never really been a favorite of mine but I do eat it- mostly as part of the onion/carrot/celery base for soups but I have been drinking some celery juice too. I cannot stand the taste by itself though so I have to do a mixture of celery, cucumber, lemon or apple. 

Celery is anti-inflammatory, especially protecting the digestive tract from inflammation. Celery contains pectin which forms a gel like substance and can help move things along so to speak. It can also help lower cholesterol. 

Celery is a good antioxidant containing vitamin C and flavanoids. You should eat your fresh celery within 5-7 days to be sure you are getting all the good stuff before it loses all the nutrients you are buying it for. 

It is high in vitamin K, molybdenum, folate, potassium, B vitamins, fiber and several minerals. 

Celery can decrease oxidative damage (damage to cells) too. So all in all it is a really good thing to have in your diet. Go ahead and enjoy it. 

I had a question a while back about how menstrual cycles are affected. I misplaced the actual question because I got so busy with school but if I am remembering right, it was about heavy periods. If you asked this question which would have been months ago and this is not correct, please email me at stephanie@outofthewoodsnutriiton.com and clarify what you wanted to know. I’ve been down a rabbit hole of scientific research which is really time consuming so I spent the better part of yesterday trying to find some good information on how hypothyroidism affects a woman’s menstrual cycle. If you are a guy who is listening- this is for you because you likely know a woman or two and it won’t kill you to know this information. 

It seems like everything I research boils down to not enough free T3 when it comes to problems and hypothyroidism. 

How does thyroid problems, specifically hypothyroidism affect a woman’s period?

• not enough thyroid hormone, ovaries might not make enough progesterone which helps keep flow low

• not enough thyroid hormone, you might not make enough of the coagulation factors that prevent heavy bleeding

• not enough thyroid hormone, you make less sex hormone binding globulin and are exposed to more estrogen which can lower progesterone. progesterone thins the uterine lining and prevents heavy menstrual flow.

Weeks AD. Menorrhagia and hypothyroidism. Evidence supports association between hypothyroidism and menorrhagia. BMJ. 2000 Mar 4;320(7235):649.

Menorrhagia is the medical term for heavy menstrual periods which can be common for women with hypothyroidism. It has been suggested that diagnosing hypothyroidism as a cause for menorrhagia is not happening as often as it should be. One study tested for thyrotrophin releasing hormone (a signal from the brain to release TSH which tells the thyroid to make T4) in 67 women with heavy periods that had normal blood levels of thyroixine (t4) and TSH. The women treated with thyroxine saw an improvement in their periods/flow to what is considered normal. So if you are on medication and still having heavy periods, your medication may not be optimized. This was me from the get go. I finally went to the doctor for heavy periods and she put me on the pill plus an IUD and then offered to remove my uterus because I was not a good candidate for ablasion. Once again- we should always be asking WHY. Why do you have heavy periods. Let’s stop getting bandaids for our problems and get to the bottom of the problem. Finding the root cause. 

Another study shows that low plasma levels of thyroid hormone shift the hemostatic system - the system that prevents or stops bleeding aka prevents hemorrhage- towards a hypocoagulable and hyper fibrinolytic state. Coagulation means that blood becomes more gel like instead of liquid. Hypocoagulable would mean that clots are slow to form. 

fibrinolysis means there is the break down of clots. Fibrin is a mesh like substance in the body that is broken down by the process of fibrinolysis. It is the body’s way of keeping blood clots from forming and becoming an issue. 

High levels of thyroid hormone in the blood create more coagulation and less breakdown of fibrin. In general, low T4 can lead to higher risk of bleeding and therefore higher blood loss.

Our body works well when all systems are working well together. Much of this dysfunction with periods really starts with managing blood sugar. I really wish I knew what I know now 30 years ago. So much of my life was just messed up. I almost said wasted but it wasn't really wasted but I did spend a lot of time not feeling good. Like just feeling unwell. Low energy, bad skin, sick all the time. Food is medicine guys. I can’t say that enough. 

Low plasma levels of thyroid hormone shift the hemostatic system towards a hypocoagulable and hyper fibrinolytic state. Coagulation means that blood becomes more gel like instead of liquid. Hypocoagulable would mean that clots are slow to form. 

Fibrinolysis means there is the break down of clots. Fibrin is a mesh like substance in the body that is broken down by the process of fibrinolysis. It is the body’s way of keeping blood clots from forming and becoming an issue. 

High levels of thyroid hormone in the blood create more coagulation and less breakdown of fibrin. In general, low T4 can lead to higher risk of bleeding and therefore higher blood loss. 

How does Hashimoto's affect pregnancy? Episode 59

How does Hashimoto's affect pregnancy?

Stephanie Ewals, NTP

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Hi everybody. Welcome to episode 59. I had intended to give you a little update but I couldn’t muster up the time or energy to do it. School that is supposed to be part time turned out to be more like full time and I just didn’t have the time to research topics and put out good content so rather than giving you subpar information (and some of it may have already been) I decided to just take a break, finish out the quarter and start back up after finals. I got A’s in my classes by the way! Next quarter I am only taking one class; and actually only taking one class for the next year in order to better serve my clients and also have a life. My adrenals crashed during midterms. I was so physically exhausted I got up one morning, took a shower and had to lay back down. I spent the day on the couch and then ordered some licorice root to get me through the rest of the quarter. 

Sadly, so far in my studies there has not been a lot of thyroid information that was new to me or surprising. In fact, I have this huge book called Nutritional Medicine that is like 2000 pages and it devotes less than a page of information on Hashimoto’s stating the base for it is rooted in food allergy. Well, that wasn’t surprising at all! 

I have access to a huge database of research while I am in school so when I have a moment I look for information or studies on thyroid. 

I found a study from 2016 in the Journal of the College of Physicians and Surgeons Pakistan called Frequency of Thyroid Peroxidase Antibody and its Association with Miscarriages Among Pregnant Women. 

Around 25-30% of pregnancies end in miscarriage and the study doesn’t exactly define miscarriage. Not sure if stillbirth is in there or not which is how I lost my child. Chromosomal and endocrine system issues are a big reason for miscarriage but 20% of those miscarriages are the result of problems with the immune system and that especially affects recurrent miscarriage. 

2-3% of pregnant women have hypothyroidism and 50% of those women have autoimmune thyroid disease. Our thyroid needs to be working properly in order for the mother and fetus to be healthy. The first 12 weeks of pregnancy, the baby relies completely on the mothers functioning thyroid and her thyroid hormone for optimal development. Hashimoto’s during pregnancy is a factor in whether or not a fetus’s brain develops properly. I always wonder if my son’s brain was okay. He looked perfect but I wondered if he would have been “okay” had he survived. Anyway, when you have Hashimoto’s it can increase the risk of “loss of conception” to quote the article. 

They go on to say that diagnosis of subclinical hypothyroidism that is autoimmune in nature, it is important to test for antibodies against the thyroid. Lab values showing slightly higher TSH with normal thyroid hormone levels are common but antibodies (TgAb) show up on lab tests in 90% of patients. They go on to say that discovering the thyroid peroxidase antibodies (TPO ab) early on is a good indication of one developing hypothyroidism secondary to Hashimoto’s. 

This study measured TPO antibodies during pregnancies of 1050 women who were clinically euthyroid- meaning they had no diagnosis of thyroid disease. They found 13.5% of those women tested for TPO antibodies but they state this is not uncommon and depends on your genes, environment and more. In the women with antibodies in this study, 2% miscarried and other studies have shown the risk of miscarriage higher in women who have antibodies against their thyroid. 

These antibodies are a marker for T lymphocyte defects, which might be the cause of the miscarriage.  Lymphocytes are immune cells made in the bone marrow and “grow up” in your thymus gland. They are found in your blood and lymphatic tissue where they are on the lookout for things in the blood and lymph that should not be there. T lymphocyte is a general name for T Cells and there are a lot of those. They do not specify in this study which T-cells  they are talking about. I think the defect they mention might be the confusion the immune system has when something we ingest gets in to our blood stream that shouldn’t be in our blood stream via intestinal permeability or leaky gut. This creates antibodies against that foreign thing and sometimes our thyroid gets in the line of fire. 

This study shows why it is so important to manage diet, sleep, stress and all the stuff I’ve talked about before. It is important that you be as healthy as possible before pregnancy. If you have autoimmune disease while you are pregnant- be mindful of all things going in to your body whether injected or ingested. 

I’ve got some great questions in the pipeline which I will be answering coming up soon. I feel like I keep saying that but it is true. They are on my to do list. I’m doing this for you all so you can feel your best with Hashimoto’s and I am truly grateful you are here and stuck it out while I was on break. 

Thanks for listening. 

Is gluten sensitivity a real thing?

Is gluten sensitivity a real thing?

Stephanie Ewals, NTP

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Hi there. Welcome to Episode 58. Thanks for joining me. I missed you last week. 

I had one heck of a week with school Each week we have discussion posts we have to do research on and I spent about 11 hours trying to find research on my topic. I have to be honest. I did not do my best work the first time around when I posted on my topic. I was about 6 hours in to finding hardly anything in the way of research articles to back up my words. I posted anyway and then had to basically redo the whole thing. So I had to spend another five hours. I was so frustrated and in tears just so upset about the whole thing. This research shouldn’t take that long. I actually contemplated dropping the class. I would have been out money so I opted to stay in the class but next quarter I am dropping down to one class a quarter until next summer when I will take two 2 credit classes for a total of four credits instead of the 7 credits I am currently taking. 

It is also summer. My poor daughter is stuck not being able to do much because I am in school plus seeing clients part time. Everything in my life is being done half way so I had to drop school down to one class. I just completely forgot about the podcast last week.  It is tough to get work done when my kids are home. Lots of mom guilt going on here! 

Anyhow. I am learning about all the foods in Whole Food Nutrition and Supplementation and this week we are learning about grains. 

Grains are something that I don’t personally do well with. I have had a few gluten free sandwiches over the last couple weeks. A sandwich is just quick and easy and sometimes I miss having a darn sandwich. I also paid for it. I immediately got a scab on my chest and the other night I felt like there was some kind of poison just underneath my skin on my shoulder that I itched until it became a scab too. This was a common thing for me when I ate gluten. I am sure the stress of school just exacerbated the whole issue because I can do a sandwich here and there and I don’t have that issue. Last week we also had really horrible gluten free pizza in addition to a couple sandwiches so I really stressed my body. 

Alright.  Let’s talk about Non Celiac Gluten Sensitivity (NCGS)and how that affects those of us with autoimmune disease. 

It is an actual thing but not a lot is known about it. Here is what I learned from an article in the Journal of Gastroenterolgy 2015 called NonCeliac Gluten and Wheat Sensitivity. 

Since around 2005 the gluten free diet became quite popular and it has been going strong since then. As of 2015 when this article came out around 100 million Americans were eating gluten free this and that each year. 

Some people don’t think a gluten free diet is healthy unless you have celiac disease. I’m not sure how that makes sense to anyone since people with celiac disease seem to do just fine not consuming glutenous grains. 

There is some thought that NCGS plays some kind of part in IBS, chronic fatigue, autoimmune disease and more. 

Wheat is everywhere. Most of us grew up on it. Bread, pasta, cake, cereal, cookies and so on. It is a filler and it is in the beauty industry. 

If you have an allergy to wheat, your adaptive immune system is involved.  Your T regulatory cells are activated in your intestinal lining. In an actual allergy, you have a histamine response and the immunoglobulin E or IgE cells get involved. In celiac disease (1% of the population) your body creates antibodies against something called transglutaminase-2. 

In NCGS, you can have a reaction to gluten without it being an allergy or celiac. In my case, I don’t know if I have celiac as I was never tested. I felt better off gluten and that was enough for me. If you have symptoms and they improve on a gluten free diet then it might be likely you have NCGS. You may not experience damage to your microvilli like you would if you had celiac disease and there is no IgE reaction but you can have GI symptoms like cramping, bloating, diarrhea or no GI symptoms at all.

The example given in the article is a case of a woman with diarrhea 3x a day with bloating. Her appetite was good and she was of normal weight. She was on an antibiotic for 6 years for acne. She didn’t have any parasites or anything like that. Her symptoms did not improve with removal of the antibiotic or when she was given anti-diarrhea medicine. She lived like this for two years. 

She then tried a gluten free diet and within 4 days her diarrhea was gone. She did a 6 week gluten challenge- or went back on gluten for six weeks. They tested her intestines with a biopsy after 6 weeks gluten free and everything was normal. She went back on a gluten free diet and all symptoms were gone again. 

Now NCGS is defined in the medical literature and it looks like this: 

I am quoting from the article: “a clinical entity induced by the ingestion of gluten leading to intestinal and or extra intestinal symptoms that resolve once the gluten-containing (food) is eliminated from the diet and when celiac disease and wheat allergy have been ruled out.”

There is some question still about the validity of NCGS so defining food sensitivity and food intolerance has become an issue. 

The US National Institute of Allergy and Infectious Diseases define it as: 

Food intolerance: when the body lacks a particular enzyme to digest nutrients, nutrients are too abundant to be digested completely, or a particular nutrient cannot be digested properly… symptoms are mostly gastrointestinal and secondary to sugar fermentation by our gut microbes, causing gas/bloating/abdominal pain/diarrhea or constipation or a problem with FODMAPs (fermentable oligo- and disaccharides, monosaccharides and polyols or lactulose. 

Food allergy: When as stated earlier, your body has an immediate immune response to something you ate. 

Grains and wheat are not huge sources of FODMAPs and the authors make clear that in the case of NCGS, FODMAPs are not causing inflammation in the gut and are not causing NCGS or IBS. 

There are proteins in grains that are only in grains that are thought to be the reason so many of us are developing NCGS and so we should maybe be using the words wheat sensitivity rather than gluten sensitivity.  For me this makes sense if my food allergy testing from Genova Diagnostics was correct all those years ago because it showed I was more sensitive to wheat than to gluten. 

When you experience symptoms of NCGS they can happen in a matter of hours or take days after you consume gluten containing grains and they go away quickly when you take the offending food away. They are saying the most common symptoms are stomach related- pain, gas, bloat, constipation, diarrhea. Others will have headache or migraine, brain fog, chronic fatigue, joint/muscle pain, tingly extremities, numbness in leg/arm, eczema, anemia, depression or a lessening of your autoimmune symptoms or antibodies. 

NCGS can be related to or affect schizophrenia, autism, allergies and autoimmune diseases. It is not thought to be all that uncommon with the prevalence of it being underestimated. The article states that many people with digestive distress may not relate their problems to gluten and NCGS. It appears to be more often occurring in woman and young to middle aged adults. 

We know for sure that the antigen(something that creates and immune response)  gliadin in gluten is a big player here. Gliadin does a lot of stuff in the body related to the immune system, causing cell death and most notably creates openings or spaces in the tight junctions of our small intestine. It doesn’t appear that people with NCGS are having more intestinal permeability than the average person though I don’t think a lot of testing has been done. They do have some higher levels of some immune system cells leading researchers to believe the the innate (quicker to respond) immune system is responsible. 

What are you supposed to do with this information? We know the proteins in wheat are similar to the proteins of our thyroid. If we have inflammation and antibodies- our immune system can attack our thyroid tissue. This is important to know. You have nothing to lose by removing gluten and eating more real whole foods. You can remove it for a month and try reintroduce it and see what happens. Take note of symptoms mentioned like brain fog, headaches, fatigue, joint/muscle pain. If you are experiencing those, you can try to eliminate gluten and all processed foods really and see how you feel. And remember. It took some time for you to “get sick” and really notice your symptoms. True healing takes time. Not just a couple weeks though you might find yourself feeling better, your body needs time to really heal. 

That is it for me today. If you have a question you would like to address send me an email at helpforhashimotos.com or fill out the contact form on my website Helpforhashimotos.com. 

I am currently taking new clients and would love to help you navigate your way through diet and lifestyle changes. 

Take care. 

Why do I still feel horrible on my thyroid medication?

Why do I feel horrible on my thyroid medication?

Stephanie Ewals, NTP

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Can CBD oil help Hashimoto's?

Can CBD oil help Hashimoto's?

Stephanie Ewals, NTP

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Welcome to episode 56. 

I have a question that I think could be good for your podcast. I was recently diagnosed with hypothyroidism (presence of TPO antibodies but only at 10) and came across your podcast in my research. 

I was wondering what you thought about the use of CBD oil to treat autoimmune diseases, Hashimoto’s and hypothyroidism. I haven’t found a lot of research on it, but I’m always interested in anything that has the potential to reduce inflammation. 

Thank you!  Tiffany

Well Tiffany, this is a good question. I’ve tried CBD myself and have not found much of a difference but that doesn’t mean you won’t.   

Let’s talk a bit about what CBD is. Cannabis sativa L. plant has around 750 chemical compounds of which more than 100 are cannabinoids. THC which is what has a psychotropic effect on you when you take it, and cannabidiol or CBD are the most plentiful chemical compounds in the cannabis plant. 

Both of these have a lot of therapeutic effects and when taken together, they work together. CBD has been found very useful for treating all kinds of chronic illness including seizures, cancers. 

CBD has no mind altering properties to it but it does have really great anti-inflammatory properties so in the case of autoimmune disease in general it may be very helpful. CBD is also a great anti-oxidant, anti-seizure, helps with inflammation in joints, muscles and fibrous tissues, helps keep you from vomiting or being nauseous and has properties to it that make it antibacterial. 

CBD is found in hemp seeds and fiber but probably so low that you would have to consume a fair amount of the seeds to get the effects of the cannabinoid. 

We have receptors all over the body for cannabinoid which causes a physiological response to CBD and other biologically active compounds found in cannabis along with the cannabinoids our own body naturally produces. 

In 1992 a whole entire system called the endocannabinoid receptor system was discovered. This means we make our own cannabinoids. 

Some studies show that CBD is not toxic even at high doses but it can affect how your liver processes some drugs- actually stopping metabolism of other drugs causing you to need more and more of the drug.  Other studies have shown it can affect your fertility. Low doses may be stimulating and high doses of CBD can cause the opposite effect. 

Let’s talk a bit more about the endocannabinoid receptor system. 

We are made up of trillions of cells. Those cells make up tissues which make up organs which make up systems. We have a cardiovascular system, and immune system, endocrine system, nervous system and so on.  The cells that make up your nervous system will talk to another system through neurotransmitters, hormones, cells and even drugs to cause things to happen in the nervous system as well as other systems. So stress of any kind will affect the nervous system which will also affect the immune system and the chemical messaging endocannabinoid system. 

This system helps the nervous system cells talk to each other and their environment which has a goal of achieving balance or homeostasis throughout the body.  Apparently it plays a general role in our health but especially is important to our brain and immune system. 

This endocannabinoid system influences to some degree the immune system to help protect us from autoimmune disease and to reduce inflammation. 

I found one study particularly for cannabinoids and autoimmune disease but when I pulled it up it was all in Hebrew, literally. There is a ton of research on it for schizophrenia and other brain type disorders as well as pain management. 

Where cannabinoids may be helpful for us is in regulating the immune system, in how they affect the brain and as an anti-inflammatory. It helps to keep the immune cells in our brain in check but other studies show it can raise the Th-1 response and if you are Th-1 dominant that can be a problem but that it can also help the immune system behave. 

So as with everything, you can give it a try and pay close attention to how your body responds. It is not the panacea it is made out to be, that is for sure. 

Also, be aware that many products on the market are testing negative for CBD according to a 2015 study and 70% of online CBD products are testing negative or are mislabled.  Get it from a trusted source. Personally I cannot recommend any products. 

How do I know if my disease is in remission?

How do I know if my disease is in remission?

Stephanie Ewals, NTP

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hello, 

My name is Yolanda, and I’ve been suffering with hashimotos for almost 8 years now. My question is regarding thyroid antibodies. I’ve never had high antibodies yet I was diagnosed with hashimotos after an ultrasound to my thyroid. I had 2 small modules that have now disappeared, and also my thyroid has shrunk considerably, I imagine because of the medication. 

I take 90 mcg of NP Thyroid plus a bit of t3 and LDN at night, which has been a godsend for my insomnia. It’s not that I’m complaining of not having high antibodies but it makes it harder to know if I will ever be in remission, given that that is usually how people measure their level of sickness. 

I’ve read that a small percentage of people don’t show high antibodies and yet still have the disease. Should I approach my hashis from a different angle? Any insight on why and how this happens would be of great help.

Hi Yolanda, 

Thanks for writing in. This is a good question- all questions are good questions though! 

since I currently have access to loads of scientific research I found a study called A comprehensive score to diagnose Hashimoto’s Thyroiditis: a proposal. 

I the study they kind of explain how ultrasound diagnoses hashimoto’s. 

Sometimes this disease is diagnosed with labs, antibody tests or with labs and an ultrasound. With ultrasound they are looking for echogenicity which means a uniform thyroid gland- it looks the same on both sides- no damage or issues. 

Antibodies are used as a tool to predict disease development.  TPO antibodies are only found in 12-26% of people tested and thyroglobulin antibodies are found in around 14% of people. 

Ultrasound findings would be things like Diffuse hypoechogenicity which as far as I can tell means there is a nodule on the thyroid. An irregular echopattern from the ultrasound waves indicates hypothyroidism. 

I couldn’t find a lot of information about this with the amount of time I have to spend on it. 

I found another study called Comparison of thyroglobulin and thyroid peroxidase antibodies measured by five different kits in autoimmune thyroid diseases. 

In it they discuss how diagnosis or finding hashimoto’s is done with TPO antibodies which is the better test of the two antibody tests. The other test is thyroglobulin antibodies.  There isn’t a lot of information to compare the two tests in diagnosis. In those tested, Hashimoto’s patients were more frequently testing positive for thyroglobulin antibodies than TPO antibodies.  

The kits mentioned in the title are testing kits. 

This information doesn’t feel very helpful to me. I’m not sure why your antibodies are lower. It could be that something else has caused damage to your thyroid gland. 

I would pay close attention to your symptoms and notice how you feel. If you are not doing dietary changes then you should consider that first and foremost. Food is medicine and what we eat is information for our cells and helps them operate optimally or keeps them from operating optimally. 

Antibodies will fluctuate from day to day because   your immune system varies from day to day so you have to keep that in mind. A blood test of any kind is just a snapshot of what was going on in your body at the time your blood was drawn.

I’m sorry I couldn’t find a good answer to your question. I think you have to not worry about relying on a lab test to know you are in remission. Go by how you feel, how you are sleeping, what your energy levels are. Those things matter more than a blood test. 

You will always have to manage this with diet and lifestyle. That will never change. 

Nutritional Detoxification for your Thryoid

Nutritional Detoxification for your Thyroid

Stephanie Ewals, NTP

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Branch Basics All Purpose Cleaning Concentrate http://branchbasics.refr.cc/stephanieewalsntp

Beautycounter.com/stephanieewals

Nutritional Detox

1. Most detoxing takes place when we are sleeping. If you are always in overdrive detoxification can’t take place. We must be relaxed for detoxification to happen. 

2. Your body is designed to constantly be “cleaning house” or removing toxins and debris that build up in the body. 

3. Without ensuring your digestion and other systems are running optimally, detoxification can overload a system and toxins can recirculate in the body. 

Detoxification is the way the body heals and repairs itself 

Body Systems involved in Detoxification: 

Cardiovascular ~ circulating blood cleanses other detox sites such as the liver

Lymphatic ~ fluid flow through lymph where pathogens are filtered out

Digestive ~ GI tract scans food for invaders, detoxes poorly digested and 

  fermented toxins all of which leave the body through elimination

~ Liver- cleans and purifies blood by filtering toxins from blood &

    neutralizing them before elimination (includes pharmaceuticals)

~ Gallbladder neutralizes toxins which are carried out through the bile

    and excreted in elimination!

Kidneys ~ Filter blood and remove waste through urine

Skin ~ Sweat glands are like a second kidney removing waste through sweating

Lungs ~ eliminate waste like carbon dioxide

• Fasting is not recommended for someone with blood sugar issues or what is commonly called hypoglycemia or low blood sugar.

• Releasing toxins too quickly can be detrimental

• The liver is the Spring organ. A good time for detoxification is in Spring because our bodies tend to hold on to things through the winter. 

• Scientists estimate that humans carry over 700 toxic chemicals in their body. A toxin is defined by any substance that creates irritating and/or harmful effects in the body. 

• ANY substance in excess can create toxic elements in the body. 

Pesticides and your food

Strawberries: the soil in strawberry fields are/were repeatedly saturated with methyl bromide and covered with plastic sheets. Methyl Bromide kills all weeds, insects and soil microbes. In 1999 over 5 million pounds of Methyl Bromide were applied to strawberry fields in CA. Methyl Bromide is a category 1 acute toxin (the most toxic kind). Side effects of exposure include: headaches, nausea, muscle aches, blurred vision, dizziness, damage to lungs, kidneys and other systems in the body. Field workers are often told they have the flu when picking berries in June and July. Source: Kimbrel, A., Fatal Harvest 2002.

Processed lifeless food is seen by the body as a toxin. 

Too much food consumed at one time uses too much energy. It doesn’t leave any energy for “house cleaning” 

The best foods to consume for maintaining healthy systems and proper detoxification 

Check EWG.org for the list of the CLEAN 15 and DIRTY DOZEN produce guides to know which items you should always buy organic and which are okay to buy conventional. 

Foods that love the liver:  

acerola cherries rose hips red chili peppers kiwi mango  guava sweet peppers

strawberries parsley  cantaloupe citrus fruits papaya asparagus  collard greens

kale cauliflower red cabbage broccoli brussel sprouts spinach

Consume High Quality Fats: keeps your gallbladder working well and bile free flowing

Avocado oil, coconut oil, olive oil, ghee, lard, tallow or expeller pressed sesame oil 

If you are not digesting your food, even the most perfect diet can clog detox pathways.

• It is important you are relaxed when you sit down to eat a meal. Take time to give thanks, take a deep breath, chew and savor each bite (ideally 20-30 times). 

• The breakdown of proteins provides amino acids that are critical to detoxification throughout the body. It is important to know if you are making enough stomach acid!

• Poor fat digestion clogs the lymphatic system and the liver- if you don’t have a gallbladder it is imperative you take bile salts with each meal. 

• If your blood sugar is out of control your liver will be stressed  Sugar depletes B vitamins (B6 needed by the liver to detox and B2 needed for the detoxification pathways to work properly

• Fat tissue is the storage shed for toxins like metals, petroleum and other chemicals (soap, shampoo, hair styling products, make up, shave cream)

• Consuming and Digesting healthy fats causes less liver stress

• Bile is built of healthy fat- toxins flow through and are removed by bile

• Minerals from the soil and your food are needed by the body for detoxification

• Selenium detoxes heavy metals (many people with thyroid problems are deficient in selenium)

• Zinc is depleted by heavy metals and needed to produce adequate stomach acid

• Molybdenum plays a role in detoxing- if you are sensitive to perfumes, smoke, diesel fumes it indicate deficiency

• Water is extremely important for detoxification. Keeping hydrated (half your body weight in water approximately) helps the body flush toxins through the urine and keeps elimination regular (two major detox pathways)

• Keeping hydrated allows the body to sweat out toxins. The skin is the largest detoxification pathway the body has. Taking regular saunas is ideal

• Hydration allows your lung tissue to remain moist and detox through carbon dioxide

• Hydration keeps your blood fluid allowing intracellular waste to be transported through the liver 

Super Foods For A Super You

Super Foods For A Super You

Stephanie Ewals, NTP

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We are talking about foods that build a healthy thyroid and a healthy body today.

How can I put my Hashimoto's in to remission if my thyroid is burnt out?

How can I put my Hashimoto's in to remission if my thyroid is burnt out?

Stephanie Ewals, NTP

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Welcome to episode 52.

I can’t believe I made it a year. I’m grateful you are listening. I suppose I should have done something to celebrate a year of podcasting but I have a crap ton of work to do for school this week which is generating a fair amount of stress for me so one day I will get it together and do some kind of giveaway. 

I have been monitoring my blood sugar levels for the last few days because I have really been struggling with some symptoms of blood sugar dysregulation. It turns out that my body is not so much appreciating the morning protein shake, especially when it is made with raw cacao. The caffeine from that alone is causing me to get a jittery feeling. I did much better with a meal of chicken and cabbage for breakfast yesterday with more stable blood sugar all through out the day. 

I am hoping to get a handle on this so my adrenals can have a break and I can gain some muscle. I’m finally able to get some exercise in after my broken collarbone. 

Okay- on to a listener question

Hi Stephanie,

I get confused with all the varying things I am reading about Hashi's, in particular how can my Hashi's be put into remission when  technically it has burnt out?  I am hoping you can shed some light on this for me, please.

Good luck with your studies - I know how much work goes into a Masters Degree.  

Many thanks

Kind Regards

Dorothy

There are varying degrees of damage done to your thyroid when you have Hashimoto’s. The longer you go with inflammation in the body that creates higher antibodies you may have more damage done to your thyroid leaving it unable to produce hormone. 

When you are putting Hashimoto’s in to remission you are putting out the inflammatory fire that is causing your body to be out of balance. That inflammation will be different for everyone and it will cause your thyroid to be damaged but how long it takes to put your autoimmune disease in to remission depends on how much damage was done and how long you have gone before you started making changes to your health. 

It can often be diet changes that will bring antibodies down and put your disease in to remission. Often times though, you will need to do more than just a few simple diet changes. 

Food is information for our cells. What you put in your body matters. Processed foods are basically dead foods. They have no good information for our cells to take in to build healthy tissues which build healthy organs which build healthy systems which build a healthy person or organism. 

So food is important. What you eat is important and the quality of that food is equally important. It can be expensive to eat healthy, especially if you are buying any amount of convenience “health food” such as gluten free crackers or breads or lunch meat that is of higher quality. 

It is time consuming to cook healthy foods especially if you get caught up in all the fun stuff so many food bloggers are making. I don’t have time for complicated dishes so I don’t make them. I made venison steak bites seasoned with Redmond Real Seasoned Salt, and pepper cooked in coconut oil and I steamed broccoli and sautéed Brussels sprouts in olive oil and added minced garlic at the end with some lemon juice. I added a side of my homemade sauerkraut and that was it. The night before I had chicken breast cooked in a cast iron skillet and roasted cabbage. 

Real whole clean foods are a good place to start to put your disease in to remission. 

You also have to look at what your blood sugar is like. If you have blood sugar dysregulation you will likely still be dealing with inflammation and thyroid issues even if your diet is perfect. 

• Do you wake up a few hours after falling asleep (or between 1-3am) and find it hard to get back to sleep?

• Do you crave sweet things?

• Do you have binge type eating  or uncontrolled eating?

• Do you feel like your appetite is excessive?

• Do you crave coffee or sugar in the afternoon?

• Do you get sleepy in the afternoon or after a meal?

• Does your fatigue get relieved by eating?

• Do you get a headache or feel shaky if meals or skipped or delayed?

• Do you get irritable or hangry before meals?

These are all signs you need to work on balancing your blood sugar which can be done with diet but also lifestyle changes because it isn’t only food that causes a rise in blood sugar. 

Lack of food, low blood sugar in the morning or not eating soon enough in the morning can cause your adrenals to have to get involved in raising blood sugar- a cortisol release and then you have an insulin surge and maybe you are insulin resistant and you are then storing fat because insulin is a fat storage hormone. 

Foods to help blood sugar regulation include: 

• asparagus

• avocado

• soaked and sprouted beans

• brewers yeast

• broccoli

• brussels sprouts

• butter

• carrots

• cauliflower

• eggs

• full fat dairy

• kale

• liver

• onions

• peas

• pecans

• salmon

• seaweed

• sweet potato

• tomatoes

These foods and others have the very important B vitamins which are so important in blood sugar regulation as well as some amino acids and other compounds that help promote insulin to do its job as well as maintain hormone balance. 

You won’t be able to put Hashimoto’s in to remission if you have low iron stores- ferritin. So have a full iron panel done at the lab. the lab range for ferritin is ridiculous. It is like 17-80 or something. Most people with thyroid issues feel better with ferritin in the higher range. 

You also won’t put Hashimoto’s in to remission if you are dealing with adrenal insufficiency or hpa axis dysfunction. Your adrenal glands have many roles, one of which is to manage blood sugar. Another is to manage stress. So if you are having fights in your head with your parter or spouse, your mom or whoever, if you get really mad in traffic or have a lot going on and zero support you will likely be dealing with some kind of adrenal issue. 

• If you tend to be a night person- you get a second wind later in the evening and have trouble falling asleep and then are slow to start in the morning. 

• If you feel keyed up and can’t calm down. 

• Higher or lower than normal blood pressure, get dizzy when standing up. 

• Feel wired or jittery after drinking coffee. Caffeine is one of the worst things you can do for your adrenal health, especially if you are dealing with some kind of adrenal imbalance which most of us are. 

• If you get a headache after exercising- I had a friend who this happened to and she never could figure out why this was. I wonder now if she wasn’t dealing with adrenal issues. My guess is yes based on knowing a bit about her life. 

• Do you clench or grind your teeth? 

• Do you crave salt or salt your food before you taste it?

• Do you have chronic low back pain that gets worse with fatigue?

• Have chronic fatigue or get drowsy or tired often or easily?

• Do you get a headache in the afternoon or yawn a lot?

These are all signs you may be needing to do some work on your adrenal glands. 

Making sure you eat a meal with protein in the morning within an hour of waking will help your adrenals heal. Also make sure that you are getting plenty of rest and doing some gentle exercise along with a no sugar diet for a few weeks will help your adrenals reset. 

There may be some burn out in your thyroid or damage. You may need medication for the rest of your life but you are not resigned to a life of fatigue and general malaise. 

In my functional medicine training we are talking about making the whole person better- mind, body and spirit.  One cannot work great without the other two in balance as well.

You can feel better and you deserve to feel better. This disease ruins so many lives but we don’t have to let it. 

You can take charge of your health. This is what I most passionate about. Take charge of how you perceive your illness. Do not let it be who you are. This is so important. 

I spent a lot of years hiding behind my disease and letting it define me. My kids got a sick mom. They also got a mom who for years let that sickness be her excuse until one day I woke up and wanted more. 

I wanted a better life. I took that to an extreme for awhile too and now I have finally found some balance. I am less dogmatic with myself and am okay with the choices I am making in food and in life. 

It is a process and takes some time to figure out- which can all depend on your life view and what kinds of baggage you took from your childhood and all that stuff. 

Getting well is a bit of a process but it can be done. Of course it is much easier when you have support from those around you and the energy to get started but it doesn’t have to all change over night. Baby steps can be just the right place to start. 

And one more thing about diet. The autoimmune protocol is a wonderful diet. Elimination diets in general are the best way to figure out which foods your body doesn’t really do well with. They are not the be all end all. You don’t have to stress about doing it.

Start with what you are comfortable with but also know that healing may take longer if you are consuming things that inflame your body. The stress of trying to change your life can also cause inflammation so do it in a way that works for you and don’t compare your journey to any one else’s. We are bio individuals and so is our healing. 

Thanks for writing in. I thank you for that. If you have any questions about this episode please head over to helpforhashimotos.com and leave a comment on episode 52. 

I’m not loving how the social media outlets are banning some people these days because they don’t align with big pharma or big food companies.

 People are starting to notice that these big companies care much less about our health and more about profits no matter the expense of the people consuming or being forced to use their products. 

Nothing wrong with making a profit but there is a lot wrong with the integrity of some of these big companies and people are standing up for their health and changing the marketplace. 

Please continue to do that. Stand up for what you believe no matter what side you are on and have a conversation about your side rather than slinging mud at others. We can’t change the world with mud but we can agree to disagree. 

So anyway, I don’t have a big social media presence and not many of you would miss me if I disappeared off of social media. I encourage you to take a break from it as well. Spend time looking at the sunset instead of scrolling at pictures of one. Go for a hike or a walk with someone you love instead of texting them. Go to someone’s website instead of their facebook page. 

You have the power to change the way things are done in this world and because it is money that rules the world, choose wisely where you spend yours. 

Thanks for listening. 

Find me at helpforhashimotos.com or email me at helpforhashimotos@gmail.com or fill out the contact form on my website. 

Have a great week. 

Should I give up gluten and what kind of vitamins should I take? Should you remove gluten from your diet? What k

Should I give up gluten and what kind of vitamins should I take?

Stephanie Ewals, NTP

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Q: My daughter-in-law just got diagnosed with Hashimoto's thyroiditis and told to go on a gluten-free diet. I've had Hashimoto's and have never been told to change my diet. I feel like I live in the outback of some remote mountain. My doctors don't seem to know anything. Just want to put me on medications. So frustrated!

While there are no studies for hashimoto's and diet now, there is one being done and there has been one done showing the positive effect that an elimination diet has had on IBS. Gluten and dairy have proteins that are similar in structure to the thyroid and if you have intestinal permeability and those proteins get in to your blood stream your immune system can attack your thyroid tissue. So, many people with this disease and other autoimmune diseases find that starting with an elimination of those two things along with then going on a full elimination diet can be helpful to find triggers that may be causing your antibodies to be higher. It isn't forever and you will be able to reintroduce many foods but you might also find that you feel much better having eliminated some of them for good. Can't hurt to try it. 

Also, you said you have had hashimoto’s. I just want to clarify for everyone that once you have this disease you will always have it. You can put it in to remission but you will always have to manage it. 

Q: Any recommendations for best vitamins to take to help with vitamin levels ? Grace

You need to first make sure that your digestion is working well. 

Are you chewing foods 20-30 times per bite? The breakdown of carbohydrate starts in the mouth with enzymes in our saliva. Then in the stomach pepsin is triggered to break down proteins. If you are not making enough stomach acid you will not be breaking down proteins. Stomach acid also helps to release vitamins and minerals from the food you ate. You will find yourself deficient in those if you are not having enough stomach acid. Once food is broken down in the stomach then it will be released little by little in to the small intestine where bicarbonate will be released to neutralize the chyme so it doesn’t damage the small intestine and bile is released to break down fats. The brush boarder of your small intestine further breaks things down to ensure you are getting all the nutrients out of your food and it can be shuttled to the cells for use as energy and in other chemical processes and in building healthy cells and a healthy body. 

Before wasting money on vitamins check your digestion. How is your stool when you go to the bathroom? Does it float? Is it greasy or shiny? Do you see food particles? Is it a soft blob or is it like rabbit poop? Maybe it is that perfect shape and comes out with no issues and the toilet paper is relatively clean when you wipe. This is what you are striving for but if it isn’t then you have an issue with your digestion and that should be fixed before spending money on supplements, except something that will help your gut heal and maybe some betaine HCl to help you digest your food. 

Cabbage juice is supposed to be super healing to the gut. I don’t know if there are any studies on it but it is what I have been told. 

If you are dealing with hashimoto’s you should definitely have your iron levels checked in a full iron panel. You need to have good iron stores in order to heal. Iron brings oxygen to your cells. It is important.  If you don’t have enough oxygen getting to your cells, your body is going to struggle to heal itself. Make sure you don’t have anemia, including pernicious anemia which is an autoimmune disease where you don’t absorb B12. Sometimes supplementing with iron won’t help bring your iron levels up. This was the case for me. Nothing brought my iron levels up. I have not had them checked either and I should. 

If you are not absorbing iron when supplementing, you should look at how red blood cells are breaking down. 

Other things that can be helpful for someone with thyroid problems is essential fatty acids like DHA and EPA or the omega 3 fatty acids. They should be in about a 1:1 ratio with the omega 6 fatty acids which we typically get way too much of because our biggest source is from “vegetable oils”. You may want to take a fish oil supplement with EPA and DHA if you are dealing with any insulin resistance. This condition makes it hard for the body to use an EFA like flax oil, evening primrose oil, borage or black current seed oil which are popular as well. Those oils will actually become inflammatory in the body rather than anti-inflammatory when someone has insulin resistance. EPA and DHA will help your cells take in glucose better and keep insulin levels in check. 

The enzyme thyroid peroxidase helps make thyroid hormones. In order for the chemical processes to work well, you need selenium, copper, magnesium, B vitamins and zinc. 

You may or may not need these- work with someone to know for sure so you don’t waste your money. 

Vitamin A helps the receptors on cells for thyroid hormone to work better. 

Magnesium is needed if you are dealing with blood sugar regulation problems. It takes around 20 or so  molecules of magnesium to process one molecule of glucose or sugar in the body. 

What you need will be different from what someone else needs. Remember that. Bio-individuality is important. 

Listener question answered.

A listener question answered

Stephanie Ewals, NTP

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Is there a magic pill for thyroid disease? How to detach from the false promise of a magical solution or quick fix to our thyroid problem.

om the false promise of a magical solution or quick fix to our thyroid problem.

Stephanie Ewals, NTP

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We are often looking for a quick fix to our health problems. In today’s episode I am talking with Danna Bowman and Ginny Mahar from Thyroid Refresh about how you can make small changes which can lead to bigger ones that ultimately gain you your health back. I love talking with these two fabulous women who have turned their own chronic health problems in to something so positive.

You can find out more about them at www.thyroidrefresh.com/thyroid30 Registration for their summer session starts June 3, 2019.

My hormones are all screwed up. What can I do to get my adrenals back in to balance?

My hormones are all screwed up. What can I do to get my adrenals back in to balance?

Stephanie Ewals, NTP

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Welcome to episode 48. 

Hi Stephanie,

I love listening to your hashimoto’s podcast

I’ve been listening now consistently for a few months and feel it’s been so helpful for just more understanding of hashimoto’s and knowing I’m not alone in this battle

I was diagnosed after I had my son (he is 2.5 now). I had no difficulty conceiving him but since him have had 2 miscarriages. I feel like my thyroid is to blame. I’ve been working with a functional medicine doctor and have gone gluten free 100% and as much as I can grain free dairy free and soy free. 

I’m on 60mg on NP thyroid

I’m 33 years old 

My latest blood work still show concerns. My TSH increases from .11 (nov 2018) to 3.29. My t4 is low at 3.9 and free t4 low at .68

My t3 is 88 so low on the normal scale

My free t3 is 2.4 again low on the normal scale

My anti thyroglobulin antibodies did decrease from 329 to 183 (so I guess that’s one good thing)

My dehydroepiandrosterone sulfate is 104

Estradiol is 223

Progesterone is .33

Testosterone is super low at less then 12

She thinks if I decrease my adrenal stress this should help thyroid and testosterone . I’m trying to get more sleep and decrease stress but let’s face it with a 2.5 year old, I work full time, my husband travels a lot for work so I’m solo a lot -it’s just hard.

She said to try acupuncture so that’s on my list to start 

I’ve read some info about having hashimoto’s and low stomach acid . What are your thoughts on this? Having low stomach acid might mean I’m not breaking down and getting as much nutrients from food. I read it talking about taking a pepsin enzyme with meals but it did caution about taking them if you don’t really have low stomach acid. It said papaya and pineapple might naturally increase stomach acid so I was thinking of adding more of these into my green smoothies in the morning

I just added hemp seed for more zinc in my morning smoothies and would like to try selenium too (you have talked on both of these in your podcasts previously) 

I have stopped doing orange theory and other high intensity exercises and now just do yoga or light short jogs. I have always done consistent regular mod to high intensity workouts so this is a change for me

Any feedback you have would be so helpful

Thank you again for providing me with a hashimoto community 

Have a great day

Jennifer 

Thanks for your question Jennifer. It sounds like you could have had pregnancy induced hypothyroidism which is not the correct technical name for it but it is really common. It could also be that you had the autoimmune component before pregnancy and the pregnancy triggered a full blown attack which you felt symptoms of after your son was born. 

If you want to see if your thyroid can function on its own, so meaning you get off your medication, then you are going to have to be diligent with your diet and your doctor is right- you will need to work on getting your adrenals in to a normally functioning range which will also help your body keep a pregnancy. I am so sorry you have had two miscarriages. Your body definitely needs some time to get back in to balance. 

There are several things that could be going on here. I mentioned pregnancy being one thing that is messing with your thyroid. The other is the possibility that your pituitary is sensing the thyroid isn’t working well and will release more TSH in order to tell your thyroid to make thyroxine but your T4 is low so I’m honestly not too sure about that. 

DHEA is on the low end which means your adrenals have become tired so to speak. I can’t comment much on the other hormone levels as I am not even close to being an expert on them. They do work in concert with adrenals and thyroid though so if one is not working well the others will not be either. 

I think you need to work on your adrenal health first and foremost and then retest hormones and thyroid levels. 

Here are some signs you might be struggling with hypo or hyper adrenal function: 

• You tend to be a night person or have that second wind late evening

• You struggle to fall asleep, tend to be keyed up and have trouble calming down

• You are a slow starter in the morning

• Have either really high blood pressure or really low blood pressure

• Do you feel wired or jittery after drinking coffee?

• Do you get a headache after exercising?

• You clench or grind your teeth?

• Feel calm on the outside and troubled on the inside

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

• You become dizzy when you stand up suddenly

• You crave salty foods, salt foods before tasting them

• You tend towards arthritis

• You sweat easily

• You have chronic fatigue or get drowsy often

• You experience afternoon yawning or headache

• Tendency to sprain your ankle or get shin splints

• Do you need sunglasses when you go outside?

If your cortisol is highest in the morning, you will not be dragging yourself out of bed. High cortisol in the morning and low cortisol at night is what you are striving for. You need your melatonin to kick in at night so you can feel tired and fall asleep. 

Being keyed up with trouble calming down is a sign that your adrenals are in hypermode and your DHEA is low. 

Chronic stress lowers cortisol which will cause your body to not be able to manage your blood sugar very well- low blood sugar, irritability and headaches. 

Wired after coffee indicates excess adrenal/cortisol output, need for supporting your liver and high cortisol with low DHEA will cause this wired feeling as well. 

If you are craving salt this is a classic sign your adrenals are not working or are in a hypo functioning state. You may also need electrolytes. Your adrenals help with mineral balancing. When you are in a state of chronic stress, you are losing minerals. 

You want to make sure you are eating real whole foods as much as possible. Avoid refined sugar and refined carbohydrates- basically avoid most things that come in a box. Avoid caffeine. Make sure you are eating a clean source of protein at every meal and avoid those foods that may cause a reaction because the inflammation in the body will also affect your adrenal health. 

Do not fast. Fasting will affect your blood sugar levels which will then affect your adrenals. No cleanses, no detox diets. 

You can take things like herbs from the ginseng family that will help your body deal with stress. Licorice root can be helpful as it will increase cortisol or help you if your cortisol is low which will allow your adrenal glands a chance to take a break and heal a bit. 

Please check with your functional medicine doctor about this. It might be a good idea to to the cortisol salivary panel to see just where you are in adrenal fatigue. 

Make sure you make time for sleep. Not so easy with a 2.5 year old at home but you can go to sleep when he does. Stay off screens at night and wear the blue blocker glasses starting at about 7pm. 

Work on relaxation techniques, meditation, biofeedback, acupuncture. 

Keep exercise to a minimum for about a month. Stick to walking and light weights 2 days a week for a month. You have to give your body a break, especially since you are on your own so much with a spouse that travels. 

If you can buy pre-made meals for some way to give yourself a break on cooking- buy from Paleo on The Go or some other delivery service like that. You can get $10 off your first order with the code GETCLEAR. I use them for situations where I know I need food and I don’t have the time or ability to cook up a bunch of stuff for myself. When I broke my collarbone I bought a weekends worth of food from them for a seminar I was going to. I couldn’t cook so I didn’t have a choice. 

Lastly- for the adrenals- get outside and expose your eyes to natural light as much as possible especially right away in the morning. 

You asked about stomach acid. If you are dealing with chronic stress, it is likely you are not making enough stomach acid. Dealing with hypothyroidism also means you are probably low on stomach acid. So, you can start out with pepsin and digestive enzymes and see if you notice a difference. You may need to get some Betaine HCl which is actual acid that is needed to convert pepsinogen to pepsin (I hope I have that right- I just learned that in school- it is that way or the opposite) which is what breaks down protein and then more breakdown happens in the upper small intestine and then absorption of nutrients through the rest of your small intestine. 

So, you need to be relaxed when you eat and you may still need some digestive support. Just adding papaya and pineapple to your smoothie will not help you digest your meals well. In fact, those are pretty high in sugar if I am not mistaken so they may make your blood sugar worse which will just trigger a cascade of issues, including more adrenal stress. 

 Most brands of Betaine should be fine- there is no one betaine that is more special than the other. Although many supplement company reps will tell you the quality of their betaine is better which may be true. Who knows.  You will know if you don’t need the stomach acid if you feel a burning sensation after taking it. Do a “challenge” to see how many you need and start small at about 150mg of betaine.  If you have an ulcer or an H. Pylori infection, you can make things worse so be aware of that. 

Speaking of your smoothies- add frozen chopped zucchini and frozen riced cauliflower to them. I have been adding those to my smoothie and zero fruit which is helping my blood sugar a ton. Here is what I put in my smoothie: 

• 1 cup crushed ice

• 1 scoop Designs for Health Pure Paleo Protein powder

• 1 scoop Designs for Health Pea Protein powder

• 2-3 tablespoons cocoa powder

• ⅓ cup coconut flakes

• Apex Energetics Nourish Greens and Collagen- 1 scoop each

• 5 or so drops vitamin d, and AEK

• 2 tablespoons hemp seeds

• 2 tablespoons chia seeds

• ½ cup chopped frozen zucchini

• ½ cup frozen riced cauliflower

• sometimes 2 tablespoons sunflower seed butter, sometimes 2 drops mint essential oil from organic ecocertified oil 

• 2 teaspoons cinnamon

• sometimes 2 teaspoons monkfruit or ⅓ ripe banana

• 1 cup or so of water

For selenium, I take GTA Forte II from Biotics which also has zinc and copper in synergistic amounts so that one mineral doesn’t deplete the others. Getting your minerals from food is fine because our food, real food, is packaged perfectly so that we get just the right amount of each mineral. If you are supplementing, you maybe don’t want to just go buy selenium because someone says it works for them. It is always a good idea to have a practitioner monitor that type of stuff. 

I hope this helps. Good luck to you and thanks for writing in.

That is it for today. Please leave me a rating or review on iTunes so more people can find the podcast and get the ever loving help they need. 

Sign up for my newsletter at helpforhashimotos.com and get the ebook- 5 things your doctor won’t tell you about hypothyroidism. 

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

Why are my antibodies high with normal T4 and T3?

Stephanie Ewals, NTP

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

-Laura

TSH high

T3 in range

T4 in range

TPO and TgAb high

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

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

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

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

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

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

What contributes to Hashimoto’s disease?

• Either too much or not enough iodine

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

• Selenium and Vitamin D intake or lack of intake

• Stress

• Nutrient deficiencies

• Infections/viruses

• Impaired gut function

• Low iron

• Adrenal fatigue

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• sleep

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

• spritual stuff- whatever that means for you

• get out in nature

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

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

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

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

Until next week! 

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

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

I feel like I am dying... A listener writes in detail of his symptoms. Episode 46.

Why do I feel like I am dying? A listeners symptoms

Stephanie Ewals, NTP

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Episode 46.

Can I eat almond flour with Hashimoto's? What is functional medicine? Episode 45.

Can I eat almond flour with Hashimoto's?

Stephanie Ewals, NTP

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*******These are my notes below- this is not a transcript*********

Hi Stephanie

Thank you for all your email. I really appreciate what you do to help people like me who suffer the same disease as you. I have been listening to your podcast lately in Spotify which is very helpful. 

Currently I have been prescribed levothyroxine of 75 mg which I take everyday in the morning. I have tried to ask my doctors several times about the kind of diet I should be following. My family doctor told me to avoid Soy but nothing else while my endocrinologist said my thyroid is not even working to begin with and that there is nothing I can do to reverse it. He just advised me to eat less calorie and work out. 

After I listened to yours and other podcasts, I have been trying to follow gluten free diet while also doing keto. I have been trying to eat lot of green vegetables which is really difficult for me. For fat I am consuming olive oil, coconut oil, ghee and grass fed butter. I also eat avocado for fat. I haven’t stopped eating dairy products or eggs though. I don’t feel bloated or bad when I consume them or may be I am unable to say how I feel after I consume them. 

Do you still recommend not eating eggs or dairy products ? 

I have substituted bread and rice with gluten free organic almond and coconut flour using which I bake my own bread. Do you recommend using almond flour ?

I would really appreciate your response to my questions. 

Thank you again for taking our your time to send constant emails and podcasts 

Regards ,

asked that name be withheld 

Thank you for listening and for your kind words. 

Soy- good to avoid. 

GMO and can compete with receptors on your cells for estrogen.  This is called a xenoestrogen which mimics the effects of estrogen in the body and can lead to estrogen dominance as well as affecting your immune system, adrenal glands and how well your thyroid works. 

inhibits T4 to T3 conversion by blocking the enzyme activity that does the conversion. It is the TPO enzyme. 

If you have hypothyroidism and/or hashimoto’s avoid soy. 

Millet also keeps your body from converting T4 to T3. 

You may not be able to reverse the damage done to thyroid by autoimmune attack but you can reverse symptoms. 

Eat less and workout is not the answer. 

Ask doctor for a full thyroid panel - TSH, Free T4, Free T3, Reverse T3 and TPO and TgAb antibodies. If they won’t do it, order it yourself from somewhere like Direct Labs and then find help interpreting the results from a thyroid book or a holistic practitioner. 

If your T3 is low you will want to ask why? Always ask why. 

Maybe your body is not converting your Levo very well. Maybe you need a T3 supplement or a different medication. 

Why you may want to give up dairy. 

Why you may want to give up eggs. 

AIP and Nuts

Elimination diet and then reintroductions- why you may not feel bad while eating eggs and dairy right now— dopamine hit foods that harm us. 

Eliminate for a minimum of three weeks. I recommend a month or two to give body a chance to calm down. You may consider a healing type diet for up to two years if there is a lot of damage done. 

Reintroduce 1 food at a time and wait 4 days before introducing another food. Look for digestive reactions, mood issues, sleep issues, joint pain etc. Everyone’s reactions will be different. 

Baking your own bread is great. I miss bread. Sometimes to really heal what is going on in the body we need to give up those convenience foods. Because nuts are a top allergen and you have autoimmune disease I would recommend cutting out the nuts too just for awhile to give your body a chance to calm inflammation and have a proper reaction. 

There is no perfect diet here. It is trial and error because we are biochemical individuals. You have to do what works for you. In order to heal your body and bring your symptoms in to remission it is something that is wise to do but if the stress of it is too much, then it is not good either. We have to find balance. 

Keto is not for everyone. I’m working on a presentation about Keto so when that is done I will talk more about that. Some people do fine on it with autoimmune disease, some do not. Personally I do much better with more plants and a small amount of meat in my diet. I am not a fan of veggies either but I eat them because they make me feel better. Try roasting veggies in olive oil and Redmond Real Salt until they are crisp and golden brown. They are quite delicious that way in my opinion. 

Without knowing more about how your blood sugar is, how your adrenals are doing, how your digestion is working it is tough to really say if these foods are causing a problem for you or not. 

I get a good picture of this from my clients using a Nutritional Assessment Questionnaire which shows where each persons body is out of balance from your stomach to your immune system and everything in between. Then I look at a food journal and help clients figure out where they can make changes, what they can add and what might need to be taken away. 

Thanks for your question. I hope this helps.

Ok, Now I want to talk about functional medicine a bit because my Principles of Functional Medicine class has me really excited to learn and be able to dive deeper with clients. 

What is Functional Medicine? 

It is evidence based, science based. The estimation is now that your current conventional medical providers are 50 years behind the current science. I had always heard it was 17 years so this was new to me. Either way, that is really behind. 

FM is about critical thinking and being open to knew information either supportive of your thinking or not. 

It looks at the whole person- body, mind, spirit and how all of those contribute to disease or wellness. 

It looks at you as an individual, how your body operates. It removes what is creating and imbalance in your body and adds in what will balance you back out. So it is about finding imbalances and bringing your body back in to balance. 

It is a personalized way to work with individuals seeking health concentrating on the person and not the disease. 

Things contributing to your body being out of balance are toxins, allergies, infections, bacterias, parasites and other bugs, diet, stress, lifestyle, sleep habits. 

What is missing from your life keeping you from feeling your best. 

What might feel like normal to you may not be normal. For example, you feel tired a lot or your joints hurt a bit. You don’t remember not feeling that way so it feels normal and you deal with it. Maybe you have forgotten what it really feels like to feel good!?

Functional medicine is great at helping people with chronic diseases like Hashimoto’s but when you have an acute condition like a broken bone or you need surgery or you have a heart attack, your local hospital is the place to be. 

Preventing disease is where it’s at. If you have a disease, like autoimmune disease which affects 50 million of us in the US, then you can use functional medicine to put your disease into remission or at least reduce your symptoms. 

This is very exciting. I look forward to sharing more as I learn more. 

My doctor says I have Graves disease and Hypothyroidism? What is methimazole? Episode 44.

My doctor says I have Graves disease and Hypothyroidism?

Stephanie Ewals, NTP

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Hi, I have an appointment with the endocrinologist coming up in a month. What questions do I need to ask? I have recently been diagnosed with Graves/Hashimoto's and am very confused about my diagnosis. I was told I was hyper in January, they put me on methimazole and last month I was told to stop taking it because they had over medicated me and I am now Hypo. I was referred to an endocrinologist for further treatment.  Any suggestions are welcome! Thank you in advance!!

Alyssa

Thanks for writing in Alyssa. Let’s hope you hear this before your appointment. 

Graves is the autoimmune condition where your body will make antibodies against the receptor for thyroid stimulating hormone (aka thyrotropin or TSH- it is made in the pituitary gland and tells your thyroid gland to make T4 or thyroixine and T3—the big metabolism stimulator).  The TSI  or thyroid stimulating immunoglobulin antibody will help diagnose Graves as well. 

In this disease you can also make antibodies to T3 and T4 causing a hyper thyroid state. Anti-TPO antibodies can also be a sign of Graves though they are often tested for Hashimoto’s. 

You actually may have both Hashimoto’s which leads to hypothyroidism or a slow thyroid and Graves disease or hyperthyroidism which leads to an overactive thyroid. You may swing between the two and feel like crap. Finding a doctor to treat your symptoms is ideal when it comes to how much medication you might need. 

Symptoms of Graves disease include things like: 

• anxiety

• tremors

• sensitivity to heat

• weight loss without diet changes

• enlarged thyroid

• insomnia

• bulging eyes

• heart palpitations

Treatment for Graves includes methimazole which is known as an antithyroid drug. It basically stops the thyroid gland from making too much T4. Before pharmaceutical drugs were created for this, Fluoride was the treatment to slow down the thyroid.

Side effects of this drug are numerous but include hair loss, headache, toxicity to your liver, muscle or joint pain, nausea, changes in skin pigmentation and more. 

I think the biggest concern with this drug is the damage it can do to the liver. 

Another treatment option for hyperthyroid or graves and even Hashimoto’s is to use Radioactive iodine which results in killing off the thyroid gland by the radioactive iodine. The thyroid gland is a big consumer of iodine and so if you give it radioactive iodine it will destroy the tissue making you hypothyroid for life. 

Let’s talk about the diagnosis of hypothyroidism after the methimazole. This drug keeps the iodine and peroxidase from having their biological interactions with thyroglobulin to make T4 and T3 which will chemically slow down thyroid hormone production. 

If you are dealing with Graves disease the best thing you can do is immediate diet changes to stop the autoimmune attack.

Remove gluten and dairy and then go on some form of elimination diet for at least a month with three months really being optimal. 

Elimination diets will remove all the big allergens or triggers for the body. It will include removing eggs, nightshades, beans/legumes, nuts, seeds, sugar, alcohol, all grains and of course all dairy. The stricter elimination diets like the autoimmune protocol also remove chocolate or cocao, coffee and all spices made from night shades including vanilla which is a bean.

After eliminating these foods for the suggested three months you can begin to reintroduce them one at a time waiting 4 days in between reintroductions to be sure you don’t react to it. It is often suggested the reintroductions start with a teaspoon of a food and then if no reaction after a short time period you add more and more of the food gradually throughout the day checking for reactions as you go. Then wait four days before reintroducing another food. 

There is an introduction schedule that shows how to reintroduce foods and which foods to reintroduce which you can easily find by googling AIP diet and AIP re-intro foods list. I use this diet with my autoimmune clients when they are ready to make the commitment because it is a huge commitment to do this diet. 

It is a lot of cooking from scratch and a lot of dishes to wash and it really never ends. Even if you are able to reintroduce many foods yet you still need to eat really clean. I’m not going to lie. For me, it gets old to have to cook all the time. I don’t like fish so that is one whole group of food that I don’t eat that would make it much more convenient to eat on the go. Eating a can of salmon or tuna or even sardines would make my life easier on the go but I can’t stand fish of any kind and I cannot bring myself to eat organ meats which are highly recommended on AIP. 

So anyway, you do the best you can and you eat clean and cook your food and really stick with it and you will feel better. 

Let’s talk about going to the doctor’s office and specifically the endocrinologist. They are a little harder to work with. My endocrinologist was zero help to me- he didn’t know I had autoimmune disease and didn’t bother to check. Is this his fault? 

Not really.

 I was still really angry for a long time over this because my baby died in a thyroid storm and no one knew what to do for me. His death could have been prevented so I was angry. I still get tiny bouts of anger over it, especially when I read more and learn more about the thyroid and how my diet could have prevented a bunch of problems for me and my family over the years. The important thing is not to hang on to the anger. I have to let it go or it would consume me and that does no one any good. 

So - the doctor. 

They are taught to find the correct or right answer all through their schooling. 

They are taught about synthetic thyroid hormone replacement like Synthroid. 

They are taught to not question the norm or status quo. They are taught to conform in order to do well in school. 

They spend countless hours having to memorize what they have read or been lectured on so they can have the right answer which means they are a worthy medical student, doctor and professional person. 

We look at doctors as all knowing. We forget they are in a medical practice. Practice means they don’t have all the answers but we expect them to have all the answers. So, do you think they would want to admit they are wrong about something they studied for 4-6 years or more?

We expect doctors to tell us how to feel better yet we are not willing to listen to our own body which innately wants you to be in balance and healthy. 

Doctors cannot and do not know everything and that is okay. They do have faith in their education and in what their textbooks and class materials are telling them. An endocrinologist should be more familiar with the workings of the thyroid than a family practice doctor, you would think. 

If they see the same thing coming through their door every week and the treatment isn’t working, you would hope they are wondering why. Maybe they are but they have to remain with the status quo and conform to what the medical board says or they risk losing their license. 

It seems that the doctor who has suffered the condition you are there to see him or her about is way more sympathetic to your symptoms than a doctor who has not had to deal with it. 

We all would love to have a doctor that can admit they don’t know it all about our condition and that they want to hear what our symptoms are and how they can help alleviate those symptoms. Sometimes that is what the functional or holistic nutritionists job is because food is medicine and I am a living example of recovering my health through diet and lifestyle changes. 

But you are in your doctors office asking for natural thyroid hormone instead of synthroid because you feel like crap and you think this will help you. But maybe you have only read a couple books that suggested this. So, is your doctor who has spent years training for their job just supposed to listen to you? This can be hard form them and while I think they should listen, just think about it from their end. 

They have to worry about answering to their boss and the rules of the clinic, worry about getting sued, they don’t have enough time to sit down with you to really understand what is going on and their protocol is synthetic thyroid hormone or methimazole or radio active iodine treatment. 

Your endocrinologist probably got in to their line of work because they wanted to help people. Believe that they really do.

They don’t want to be challenged by their patients and may not understand how to treat your condition without what they consider the gold standard. 

It is not unlike my own nutrition practice where I know very well how to help people with autoimmune disease because I have spent countless hours studying this topic. But if you came to me with say, SIBO or Colitis- I could help you to some degree but I have less knowledge about those two very specific conditions than I do autoimmune thyroid disease so I would refer you out to someone who works specifically with that condition. 

How can you be ready for your endocrinologist visit?

1. Be prepared but don’t inundate your Doctor with too much information. Write a list of your symptoms to give him or her. Let them know what your goal is for the visit and have a short list of questions. So for you it might include getting an explanation of how you became hypo from hyper and getting a full thyroid panel including TPO, TgAB and TSI, TSH, Free T3, Free T4. These are the biggies. 

2. Have a complete list of every medication and supplement you are taking at the time of the visit. Include the name of it, the dosage and what form you take it in like capsule or drop, etc. 

3. Take notes or bring someone along with you to take notes so you can remember everything. 

4. Don’t trash talk other doctors you have seen. This will not serve anyone in the end. It may put your current doctor on the defensive. 

5. Try not to cry on your visit. This is overwhelming to the doctor. 

When you are done with your appointment ask yourself this: 

1. Can you work with this new doctor?

2. Do you feel comfortable with them?

3. Did you feel listened to?

4. Will they agree to work with your symptoms and adjust your dose accordingly?

Good luck Alyssa. I hope your visit goes well. 

That is it for me. You can find me at Help For Hashimoto’s dot com. You can sign up for my newsletter on my site- on the left side bar there is a little sign up form. I am told that needs to be more prominent. 

Please leave a rating and review on iTunes so more people can find the podcast. I would really appreciate it. 

If you are looking for help with your thyroid condition, use the contact form on my website and we can chat to see if we are a good fit for working together. I’m here to help.   Until next week. 

Why do I have hives? Hives and Hashimoto's — is there a connection? Episode 43.

I broke my collarbone so the following is not really a transcript but my notes on the listener question. It has been challenging to type so I took some notes instead of typing up a transcript.

Listener question:

I recently discovered your podcast and have power listened to every single episode since the weekend before last. Thank you so much for all you’re doing; you’ve already helped so much.

My question is pertaining to the correlation between Hashimoto and Urticaria. I’ve suffered with chronic hives for a few years; however, must admit, I haven’t been as proactive as I should have been to find resolve. I am changing that.

My hives come and go. Approximately 3-4 episodes a year, each about 3-4 weeks in duration. There are no apparent triggers with diet, activity level or stress. My endocrinologist pulled my off Synthroid and onto Tirosint. I was hive free for quite sometime following the change a I was assuming it was secondary the Synthroid.

Wrong! Sadly, they’re back and I have already scheduled to see my Endocrinologist but also was curious as to your thoughts.

Thank you again,
Susan

Everything I have read about thyroid and hives says there is no real explanation for why it happens in thyroid patients but I have some ideas. 

Hives or urticaria are a reaction by your immune system that causes the release of histamine and results in swelling, itching and redness of the skin. 

A mast cell is a cell full of white blood cells called basophils and are found in connective tissues. They release histamine and other chemicals during an inflammatory or allergic reaction. 

Histamine is a chemical that our cells release in response to an injury or in allergic reactions or inflammation. it causes your smooth muscle tissue to contract and capillaries to dilate or swell up so white blood cells can get to the source of the problem and attack. It plays a big role in controlling itchiness in the body. 

It is a neurotransmitter that also plays a role in digestion as a part of stomach acid so you can break food down properly and the central nervous system uses it to communicate between brain and body. 

Hives are the result of histamine which can be caused by consuming foods high in histamine, small intestinal bacterial overgrowth, intestinal permeability, and a deficiency in an enzyme called diamine oxidase (helps clear histamine from the body). 

In about half of patients with chronic idiopathic hives, the explanation is that body's immune system is, in a sense, overactive. The urticaria is "autoimmune". The immune system is attacking the normal tissues of the body and causing hives as a result.

https://www.ncbi.nlm.nih.gov/pubmed/19331714

Caused by an allergic reaction to medications and food.

Hives lasting less than six weeks: The most common causes are certain foods, medications, or infections. Insect bites and internal disease may also be responsible. 

The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, and milk.

Foods high in histamine include things like: 

• fermented foods and drinks including alcohol

• vinegar based foods

• cured meats including bacon

• dried fruits

• citrus

• cheese that is aged

• nuts

• avocados, eggplant, spinach, tomatoes

• smoked fish and certain kinds of fish

Foods that keep the Diamine oxidase enzyme from working: 

• alcohol

• energy drinks

• black, mate and green teas

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839887/ —- a histamine free diet is helpful for tx of adult patients with chronic spontaneous urticaria

Another option for urticaria is adrenal dysfucntion. 

When the body experiences stress it can cause a flare of hives due to increased adrenocorticotrophic hormone or ACTH. ACTH is secreted by the pituitary gland which then stimulates the adrenal gland to release cortisol. 

This can be triggered by emotional or physical stress in the body. Keep in mind that the physical stress can be inflammation from food intolerances or unmanaged autoimmune disease. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256343/

https://www.ncbi.nlm.nih.gov/pubmed/11270265 (A cross-linking of IgE receptors of mastocytes induced by antithyroid antibodies may be a cause of histamine release)

IgE or immunoglobulin E are antibodies made by the immune system when you have an allergy to something which will cause an allergic reaction to something from the environment or from a food.

chronic infections or autoimmune disease can cause that overreaction in your immune system. 

Why Do I Have Hives? Episode 43 Is there a connection between hives and Hashimoto's?

Stephanie Ewals, NTP

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