What do my labs mean?

Your lab tests are only as useful as their interpretation.  I may have told you to ask for certain labs or maybe you have read on the internet what the best labs to ask for are to figure out why your thyroid isn’t working well.

Maybe your doctor will order the labs you ask for but do they know how to interpret them beyond the standard lab ranges offered? Do you? Probably not. So you have all this information and no plan to get you feeling better.

I’ve even seen functional medicine lab ranges that are more narrow than the standard or conventional lab ranges not be good enough to figure out a problem. The reason behind that is that the functional lab companies are getting their ranges based on the people who are coming to them for tests.

What does this mean? It means that the sick people going to a functional medicine doctor to get their labs are the people who’s results are making the lab ranges. This is true for most labs.

Does that sound like a way to figure out whether or not YOUR labs are out of range or within range? They might be within range of a bunch of other people who feel like crap and don’t know why.

Basic blood chemistry labs like a CBC, CMP, lipid panel, iron panel, thyroid panel can be super helpful but also know that your symptoms matter regardless of what your labs say. The labs are a way to help put the pieces of the puzzle together.

Your symptoms are your body’s way of telling you something is up. They help gauge whether an intervention is working or not. I saw plenty of people who could not help my fatigue because they were not looking in the right place or they were trying to bandaid the symptoms without really getting at the root cause.

Today I wanted to share with you my old labs and how they were interpreted by my practitioners at the time and show you what was missed based on the scientific research based lab values I use.

I was looking in a file cabinet for some financial documents and then got side tracked with all the stuff that could be thrown out in the file cabinet and I came across a green folder with a hand written schedule of appointments for a plan I paid for through a certain chiropractic office. I dug into it and found so much stuff related to my health and trying to feel better over the years. I thought this would make a great podcast episode since many of you have been to multiple practitioners and still feel like crap.

I’m taking you back to 11/25/2011 which is the first wellness plan I found from the 1st holistic practitioner I saw. She was a naturopathic doctor and from what I can tell from my research on her, she was out of ND school/residency about a year or less when I saw her. She was a kind, passionate doctor. I saw her for a few years until it got to be too far of a drive and I still wasn’t feeling great. She was actually on to why I wasn’t feeling great and it was an emotional component I wasn’t dealing with and her suggesting we work on it scared me away. I quit working with her after that and kept looking for the magic pill with other practitioners and never ever felt quite right.

I remember one visit with her where I had brought her a list of supplements I was taking based on testing I had done in my nutritional therapy practitioner training and she said, “I don’t even know what to do with this.”. I could tell she was super annoyed and I get it now as a practitioner because when a client/patient is taking stuff outside of the protocol that was set for them it may or may not be detrimental to the outcome. Plus, you might also just be wasting your money.

Anyway, I went to her for fatigue, hypothyroidism, mood issues, blood sugar issues, and apparently heavy bleeding during my cycle- super heavy. I’m sure there was other stuff but I don’t have my intake form.

Any of this sound familiar to you?

She recommended to me before testing was done:

• Coconut oil for low blood sugar/shakiness

• Flax meal, 1-2 T daily (she suggested mixing in applesauce) all month

• Omega 3: super EFA liquid 1 tsp/day all month

• GLA: 1000mg flax and 1000mg EPO days 15-28

• Vitamin D3: start at 2000IU/day, get tested within 2 weeks

• Probiotics: HMF Neuro caps 1/day

• Acupuncture for mood support

• Labs to get: TPO Ab, Tg AB, FT3, FT4, TSH, rT3 ($155); 25 OH Vit. D, 22IgG Food intolerance test

• See a gynecologist to get pelvic/transnational ultrasound to rule out organic causes of heavy bleeding with menses

• Schedule next appointment in 6 weeks

I did some testing on 12/9/2011: Intestinal barrier assessment 22 IgG through Pharmasan Labs. Just for reference, I was 40 years old (I’m 51 now) and my kids were 11, 9, and 6. I was working as a social worker 20 hours a week and not a very happy person.

Results were:

• Intestinal barrier assessment showed a moderately leaky gut

• Food parameter summary/food sensitivities detected

  • Yogurt was high

  • Baker’s yeast, egg white, tuna, wheat were moderate

  • Cows milk, gluten, goats milk, oats, shrimp were low for presenting antibodies

• Vitamin D test was at 33.3 on 12/8/11 and she told me the range was 40-100

I saw her on 1/2/2012 to go over these test results.

The wellness plan was:

• Avoid yogurt, bakers yeast, egg white, wheat, milk, gluten, oats for at least 4 weeks. Then trial reintroduce the low foods one at a time in this order: oats, milk/cheese- wait at least 4 days in between reintroducing when not eating oats. So eat oats for 4 days, wait four days then reintroduce milk/cheese but don’t eat oats while doing that.

• Breakfast ideas: quinoa porridge, organic chicken sausage, avocado with sea salt, egg yolk

• Flax seeds 1-2 tablespoons/day all month

• Super EFA liquid 1 tsp/day all month

• GLA: 1000mg flax and 1000mg EPO days 15-25

• Vit. D: 10,000IU per day for one month, then reduce to 4,000IU/day

• B6 complex 1/day with breakfast

• Probiotics: HMF neurocaps 1/day

• Slow Flow- use day 1 of period 3 caps every 3-4 hours

• Progesterone cream: day 15-28, stop if period comes before day 28, 1 pump per day at bedtime

• Permeability complex II- 1 cap 2x/day with meals

• She will contact me with thyroid results

• Retest vitamin D in 3 months

• Pelvic/transvaginal ultrasound due to menorrhagia to rule out other causes before getting ablation

• Schedule next appointment in March.

• On the back of the plan was a drawing of leaky gut

The wellness plan for my next visit on 3/9/12 went like this:

• substitute sugar for yacon syrup, read labels and eat less than 20-30g of sugar per day and watch to see how skin reacts.

• Snack ideas: celery/nut butter, carrots/hummus

• Same supplements as before with addition of

  • orthothyroid 2 caps/day

• Remove IUD

• Next visit 8-10 weeks, discuss periods, skin

I’m missing a years worth of labs and wellness plans from her- I do remember her diagnosing me with Hashimoto’s after these thyroid labs were done so I was off to see about medication changes from my doctor because ND’s in MN cannot prescribe medication.

I got more labs done on 1/8/2013 from Pharmasan Labs. The panel was called the Endocrine Health Basic and it was a saliva test.

The cortisol test wasn’t horrible as far as results go- it was a little low in the morning and stayed below range until about 2 pm where it barely went within the range and then was a little high around 9pm. This is a typical pattern for someone with thyroid problems. According to the reference range, my cortisol was below reference range all day long- could be why I was so tired all the time and my blood pressure was super low (I was also freezing all the time).

DHEA was 274.5 with reference range for women at 57.0-615 so that was normal

Estradiol was off the charts low at <0.8 and it should have been between 1.0-14 according to the lab range.

Estrone was 0.8 and that was within the range for my age group.

Progesterone was 566 so high for the range of 38.0-462 but she had me on progesterone cream so I can only imagine that it was probably in range before that.

Testosterone was 26.2 which was also within this labs range.

I wrote her an email on 2/20/2013 saying i got a new presecription for thyroid meds with an increased dose. I got a referral to an endocrinologist which I did not use because I have not found them helpful in the past and they are more expensive to see. I was getting heart palpitations on my new medication so I was taking half a pill and working my way up to a full pill to let my body adjust. I told her I didn’t feel clear headed, probably brain fog, and I was super forgetful and having a hard time concentrating. I said, ‘my kids think I’m crazy’. I told her I was worried about taking a higher dose and asked if I should take it and see how it goes.

She replied that my thyroid needs more support so it might be worth trying to see how my body tolerates it. She wondered if there was something in the medication that my body didn’t like. I believe the real problem was that my cortisol was so off still, I didn’t handle stress well and my body was just responding to the T3 in the new medication. She suggested I ask my doctor for Westhroid or Naturethroid and to ask my pharmacist about the medication I was taking and why I might be having palpitations on it.

I do remember taking Westhroid and doing really well on it and then there was a shortage or whatever and I had to find something else. Story of my life!

On 10/25/13 I redid the Endocrine Health Basic lab panel

• cortisol was within normal range except at 8pm it was high at 3.3 and it should have been below 1.5. She told me to take magnesium at 7pm. I remember the first time I took a powdered magnesium in water. I felt a rush of calm over my whole body from top to bottom. That is the only supplement that has made me feel a physical difference.

• DHEA was at 58.6, remember last time it was in the 200’s. It was still within the normal lab range but much lower this time. My notes say DHEA is a counter balance for cortisol

• All the sex hormones were within the lab normal range. The healthy lab ranges I have are for blood and not saliva so I can’t compare the two. One thing to know is that even functional medicine labs are making their ‘normal’ lab ranges based on the results of people who use the lab. Who goes to practitioners who use ‘functional medicine’ labs? Sick people! I think my hormones were off because I was still a long ways from feeling good with severe mood swings, poor sleep, angry all the time, terrible blood sugar and more.

• I must have had a visit on or around December 4th 2013 because I got a wellness plan via email with 24 things on it

• Supplement protocol changed a bit- ground flax in applesauce was making me throw up shortly after taking it.

  • Floravital iron and herbs at 10ml per day to see if tolerated and reduce dose if it caused constipation

  • NO RAW brassica veggies or soy because they can interfere with thyroid function- we now know this not to be true unless all you ate was brassica veggies and nothing else in huge amounts every day.

  • Add a pinch of sea salt to my water

  • Cornus Sanguinea for autoimmune thyroid support 1 spoonful in the morning (I don’t remember taking this)

  • Adrenal support 2 caps with breakfast

  • EstroMend 2 caps with dinner for memory/estrogen support instead of Femmenesence Pro Peri

  • Take a break from Sepia 200ck for at least one month to see if PMS is manageable without it (she was throwing supplements at this mood problem and nothing was sticking)

  • Repeat thyroid labs in 5 weeks

  • Glutenzyme by Pharmax in case of accidental gluten exposure - at the time we were not sure if I had celiac disease because I never got tested. I felt so good off gluten I didn’t want to go back on to be retested. At this time I was very strict with avoiding gluten.

  • Exercise: do yoga and she wanted me to go to a Qoya class which was about a 40 minute drive for me from my house and I never went. I don’t like driving that far for a workout- even now, my gym is 5 minutes from my house.

  • Grounding/visualization: imagine roots growing from your feet that firmly connect you to the earth. I still do this when I feel stressed. She said the roots provide you with nourishment/energy and offer a way to release any unwanted energy back to the earth to transform it.

  • We discussed removing my mercury fillings from my teeth.

  • Return visit in 8 weeks.

The next set of labs is from 11/26/2014 so almost a year later. By this time I probably did have my fillings removed. I did 1/4 of my mouth at a time with a dentist who knew how to remove mercury safely.

By this time I had found an MD willing to treat my symptoms along with my labs and I don’t think I was seeing the ND anymore- she was too far away for me. That said, I was driving almost an hour to the MD but she took my insurance so the visits were way cheaper. I had also gotten my nutritional therapy practitioner certification by this time. The notes on the reason for the visit was that I was here to check on thyroid, I fell really good, not fatigued, sleeping 7-8 hours, feels well physically, stress is reduced, had heart palpitations when tried raising dose of thyroid meds last time. This doctor was the only doctor in her practice willing to use something other than levothyroxine to treat thyroid so I tread lightly with her in order to continue to get the meds that made me feel good. I’d also make a note that I was not feeling tired even though my iron levels were super low- I think this was attributed to being filled up with friends in a community of like minded people who I really enjoyed. I had previously lost a friend group in 2010 and had found friends through my certification program.

• FT3 2.0 (lab range 2.0-4.4) normal but low by my ranges

• FT4 0.74 (0.82-1.77) low by lab and my ranges

• TSH 5.070 (0.450-4.500) High by lab and my ranges

• TPO Ab 69 (0-34) high

• Tg Ab 1.0 (0.0-0.9) high

• RT3 11.4 (9.2-24.1) lab range only

Again, these are lab ranges here that are done on probably both healthy and sick people because it was the lab at the doctors office though some of this, like Reverse T3 and the antibodies may have been sent out to Quest diagnostics. Had my doctor used the ranges I have which are based on healthy people and from the research, it may have painted a different picture. Here I have low T3, low FT4 and High TSH which indicates I’m not making enough T4 and not converting it for whatever reason. My meds were raised.

Fatigue was back with a vengeance and by January 2015 I was going to a chiropractic office that had a medical doctor on staff. My hope was that I would be able to see the doctor and have him prescribe my meds. The funny thing is, I never asked the chiropractor if I could do that. I just assumed. When they presented their plan and the cost, there was no mention of the doctor. I figured out later, he was a place holder so they could do certain things in their clinic that needed an MD on staff. I don’t think he was ever there. I didn’t have my voice, I was too timid to ask about seeing the doctor.

So for this office, their treatment plan was for my complaints of low energy, anxiety, brain fog, constipation. Based on my history and his exams he recommended the Nutritional Function lab test, GI Effects Stool test, Cyrex Array 4 for food hypersensitivity with the knowledge that I may need further testing based on the results of these tests.

Their plan included 6 visits with the nutrition chiropractor and 16 visits doing oxygen therapy which was their fix for my fatigue. He put me on the Apex Energetics RepairVite Diet and their powder. I did feel really good after this diet but it was restrictive. They used the IFM MSQ each visit to see how things were either improving either for the better or worse. In 2015 this plan cost me $1235 after discounts.

They did a body composition by hooking me up to some electrodes and having me lay on my back for around 10 minutes or so. I got a super fancy report showing my BMI at the time was good. It also had something on it called phase angle and mine was low. This report indicated that that is consistent with cell death or cell breakdown which could very well have been the case. I was thin and tired and brain foggy. It is said to be a predictor of malnutrition and I do think at the time I was not absorbing nutrients really well. It also showed that I was about 31.4% body fat so likely losing muscle and what you might call skinny fat. All that from a really fancy nine page report.

I did have my blood drawn for a CBC at their clinic. They didn’t give me the actual results but a fancier paper with each marker, my lab value, functional ranges and laboratory ranges. The entire thing was highlighted line by line in green for normal, yellow for out of the functional range and red for out of the laboratory range.

This blood draw was from 2/24/2015 - I was originally going to go through each lab marker and tell you the differences between their lab range and my lab ranges but I think that is going to be too much so I’m going to skim over them. The point I’m trying to get across is that this chiropractor missed some things that I would catch with my lab ranges. These things would be minor for the most part and could be fixed with some diet changes and supplements.

They missed low albumin, high AST and ALT liver markers, low sodium, high CO2, high bilirubin, low glucose, high HBA1C, low HDL cholesterol, high iron, low ferritin, low neutrophils, and high lymphocytes. They had shown high monocytes and eosinophils where my ranges said they were normal.

When the lab ranges vary so crazily from lab to lab and practitioner to practitioner, things can get missed. The blood chemistry training I received from my former professor allowed me to get scientific research based lab values on healthy individuals that are sound with ranges tight enough that I’m able to catch things before they get bad so to speak. This lab also showed TSH was a little high and T4 was low which would indicate I was in need of an upped dose of medication which I could not get from them because their doctor on staff was not actually on staff.

I was more mad at myself about that whole doctor thing because I didn’t have the confidence to ask them about it. I was intimidated by the chiropractors for some stupid reason. Things would definitely be very different now- I have found my voice! I would have questioned them about seeing the doctor. I was just so desperate at the time.

They also had me do a Cyrex Labs Array 4 - Gluten Associated Cross Reactive Foods and Fodds Sensitivity which is for IgG and IgA antibodies. Nothing was out of range but soy and corn were considered to be just slightly out of the normal range. He put me on the RepairVite diet for 3 or 4 weeks then when my MSQ showed I felt really great he told me I could go back to my normal diet. That was it. According to him my gut was healed.

Next was a Genova Diagnostics GI Effects stool test. A huge fancy report with graphs and pictures in color on the first page that told me nothing. I had undigested fat in my stool and some species of bacteria were low. So the solution was to take HCL with meals.

They also did a comprehensive melatonin profile which came back normal. I think he did that one because I was so tired. Remember that they missed low ferritin which will make one tired so I think this test was a waste.

In April 2015 they had me to the Adrenocortex Stress Profile which is a saliva test. It showed my cortisol was high all morning and high normal in afternoon and normal at night. I think the stories in my head contributed to my stress levels. I was not a happy person and I was wound up pretty tight.

Once I was done with their program I told them I was still fatigued and they told me to go back to my doctor to have my thyroid checked. And that was it.

I was back at my doctor that took insurance in August 2015 and had a CBC done again. There was about a 5 months difference between the two labs and this one was showing anemia and likely micronutrient deficiencies. RBC, Hemoglobin and Hematocrit were all low and MCV was high by my ranges all of which indicated I needed some nutrients. I had my B12 tested too and it cam back normal by the lab range. I don’t have a different range for that but it would be interesting to dig through the research which I might do at some point. All of this would point to fatigue for sure but it was missed by my doctor.

Same doctor tested my thyroid on October 6, 2015. FT3 was normal (low by my range) at 2.0, FT4 was low by both ranges at 0.74, TSH was high by both ranges at 6.130. I was on naturethroid at the time and struggling with palpitations when the dose went up so this is when I started splitting the dose and taking it twice a day. When TSH and T4 are low it could mean an iodine deficiency (not likely though I was not eating a lot of processed foods and using sea salt), autoimmunity- so antibodies could be high, and there was likely less conversion of T4 to T3 because there was less T4. There was a definite thyroid gland dysfunction.

Fast forward to April 2017 when I had my blood and urine tested for life insurance.

By my ranges, glucose was low, BUN was low, Creatinine low, Uric acid low, bilirubin low, liver enzyme ALT high, AST high normal but better than the previous years labs, GGT low (indicated oxidative stress), protein low (low by their range too), albumin low, globulin low normal (low by their standards), calcium low, LDH low (indicative of glucose issues), HDL low (inflammation), cholesterol/HDL ratio leaning towards an increased risk of CVD. They missed a lot of stuff with their ranges and I got the best life insurance rating you can possibly get.

My latest labs were done at my last visit to get my prescription renewed. I’m grateful to have a quality nurse practitioner willing to work with me based on my symptoms. She is cash pay though so I do pay out of pocket every time I see her. She is also functional medicine trained. The first time I saw her, she had me do a Dutch test and a Cyrex leaky gut panel- that was around $1000 for the two tests. I didn’t learn much from either- stuff I kind of already knew. I also did a food sensitivity panel from Cyrex that came up positive for foods I had been eating a lot of and tuna and shrimp. Since those two were on that very first food sensitivity panel I did back in 2012 I wonder if there isn’t some significance to that.

I did a gut healing protocol- a mix of following her recommendations and my own gut healing protocol from my GI class. It worked. I have been able to reintroduce dairy on a limited basis, meaning I don’t eat it every day, and nuts.

Back to my latest labs- done in April 2022. I compared them to the labs I had done July 2020 which was fun for me given my blood chemistry background.

What was missed?

Everything came back normal according the the lab values from the lab which was Quest Diagnostics.

My lab ranges revealed some white blood cells were high indicating a potential for low cortisol, a virus, parasite, and general inflammation. My blood sugar was low at 70 but can be low if cortisol is low or in hypothyroidism. My HDL cholesterol was low indicating the need for gallbladder support and triglycerides were high which can be high if there is hypothyroidism or elevated estrogen. My cholesterol to HDL ratio was high which can indicate an increased risk for cardiovascular disease.

My calcium was low indicating potential need for getting more in my diet or poor absorption. It could also be a mineral deficiency but I can’t confirm that because the minerals were not measured.

Creatinine was low which would either be decreased muscle mass or poor protein intake. LDH was high which can be high with hypothyroidism and my TSH was 20.39, FT4 0.7, FT3 2.2.

Clearly my thyroid labs say I was hypothyroid which affected the results of my other labs.

Why was I so hypo? I forget to take my afternoon dose of NDT a lot. I retested in June of this year after being more diligent about taking that afternoon dose and my TSH was 0.44, FT4 1.1, and FT3 3.7.

Why did I share all of this with you?

So you know you are not alone on this journey. I get what it feels like to feel bad.

I’ve done the work to understand what your labs might be saying about what’s going on in your body and I can help you figure it out.

I also want to point out that a lot can change in a couple of months of giving your body what it needs or what it is asking for so one bad lab result does not mean you are doomed. That lab draw is just a picture in time of what is going on and retesting with the same labs after a couple months of changes can help me see if things are going in the right direction.

Let’s figure this out together. I am on your team.

Thanks for tuning in.

Why Did I Get Hashimoto's?

Thanks for tuning in. It has been 7 months since I recorded an episode and I am grateful to every one of you who is still here or who has waited for me to finish school. I graduated in December with my masters in nutrition and FM and now I am mentoring with a nutritionist and 2 naturopathic doctors to get the hours I need for my certified nutrition specialist exam and subsequent licensure to become a nutritionist in my state.  Why does all of this matter to you? There are so many practitioners in the health space these days- the market is flooded and every one of these practitioners has the perfect program or protocol for you to feel your very best. I’ve seen many of these practitioners myself from medical doctors to naturopathic doctors to chiropractors to nutrition practitioners spending thousands upon thousands of dollars and being loaded up on supplement after supplement. The failure of any and all of these people to help me feel better lead to my own certification in nutritional therapy. The problem was from the very beginning I knew I didn’t know what I didn’t know. I didn’t like reading research and I didn’t really know how which is what led me to get my masters. I knew I needed more information to be able to help the population of people I wanted to help which is you. Wonderful humans with thyroid problems who are not being served well by their doctors or who just need a little something extra to get them feeling better. 

The doctors I am mentoring with (and I paid a pretty penny to do so) are amazing. They are a husband and wife team and one of them was my professor for two of my courses in my masters program and his teaching literally changed the way I think about health and wellness. He does not teach protocols. He taught me how to critically think about WHY someone’s body is not working well and all of this starts at the cells and your biochemistry. The word biochemistry used to scare me because I never ever thought I was smart enough to learn and know the science of the body. I have taken a deep dive into biochemistry and physiology- further than I needed to go for my degree because if I can really know the inner workings of the cells of the body then I have the tools to help anyone and my passion is helping you because I have been there. I have felt like crap for years- low energy, fatigue to the max, not just cold hands and feet but cold bones. 

The sea of health coaches and people with certificates in nutrition is full and like I said, each one tells you they have the answer to your problem. Generalized protocols for chronic conditions will work for some people but they will never work for everyone. Just like diets don’t work for everyone. You are a biochemical individual and that is why a general protocol isn’t the answer. You have all this conflicting and frustrating information on google but all you want is to live your best life or you would not have tuned in. If only you could get a clear set of instructions to follow so you knew just what to do to feel better. You can but you won’t find it in a book or a program because those things know nothing about who you are and what is exactly going on with you. 

My mentors have created a short questionnaire that is based in the scientific literature called The Cell Blueprint. It tells me what is going on with you and the best part is it doesn’t tell me what you need but it does tell me where I should go looking next. Add to that the ability to really interpret your blood chemistry from a simple complete blood count with differential and I can have a really good start in understanding exactly what is going on with your body and how to start you on the road to feeling better. You likely do need some supplements but they are individualized for you! Someone recently contacted me about wanting a supplement protocol to make her feel better and I need you to know I don’t work that way because you can’t supplement your way out of a bad diet or an unhappy life and an unhappy life can definitely affect your cellular health.

Aside from this, I found a study through Dr. Bryan Walsh that talks about the season you were born and how that may play a role in your getting Hashimoto’s or Graves disease so that is what I’m talking about today. 

This was a really interesting study done in Greece looking at this idea of birth month and autoimmune thyroid disease. It is well known that 21% of the cause of Grave’s is attributed to triggers from the environment such as infections and viruses with less research being able to pinpoint this to Hashimoto’s disease. There is also a confirmed connection in the research between a Rubella infection and hyperthyroidism. In addition, there is a clear connection between viral infections and T1D and MS. The association between T1D and both Grave’s and Hashi’s and possibly MS is also high meaning that having one of these leads to you being more susceptible to having the other which is a great reason to get your thyroid condition well maintained. It is nothing to mess around with - I certainly do not want MS or T1D. 

The thought behind this is that infections occurring in utero may play a role with the fall and winter months when infection rates are generally at their highest.  All Grave’s and Hashi’s patients in this study (around 1200 people) had their month of birth compared to disease development. Grave’s was more prevalent in men who were older at diagnosis and they had high FT4 and low TSH. Hashi’s was more prevalent in women, they were not as old at diagnosis compared to those with Graves, TSH levels were higher than 10, FT4 lower than 7.0 and TPOAb were greater than 50. An ultrasound of the thyroid diagnosed Hashimoto’s autoimmunity. 

Grave’s Disease diagnosis was based on diffuse goiter (which means the whole gland is involved rather than just a nodule), ophthalmopathy (eye balls stick out, or increased levels of thyroid receptor antibodies/TRAbs). In the general population, in both sexes, the highest incidence of births was in summer and more males with Graves were born in winter while women with Graves were more likely to be born in spring and fall. 

In Hashimoto’s, patterns between birth month for the general population and both men and women the birth month patterns were different between men and women as well. Men were born in summer months and winter months and women were more often born in winter months and the birth month correlated with how high the antibodies were. Researchers even checked to see if there was a significant difference in overall viral infections when these subjects were in utero and there appeared to be no change in general viral infection rates from the norm. 

The idea behind this study was to find a similarity or not between viral infection and T1D compared to viral infections and Hashi’s or Grave’s as the two are commonly held together and T1D is more commonly associated with infections in fall and winter when more people are getting sick. This supports the idea that a viral infection could be a trigger for any one of these conditions in those who are genetically susceptible. 

The high antibody connection between birth month and high antibody titers is similar to birth month and high antibodies against B cells in T1D. Being genetically predisposed to autoimmune disease combined with the trigger of infection could be all it takes to progress into a full blown autoimmune disease. 

One thing that allows this progression is unhealthy cells which don’t need curcumin or gogi berries to run well. Let me help you figure out where your core or root cause issues are stemming from by having a look at your Cell Blueprint. This is the best time to do this while I have my mentorship. They charge $500 for a one hour consult so you are getting three minds for the price of $153 which is what I currently charge for a one hour consult. Most people only need 3-4 visits total with the subsequent visits costing $79. I don’t have any packages right now but will be eventually. My sole concentration right now is seeing as many clients as I can while I have mentors so I can be the best at what I do. If you are interested, please reach out at outofthewoodsnutrition.com and fill out my contact form. If you haven’t already, you can sign up for my newsletter as well and get your copy of Five Things Your Doctor Won’t Tell You About Hypothyroidism. I look forward to helping you get back to your old self. 

There will not be an episode next week but I do hope to be a bit more regular with getting episodes out now that I am out of school and done with my interpreting blood chemistry course. Thanks again for tuning in. I appreciate you! 

Should I take antibiotics?

Someone emailed me and asked about taking antibiotics and whether or not it was a good idea to take antibiotics at all for a particular condition since she knows that they can harm the population of bacteria in the gut. If you go back and listen to episode 81 you will find some good information on probiotics. 

If you have to take antibiotics for something, it’s okay. I don’t think they are always warranted but it isn’t my place to tell you whether or not you should take them. There will be changes in gut bacteria when you take antibiotics and you can take probiotics at the same time as you take antibiotics, just not together. The scientific research shows that taking the probiotics while on antibiotic treatment will decrease antibiotic-related side effects like diarrhea or other GI symptoms and will also reduce the associated damage that comes with antibiotic use to the gut microbiome. This means taking specific probiotics will help minimize the damage that probiotics can do to those good bugs. 

Florastor which is available almost everywhere is a Saccharomyces cerevisiae variety boulardii (Biocodex strain). When you see saccharomyces boulardii listed on a supplement label- it is incorrect. It should be Saccharomyces cerevisiae with a strain name after it. So they are not all the same. The strain matters. Florastor has the rights to this strain I believe so it is a good thing you can get it anywhere. 

Another probiotic you can take is called Lactobacillus helveticus R0052 or Lactobacillus rhamnosus R0011 which will provide similar support as Florastor. These two strains are found in Xymogen Probio Defence, Xymogen Lacidofil, Jarrow Jarro-Dophilus EPS & EPS higher potency, Jarrow ultra Jarrow-Dophilus and Natural Factors Relief Biotic.  ORDER YOUR PROBIOTICS HERE

When taking antibiotics you want to take the probiotics 2-3 hours after the antibiotic so it can survive and taking them with a meal will help them survive digestion.  In addition, make sure you are eating lots of fiber, always, because your gut bacteria feed off of insoluble fibers which keep their populations healthy and strong. 

This is probably the shortest episode I’ve done. Remember your are not your diagnosis, you can live well with Hashimoto’s. Of any autoimmune disease, this one is the least debilitating and you can manage it well with diet, lifestyle, and proper medication dosing- so having a good doctor is helpful and I know that is the problem for many of you. I’m sorry for that. I wish there was something I could do to help with that. 

How Does My Immune System Work?

How does my immune system work? 

If you have tuned in it is probably because you have Hashimoto’s thyroiditis. If you have Hashimoto’s it is because your immune system has gone wonky. In future episodes, I will cover why this happens in more detail but to understand autoimmunity you first need to understand your immune system in general. 

The main purpose of your immune system is to keep out bacteria, viruses, parasites, and fungi. Our body has the perfect environment for all of these things to flourish which is why we have an immune system. The body has barriers such as skin, mucous membranes, and even stomach acid to keep these bacteria, viruses, parasites, and more from fully entering the body. If the body doesn’t keep out these bugs because one or more of the first lines of defense are not working well then your immune system gets to work to keep them from wreaking havoc. 

When something enters and gets past the first lines of defense, the immune system has to distinguish between self and non-self. It asks the question, ARE YOU ME? and ARE YOU DANGEROUS?  When your immune system is healthy, it will be able to tell the difference between self and non-self, so it doesn’t attack your tissue and just sets out to destroy actual invaders.  Your cells are marked as self and should not be attacked. When the immune system encounters cells or other organisms such as viruses or bacteria that are marked as non-self or foreign, an attack will be launched. 

The chemical triggering that attack is called an antigen and the response is called an immune response. Antigens can be a microbe like a virus, it can even be just part of a microbe. Other human tissues or cells will have foreign markers as well which is why organ transplants have a risk of rejection. 

Let’s talk a little bit about how the immune system is structured.  All organs of the immune system are called lymphoid organs. They house white blood cells called lymphocytes. Tonsils, adenoids, lymph nodes, lymph vessels, the thymus gland, the spleen, Peyer’s patches, your appendix, and bone marrow. Bone marrow is where we make blood cells which include white blood cells.  The thymus gland is where T cells mature. Lymphocytes travel through the blood and through the lymphatic system which runs parallel with our veins and arteries so cells and fluids can be exchanged between the two and be on the look out for invaders.  The fluid running through your lymph system is clear and it sort of “cleanses” the tissues of the body. 

You may have felt a lymph node when it is swollen. These are clustered together along your lymph vessels but especially around the neck, armpits, stomach, and groin areas. Your immune cells hang out here waiting to catch an antigen. Antigens are a protein or chemical that the immune system responds to and it can be pretty much anything but is likely to be a bacteria, virus, worm, food, allergen, or mold.  Your response to an antigen will be or can be different than someone else’s response because we all have different immune cells that are specific for things like mold or bacteria. That is why mold really affects some people and not others. 

Invaders and immune cells go through lymph vessels, exit through the lymph nodes, and make their way to the bloodstream where they go throughout the body looking for antigens, go back through the lymphatic system, and do it all over again. They are like a 24-hour patrol center. 

In your spleen is where immune cells congregate and plan. They bring an antigen there and that’s where they deal with it or decide what to do with it. 

The immune system has the ability to recognize most of the foreign invaders we could possibly encounter and when one of these invaders is known to be in the body, the cells that recognized it multiply themselves to create an arsenal of attacking cells to get rid of the invader. Once it’s gone, they dissipate but leave a few cells around to watch for that invader to come back. Kind of like a watchman that will alert the need for supporting troops to come help. 

Lymphocytes, those white blood cells, can be split into two groups. B cells and T cells.  B cells are made in the bone marrow and they make antibodies like IgG, IgA, and IgE (immunoglobulins).  Antibodies attack antigens in the blood. This applies to autoimmunity and leaky gut. When the gut is leaking and your digestion isn’t working well, antigens from food end up in the bloodstream, your immune system attacks and you become sensitive to the food. Once the B cell has identified an invader, the T cells are called in to attack it. B cells make antibodies, but only one per cell. So a B cell discovers an antigen and it tells a plasma T cell about it. The plasma cell then makes antibodies and sends them to the bloodstream. Antigens and antibodies are like puzzle pieces- some fit exactly right and sometimes you think you have it right but it’s not quite a good fit. Either way, when they fit together, the antibody sends a signal that the antigen needs to be destroyed. 

T cells don’t go around looking for antigens just floating around in the blood but instead, they have receptors that find antigens on a cell’s surface. These special cells will either regulate and instruct an immune response or they will attack an infected cell. You may have heard of Th1 and Th2 dominance spoken about in autoimmune disease, especially hashimoto’s. That is referencing T helper cells. These cells are like the cruise director on the old tv show The Love Boat. They coordinate and communicate with other cells like telling a B cell to make an antibody, or they call in the eater cells called phagocytes or they call in the killer cells. 

Natural killer cells are a type of killer cell. They release little particles that release a chemical that kills the invading cell and can attack any kind of invader. Other killer-type cells only kill cells with a specific antigen on them. 

I mentioned phagocytes or eater cells before. These types of cells swallow and digest invaders. A monocyte is a type of phagocyte in the blood that turns into a macrophage or big eater when it makes its way into tissue. They are found in the lungs, kidneys, brain, and liver among other places. Macrophages are like scavengers that clean things up. 

You have likely heard of histamine. That is produced by a cell called a granulocyte. They release granules that are full of chemicals, histamine being one of them, that set out to kill microorganisms that cause inflammation and allergic reactions like last year when I ate a tomato for lunch and proceeded to immediately get flush in my face and on my arms and legs. It was august and I tend to have a bit of a fall allergy so that combined with the fresh garden tomato was all my body needed to have a histamine reaction. 

Other cells that have granules they release are called neutrophils, a type of phagocyte, as well as eosinophils, and basophils. Mast cells are similar to basophils but aren’t found in blood but in the lungs, skin, tongue, and in mucosal linings and they also cause allergy symptoms. 

If you have been following Covid research at all you may have heard of a cytokine storm. Cytokines are hormone or chemical messengers. They talk to each other using their chemical messages where they act on other cells to create an immune response. Interleukins, interferons, and growth factors are cytokines. Interleukin 2 will tell the immune system to make T cells and, they can boost the immune system. Cytokines are also involved in repairing damage from inflammation or fighting off an invader- a bodyguard of sorts. 

We have something called a compliment system that has proteins that work with antibodies kind of like an additional force for good. They play a role in our inflammatory responses like when we hurt ourselves. The warmth of an injury, as well as the swelling, pain, and redness, are partially from the complement system.  In an immune response, there is a cascade of reactions that result in an invading cell being sort of drilled into. 

Infections are the most common issue we have as far as disease is concerned and the bugs causing those infections to have to get past our skin, mucous membranes in the respiratory system, and our digestive system. The only way to get past the skin is through a break in the skin. If a microbe enters your nose, you will make more mucous, you may even sneeze or cough in an attempt to keep invaders out. I think about sneezing in allergy season- that is your body’s way of trying to keep those little buggers out of the body. My daughter said she must have sneezed 40 times last night in the middle of the night- she has pretty bad seasonal allergies. I also think about my husband’s smoker’s cough. I imagine that his lungs are so damaged from smoking for 40 years (he’s only 54) that anything entering his lungs may be why he coughs so regularly. 

Our stomach is supposed to be acidic. I have talked about this in episodes about digestion. You need stomach acid. It is a line of defense against microbes that we swallow with food. If something makes it past all these barriers and we know that they do because we have all been sick. Our mucosal surfaces, stomach lining, intestinal lining and even the genital area are all lined with mucosal membranes that have IgA antibodies in them. Under that layer are macrophages, B cells, and T cells just waiting to identify an invader. Then they have to get past the phagocytes, natural killer cells, and the complement system which are all set up to destroy an invading substance.  On a side note to that- all this hand sanitizer being passed around everywhere these days to avoid Covid virus exposure - what do you think that is doing to your skin microbiome?  Likely changing its makeup and causing an issue with that particular immune barrier. Maybe instead of killing off the good bugs in addition to viral bugs, we should be providing our skin with the proper bugs to keep that immune barrier strong and healthy so it can fight off the bugs. Just something to think about- critical thinking my friends. 

Bacteria live in between cells and get attacked pretty easily by antibodies. Viruses and parasites have to enter cells to survive. If a cell gets infected it has its own defense system in place to tell the immune system to kill it. There are some parasites that can live outside of a cell, if they live outside the cell it is likely because they are too big to enter the cell and so more of the immune system has to get involved. 

We have two types of immunity. Innate/non specific and specific/acquired/adaptive. 

You are born with your innate immune system and it becomes active around 3-4 weeks and you need it to live. All microbes that get into the body are monitored by this system like a surveillance team. This is where most of the immune cells are made: 

• macrophages: this cell is in every tissue of the body ready to respond to invaders at all times and are very useful in the skin, GI tract, nose, and lungs where they produce cytokines which can be toxic to some invaders but they also call in more macrophages, dendritic cells, white blood cells to help in defending against invaders.

• Neutrophils: a white blood cell and a granulocyte (releases granules that are toxic to the invader) that kills anything. It wraps itself around the invader/eats it and kills it. And they eat and eat until they die. Pus is a good example of a neutrophil that has died and is a barrier between infection and the rest of the body.

• Eosinophil: another white blood cell that eats and kills but also will present antigens to T cells and B cells, is involved in allergies.

• Basophils: Another white blood cell doing similar work as neutrophils and eosinophils and is involved in allergies but there isn’t a lot of information on this one.

• Mast cells: these hang out around blood vessels and nerves and these are what release histamine, heparin (anticoagulant), and cytokines that cause swelling and bring in more of the macrophages and neutrophils to eat things up.

This branch of the immune system is what creates inflammation and part of that inflammatory process is due to the complement system because it calls in inflammatory cells coating invaders so they get eaten. It is also quick to react which is why it isn’t super specific so every response will be very similar no matter the reason it was activated. It also doesn’t care if it is a foreign invader, a damaged cell that needs to be taken care of or a perfectly healthy cell like one near a cut on the skin for example. This non-specificity only becomes a problem when you are dealing with inflammation due to chronic stress, infections that stick around, hormonal issues, or consuming a lot of foods that create inflammation which then leads to further health problems. 

Your specific or adaptive immune system is developed over time. The flora of the gut help develop it and you won’t live well if this system doesn’t work, but you can live. It can take over when your innate immune system can’t handle the infection, injury or inflammation occurring. When innate needs help, it takes one of those eaten microbes/viruses and presents it on its surface to show a T helper cell that can recognize the antigen presented. The T helper cell then gets activated, multiplies, and further activates the specific/adaptive immune system. 

This branch is specific in what it attacks and it remembers these invaders so next time they come by they can respond faster and more aggressively. If you have had chickenpox this is why you only get them once. Your immune system remembered that virus and keeps it from reinfecting you. It differentiates between self and non-self very specifically when responding to pathogens but this branch is also what attacks our tissues in autoimmune disease. 

There are two categories of adaptive immunity. 

Humoral and Cellular Immunity. 

Humoral immunity uses B cells created in the bone marrow and sent out into blood and lymph. B cells are what produce antibodies or immunoglobulins to fight off very specific things. Your body produces millions of B cells each day and each of these cells has a specific antibody on it so as it is circulating through your blood and lymph it is looking for a match to the antibody it is specific for. Once it finds it, if it finds it, it attaches to it and releases a signal to activate cytokines (made by T helper cells- which we will learn about later). The B cells for that antigen will then multiply themselves so the rest of that antigen can be gathered up. While it is multiplying it is also making a different kind of B cell called a plasma B cell that makes more antibodies to increase the attack on the antigen/foreign invader and memory B cells so it can remember this antigen for the next time it tries to invade. The innate immune system helps out here with their macrophages or eater cells and the complement system to clear out the invader quickly. 

Cellular immunity involves the T cell white blood cells that are developed in the bone marrow but go to the thymus for training before being released into the blood and lymph. There are two classes of T cells: CD4 and CD8 and they work with the receptor on the T cell to find invaders recognizing even a fragment of a foreign invader that may have been partially broken down inside the cell already. 

There are two major types of T cells: Killer T cells and Helper T cells. 

Killer T cells are CD8 cells that attack infected cells in the body- they are looking for foreigners presented on the cell surface and can be activated by other cells like macrophages, B cells and T helper cells to kill an infected cell. These are the ones causing issues with organ transplants and killing cancer cells. 

Helper T cells you may be familiar with as Th1 and Th2 are a part of this group and you may have heard these mentioned in relation to being Th1 or Th2 dominant. These cells tell the killer cells what to kill but they also release cytokines (inflammatory chemicals). Each of the Th cells releases a different kind of cytokine to create a certain type of immune response. 

Th1 cells involve innate immune cells like macrophages and cytokines that tell T cells to turn into killer T cells. Having too many Th1 cytokines can create hypersensitivity to food. These are the most commonly made cytokines and are also effective at taking on bacteria, viruses, some parasites and cancer. Taking ashwagandha can increase Th1 and that is only good if your Th1 is low. Reishi mushrooms also increase Th1. In the case of an infection, increasing Th1 would be okay. Th1 is high in ulcerative colitis in addition to food sensitivity. Low Th1 is related to actual food allergy and colon cancer. 

Th2 cells activate B cells which multiply and create antibodies. These are made in response to worms and parasites and when these are overproduced in the gut they can lead to food allergy or anaphylaxis. High Th2 is implicated in Crohn’s disease. 

Another T helper cell called Th17 is very inflammatory and is activated when we encounter some bacteria, fungi, or parasites. This increases inflammation to help get rid of bugs and is involved in asthma. This one is implicated in autoimmune disease and can produce Th1 or Th2- it all depends on the person and what is going on with them. This is probably too much information for you but I just wanted to lay it out there. The more you know the better equipped you are. 

There is another T cell called a regulatory T cell or T reg cell which is also a CD4 T cell that helps regulate (hence the name) the specific/adaptive immune system by shutting down the immune response when appropriate. They play a role in regulating the immune system in a way that creates tolerance where it will not attack an antigen (in pregnancy- so your immune system doesn’t attack your baby) and in stopping T cells that are preparing to attack self (our tissue). It is said that T reg cells also play a role in autoimmunity. They work to keep other cells from becoming pathogenic. If Th1 is out of control, T reg cells are supposed to keep it under control. You can increase your T regulatory response which will even out Th1 or Th2 by eating well, meditation, yoga, singing with people (strange I know), and some supplementation which I am not going to tell you about because I don’t want you to just go supplementing with something because you think this is a problem for you. 

To summarize 

Your immune system, when working well or when it is healthy, plays the role of detector and defender. It is tightly regulated within the body systems. It is reparative and it is tolerant (won’t attack you or the foods you eat).  We will get to what happens when it attacks you in a future episode. 

What is an antibody? 

These are proteins and are actually immunoglobulins which are the Ig in IgA, IgG, etc. The job of an antibody is to notice when another protein is near and bind to the part of that protein and deactivate it and also will send a signal out to the rest of the immune system if it has attached to a foreign protein (one it doesn’t recognize as safe for you). This can cause the immune system to react and attack.  Antibodies are Y-shaped with each part of the Y having a specific job. The tips of the Y have an antigen-binding site meaning it binds to antigens. It is like a lock and key. The antibody won’t bind to the antigen if it doesn’t fit just right. 

Immunoglobulins have classes or types characterized by another type of protein attached to them and are named IgM, IgD, IgG, IgE and IgA. Each has a specific type of thing it looks for in the body. 

IgM antibodies: these signal a potential recent infection as they are the first thing to respond to an antigen in the body. They are secreted by the B cells which remember are there to identify the invader/antigen and tell the T cells to attack. We make IgM antibodies to everything. 

IgD antibodies: there is not a lot known about these but they work with new/immature B cells and can activate other immune cells like basophils and mast cells to produce cytokines (inflammation chemical messengers).

IgG antibodies: these are in the greatest numbers in the blood (3/4 of the antibodies circulating) creating most of our antibody type immune reactions and gives us a Th1 response. These respond to bacteria and viruses. 

IgE antibodies: these bind to allergens and cause a histamine release giving you the symptoms you feel from your allergies such as pollen, rag weed or hay fever. These also bind to parasites and worms which are more common IgE reactions in less westernized countries.  

IgA antibodies: in mucosal areas like the small intestine, respiratory tract, and basically anywhere there are secretions in the body. These respond to food and some infections. 

All of these can be found in the blood with IgA being found in all secretions. 

What do antibodies do? 

They can coat or surround a microbe or other substance so it can be eaten and disposed of. They can neutralize things like toxins which in the case of botox injections is the reason why you have to get more and more of an injection for it to work. They activate the compliment system which is a series of proteins that poke holes in bacteria. They activate other cells like mast cells to break up worms to be eaten by macrophages or eater cells. 

Your immune response will be the same whether it is food, bacteria or viruses or allergens that your body is responding to. The immune response to food is the only thing that has what is called immunological tolerance so you are not reacting to everything you put in your mouth. When you have tolerance to food that is an IgA reaction. When you have a hypersensitivity or food sensitivity that is an IgG reaction and allergy is an IgE reaction. You can react to something you are sensitive to with the same reaction as an allergic reaction, the difference is that one is an IgG reaction and one is an IgE reaction. I have been told that healing the gut can allow someone to reintroduce those IgG reactive foods again. 

Consuming foods that provoke an IgG reaction regularly will create chronic inflammation through the overproduction of reactive oxygen species and oxidative stress along with the inflammatory cascade in the gut and then into the body systemically depending on how bad it is. Chronic inflammation can also be caused by obesity, gum disease, injury, underlying infections, mood disorders (here it is a chicken or egg situation- which came first). 

Bottom line- there is a lot we don’t know about the immune system and how it acts/reacts etc. Now you have a very basic understanding of the immune system so you can be more proactive in your own health. When we know better we do better. 

Please sign up for my newsletter at outofthewoodsnutrition.com and get my report on the five things your doctor won’t tell you about hypothyroidism. Older episodes refer you to social media accounts which are no longer around and I’m happier and more sane for it! You can find me here on the podcast or on my website. 

Thanks for listening. 

Will Selenium help my thyroid?

Hello and welcome to episode 102. Thanks for joining me. I have a couple of announcements before we get to today’s content. 

First, on a personal note, someone close to me was scammed by one of those internet gift card scams. Because they used to work for the company that the scammers pretended to be, this person, an older person, believed them. It is a scam where they get you to sign in to your online bank account and they say they are refunding you say $299.00. As you are typing, they add an extra 9 to the account so it looks like you are getting a refund of $2,999.00 and then they say they will get in big trouble with their boss and the only way to remedy this is to buy gift cards and read them off the numbers. This person bought a total of $3500 in gift cards, $1000 of which was able to be frozen but they were out $2500. So please have a conversation with the older adults in your life. I never thought this person would have been able to be scammed like this in a million years and they were. There are a lot of great YouTubers getting back at these scammers if you want to check them out Kitboga is a good one as well as Scambaiter and Jim Browning. 

Okay, the second thing I wanted to talk about is LifeTune - they sell emf-type devices and they sent me a couple for my phone. I muscle tested them and they seem to work for me. If you are interested in checking them out, they seem to have a sale going on all the time at up to 35% off. You can use the discount code GETCLEAR for 10% off at www.airestech.com. 

You can also get 10% off Meizen skincare at myzenskincare.com using the code 10% off. That is the number 10, percent sign, space, off. I love their skincare, especially the edelweiss serum and the vitamin c spray. Dr. Martha also has some nice essential oil blends and awesome body oil that smells like cinnamon. Please support local small businesses if you can. 

Okay, now on to the good stuff. I’m in a program called Practice UP from the good people at Metabolic Fitness Pro. They strive to give practitioners the latest information/science to help them put into clinical practice so they can be the best practitioners out there. That is my goal. To be the last stop for all of you fantastic Hashi’s patients out there. I am still learning and plan to continue to always be learning so I can serve my clients in the best way possible. Anyway, each month we learn about something clinically relevant and last month we learned about Selenium and the role it plays in thyroid health and in type 2 diabetes. I’ve got some great info for you guys. 

What we know: 

Autoimmune thyroid disease accounts for around 85% of people with hypothyroidism and the cause of Hashi’s has many factors involved. Our genetics and environmental triggers play a role but are not well understood. We have the highest selenium concentration per mass unit of tissue in our thyroid gland and has direct effects on the metabolism of thyroid hormone. Many of you have heard or been told to take selenium to help with reducing thyroid antibodies and many studies have shown that it is, in fact, effective at reducing TPO antibodies. There are several studies that show it has no effect as well. Many of the studies going either way here have a poor quality of evidence. That means the way the study was conducted had some problems that may have affected the outcome and results. 

Those studies that showed an improvement in antibodies could have had people in the study that were deficient in selenium in the first place but baseline levels of selenium were not measured. When people were followed for 3,6,12 months and antibodies were measured, they didn’t see much change in antibody levels after 12 months which could suggest there was a deficiency in selenium that was fixed by supplementation and could also be why there was no clinical improvement in those subjects. 

A study published in January of 2021 goes over many of these studies in detail. It is called Insufficient evidence to support the clinical efficacy of selenium supplementation for patients with chronic autoimmune thyroiditis with the lead author being a name I can’t pronounce but will have the reference in the “transcript” on this episode on my website. The bottom line is I have three studies I’ve read today that are suggesting that supplementation with selenium may not be needed. 

As I said, it can improve or lower antibodies but it really doesn’t do anything for the course of the disease. In Graves’ disease, it might lead to faster remission of hyperthyroidism and improve upon the quality of life- so keep that in mind. 

Other nutrients interact with Selenium which will affect you. For instance, Vitamin C is thought to increase the absorption of Se. If you are deficient, Vitamin E will make the selenium deficiency worse and if you are not deficient, having adequate vitamin E levels may help prevent toxicity from too much selenium. Large doses of Omega 3 fatty acids, potentially several grams of fish oil for example, my cause the need for more selenium. Large amounts of zinc and copper can cause a selenium deficiency so if you are deficient in those, you may also need selenium. Vitamin D supplementation can increase selenium. 

What I am getting at is that you may have been told to take selenium because a few studies showed that it reduced antibodies but do you know if you really need it??? 

The average adult’s selenium levels are said to be optimal at around 80-120 mcg/mL and at that level are said to be good. It does act as an antioxidant at this level in the body but anything more than that can mess with insulin signaling and eventually causing insulin resistance. Too much selenium causes insulin resistance, higher HBA1C, and metabolic syndrome. Hashi’s patients are already at risk for developing these things and adding selenium supplements to your regimen could almost guarantee these things in your future. 

There is also an association between serum selenium levels and all-cause mortality and cancer deaths when selenium in your blood is measured at over 150 ng/mL. Below 130 ng/mL is more protective. Another study showed a direct relationship between exposure to selenium and odds of type 2 diabetes with the higher plasma or serum levels of selenium at around 140 ng/mL. 

Another study called Effects of Long Term Selenium Supplementation on the Incidence of Type 2 Diabetes that was almost 8 years long found that long term supplementation with selenium may increase the risk for type 2 diabetes. The group in this study with the most type 2 diabetes while supplementing with 200mcg per day was the group that had the highest Se levels at the beginning of the study which was around 121 ng/mL or higher. That is not a lot- that is within the normal range. 

If you are deficient, you may need to supplement with it for a bit but it is likely once you are absorbing nutrients with some gut healing you will get enough from food. You can go to whofoods.com and type in selenium in the search bar, scroll down and click on selenium and it will tell you all about this mineral and which foods are highest in selenium. Here is a shortlist in order from the highest amount of selenium per serving to lower but all have good amounts: 

• tuna

• Shrimp

• Sardines

• Salmon

• Cod

• Crimini & shiitake mushrooms

• Asparagus

• Mustard seeds

• Turkey

• Chicken

• Lamb

• Scallops

• Beef

• Tofu

• Eggs

• Brown rice

• Sunflower and sesame seeds

• Cows milk

• Cabbage

• Spinach

• Garlic

• Broccoli

The RDA for selenium is around 55 ug/mL day with the tolerable upper limit at 400 ug/mL but remember what I said earlier- at 121 ug/mL in the blood- long-term supplementation can cause type 2 diabetes. 

Use an app like Cronometer to see what you are getting in nutrients, not just selenium but all nutrients. 

Take out all your supplements. If you are really anal or organized, make a spreadsheet of all the nutrients in everything you are getting from supplements so you can see if you are getting not only too much selenium but maybe you are getting too much or not enough of something else. For this very reason, I don’t recommend just Willy Nilly taking a supplement because you read it was good for you! 

Dr. Walsh in Practice Up gave the example of a supplement company which he didn’t mention that has a thyroid protocol. All the supplements in this protocol that would be given to a practitioner from the supplement rep because the bottles all say 1 cap per day because then the FDA doesn’t get involved in their business and then the practitioner passes the protocol on to the client—- The bottle of a thyroid conversion supplement says take one cap per day but the rep says to take 3, three times a day..... see what I’m doing here??

This protocol amounted to almost 1400 mcg/day of selenium and I just told you that 200mcg per day over 7 years caused type 2 diabetes. Granted, you would not be on this type of protocol for 7 years but maybe 3-6 months? Do you need that much selenium over even that time period?? 

This type of thing can happen with any nutrient- so go through all your supplements and really look at what you are getting in. In addition, you can ask your doctor to test selenium levels in your blood but if they won’t do it, you can order your own lab test from a direct to consumer lab company like Ulta Labs or Any Lab Test Now and it should be around 110ug/dL - 120 ug/dL

You may or may not need selenium, it may lower antibodies but it probably isn’t going to fix the problem, and remember there is plenty of selenium in food. 

Where you live matters, some middle eastern countries are lower in selenium status than China which is really high. The US tends to have plenty of selenium in general. Remember to calculate your intake of food and in supplements. Are you deficient in any other nutrients? This is why I try to hammer home that you need to work with someone to figure this stuff out. 

Okay, that is it for today. I hope you guys enjoyed this and that it wasn’t too much science or too technical. I get requests from people about 1x per month to be on the show that is really what feels like trying to promote their own business or programs. I try to only have people on that I feel have something to offer and are not just one big commercial for their business. I don’t want to do that so I hope you like what I’ve done here today. I think it is good stuff. 

Remember you can get 10% off at AiresTech.com using the code GETCLEAR and 10% off at myzenskincare.com using the code 10% off.  You can learn more about Practice Up here.

Until next time. 

Can a Vegan Diet Help Hashimoto's?

Hi everyone. Thanks for joining me today on Help For Hashimoto’s. I’m so glad you are here. I’m on my spring break and have a week off. It is nice to be on my own schedule but I also seem to be much less productive. 

I had a guest on a few episodes ago who was an energy worker. Her name is Rachel Vineyard and she did an energy healing session with me that cleared up many many cords I had attached to me that were weighing me down. After she cleared and sealed them I felt so much better and lighter and happier. Now that my time is up with her and I’m on my own, I had a dream that a dark figure was trying to reattach itself to me and since that dream, I have had really low energy. I told Rachel I have a sneaking suspicion of where the dark energy was coming from and I am hopeful I can keep it from taking hold. It is so frustrating to feel good, almost normal, and then have my energy just stolen away from me again. I know some of you have this same issue. Just low energy all the time. Maybe some of it is I keep forgetting to take my afternoon dose of my medication. I had my labs done on Monday so I look forward to seeing what they are. Either way, I just keep swimming as Dori says in Finding Nemo. 

I received a question from a listener so let’s get right to it. 

Hi Stephanie,

 I hope you are well.

 Firstly I just want to let you know how much I love listening to your podcasts.  I listen to them after I drop my daughter off at school and before going to bed everyday.

 Thank you so much for the time that you put into these podcasts and for keeping it REAL!!

I first got diagnosed with Hashimoto's by my naturopath end of Jan this year after years and years of feeling crap! I have been back and forward to numerous Dr's only to tell me that everything was fine, only when i knew it wasn't.  I knew something was not right when none of my clothes fit me, I was feeling tired and exhausted all the time, I was feeling extremely anxious, getting rashes all over my body, constipated/diarrhoea and bloated all the time (to the point I look like I'm about to have triplets), body aches and pain and so the list went on.

I tried to treat it naturally with herbs and i gave it a month, but I just simply was not feeling right.  I was then told my naturopath to cut out gluten and goitrogenic vegetables and take supplements.  I was following all of this strictly, and cut out drinking on the weekends, but I was still feeling awful.  I was starting to feel so alone and lost in this journey that I felt suicidal.  I hated my puffy, chubby body, the pain I was in and this new person.

I have also suffered from candida since I was 11, to the point that I had a diatherme of the cervix, tried every anti candida diet, coconut oil-EVERYTHING YOU NAME IT!

 Now my Naturopath thinks I may have leaky gut or SIBO and wants to treat me for this.  I keep getting told by numerous health professionals that I cant be vegan with Hashimoto's but I have been eating this way for most of my adult life.  I have an extremely clean diet, don't eat the vegan junk processed foods (like people think), and prior to Hashimoto's was extremely active.  Now i just feel like this lost fish drowning in a deep sea taking Levrothyroxine which I had to force my endocronologist to give me a compounding script free without the CRAP!!

 I just feel like my head is spinning and so alone.  I don't want to give up my plant based lifestyle because I HATE MEAT.  I love vegetables, lentils and legumes. 

 Is there anyone that can help?

 (Sorry for the long email)

 Kind regards,

Lizz

I kept getting told by health coaches that I can

The short answer on whether you can be a vegan or vegetarian and have Hashimoto’s is yes but there is a few things we need to discuss. First, had anyone asked me this question even a year ago, I would have told you there is no way you can be healthy and be a vegan or a vegetarian. I have changed my mind on that by being open-minded and willing to listen to the other side. I will say, I don’t necessarily agree with any type of diet that requires supplementation because you can’t get all the nutrients you need in high enough amounts from food. This is not a philosophical episode. You believe what you want. I’m basing my opinion on science. I’m also prepared to say that for the majority of people who are vegetarian or vegan, you can have an autoimmune disease and be healthy. In fact, there is a lot of research on Rheumatoid Arthritis being helped significantly by a vegan diet.  So, there will be no dogma about this. I want to help each of you be the best you can be so here we go. 

The first study I found is called Iodine Status and Thyroid Function of Boston-Area Vegetarians and Vegans.  We know iodine is important for thyroid hormone to be made. For women of childbearing age, getting enough iodine in your diet is important too. Iodine deficiency affects around 2 billion people worldwide and is the leading cause of preventable mental retardation (Leung et al., 2011). Here in the US, we get iodine from iodized salt, dairy products, eggs, seafood, and some bread. Iodine content isn’t usually on a food label and salt restriction is associated with iodine deficiency. Vegetarians consuming dairy and eggs may be getting enough iodine but vegans can end up deficient. This study recruited vegans and vegetarians who had been on their respective diets for at least 3 months and iodine was measured in their urine along with some other metabolites affecting thyroid function such as thiocynates in soy, a chemical found in cigarette smoke, and perchlorates which is an environmental toxin. The study had 78 vegetarians and 62 vegans of mixed races and sex. 

Vegans had lower iodine status compared to the general population and vegetarians. Women of childbearing age or those who are lactating should consume 150 ug (micrograms) of iodine per day as potassium iodide. The other compounds were measured to determine if they had an effect on thyroid function in competing with thyroid hormone. It wasn’t clear if that was the case but I think likely not since vegetarians had normal iodine status and vegans were low. 

Another study looked at lower intakes of iodine and selenium between vegans and vegetarians. While these diets tend to have better food quality and they also tend to be higher in vitamins C, E, B1, folate, magnesium they tend to be lower in vitamin A, D, B12, calcium, and zinc.  You may have read something different elsewhere. I am just telling you what the study says. Studies can be wrong but the internet can also be wrong. There were 62 women in this study- 26 omnivores, 16 vegetarians, and 20 vegans. A small study, so we need to take that into consideration. There were obvious differences between omnivores and vegans such as saturated fat intake and fiber intake- no excuse on the fiber intake for omnivores. All of us should be getting about 30 grams of fiber a day. I struggle with that myself which is so stupid because I feel exponentially better when I consume a lot of veggies. Anyway, this study reports all three eating groups had sufficient intakes of vitamins A, C, E, B’s and zinc and sodium. This information was taken via a food questionnaire that was analyzed by a computer. All three eating groups were not getting enough vitamin D, potassium, or iodine. The vegan group was especially low on selenium and iodine, B12, and calcium. (Fallon et al., 2020). 

Another study called Prevalence of Hyperthyroidism According to Type of Vegetarian Diet found that those consuming a vegan diet had a lower incidence of hyperthyroidism compared to meat-eaters and semi-vegetarian diets were not protective against hyperthyroidism. Hyperthyroidism is caused most commonly by Graves Disease which is also an autoimmune thyroid condition and equally not as fun to have. I’d even say less so than Hashimoto’s because while having a hyperfunctioning thyroid can cause weight loss, which many of us would not mind, it is not the right way to lose weight, and hyperthyroidism that isn’t controlled likely leads to thyroid storm and can result in you having to purposely destroy or remove your thyroid gland. This study used a food frequency questionnaire to determine nutrients taken in which is a common way to do that in scientific studies. It has some downsides, but it is a much less expensive way to determine this outside of monitoring or providing all food eaten by study participants. The information for this study was taken from the Adventist Health Study-2. Seventh Day Adventist’s are known for consuming a vegetarian diet, and 97,000 of them participated in this study. Predictors for hyperthyroidism were being overweight, obese, and female. Most vegans and vegetarians have a lower BMI which the researchers list as a possible reason for having autoimmune disease in general. That said, I know a lot of people who are not overweight who have an autoimmune disease so not sure how accurate that statement is. 

A study called Intake and Adequacy of The Vegan Diet. A Systematic Review of The Evidence (Bakaloudi et al., 2020) found that in general vegan diets are lower in protein than all other diets, and had lower intakes of B2, Niacin/B3, B12, Vitamin D, iodine, zinc, calcium, potassium, and selenium. 

I looked at one last study called Vegan Diets and Hypothyroidism. They discuss the higher incidence of hypothyroidism as autoimmune thyroiditis aka Hashimoto’s where almost all of us have anti-thyroid antibodies, are women, and are of increased age. Again, this study discusses the lower BMI found in most vegans/vegetarians as being protective against autoimmunity. This study also combed through the data from the Adventist Health Study-2. It is interesting to me that the folks with hypothyroidism in this study were found to be more likely to use salt, had higher BMI, lower-income, and education compared to people without hypothyroidism. Their main findings were that those following a vegan diet tended to not have hypothyroidism but this finding was not statistically significant which means that there wasn’t enough of a difference between groups for it to be a big deal. 

Outside of looking at diets, it appears that many hypothyroid patients are low in Zinc compared to normal healthy people. One reason for this can be that if you have hypothyroidism, you are not absorbing zinc as well in your gut or that other areas of the body are stealing it for their use. There is also a possibility that levels are just lower in hypothyroid patients as one study found that hyperthyroid patients had higher levels of zinc. We need zinc for thyroid hormone to be made, we need it to make proteins and it helps T3 get where it needs to go. 

Selenium is needed for thyroid gland function and a bunch of other stuff in the body. Rat studies show that production of T3 is inhibited in selenium deficiency without changing how much is stored in the liver and in rats, a deficiency will present as higher T4, lower T3, and lower enzyme activity involved in thyroid hormone conversion from T4 to T3.  Low selenium also means less glutathione which is a big antioxidant in the body that can play a role in more damage to the thyroid gland. 

The bottom line is you will want to be pretty diligent in making sure you get adequate amounts of foods with these nutrients. You can look up food sources of any nutrient at world’s healthiest foods dot com or whfoods.com. Just put selenium in the search bar or whatever vitamin or mineral you are looking for and it will show you which foods are highest in those nutrients. If you don’t think you can get enough from food then you should probably supplement. 

I’m awaiting a book that can help me further understand how to help my vegetarian and vegan clients but I can share some information on how to get enough of some nutrients through food. 

Calcium recommendations for adults is 1000mg/day but if you are a woman over 50 you need 1200mg/day. Plant-based sources are navy and pinto beans, dark leafy greens, tofu, blackstrap molasses, corn tortillas, figs, almonds, fortified juice or soy milk. Soy is okay to eat- please be sure it is organic. Vitamin D will help your body absorb calcium and if you supplement, you can take calcium citrate or malate any time of day, not just with meals. If you take it between meals, it is less likely to interfere with the absorption of other minerals. 

Vegans can get enough iron but it is not as well absorbed in plants so you need to consume more iron than the RDA to make sure you get enough, around 32g/day. Legumes, dark chocolate, spinach, blackstrap molasses, seeds, or fortified cereals are good sources. Foods with vitamin C increase iron absorption and you can cook more acidic foods in cast iron. 

Zinc- RDA is 11mg/day for men and 8 mg/day for women. If deficient it can manifest as poor wound healing, hair loss, immune system dysfunction, or dermatitis. You can get zinc from legumes, whole grains, nuts and seeds, and fortified foods. It is not as bio-available in plant foods compared to animal sources. I see a lot about “well planned” diets which to me means you must be really aware of what you plan to eat say over a weeks time to ensure you get all the adequate nutrients your body needs. 

Iodine- RDA is 150 micrograms with the upper tolerable limit at 1100 micrograms which is equal to 1/2 teaspoon of iodized salt, sea vegetables, and 1/16th teaspoon of kelp. If you are deficient in iodine, then brassicas and soy can cause thyroid issues. This one is kind of Goldilocks like- you can get too little and you can get too much and it will cause thyroid problems. 

B12- this is made in the gut of animals by bacteria. Vegans should supplement with this nutrient as it is not in many plant foods. You can get some in tempeh, sea veggies, and chlorella but the amounts are inconsistent. Supplement first, then fortified foods. RDA for B12 is 2.4 mcg per day and can be checked in serum on a lab test. The normal range depending on the lab can be from around 225 to 950. You can supplement with 1000-2500mcg 2x/week to get enough. If you are deficient, the type of B12 you should consume is methylmalonic acid. Deficiency presents as weakness, fatigue, mood changes (ha- maybe I am B12 deficient) with more severe symptoms of deficiency as megaloblastic anemia and nerve damage. 

Vitamin D- get it from sunshine, fortified foods,  and supplements. RDA is 600 IU/day with the government saying the upper limit is 4000IU per day. Some studies show up to 1800 per day will improve health while over that will worsen some health outcomes. Hashimoto’s patients need to be sure this is at a level above 30 since it plays a role in immune health and helps the cells grow and mature. 

As I learn more about this, I will share it with you all. I think we just need to be mindful of what works for our situation, beliefs, and body paying special attention to what works for our body. My body feels better when I eat a lot of plants but I also enjoy eating meat so I have no plans to give that up. If you prefer only plants for whatever reason, then do that. I do believe that vegan diets do have to be well planned. It can’t be all impossible burgers and fries with pop/soda and vegan cheesecake for dessert. There are plenty of ways to eat junk food no matter what kind of diet you eat. The most important piece is to make sure you are eating real whole foods as often as possible with the majority of them being plants no matter what kind of diet you choose. 

I made a few plant-based recipes over the last couple of days from the app Deliciously Ella. I discovered her from watching the Netflix show with Zac Efron where he traveled the world talking about sustainability or something. Anyway, Ella made him a vegan curry dish that looked so delicious I wanted the recipe. It was on her app so I bought it. I think it is around $15 for the year and let me tell you it is worth every penny. She has amazing recipes and there is a wellness component so you can exercise and track food, water, and sleep. I do struggle to get enough veggies in and this app helps. I will say it is a lot of chopping of veggies but the end products are worth it and I do feel so much better when I eat a ton of vegetables so there is a trade-off. 

We sometimes are looking for shortcuts to health because they seem like they are easier and the internet makes them look really alluring. Things like fix your gut with these five steps or 3 herbs that heal your thyroid, the 3 step plan to fix your thyroid. These are all internet marketing terms and if you have been listening awhile you know you can’t fix anything in just three steps. Our bodies are machines dependent on the proper fuel to keep them running well. You didn’t end up with hashimoto’s in three short steps and you are not going to fix it in three short steps. Diet and lifestyle changes are key for long-term health. 

Thanks for listening. Please sign up for my newsletter over at outofthewoodsnutrition.com and if you would be so kind to leave a rating and review on apple podcasts I would so appreciate it. Send me your questions too. I love hearing from you guys.

Also, there is a theory about women who have lost their voice in life and the relationship it has to thyroid problems. If you have a story of losing your voice in your life- due to emotional abuse or whatever if you want to share your story with me email me at stephanie@outofthewoodsnutrition.com .  Until next time. 

References:

1. Leung, A. M., Lamar, A., He, X., Braverman, L. E., & Pearce, E. N. (2011). Iodine status and thyroid function of Boston-area vegetarians and vegans. The Journal of Clinical Endocrinology and Metabolism, 96(8), E1303–E1307.

2. Fallon, N., & Dillon, S. A. (2020). Low Intakes of Iodine and Selenium Amongst Vegan and Vegetarian Women Highlight a Potential Nutritional Vulnerability. Frontiers in Nutrition. 

3. Bakaloudi, D. R., Halloran, A., Rippin, H. L., Oikonomidou, A. C., Dardavesis, T. I., Williams, J., Wickramasinghe, K., Breda, J., & Chourdakis, M. (2020). Intake and adequacy of the vegan diet. A systematic review of the evidence. Clinical Nutrition.

4. Tonstad, S., Nathan, E., Oda, K., & Fraser, G. E. (2015). Prevalence of hyperthyroidism according to type of vegetarian diet. Public Health Nutrition, 18(8), 1482–1487.

5. Tonstad, S., Nathan, E., Oda, K., & Fraser, G. (2013). Vegan Diets and Hypothyroidism. Nutrients, 5(11), 4642–4652.

PCOS and Hashimoto’s

I’m talking today about PCOS. There is a relationship between this condition and Hashimoto’s so it is a good subject to cover. 

What is PCOS or polycystic ovary syndrome? 

It is a metabolic disorder that causes irregular periods or no ovulation, excess testosterone levels and polycystic ovaries. The criteria for diagnosing this condition is to have 2 of the three of the characteristics just mentioned. 

Signs and symptoms of PCOS: 

• Acne

• Hirstuism- excessive hair growth on face, back or chest for example

• Hair loss

• Obesity or trouble losing weight

• Infertility

• Low libido

It is thought that as many as 1 in 5 women suffers from this condition which has risk factors for diabetes of any kind and 50-70% of women with PCOS have insulin resistance. You don’t have to be overweight or obese to have insulin resistance with PCOS either. 

Other chronic conditions affecting those with PCOS can include metabolic syndrome, high blood pressure, cholesterol issues, sugar intolerance, higher calcification of coronary arteries, depression, anxiety, bipolar and binge eating. 

The standard of care for PCOS in conventional medicine is to put you on birth control pills, drugs to control the excess testosterone, infertility treatments if you want to get pregnant and metformin to control blood sugar issues/insulin resistance. 

The cyst in this condition develops when/if ovulation doesn’t take place, there is no surge in luteinizing hormone, estrogen doesn’t peak and the egg doesn’t get released for ovulation so it continues to grow as a follicle creating a cyst which continues to make more testosterone and cause low progesterone and create insulin resistance. It is an unruptured follicle at the antrum stage of creating an egg for release. This, keep in mind, is a very simplified version of what happens. 

The insulin resistance through a variety of processes leads to anovulation or lack of ovulation- no egg released and insulin resistance also keeps eggs from being produced. 

High insulin will cause high testosterone levels in women with PCOS but also, high testosterone causes insulin resistance. 

What else is common in PCOS?

Liver issues- Non alcoholic fatty liver disease is a common issue. So common that it is safe to assume if you have PCOS you probably have some degree of fatty liver. Fatty liver leads to insulin resistance and visceral fat accumulation which leads to obesity which leads to inflammation with leads to accumulation of fat in the liver which leads to fatty liver. Fatty liver decreases sex hormone binding globulin which leads to more testosterone which leads to insulin resistance. 

GI issues- gut dysbiosis, leaky gut, gram negative bacteria- interferes with insulin receptors driving up insulin and screwing up egg development. Gut dysbiosis all by itself can contribute to all of the three criteria mentioned for diagnosing PCOS. One study showed that women with PCOS had higher zonulin levels which is the compound that causes the tight junctions in the small intestine to open- causing permeability or leaky gut. It is also more common for women with PCOS to have higher incidence of H. Pylori infections. 

Other hormone issues- lean women with PCOS will get excess testosterone from their adrenal glands whereas obese women will get it from their ovaries. I don’t know why this is but if you have high DHEA and PCOS it is likely because DHEA is making testosterone

Environmental toxins- BPA tends to be higher in women with PCOS- glass, stainless steel should be in your cupboards. One study suggests that BPA affects fertility. It increases testosterone production in both women and men. BPA also lowers one detoxification pathway in the liver- creating another vicious cycle of excess BPA in the body- the body is not able to get rid of it so it just circulates in the blood. Prenatal exposure to endocrine disrupting chemicals can cause a change in genetics for a fetus leading to PCOS or other health issues. 

Immune system dysfunction- discussed later

Inflammation- just having PCOS can lead to inflammation in the body creating a vicious cycle and wreaking havoc on the central nervous system. 

Oxidative stress- PCOS will often cause you to have less antioxidant status which means more oxidative stress, especially when dealing with insulin resistance too. One study showed those women who were also infertile had even more oxidative stress than PCOS women who were not infertile but had insulin resistance. Bottom line is the more insulin resistance, the more oxidative stress there will be and the greater the infertility the more oxidative stress there will be. There also seems to be more of a deficiency in glutathione levels, the master antioxidant, in PCOS. Supplementing with glutathione is tricky- oral supplements are not effective unless they are acetylated but you could also potentially take things like N-Acetyl-Cysteine to boost glutathione levels. Resveratrol also might be helpful. 

Nutrient deficiency- Deficiency in B12 and folate were common in PCOS women and also not eating enough can drive this condition. Maybe higher copper, low selenium, low zinc, high or low magnesium and more. Again- don’t just start taking one of these minerals. Know what you need. 

Glucose dysregulation- Mood or behavior issues due to reactive hypoglycemia can be a common symptom and a feeling of being tired but wired. 

Low cortisol can be a problem in this condition as well. Women with PCOS tend to have more of an enzyme that breaks down and degrades cortisol so you get rid of cortisol faster eventually leading to low levels. Morning cortisol tends to be lower and evening cortisol higher which means you maybe struggle to get out of bed in the morning and get that evening second wind. 

The thyroid connection. 

Women with PCOS had a much higher chance of having thyroglobulin antibodies. Low progesterone in PCOS causes the immune system to be overstimulated which produced more estrogen and lead to higher anti-nuclear antibodies, anti-thyroid antibodies and a bunch more antibodies against various tissues. 

It turns out perception may also have something to do with it. There was a study done on PCOS where women were given an MRI and shown pictures of a high-calorie food, low-calorie food, or some kind of control, and the high-calorie food picture increased insulin resistance. Crazy to think our brain has that much power. 

There is also the idea that insulin resistance is a protective mechanism for survival. We have increased glucose which the brain can use to stay alert, increase in blood pressure and blood coagulation for wound protection and obesity so you can survive a famine. Increased inflammation can prepare the body for trauma. All this is very primal and our brain and our physiology is still very primal and will lead to infertility or a bigger delay between pregnancies so there are less babies to feed and higher survival rate for mom and existing babies. The study this came from is called The molecular genetic basis of functional hyperandrogenism and the polycystic ovary syndrome. 

The best thing you can do with this condition either alone or combined with Hashimoto’s is to take a good hard look at your diet, then do some exercise. Get rid of the sugar and refined carbs and get moving. Exercise will help you get rid of excess glucose. 

You have to be careful with what you supplement with because not every one of you will need the same thing. I feel like a broken record saying that but it is sooo true. There are certain compounds called insulin secretagogue’s- they increase insulin in your body. If you have high blood sugar or hyperglycemia and high c-peptide then you don’t want to take compounds that will increase insulin secretion- things like Gymnema or bitter melon will raise insulin even further. 

If you have hypoglycemic tendencies you may be able to take something like licorice root or take fish oil, to stimulate proper use of glucose in the body. The thing is you don’t know what you need until you work with a qualified professional to help you figure out what your body is doing. 

Using a sauna as often as you can be helpful in the detoxification of toxins. Toxin levels measured as normal or negligible in urine and blood can be found in sweat. Sweating via exercise is good too. 

You also want to address inflammation, gut function, make sure your liver is able to do its job of detoxification of all the things, address oxidative stress, nutrient deficiencies, and fatty liver. 

That is it for today. Thanks so much for listening. If you like what you hear, please leave me a rating and review on Apple Podcasts. If you don’t like what you hear, please reach out to me and let me know what you don’t like. 

All my best to all of you! I am grateful you chose me! 

References: 

Arora, Sheetal, Kiran Sinha, Sachin Kolte, and Ashish Mandal. 2016. “Endocrinal and Autoimmune Linkage: Evidences from a Controlled Study of Subjects with Polycystic Ovarian Syndrome.” Journal of Human Reproductive Sciences

Blumenfeld, Z., Kaidar, G., Zuckerman-Levin, N., Dumin, E., Knopf, C., & Hochberg, Z. (2016). Cortisol-Metabolizing Enzymes in Polycystic Ovary Syndrome. Clinical medicine insights. Reproductive health, 10, 9–13.

Rutkowska, A. Z., & Diamanti-Kandarakis, E. (2016). Polycystic ovary syndrome and environmental toxins. Fertility and sterility, 106(4), 948–958.

Palioura, E., & Diamanti-Kandarakis, E. (2015). Polycystic ovary syndrome (PCOS) and endocrine disrupting chemicals (EDCs). Reviews in endocrine & metabolic disorders, 16(4), 365–371. 

Duleba, A. J., & Dokras, A. (2012). Is PCOS an inflammatory process?. Fertility and sterility, 97(1), 7–12.

Kurdoglu, Z., Ozkol, H., Tuluce, Y., & Koyuncu, I. (2012). Oxidative status and its relation with insulin resistance in young non-obese women with polycystic ovary syndrome. Journal of endocrinological investigation, 35(3), 317–321.

Sam, S., Vellanki, P., Yalamanchi, S. K., Bergman, R. N., & Dunaif, A. (2017). Exaggerated glucagon responses to hypoglycemia in women with polycystic ovary syndrome. Metabolism: clinical and experimental, 71, 125–131.

Gluten Free diet to reduce antibodies

Welcome to Episode 99. I’m so glad you are here. Thanks for tuning in. My daughter and her friend were reading reviews for this podcast and came across a lot of really nice ones. Thanks so much for leaving reviews so more people can find the show. They also came across a couple of one star reviews because I was too political in a couple of episodes. The reviews said  they were listening to me to get away from all the craziness in the world and didn’t appreciate hearing about politics. One mentioned something about the former president and I think it may have been because I suggested we should respect the title, no matter who has it. So I just want you all to know, I do want this to be a place where you can come to let go of what is going on in the world and focus on yourself and your health. I will do better to keep things focused on you as best I can. Everyone is entitled to their opinion though and I do respect that as well, I’m not so sure it deserves a one star review but I get it. We are all polarized these days and cancel culture is a thing. If you feel so inclined, a rating or review would be helpful to get more people to find the show so more people can be helped. I truly do this so you don’t have to suffer like I have and that is the only reason. It takes a lot of time and thought and a little bit of money to put this out so please spread the word if you feel it is worth it- and let me know if you think I could be doing better. My plate is full- overflowing in fact and I don’t want to put out crappy content.  Ok. Enough about that. I really am truly grateful that you all tune in and listen and know that I really do this for you all. 

Today I am going to talk about a study I found discussing diet and hashimoto’s. I was just putting dishes away one morning and wondered if anyone had done any studies on Hashimoto’s and gluten and I had just been discussing a gluten free diet with one of my clients who has been a bit resistant. Sometimes having data to back up what I am saying can be not only helpful but also when you use science to back up what you are saying in addition to clinical experience or even the experience of others with the same condition it kind of validates everything. 

I went to searching the PubMed database using the words gluten and hashimotos and nothing came up so I messed around with my search terms and found a couple of studies I thought were interesting and they validate what myself and other practitioners have been saying about the effects of gluten and diet in general on hashimoto’s patients. 

The amount of research done on diet and hashimoto’s is slim and much research on the topic of this disease doesn’t take in to account our reduced quality of life. You wouldn’t be here if you didn’t have Hashimoto’s or know someone who has it. It is the most common autoimmune disorder and the cause of hypothyroidism in countries like the US that are NOT deficient in iodine. 

Primary hypothyroidism which is where your thyroid isn’t actually producing thyroid hormone and affects around 1-3% of the population. Sub clinical hypothyroidism is when you have a high normal or just over the high normal level of TSH on a lab test and all other labs, typically only T4 is measured, are “normal”. This affects around 4-10% of the population. 

As you probably know, women are more affected than men and I hope to uncover why that is over the coming weeks in my hormone class but my hunch is that because the thyroid is part of the endocrine system along with sex hormones, I think there is a connection between all the parts of the endocrine system but thyroid and sex hormones in particular. 

I was listening to my professor on a podcast and he said something I think we all need to keep in mind. Science is ever evolving and what we thought we knew to be true 20 or 30 years ago turned out to be not so great advice sometimes. His example was the whole low fat diet craze in the 80’s. Turned out to be sooo wrong. Another example was back when Pelegra was around. It was thought that a black fly was causing it and it turned out to be a B vitamin deficiency. And then there was the doctor who suggested that his colleagues wash their hands between working on corpses and delivering babies to potentially prevent the death of the women giving birth. Hmmm. Novel idea. He actually lost his medical license for that I believe. Turns out he was right. 

So the point I’m making is that what I am telling you is what the science shows today. Don’t take what I am telling you as set in stone fact and there is no other answer to be found. I’m telling you what I am reading in the science and the science is rarely settled. Critical thinking is important. Always. Keep that in mind. 

I guess what I know to be true now is that thyroid disease is increasing and women suffer from it more than men and according to the National Health and Nutrition Examination Survey (NHANES) Hashimoto’s occurs in 4.8 per 1000 people in the US. 

Your thyroid hormones control your metabolism. Not just your weight but also the metabolism of your skin- think poor wound healing. It controls growth and how your body develops. They also are a part of the production of proteins that build bone and cartilage, production of enzymes (which do all kinds of things in the body but also includes digestive enzymes), and they help produce other hormones. 

Weight gain and the inability to lose weight are common though I have seen plenty of people with hashimoto’s not have an issue with weight. In severe hypothyroidism though your metabolism can be slowed by up to 50% which can create obesity without you doing anything different. A slowed metabolism can also screw up your blood sugar regulation. 

And as we all know, after getting your diagnosis, and getting on medication you still may have symptoms of fatigue, irritability, dry skin, hair loss, nervousness, and a poor quality of life. The American Dietetic Association and the American Thyroid Association appear to have no recommendations for diet and hashimoto’s. There is some research on a gluten free diet and hashimoto’s which shows it can be beneficial but the researchers speculate that it would be too difficult to maintain a gluten free diet because it is so restrictive and would lower the patients quality of life. I am here to tell you that is not true and if the gluten free diet improves your symptoms of fatigue, brain fog, hair loss, irritability etc- which would you rather have? It is a choice you can make. You don’t have to feel like crap and blame your doctor. You do have control of your life don’t you?

It is interesting that the one study done on the autoimmune protocol teaching diet and lifestyle changes in an online program didn’t improve labs but did improve symptoms. The study was only ten weeks long so I would argue that it could take longer to see improvements in antibodies and other labs since it didn’t take you ten weeks to get the autoimmune disease in the first place. The body is amazing and wants to heal but sometimes there is so much damage, ten weeks is not enough to see significant change. And that is okay. Know that healing takes time and some effort. It doesn’t happen overnight or magically. 

The science is on the fence about whether a gluten free diet will be helpful or not. Clinically I have seen it reduce antibodies and bring people back to life. The study protocol for a new diet called Diet4Hashi in the paper titled Evaluation of Qualitative Dietary Protocol (Diet4Hashi) Application in Dietary Counseling in Hashimoto’s Thyroiditis: Study Protocol of a Randomized Controlled Trial by Wojtas et al., (2019) which is basically the description of the protocol for their proposed study on this diet in helping hashimoto’s says that you should eat vegetables several times a day, eat calcium rich foods several times a day, fruit once a day, whole grains once a day and animal foods (rich in selenium and zinc) several times a week and nuts and seeds can be eaten several times a week. This is their protocol for what you should eat. Very vague and based kind of the dietary guidelines. 

They say you should limit your raw cruciferous veggies to one time per week, sugar to once a week which includes drinks, fast foods or processed foods once a week, soy products can be consumed twice a month and alcohol once a month. This is not a bad diet to be on but it is what everyone should be on so the question remains as to whether you need to do anything extra special for Hashimoto’s. I might argue that you do, at least in the beginning. Most of us when we are diagnosed are dealing with a breakdown of more than just thyroid. Likely you also are having blood sugar issues, female hormone issues, digestive issues either all at the same time or you have at least one of those issues. Your gut likely needs to be healed.. there is so much. 

While this study isn’t done yet is is just one more way of looking at diet and Hashimoto’s. I did find another study called The Effect of Gluten-Fee Diet on Thyroid Autoimmunity in Drug-naive Women with Hashimoto’s Thyroiditis that studied women between the ages of 20 and 45 to see if a gluten free diet would affect autoimmunity, the HPT axis or thyroid brain signals and thyroid lab markers.  One group was on a gluten free diet for 6 months and the control group had no diet change instructions. 

The idea behind this study is that Hashimoto’s and celiac disease together are a very common occurrence so much so that one study done led the researchers to conclude that all autoimmune thyroid patients should also be screened for celiac disease. In the gluten free diet study, the women did not have a celiac diagnosis but had positive antibodies for it along with positive TPO antibodies and “normal” thyroid labs. At the end of the 6 month study, the gluten free diet group 6 of the 16 patients in the gluten free diet group still had positive antibodies for celiac disease and all 18 in the control group or non gluten free diet had the antibodies. Turns out the gluten free diet was well tolerated- meaning easy to follow. The gluten free diet also lowered TPO antibodies and thyroglobulin antibodies and increased vitamin D levels but it did not have an effect on TSH, T4 or Free T3 or Free T4 and the women in the gluten containing diet group had no change in antibodies. 

It is curious that vitamin D levels went up on the gluten free diet. They also referenced another study where taking vitamin D in supplement form reduced antibodies too. Pretty cool stuff if you ask me and also some good data to maybe nudge some people in the direction of a gluten free diet. 

I re-recorded part of this because that first study was all I was going to talk about but it wasn’t anything conclusive and felt kind of like a waste of time. I double checked what episode this is and turns out this is episode 99! So when you search for the “transcript” of this episode it is under 99. 

That is all for today. I’ve been sitting on this for a few weeks wanting to add to it but spent all day yesterday reading two studies for one discussion forum post - not because they were that long but because they were hard to understand! I figured I’d just give you what I had so far on this topic. I hope it was helpful! 

Thanks for being here! I appreciate you!!! 

Adrenal Fatigue Revisited

The adrenal glands sit on top of your kidneys. When your brain perceives some kind of stress, you get a signal from your brain that actually goes right from your spine to your adrenal glands. Other organs and glands have a little different way of getting their signals from the brain. It’s kind of cool and maybe signifies how important the adrenals are that they get a short cut signal from the brain. This signal will tell the adrenal glands to release cortisol after a series of reactions. So this hasn’t changed. 

I mentioned in an earlier podcast that it turns out there is really no such thing as adrenal fatigue. What it actually is is a low output of cortisol. So your adrenal glands are working fine but something is getting in the way of them releasing the hormones your body needs.  There is a ton of information on the internet about adrenal fatigue with books written and websites dedicated to it. This idea of adrenal fatigue is what was known several years ago. Like I have said before, it is what I was taught in my Nutritional Therapy training. The science has changed because scientists have learned more and done more research on the adrenal glands. I think there is rarely a time we can say that the science is settled- maybe that we know vitamin C keeps us from getting scurvy but honestly even that could change at some point. Scientists are still discovering new body parts so I don’t really think the science is settled at all. 

Searching the internet for health advice can be confusing and mind boggling with so many so called experts each telling you that their way is the best way and sometimes the only way. I don’t profess to be an expert in anything but I will try my best to help you walk through the forest of information and in some cases misinformation to figure out what might be correct. My goal has always been to help you get clear about what’s out there.  I don’t want you to suffer like I have - know that in my heart I just want to help. 

So how does cortisol get low?

First of all, you need cholesterol to make cortisol but also sex hormones which are also produced in the adrenal glands. The production of cortisol happens in the mitochondria which are those energy factories in each of our cells. So if you have any type of dysfunction in your mitochondria or in your cells you may struggle with cortisol being low. 

What causes Low Cortisol? 

There can be a communication problem with your hypothalamus and your pituitary gland in your brain. There can be dysfunction at the cellular level, you can have low cholesterol, you can also be dealing with infection, inflammation or too much leptin (appetite hormone that tells you you’re full).  Nutrient deficiency (around 80% of people are deficient in vitamin E- don’t just go supplementing this), intestinal permeability, toxins- big player in all of our health. 

There is no protocol for Adrenal Fatigue in general. There is no specific diet for Adrenal Fatigue. You can try an elimination diet which will lower inflammation or paleo or you know, what works for you.  You have to clean up the toxic chemicals in your life. Organic food when and where you can, clean up your beauty products, your household cleaning products etc. A good resource for learning more about this is ewg.org

My favorite household cleaner is Branch Basics. You can get $10 off your first purchase by going to www.branchbasics.refer.cc/stephanieewalsntp 

My favorite skin care is kind of all over the place but you can get 10% off meizenskincare.com by using the code 10% OFF 

I also love Intelligent Nutrients for skin and hair care and Evan Healy skin care. 

What else can you do if you think you have low cortisol? 

Figure out how to deal with your mental/emotional stress- whatever works for you. Journaling, meditation, whatever you need. 

You can use an adaptogen like Ashwagandha or rhodiola but they will only be a bandaid until you figure out what is going on with your body. That is the biggest thing.  We all need to remember that when something goes wrong in one area of the body there is usually something systemic - system wide going on and that is what you need to figure out. 

If you can’t figure out where things are going wrong in your body, you can use my Nutritional Assessment Questionnaire to get a picture of where your body is out of balance and get headed in the right direction. A one hour initial consultation is $153 right now with 30 minute  follow up visits at $79. 

You will get a personalized protocol which includes diet and supplementation to be used for 3-6 months and then you should recheck where your body is at and what needs to change within your protocol. 

If you want support with diet changes, I am running The RESTART Program from 2/1/2021 until 3/1/2021 via Zoom. That is a wonderful way to get started on feeling better. This program is a five week nutrition education program, a sugar detox and support group all rolled into one wonderful class. People love this class and what it has to offer. The cost is $119 for the five weeks and I supply all the materials via email the day of class. It will be running from 6:30 pm CST until around 8:00 pm CST each Monday from 2/1-3/1. There are only a few spots left so email me at stephanie@outofthewoodsnutrition.com if you want to enroll. 

All my best to you all. Thank you so much for listening. Please always remember to think critically in not only the health arena but all areas of your life. Always ask why. 

I have no plans to join the main social media outlets due to their censorship. I have joined Parler but don’t currently post anything on there. The best way for now to see what’s up is to join my newsletter. 

Until next time. 

Is Synthroid better than Levothyroxine?

Hi, I love listening to your podcasts, I have recently been diagnosed with hashimoto's and the doctor put me on levothyroxine. I have been reading that name brand thyroid medication has much better results. Is this true and if so is it safe to switch from levothyroxine to Synthroid? Or other name brands? Are there major differences between the different brands? Thank you so much for your time and expertise! Brie

Hi Brie, 

Thanks for asking this question because it can be really confusing for people especially when the internet is full of “experts”. Since I have been in school I am a bit of a convert to following what the scientific literature says in addition to going with clinical experience. First I would ask where you read that name brand thyroid medication has better results. Who wrote that or said that? Is it a blogger who has better results on Synthroid vs. Levothyroxine? Is it the makers of Synthroid saying there are better results on their product? These are the kinds of questions you want to ask yourself when you are reading something like this. Becoming a critical thinker is crucial to you taking control of your own health. 

On the website for Synthroid, there is a lot of marketing telling you that this product is more effective and better for you. They don’t list the full ingredients on their website so I searched the internet via DuckDuckGo for Synthroid Package Insert. Because it is a drug there should be a full list of ingredients and side effects for it in the package insert and it should be available to you to read. You can ask your pharmacist for it. I have done this before and it totally stumps them because they often just throw it out. They sometimes don’t know what to do with me when I ask for that kind of stuff. You have a right to know what is in it so don’t be shy about asking for it. 

The package insert for Synthroid aka levothyroxine sodium tablets, USP shows you the chemical equation for the product as well as the ingredients. The main ingredient is synthetic crystalline L-3,3’5,5’-tetraiodothyronine sodium salt which is levothyroxine (T4) sodium. Basically this means it is a lab made T4 only medication.  The inactive ingredients are listed as Acacia (or gum Arabic which is an emulsifier, stabilizer, binder), confectioners sugar (with cornstarch), lactose monohydrate (a milk sugar used to compress the tablet- only an issue if you have a severe lactose intolerance), magnesium stearate (used to keep the drug from sticking to the equipment it is made on and can be made from plant or animal sources). There are also artificial colorings added to the medication depending on the dose: FD&C yellow #6 or 10, red #4 or #27 or 40, Blue #2 or #1. 

On the Synthroid website under safety information that you should not use this medication if you have adrenal problems that have not been fixed and that taking too much of this product has been associated with increased bone loss, especially for those of us who have entered menopause. It also says that foods like soybean flour, cottonseed meal, walnuts and dietary fiber may keep you from absorbing all of your medication. If you consume a SAD diet you are likely getting a ton of soy flour because it is in everything these days- read an ingredient list for bread from your grocery store. One of the local stores near me who does their own bakery bread lists soy flour as one of the top ingredients. 

Your pharmacist likely says to not take this product with food but the website says to wait 4 hours before or after eating when taking this product. 

I found a study called Comparative Effectiveness of Generic vs. Brand-name Levothyroxine in Achieving Normal Thyrotropin Levels in the Journal of American Medical Association. The study included almost 18,000 thyroid patients where around 15,000 had generic prescriptions and 2200 had brand name prescriptions. The study concludes that generic levothyroxine is as effective as name brand. The conflicts of interest listed in the study are interesting and should be considered. Some researchers received funding from Blue Cross and Blue Shield, the FDA, support from the Mayo Clinic from the Centers of Medicare and Medicaid Innovation. This tells me that there was a benefit to finding that generic drugs, which are cheaper, were as effective. The listed generic drug manufacturers in the study are Mylan Pharmaceuticals, Sandoz AG, and Lannett Company, Inc. 

Maybe the reason why you read better things about name brand thyroid meds is because there are many manufacturers of generics which means when you refill your prescription you could be getting a different generic each time. I would ask your pharmacist if they switch between generics as you have a right to know. They will just give you a different medication if they run out of one kind. It has happened to me before and I let my pharmacy have it. This medication is a Goldilocks drug- they can’t switch it on you or it can cause problems for you. It doesn’t for everyone so I want to be sure I say that. 

I went to the FDA website and looked up FDA approved drugs for levothyroxine and came up with a whole list and it says at the top of the list: “products listed on this page may not be equivalent to one another”. There is a whole rabbit hole to go down here with each of the drugs listed but they are as follows: Euthyrox, Levo-T, Levolet, Levothyroxine Sodium, Levoxyl, Synthroid, Thyquidity, Thyro-tabs, Tirosint, Tirosint-Sol, Unithroid. 

Levothyroxine Sodium alone has 8 different manufacturers listed where all others have one manufacturer listed. With one manufacturer there is less likely to be inconsistencies with the drug. Tirosint is supposed to be a hypoallergenic formula meaning there is nothing else in the medication but the same synthetic drug as Synthroid but the only other ingredients are gelatin, glycerin and water. 

So there are differences and you finding which drug works best for you takes some time. Maybe you won’t feel good on any of the synthetic drugs I talked about and will do better on a natural desiccated thyroid hormone. Some people do better on the natural medication and some people don’t. It is helpful to find a doctor willing to try switching. 

The natural desiccated thyroid medications are called combination therapy because they contain T4 like the synthetic drugs but also contain T3. The natural drugs available are sometimes harder to come by. The main one is Armour thyroid which is the easiest to get. Others include WP thyroid, Naturethroid, and a few more. A study comparing the long term effects of treatment with these types of drugs compared to synthetic only drugs found that  people taking the natural desiccated drugs not only normalized their TSH but found improvements in mood, well-being and something called psychometric function which is hard to define in terms easy to understand but has to do with your ability to respond to certain stimuli. To be fair, some studies listed in this meta analysis showed no difference in symptoms on either type of drug. Overall though, many people find their overall quality of life on natural desiccated thyroid (NDT) hormone replacement to be better. Personally, I feel my best on a compounded NDT hormone replacement for which I pay a lot of money out of pocket. When the medication is compounded, it is made in house at the pharmacy where they mix the powder with a cellulose powder and put it in capsules. I pay around $200 for a one month supply or $450 for a 90 day supply. This is the only medication that has improved my quality of life besides WP Thyroid (I think it was this one but it’s been so long I don’t remember exactly) which was not available for a long time. So for now, I use my health savings account to pay for my meds and have a much improved quality of life. 

So the bottom line here is if you don’t feel good on one medication I would suggest asking your doctor to switch you to a different one. If I had no choice but to be on synthetic medication then I would go with Tirosint first and avoid the generics since there are so many manufacturers unless you can talk to your pharmacist about ensuring that you are getting the same product every time you renew your prescription. 

Other things you can do to improve quality of life are of course diet changes, figuring out which foods you are sensitive to, healing your gut, working on blood sugar balance and of course ensuring you have no adrenal issues. There will be more on this to come- my next class for my masters program is all about hormones and we will be focusing on the hypothalamus pituitary adrenal axis or HPA axis and I cannot wait to learn the latest information on this. I will give you a hint though- there is no such thing as adrenal fatigue- our glands and organs don’t get tired. Until next time. Thanks for hanging in there with me. This year has sucked and it has been a bit of a challenge for me to be motivated to do anything let alone get this podcast out. I’ve been battling a bit of depression and have been supplementing with some things that have helped a bit along with exercising and avoiding all the negativity on the news- I’ve also been trying to laugh more and it feels really good. 

Ok. Take care everyone! 

Help (ing) someone with Hashimoto’s

Hello everyone and welcome to episode 94. I’m so happy you are here and have stuck it out with me. I’ve been on a break for about 6 weeks to spend some time with family out of state but I am back! It feels good to be back at it and into my routine again. I’m grateful to have you all to come back to! I’m grateful to you for listening and for writing to me to say you love the podcast and to keep doing it. It really means a lot to me to have your support and to know that what I am putting out there is helpful. For this episode, I thought I would take you through what it is like to work with me. I have a real person with Hashimoto’s who has taken my nutrition assessment. So we are going to dive into what her body is doing and what my suggestions will be to her. There are some visuals for this one so you may want to follow along on my website www.outofthewoodsnutrition.com  and search episode 94. There will be a blog type post or transcript for this, and most episodes actually. 

When someone works with me my current practice is to use my nutrition assessment questionnaire or NAQ. It is extensive and covers all the body systems showing me where you, the client, have imbalances. I also get a health history and like to see a minimum of three days of food journaling. I have no judgment. My job is to help you optimize your health so I need your reality, whatever that is. Normally I would also take the time to listen to my client when we meet via Zoom or in person. For this client, that is not the case because I am keeping their information private and we are not meeting. They were willing to allow me to use their information on the podcast as an example of what to expect. So please keep in mind that the information provided in this episode specifically is a bio-individual approach. What I recommend here is for this person, NOT for everyone because there is no one sized fits all approach to health. There is no specific diet that will help heal you. In fact, as a side note, research shows that the best diet for you is one you can follow. So how about that. If AIP is too hard, there are other ways to get there. 

Ok. Let’s get started on this client’s info. I’m going to start with their health history. 

I guess I have to give away some personal information in that this is a 28-year-old female. her top health concerns are blood sugar dips with a severe symptom of feeling light-headed. She is also dealing with anxiety and overthinking along with brain fog. Her goal is to become healthy again and feel like how a 28-year-old should feel. 

She states that she sleeps well, doesn’t wake up in the night, and gets a good amount of sleep but feels like she has been hit by a train when she wakes up, sometimes feels just a little better than that when she wakes. 

She drinks around 3 liters of water a day, no caffeine. 

Her childhood eating habits were pretty good with sugary treats being a rarity while consumption of meat and veggies was standard. 

99% of her food is home-cooked while she eats out about one time per week. She cooks with mostly olive oil. She has just started AIP but had contacted me because she wasn’t feeling any different on this diet. Her current three worst foods she eats are dark chocolate rice, cakes, gluten-free and dairy-free cookies, and fried rice. Keep in mind that this is subjective information. What you think is bad for your diet is not what someone else sees as bad for them. Her three healthiest foods she eats are coconut yogurt, fruit, meat, fish, veggies. 

She often feels tired, bloated, and/or gassy after a meal and has constipation which was 7 days a week until she began the AIP diet. She craves sugar but not salt. 

She has exposure to gas fumes at work and she loves doing farm work. She walks 1-2 days a week. She spends about an hour per day in front of a screen. She perceived her stress level to be between 8-9 on a scale of 1-10. 

She is currently taking T3, zinc, magnesium, B6, selenium, and vitamin D along with a couple of other things. 

Ok- that is the health history. I don’t see anything out of the ordinary here. A few things stand out - We will find out more about the gas and bloating in a few minutes.

She reports the following items as being severe or regular: 

• Bloating within one hour after eating

• Sweat has a strong odor

• Feel like skipping breakfast

• Sleepy after meals

These are all indications that your stomach is not breaking down the food you eat due to a variety of reasons. 

• Become sick if you were to drink wine

• Easily intoxicated if you were to drink wine

• Easily hung over if you were to drink wine

• Sensitive to chemicals (perfume, cleaning agents, etc.)

• Exposure to diesel fumes

These indicate issues with liver detoxification or an issue with gallbladder health and/or function. 

I’m going to just highlight a few things from other categories since this client has so many issues. 

Small intestine imbalance: hives, wheat or dairy sensitivity, bloating within 1 hour of eating

Large intestine imbalance: cramping in lower abdominal area, yeast symptoms increase with sugar, starch, alcohol such as fatigue, poor memory, feeling spacey, muscle aches, joint pain

Essential Fatty Acids are out of balance: headaches in the sun, sunburn easily, dry flaky skin

Blood sugar dysregulation: excessive appetite, crave coffee/sugar in afternoon, sleepy in afternoon, fatigue relieved by eating. 

Now let’s take a look  at her food journal: 

Day 1

• Breakfast: (I sometimes fast until 10am) coconut yoghurt with some fruit

• Morning tea - coconut wrap with leg ham (unprocessed) salad

• Lunch: meat and veggies including sweet potato plus more fruit (I get sugar cravings and migraines until I bring my blood sugar back)

• Dinner: coconut chicken and broccoli soup

Day 2:

• Breakfast: coconut yoghurt fruit and carrot/bacon fritters topped with avo

• Morning tea: same again

• Lunch: chicken, veggies and sweet potato

• Dinner: coconut chicken soup with broccoli 

Day 3:

• Breakfast: same as day 2 just no Avocado on fritters

• Morning tea: lamb chop with veggies

• Lunch: soup with chicken

• Snack: watermelon and mango

• Dinner: steak with veggies

“I get a bad slump at 2pm just after my lunch at 1pm and I get dizzy, light headed and bad anxiety. My thoughts lately have been all over the place as well since starting AIP. It’s like everything has been disrupted.”

This diet looks good at first glance. When you take in to consideration that she has a potential issue with digesting fat, the AIP diet may not be ideal since it is pretty high in fat. She is consuming quite a bit of fruit and since she is having blood sugar issues, those snacks of fruit would be better served by switching them to veggies and doing less fruit. That said, for the constipation- blackberries and kiwi can be very helpful in getting your bowels moving. If I were to discuss her food journal with her I would want more details about how much animal protein at each meal and how much veggies. The average healthy person should be consuming around 1 to 1.5g/kg/day in protein and ¾ of a plate of veggies at each meal. This person needs some help with digesting their food so a recommendation of some digestive enzymes and potentially  some stomach acid supplementation will be the first step. This might also help the constipation. If we are not digesting our food, we are not extracting the nutrients from it which can cause all kinds of imbalances. I might also recommend something to aid in fat digestion such as TUDCA which is a water based bile support. 

As far as the slump in the afternoon- after lunch- it could be due to waiting too long between the morning tea and lunch, it could be that the lunch meal is too heavy, it could be that it isn’t enough food, it could be a food sensitivity. These are all things we would normally  hash out on the phone. 

The sugar cravings could be a blood sugar issue or they could be a yeast overgrowth or a vitamin or mineral imbalance. 

Since you feel horrible on AIP, I would back off of the restrictions, keeping off gluten and making sure you are eating a ton of veggies, moderate protein and even less fat until you get your body back in to better balance. I would do this for 3 months and then revisit your progress on the NAQ and then make adjustments. 

As far as supplementation goes, I would have you take something to help with fat digestion such as bile salts or TUDCA. This will also help with sugar cravings. You may also need some kind of blood sugar regulation support and I will not give the specific product name here because it isn’t supposed to be sold on Amazon and it is being sold there. It is a practitioner only product. Next, you probably need some digestion support. Likely low dose Betaine HCl- look for 150mg betaine in a product. I would suggest electrolytes in your water or a pinch of salt and if you like fish, consume fatty fish 1-2 times per week. I don’t like to throw supplements at a problem so I won’t recommend anything more. You definitely need some help via supplementation but as I always say, you should be able to get what you need from food most of the time. There are exceptions to that of course, as there always are. 

So, this is a short version of my process. I have had people come to me for help and then not follow a single bit of my suggestions and then wonder why they don’t see any changes. You really have to be willing to trust the process, make yourself a little vulnerable, be willing to change a bit and know that healing your body takes time. It didn’t all the sudden break down and it won’t all the sudden be well again either. Give yourself some credit and compassion. You deserve it. 

Ok. That is it for today. I hope that was helpful for you guys. Please sign up for my newsletter at outofthewoodsnutrition.com and if you could leave me a rating and review on iTunes/apple podcasts I would be so grateful. It helps more people find the show! 

Until next time. Peace.

Can you have chronic illness and not be chronically ill?

Michael Arterberry, Master Encourager, and Dynamic Motivational Speaker.

As a teenager, Michael was fortunate to receive guidance from positive adult role models who helped him overcome adversities and set high expectations for his future. Grateful for the role these mentors played in his own development, Michael decided to dedicate his professional life to helping people navigate the difficulties of life and launch their future into motion. For more than 25 years, he has been helping teens and adults to use what they have gone through as a catalyst for success rather than an obstacle for failure.

Michael received the 2010 USA Network’s Characters Unite Award for exceptional commitment to combating prejudice and discrimination while increasing tolerance and acceptance within the community. He is also the recipient of the 2014 100 Men of Color Award for leadership in education, government, mentorship, entrepreneurial success, and community service.

In 2008, Michael founded Youth Voices Center, Inc. a non-profit with the mission of helping young people to become active, productive members of society by overcoming their obstacles, their history, stereotypes and even their own self-image and limiting beliefs.

www.michaelarterberry.com

www.shakethedirtexperience.com

www.youthvoicescenter.org

www.facebook.com/michael.arterberry

www.linkedin.com/michaelarterberry

Can Acupuncture Help My Thyroid?

www.myzenskincare.com use code 10% off

Can you be a vegetarian with Hashimoto's and be healthy?

Hey guys, before we get to todays episode, I want to share with you an awesome skin care brand. Last year I had facial acupuncture done for vanity sake. I am turning 50 next year and I wanted to do something about some of the lines that were appearing. I always used to wonder why women can’t just age gracefully. Well, once those lines really started to appear, I knew the answer. I think I look pretty good for my age but I am not happy that my outsides look older than how I feel on the inside. Sometimes I still feel like a kid but I don’t look like one. My acupuncturist uses this skin care line in her office and I trust my acupuncturist (Aleesha D. Acupuncture in Anoka MN) so I tried the skin care. Turns out it is great stuff, clean and made by a small business which I am always up for supporting. I emailed the maker and asked if I could procure a discount for my listeners. She was happy to offer one so you all can take a look at what she has and get a 10% discount. 

We all want to look more youthful. It is one of the number one things we strive to preserve…our youth! Modern-day living can often take its toll, particularly on your skin. Rather than a vibrant and radiant shimmer, your skin ends up looking dull and dreary, and due to the high levels of toxins and pollutants around us, we may notice more signs of skin blemishes or chronic skin conditions such as eczema or acne. However, it is not all doom and gloom! Skincare requires focus, attention, and of course, the right products that work well with your skin. Those products are My Zen Skin Care! Our products have natural ingredients that are always far better to use on your skin, both short term and long term. My Zen Skin Care uses unique combinations of Chinese herbs for the skin, essential oils for your skin and spirit, and all-natural, active cosmeceuticals so your skin gets a treatment from every product.

I’ve tried it all and I love it all and they are not paying me to say that. And by now you all know that I don’t blindly recommend anything to anyone. I have to really love it.

Give it a try. go to meizenskincare.com and use the code 10% off. That’s m-e-i-z-e-n skincare.com 

If you have a chance to discuss how to follow some of your great advice while being vegetarian, that would be amazing. I find a lot of the options for Hashis to explore unfortunately seem to rely on eating meat. 

I am 47, I was diagnosed 5 years ago. I had fertility issues, and early menopause at 45, but otherwise no serious symptoms except regular headaches and moments with zero energy . I have been vegetarian for 22 years. I eat eggs and some goat cheese. I have a typical vegetarian diet meaning lots of vegetables, different grains, nuts and beans. I avoid gluten (since March) and all other dairy except occasionally butter. 

I clearly have blood sugar issues, I recognize myself in most of the symptoms you list in the recent episode on PMS. 

I usually need to eat every 3 hours to keep my energy up (and I have sweet cravings). 

I have been wanting to try the elimination diet but I am not sure what to remove! 

I am not on medication, I am trying to improve with dietary changes first. 

Best,

Priscilla 

Let’s first talk about things that can cause thyroid dysfunction. Too much copper, mercury, bromine, chlorine, fluoride. Your medication may mitigate symptoms from thyroid dysfunction but it isn’t addressing the underlying condition, right? All of these can be environmental toxins except maybe copper. Copper is found in food, in balance with zinc and other minerals. Copper is used in some city water treatment plants to kill bacteria. Even the dreaded coronavirus taking over our lives can’t live on copper. Vegetarian diets can be higher in copper because beans, nuts, seeds, avocado and soy are very rich in copper. If you combine a copper rich diet with a zinc deficiency you can end up with a big imbalance between the two. The biggest source of zinc is oysters and red meat. 

The other thing to consider when being a vegetarian and having hashimoto’s is making sure you are eating enough and making sure you are eating enough protein. You may have to add in protein powder, maybe pea to start. You need protein for your phase II detoxification system to work (after toxins are converted in phase I, they go through phase II to be made harmless and eliminated). You also need protein for your immune system so you may need to take an amino acid supplement- something that has all the essential amino acids. Since you are not on medication you may not have severe destruction of your thyroid gland so you are in a better place than some. 

Make sure you are very intentional with each of your meals being sure you are getting in quality protein options with each meal. Eggs are good. Beans and rice are good. Work towards complete proteins. Soy is not the devil I once thought it was. There is a lot of research, clinical trials involving healthy adult women and men indicating that soy does not have an adverse affect on thyroid function. However, consuming a lot of soy may cause a need for increase in your medication dosage if you are taking meds. You may also need to be mindful of iodine intake. 

Organic soy, not every day in the forms of miso, tempeh and maybe the occasional tofu.  The average female adult needs around 46 grams of protein each day. If you are active or trying to build muscle you need more. You need a variety of plant foods to meet your protein needs and you can do that with a vegetarian diet. 

The following foods protein content is based on 100grams of that food. 

• Tempeh- 20g

• Beans- 20g

• Tofu- 10g

• Steel Cut Oats (get certified gluten free)- 9g (I am guessing that is dry weight)

• Brown rice- 7g, again dry weight

• Broccoli- 3g 

• Soy Milk- 8-10g per cup

• Almond milk- 1 g per cup

• Hemp milk- 2g per cup

If you are needing to eat every three hours to keep your energy up, you are either not absorbing nutrients or you are not eating enough. I would food journal for seven days and keep track of how you feel 1-2 hours after a meal and see if you can find a pattern. I honestly think that because you are vegetarian, an elimination diet is maybe not for you unless you are willing to eat meat. They are too restrictive and not conducive to vegetarians. Food journaling may be a good way to see if you are reacting to any particular foods as well. 

You also need to consider where you will get your essential fatty acids from. Most non vegetarians get them from fish and fish oil so if you are not willing to take fish oil, do some research on where to get those. You may get Omega 3’s from products using algae or yeast. I don’t know much about these sources though so you will have to look in to them. 

You are eating goat cheese and butter occasionally  too. Those along with eggs have vitamin A but much less than you may need so you will want to be aware of that. Maybe you need a good multi-vitamin? You will want to have your vitamin D levels looked at too. Many of us with autoimmune disease are already low so you may need to supplement but have your levels checked first. 

Iron is also really important for women especially and many thyroid patients have lower levels of ferritin which is our storage iron so you should also have that level checked and supplement if needed. 

If you have a question or several, please send me a message by filling out the contact form on my website or email me at helpforhashimotos@gmail.com. You can get your first one hour consultation with me for $153. We will spend that time going over the results of your very comprehensive nutritional assessment and discuss what your next steps are to feeling better, sleeping better, getting your thyroid meds optimized and more. If you are not a thyroid patient but need help with figuring out what you need to do to feel your best, I can also help. I do love working with thyroid patients but I can also help others. 

One of my clients emailed me this: 

“Just an update. You gave me a consult two months ago. I've been following your guidelines.

Well, I have lost 16 pounds so far and my painful bloating is completely gone!

I have energy and feel very clear-headed most of the time!

Thank you!  I will send you another update in two months.

Just thank you so much!”

If you wouldn’t mind leaving me a rating and or a review on apple podcasts or spotify, I would really appreciate it. The more ratings I have the more this podcast will get in front of others who may need the help. I can’t thank those of you enough who have written in to tell me how much you like the podcast. It means a lot to me. All I wish for in life is to help people not suffer  like I have. 

Remember to check out meizenskincare.com and use the code 10% off.  Or visit them using the link in the notes for this episode. 

Listener questions about Food sensitivity testing and more.

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We all want to look more youthful. It is one of the number one things we strive to preserve…our youth! Modern-day living can often take its toll, particularly on your skin. Rather than a vibrant and radiant shimmer, your skin ends up looking dull and dreary, and due to the high levels of toxins and pollutants around us, we may notice more signs of skin blemishes or chronic skin conditions such as eczema or acne. However, it is not all doom and gloom! Skincare requires focus, attention, and of course, the right products that work well with your skin. Those products are My Zen Skin Care! Our products have natural ingredients that are always far better to use on your skin, both short term and long term. My Zen Skin Care uses unique combinations of Chinese herbs for the skin, essential oils for your skin and spirit, and all-natural, active cosmeceuticals so your skin gets a treatment from every product.

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Give it a try. go to meizenskincare.com and use the code 10% off. That’s m-e-i-z-e-n skincare.com 

What Food Sensitivity Test is best?

This is a good question and one I don’t have a good answer for. Foods play a pretty big role in immune system reactions. All foods can be a source of antigen, which is something foreign that causes an immune response in the body and produces antibodies.  Most food sensitivity testing is done by looking at toxicity in cells, called a cellular cytotoxic assay (ALCAT) or IgG (most common antibody in the body) or IgA (found in the lining of respiratory and digestive systems) antibodies tests. 

IgG antibodies cause inflammation and is a delayed reaction to a food and after some healing, in the body, you could potentially reintroduce those foods that had high antibodies. They produce symptoms like GI distress, joint pain, headaches, rashes. 

IgA is not a super concern for us but still worth noting since it is an identifier of an immune response in our mucosal lining, i.e. small intestinal lining.  

IgE antibodies are reactions that occur in the body immediately upon consumption and are life long allergies. IgE reactions produce histamine reactions like hives, sneezing, vomiting, stomach cramps, immediate diarrhea, breathing problems, or anaphylaxis. 

IgG, IgE testing is common from Genova Diagnostics. 

Another type of food sensitivity testing looks at immune reactivity to both raw and cooked food proteins reflecting how foods are commonly eaten. Looking at cross-reactivity between proteins can be helpful in autoimmune disease and only one company does that. Cyrex labs does and their test is expensive- around $600. I used my HSA to pay for their array 10 test and it showed I had cross-reactivity to T4, T3, borellia, and a few other things via chicken, bromelain (pineapple), chia seeds, sunflower seeds, and a few other things. They also look for some weird stuff you wouldn’t think of like meat glue- used in lunch meat, imitation crab, chicken nuggets, and more. 

There is no gold standard here. I used to say that an elimination diet might be closest to the gold standard and I do still believe that to some extent except for the fact that an elimination diet is going to say that chicken is okay and for me, it was a potential immune system stimulant so…… I’d say start with an elimination diet and if you still don’t feel better, save your money for a Cyrex array 10. I don’t make any money to say that and in fact, cannot even order that test for anyone until I get my license which frustrates me a bit but whatever. Can’t do anything about it right now. 

You will likely know if you have an IgE reaction to a food because you will feel bad right away. Think of nut reactions- you can start with an oral allergy to nuts- feeling flu-like symptoms on down to anaphylaxis. A good example of this is an extended family member last year- who was eating nuts here and there and wasn’t feeling so hot. Almost flu-like. Then, they ate nuts at work in a sundae and for their body, it was the last straw. They went to the store to get Benadryl and it didn’t help. They ended up having a friend drive them to the hospital and they almost died from an anaphylactic reaction. So it can build over time ending in serious consequences. The big culprit nut was hazelnuts with others being less reactive but the advice was to stay away from all nuts. I have an oral allergy to nuts so I stay away from most nuts because I feel horrible after eating them. Every once in a while I test it out to see if it really is the nuts that make me feel bad and every time my body lets me know I should not have eaten them. 

So first elimination diet with careful reintroductions to foods. Then food sensitivity testing. No one is better than the other though Cyrex claims to be the best. 

-How much is too much when it comes to cruciferous veggies? Are they best cooked?

Too much cruciferous veggies would be eating several a day for all meals each day for a week straight. It is hard to over do it despite what you may have heard. The idea that these veggies are bad for you if you have thyroid problems is outdated information. Cooking them does reduce goitrogenic properties but again, you don’t really have to worry about that as long as you are not eating them every meal. 

-Are all Hypothyroidism’s cases Hashimoto’s?

-Can you have Hypothyroidism and not Hashi’s?

No. Most cases in the US are but you can have hypothyroidism without having hashimoto’s, it just isn’t very common. 

-Can you have Hyperthyroidism and not Graves Disease?

From what I understand, if your thyroid is in a hyper state it is usually due to Grave’s disease. You can have hyper symptoms due to hashimoto’s though. When there is destruction of the thyroid due to antibodies being created against the thyroid directing the immune system to destroy it, you will get a release of thyroid hormone into your system causing hyper symptoms. 

-I am retaining too much water, bloated/lower ab pressure and retention under the eyes, tingling, achy hands, and ankles. I am gluten-free, dairy-free, soy and corn-free, and alcohol-free, additionally, my sodium=138.7, and Potassium=4.7 levels are normal. What could be causing this? My best guess here is that your medication is not optimized. Puffing and water retention may be due to a slower than normal metabolism. 

Tingling- this could be a need for B12 but I can’t say without knowing more about your health. 

Achy hands and ankles- could be food-related, could be medication-related. Maybe you need medication with T3 to see if that helps. Sometimes gluten-free and dairy-free are not enough. They may help stop the destruction of the thyroid but there may be more that needs to be done. Could be food sensitivities to nightshades which include tomatoes, potatoes, peppers, and spices made from peppers such as chili powder and paprika. 

Ok. I hope this helps. If you have a question or several, please send me a message by filling out the contact form on my website or email me at helpforhashimotos@gmail.com. You can get your first one-hour consultation with me for $153. We will spend that time going over the results of your very comprehensive nutritional assessment and discuss what your next steps are to feeling better, sleeping better, getting your thyroid meds optimized and more. If you are not a thyroid patient but need help with figuring out what you need to do to feel your best, I can also help. I do love working with thyroid patients but I can also help others. 

One of my clients emailed me this: 

“Just an update. You gave me a consult two months ago. I've been following your guidelines.

Well, I have lost 16 pounds so far and my painful bloating is completely gone!

I have energy and feel very clear-headed most of the time!

Thank you!  I will send you another update in two months.

Just thank you so much!”

If you wouldn’t mind leaving me a rating and or a review on Apple podcasts or Spotify, I would really appreciate it. The more ratings I have the more this podcast will get in front of others who may need the help. I can’t thank those of you enough who have written in to tell me how much you like the podcast. It means a lot to me. All I wish for in life is to help people not suffer like I have. 

Remember to check out meizenskincare.com and use the code 10% off.  Or visit them using the link in the notes for this episode. 

How to fix PMS and Flare ups with diet.

I have terrible PMS and I feel like my Hashimoto’s symptoms get worse right before my period. I am exhausted and extremely emotional right before my period and my breasts are really tender, like they hurt to touch them. What is going on?

************************************************************************************************************

My question is about flare ups and what tools you can use to combat them. I have Hashimoto’s and am on 30 mg of armour a day. In the last week, my grandmother died, I lost my job and had a late night. The next day I had debilitating symptoms of 100-101 fever, terrible body aches, chills, fatigue, was really weak and had no appetite. I went to the doctor and was tested for a bunch of stuff including covid- everything was negative. When this has happened before I usually recover within a few days and am starting to wonder if this is what is considered a flare up. - Kim

How to manage your blood sugar and why it is so important for managing Hashimoto’s.

If there is one thing I would suggest you do in order to get your autoimmune condition, any autoimmune condition in the direction of being under control rather than it controlling you, it is managing your blood sugar. It was the one thing that kept me from feeling better in the beginning because all I got from my naturopath was “watch your sugar intake”. Well, I needed to really watch my sugar intake. I didn’t manage my diet well in the beginning. I thought the paleo diet was going to be the life giving diet answer and it wasn’t. That’s not to say it isn’t a good diet if done properly but all I am learning now is that a balanced diet might be better for me. We are all biochemically different, remember? What works for me may not work for you. BUT when it comes to blood sugar and Hashimoto’s and other autoimmune diseases, keeping it balanced is a really big deal. Blood sugar levels that are out of balance will F up your adrenals as well because they play a role in blood sugar management when things get out of hand. It also will cause your antibodies to rise. 

Blood sugar in medical terms is called glucose. It is a part of sugar but it is also a part of fruits and other carbohydrates, especially refined or white foods. It is what our body uses for energy for the most part. As sugar or glucose goes in to your blood stream through your gut or small intestine where most nutrients are absorbed. When we take in too many sugars our blood sugar becomes out of balance and insulin is released from the pancreas to shuttle sugar to our cells and what is left over gets converted to triglycerides in the liver. The more sugar we eat, the more insulin is released. Carbs are not bad, I want to be clear. Even starches like beans and potatoes are not evil but they can be a problem when consumed in high amounts. The key here is balance. I eat beans and potatoes but I don’t eat them everyday and I don’t eat a lot of them though I have been eating beans and rice with a vegetable for lunch for the last few days. That combo is a great source of protein and I have been enjoying a break from meat two to three meals a day. I’m trying to mix things up because I tend to eat the same thing over and over and over. 

When your blood sugar is on that roller coaster, it can flare up or increase symptoms of Hashimoto’s. Diabetes and Hashimoto’s have a relationship. One more reason to manage your blood sugar. Blood sugar dysregulation is a stress on the body and as with any stress, it can cause flare ups or damage to your thyroid gland. 

What are some signs you may have a blood sugar imbalance?

If you wake up between 1am and 3am and have a hard time getting back to sleep that is a classic sign of low blood sugar. Your blood sugar will drop at night, especially around 1am, causing you to wake up due to a surge of adrenaline. When your blood sugar gets low while you’re sleeping, it is your adrenals that release cortisol to help raise your blood sugar and sometimes it releases too much and you get a big enough surge to wake you. This release of cortisol can also cause an immune response or flare. When this happens regularly it is a form of chronic stress on the body and can lead to chronic fatigue, mood swings and an increase in thyroid antibodies. 

Another indication is when you are constantly craving something sweet. Sugar cravings. The bane of my existence. I still battle with that though I have healed my gut enough to be able to occasionally enjoy a sweet treat. I still crave sugar though, like a drug. No joke. Sometimes those cravings are not something we can control with will power. There can be very physiological reasons for your cravings so just let go of the guilt right now. You can have a deficiency of B vitamins, a yeast overgrowth in the digestive tract, a deficiency in digestive enzymes or HCl, or even hidden food allergies. 

• You may have an excessive appetite- you can never get full or you always feel hungry.

• You may crave coffee or sugar in the afternoon as a pick me up

• You may feel sleepy in the afternoon

• You may have fatigue that is relieved by eating

• You may get a headache, become irritable or shaky if you skip or miss a meal

• You may have brain fog, forgetfulness, nervousness

• You may have cold hands and feet

• You may have trouble losing weight

You can test your own blood sugar swings at home by getting a glucose monitor. If you have big swings in blood sugar after eating, this will be a good idea to do. High carb meals can be the cause of this type of blood sugar swing, called Reactive Hypoglycemia, but not always. 

Here is how you test: 

First thing in the morning you test your blood sugar. Don’t eat first. Record the number on your monitor. The monitors usually come with a little book for this purpose. 

Then eat your normal breakfast writing down what you eat then check your blood sugar with the monitor every 30 minutes for the next four hours. This will give you a good picture of what a meal does to your blood sugar. You can continue to test the whole days worth of meals so you know what foods cause such spikes and dips in your blood sugar. It will help you really start to hear your body when it is telling you something isn’t right. Not all foods will cause a blood sugar spike and you might be surprised which foods do cause a spike for you. 

Other things that can cause a blood sugar imbalance are 

• Low HDL cholesterol levels

• Being overweight with a bigger midsection

• Insulin resistance

• High blood pressure

• High triglycerides

• Type 2 diabetes (an obvious one)

• PCOS for females

  • menstrual irregularities including not ovulating

  • insulin resistance

  • hair growth on the face or other odd places

  • acne

You can control your blood sugar levels through diet and lifestyle changes. You can try a Whole 30 or join a RESTART class or work with someone qualified to help you figure out just what you should be eating. You don’t have to do a ketogenic diet, paleo diet, vegan diet, carnivore diet or anything else. If you are in a flare you should be doing some kind of diet change anyway. Learn which carbs cause blood sugar spikes by checking your blood sugar levels with a glucose monitor. Proteins and fats will slow keep your blood sugar more stable than carbohydrates for the most part though that doesn’t mean stop eating them. Have one serving of protein to two servings of carbohydrates which could look like a 4 ounce pork chop with 8 ounces of rice or potato. Vegetables are carbs but are typically not an issue with blood sugar regulation. Many practitioners may tell you to follow the glycemic index to know which foods may cause a spike in your blood sugar but glycemic load may be more important.  It takes in to consideration the quality and quantity of a carbohydrate.https://lpi.oregonstate.edu/mic/food-beverages/glycemic-index-glycemic-load#glycemic-load

the glycemic index of a serving of watermelon and a donut is 76. The watermelon has 11g of carbs and the donut has 23g of carbs. The glycemic load of watermelon is 8 but a donut is 17 so in this case, the watermelon is going to be the better choice. Glycemic index compares the potential of foods with the same amount of carbohydrates to raise blood sugar. Glycemic load again, takes in to consideration the quality and quantity of the food. 

Until you get things working better you may need to eat 4 or even 5 smaller meals to help your body out. Opt for protein type snacks like hard boiled eggs, nuts or seeds. Avoid any sugars before bed time- so nothing after 7pm. Limit caffeine and try to eliminate coffee altogether for some time to allow your body to heal. Obviously we want to avoid gluten and potentially dairy but you don’t have to avoid beans and legumes. Grains may be an issue for some but not all. Eat breakfast and be sure to eat protein with each meal. 

Cinnamon can help lower blood sugar because it slows the rate at which carbohydrates are broken down in your gut and will keep your blood sugar from spiking. Add it to anything and everything you can. 

Exercise. It helps your cells become more responsive to insulin, meaning they will use it and not be resistant to it. This will help reduce thyroid symptoms. Our muscles typically use glucose for fuel so even walking everyday- for an hour if you can will help pull sugar from your blood and let your muscles use it. After awhile it will help keep your blood sugar stable. Swimming and yoga are good options too. No need to over do it. Your body doesn’t need any extra stress while it is trying to heal. 

Drink water. This will help your kidneys flush out excess blood sugar through your pee. Adding electrolytes will help that water get to your cells. I like Designs For Health Electrolyte Synergy which you can get at https://us.fullscript.com/welcome/hfh. To me it tastes like gatorade without sugar but I haven’t had gatorade in 15 years so I could be way off. 

Make sleep a priority. Big time. The quality of sleep you get is very important to healing. I probably hadn’t sleep well for 20 years and was one of the reasons why I was not getting better. My sleep suffered due to blood sugar problems and the wrong sleeping environment for years. Plus having kids- those early years, I didn’t sleep much like any mother. Not sleeping well was the bane of my existence. Honestly, when I started school last year, I had to move out of my bedroom because my husband snores so loud and he chokes in the night and then punches the air. One time he almost hit me and that was it for me. It makes me sad, I guess, that we can’t sleep in the same bed but I’ve been told it is more normal than I realize and I just wasn’t willing to sacrifice my sleep or my sanity or my health any more. I now sleep soooo good in cold, dark and peace and quiet. But my relationship has suffered and that is another stressor to deal with. For right now, I’ll take good sleep because physically I feel so much better. 

Supplements. Magnesium (most of us are deficient and we need it to process sugar at the cellular level). Chromium (helps break down carbs and fats as well as control blood sugar- found in eggs, nuts, green beans, broccoli, meat or supplements). B vitamins, particularly thiamine or B1 (converts carbs to energy, aids digestion of proteins and fats which help us use those nutrients and not crave or feel hungry). A good B complex may be needed. Florastor probiotic and prebiotic fibers like fructooligosaccharides and inulin. Glutamine (for gut healing and curbs carb cravings by suppressing insulin levels and stabilizing blood sugar). 

Is my poop normal?

When you have hypothyroid symptoms you probably are familiar with constipation. It is a clear sign things are not working right in your body and in hypothyroidism, when you don’t have enough thyroid hormone, particularly T3 you can experience constipation regularly. 

If you have abdominal pain, bloating or abdominal distention, excessive gas, and or constipation which may or may not be associated with excessive straining you may have irritable bowel syndrome or IBS. Conventional medicine defines constipation as less than 3 bowel movements a week. Natural medicine might define it as less than one a day. You really don’t want stool sitting in your colon for three days. You will reabsorb much of the water and many toxins including estrogen for recirculation in to the body which is not good. For our purposes here, we will say less than one bowel movement per day is considered constipation. 

You may have alternating constipation and diarrhea with the above mentioned symptoms which can also be categorized as IBS. To get a diagnosis of IBS, other gastrointestinal issues need to be excluded as causing your symptoms. There is no test for IBS or markers to make a diagnosis so it is diagnosed based on symptoms. You need to have abdominal pain at least one day per week in the last 3 months associated with two or more of the following symptoms: pain related to bowel movements, pain and a change in how often you go or pain along with a change in the appearance of your stools. People with IBS generally are very sensitive to pain in their gut, have inflammation in the colon (which makes the nerves in the colon extra sensitive), changes in transit time (the time it takes food to travel through the GI tract from mouth to anus) and a change in the types and amounts of bacteria found in the colon. 

IBS is thought to be the most common GI issue in the Western world and seems to affect more women than men. You might be more at risk for it if it runs in your family, if you have had some kind of gut infection, if you have been given antibiotics or even if you have had some kind of stressful or traumatic event occur in your life. 

This disorder affects quality of life, causes people to miss work, and costs the healthcare industry in the US around 20 billion a year. 

If you are suffering from constipation, IBS related or not, here are some things you can try. 

Galactooligosaccharides or GOS at 3.5 grams a day. You don’t want to start out taking that much or you can make gas and bloating much worse so work your way up to a dose that high. A study using that amount found it improved gas and bloating as well as constipated stools over 4 weeks. 7.0 grams a day also helped to reduce anxiety.  

The top three things you can do to get rid of constipation are fiber, fluids and exercise! Adding ground flaxseeds, slippery elm powder, psyllium husks, oat bran, chia seeds or pectin can be very helpful. It may take awhile to see some improvements as one study showed three months of treatment with either ground flax or psyllium husks at 6 grams a day improved constipation, bloating, and abdominal pain. The flax appeared to work better for the participants in this study.

Fiber from fruit, especially blackberries and kiwi fruit, improved bowel movements significantly. If you are dealing with blood sugar issues, you want to be mindful not to overdo it on the fruit but these two fruits seem to be really good at getting things moving quicker. Keep fruit servings to no more than 4 serving a day. You also want to be sure you are consuming plenty of leafy green salads, beets, whole grains (not all grains are bad for all people), tons of veggies and nuts and seeds if you tolerate them. 

Drinking water. Make sure you are getting around half your body weight in ounces. Maybe a little more if you are sweating in warmer weather and try electrolytes with your water if you are not ever feeling refreshed by drinking. 

Moderate exercise, especially in the morning is helpful to get things moving as well. Our bowels wake up in the morning and sometimes that morning walk is all they need to increase transit time. 

If you are desperate to get things moving, licorice root can be used short term. You can ask your doctor for a prescription for lactulose if you are in the US. Everywhere else in the world you can buy it over the counter. It can speed up transit time or get things moving as I like to say. Take with slippery elm, oat bran, and licorice root. If you can. 

If you tolerate dairy, you can eat Activia yogurt. It is the only way you can get the specific probiotic that moves your bowels. If you are dairy intolerant a different strain, Bifidobacterium lactis HN019,  found in Garden of Life Raw Probiotics, Genestra HMF Multi strain, Now Foods Women’s Probiotics 20 billion and more can help you out. 

Improving how your liver works can also be helpful. When the liver is congested it can be what is causing the constipation so taking turmeric, globe artichoke, dandelion (all parts of the plant) and beets. You can make a raw beet salad consisting of equal parts shredded beets, carrots and dandelion greens. Make a dressing of olive oil and vinegar or lemon juice and season with a bit of salt. Very good for your liver. Eat it as a condiment with meals. It is delicious too. I am not a fan of beets but I am a fan of this salad. 

What about diarrhea? Some of you likely experience that too. This is more rooted in anxiety so supporting your nervous system with things like caraway, fennel or dill seeds, peppermint, cardamom, ginger, chamomile, lemon balm all help with abdominal pain and bloating. Saffron works amazingly well to lift depression and can help diarrhea. The nervous system can be supported with verbena (vervain), rhodiola, or panax (korean) ginseng. 

If you have severe gut pain and inflammation you can try to take a product called Iberogast which will fix the underlying issue of inflammation and the sensitivity of the nerves in the gut. You can also try licorice root again, chamomile, or turmeric. A combination of peppermint and caraway essential oils (eco-certified and organic) reduce inflammation too. I just want to note, that in some countries essential oils are sold in pharmacies and I don’t recommend ingesting oils unless supervised by someone qualified to help you do that. 

Food allergies or sensitivities are a big trigger for diarrhea, especially gluten. A study showed that all symptoms of IBS were reduced within 6 months of a gluten free diet. A low FODMAP diet also improved IBS but it eliminates a ton of really good for you foods so you should not do this long term. 

If you are over 45 and have had major changes in your bowel movement patterns should send you to the doctor to have your health checked. If you have blood in your stool, you have something else going on. Other signs there is something going on other than IBS or constipation related to hypothyroidism is weight loss, fever, and a family history of colon cancer. 

Ok! I hope this information was helpful. If you have a question related to your thyroid or thyroid health, please reach out at helpforhashimotos@gmail.com or go to my website, www.outofthewoodsnutrition.com and fill out the contact form with subject, podcast question. You can also sign up for my newsletter and get my report on five things your doctor won’t tell you about hypothyroidism. 

I’d really appreciate it if you left me a review and rating at apple podcasts so more people can find the podcast and get help. The covid19 special is over but because it was so popular it has morphed in to a 60 minute consult with no package purchase for $153.00. If you can take information and run with it, this is for you. You will fill out a health history and complete a nutritional assessment questionnaire and then I will meet with you for 60 minutes to answer any questions, go over results and provide you with a personalized recommendation that includes a diet plan and supplements if needed. It is always recommended to have a follow up in 3 months so you can compare your results with your beginning. It is fun to see the changes tracked on a graph. Have questions about this or anything else I offer, please shoot me an email at stephanie@outofthewoodsnutriiton.com

My philosophy on supplements is this: sometimes we need a little help to get our body functioning at its best and supplements do that. My goal is to get your body working on its own so you don’t need supplementation. And I can’t stress enough that buying on Amazon means you cannot guarantee what you are getting. There are lots of shady people selling supplements that are not what they say they are and most of the brands I use and support have agreements you are supposed sign stating you will not sell on Amazon. When you buy from there instead of from someone like me you are supporting a multibillion dollar company rather than a small business. 

All my best to you all. It’s a crazy time right now and I’m sending you all peace and love. 

Buy supplements here:  https://us.fullscript.com/welcome/hfh

Thyroid Cancer with Tiffany Flaten of Rock Bottom Wellness

Hi there and welcome to episode 87!  This week I am talking with Tiffany Flaten of Rock Bottom Wellness.  She is a certified Nutrition Specialist (she is currently supervising my CNS hours) M.Ed., MSN, CNS and a thyroid expert in nutrition. As founder of Rock Bottom Wellness, Tiffany helps thyroid patients improve their symptoms through proper nutrition education. She’s helped hundreds of women and men get to the root cause, find a way up from rock bottom, be their own best advocate, and shortcut the path to an amazing life. Rock Bottom Thyroid Treatment: An 8-Week Thyroid Diet for People with “Normal” Thyroid Test Results to Thrive Not Just Survive is Tiffany’s first book. Meet others on the journey to better thyroid health at www.rockbottomwellness.com/group. Book a free Thyroid Breakthrough Session with Tiffany at www.rockbottomwellness.com/breakthrough to get a personalized plan for the next leg of your thyroid journey.

We recorded this in January and the audio is a little choppy on her end in some places but it is a great conversation with some great info about how she dealt with her thyroid cancer diagnosis. Here is a little bit about her book: 

If Your Thyroid Numbers Are Normal But You Feel Terrible, Read This Book

Tiffany Flaten knows what it’s like to feel sick. For ten years, she felt depressed, irritable, and hopeless. And tired. Crazy tired. Like pregnancy fatigue every day. By her first baby, Tiffany was overweight and had high cholesterol. So why did her thyroid test always come back normal?

In 2007, Tiffany was diagnosed with thyroid cancer, the “best” cancer to have. Doctors advised “easy” treatments like thyroidectomy, radioiodine, and prescriptions for the rest of her life. Then the cancer came back, and Tiffany hit rock bottom. Would she ever feel normal again?

Yes! All thanks to proper nutrition. When Tiffany learned how nutrient deficiencies contributed to both her thyroid health symptoms and causes, she cured her depression, lost weight, got her energy back, and finally felt like herself again. She went back to school to earn her Master’s of Science in Human Nutrition and Performance and become a board certified nutritionist (CNS).

Today Tiffany teaches proper nutrition to alleviate thyroid symptoms. Her secret to helping thyroid patients turn their health around is an eight-week thyroid reset diet, a personalized thyroid eating plan and thyroid cookbook with thyroid friendly recipes for people who’ve hit rock bottom. Tiffany’s first book, Rock Bottom Thyroid Treatment: The 8-Week Thyroid Diet for People with “Normal” Thyroid Test Results to Thrive, Not Just Survive, helps people with thyroid disorders:

• Translate medical mumbo-jumbo into thyroid essentials

• Advocate for your own thyroid healing

• Feel better with nutrition, the natural thyroid cure

• Help your thyroid function optimally

• Balance your blood sugar

• Get off the mood roller coaster

• Give up food rules (and cravings)

• Get better sleep with thyroid balance

• Lose weight and lower your anxiety

• Experience thyroid and adrenal balance

• Choose the right thyroid glandular supplement

Rock Bottom Thyroid Treatment is the last hope for thyroid disease patients and the first step towards better thyroid health. Whether you’re going through cancer treatment or are simply concerned about “normal” thyroid numbers when everything feels off, Rock Bottom Thyroid Treatment gives you the answers that neither your doctor or Google will.

What should I ask my doctor at my follow up appointment?

Hello everyone. Thanks for tuning in. Obviously I have been on a break for the last month or so and it feels good to be back. I have not had a lot to say over the last month, I felt like there was not much to say with all the terrible things that were happening. I live in the Minneapolis area. It was a tragic thing that happened here and I’m not going to go into it with you guys at all. This is not what this space is for and you can hear plenty of political opinions all over the internet and television. The political unrest, the censorship by google and the social media platforms is very disturbing to me. Facebook had turned in to nothing but a negative place to be for me so I did something I had been thinking of for awhile now. I deleted by account. I deleted all my social media accounts. Permanently. I didn’t take a break, I didn’t deactivate them, I deleted them all. And you know, I feel so much better. I had been holding on to facebook for some time because I was in some pretty cool groups on there. I have an addictive personality and I couldn’t just hop on to check my Help For Hashimoto’s group or my business page and hop off again. I got caught up in their “fake news” fact checking and got really really angry. It’s been a couple of weeks since deleting my accounts and I feel soooo much better. I figure if people want to get in touch with me, they will. If they don’t, they won’t and if facebook was our only way of communicating, then we weren’t that close to begin with so no real loss for me. I want to encourage you to begin to think more critically of what you are seeing and hearing on the news and on social media platforms. Our news outlets basically have to make their advertisers happy and it shouldn’t be too hard who their biggest advertisers are and how that skews what you see and hear about. Most of the bigger media outlets are so completely against our president. Love him or hate him, he is our president and you never hear anything good that he has done because the media outlets don’t share any of that. I have been reading what appears to be an unbiased, fact seeking newspaper called the EPOCH times where there is no bashing of either political side but reporting of the facts. Please get the facts, no matter what you believe. Question things, always.  Rant over. Thanks for listening. 

I had mentioned I had some labs done a while ago and I think I promised to go over them with you all. That is in the works. I plan to have someone go over my DUTCH test with me on an episode so you can understand more about it. And I am working on an essential oil episode too. In the coming weeks I will be chatting with a certified nutrition specialist about a book she wrote on thyroid disease too. So lots of fun things in the pipeline and as I have said many times before I am concentrating more on my newsletter- which will really be the case now since all my social media accounts are gone. Writing is time consuming and so I usually put it off because I have to write a lot for school. I only have about a year and a half left though so…. :) I’m also interning at a functional medicine clinic working with clients and getting hours towards my own certified nutrition specialist certificate. Each class I take now gives me so much new knowledge to pass on to you and to my clients. It is very exciting to me because I love helping people and I love helping people avoid all the crap I went through with my own thyroid disease and failure of conventional medicine to help me.  My long term goals are to have a thyroid clinic in my area- all the functional medicine practitioners are at least an hour from where I live so I want to bring functional medicine to my almost rural community at an affordable price. Some of these practitioners charge up to $6000 for a package which prices out a lot of people, including myself. The biggest challenge we face is finding a doctor to prescribe our medication. I aim to fix that for my community and I wish I could fix it for all of you. Maybe with all this Covid stuff the rules on practicing will change and you won’t need to be physically seen by a doctor to get that first prescription. If they don’t change, I will work hard to educate doctors on how to best treat thyroid patients so they can feel their best. We can do a lot together to change diet and lifestyle but some of us will always need that prescription. I have hope for a much better future for the way we are treated as patients and for the whole world too. Sounds corny but I have to have hope because if I don’t have hope, what do I have? A deep dark hole and I don’t want that for any of us. 

Okay, on to the question sent to me.  

Hi Stephanie, I have a question that may be good for your podcast. I’ve recently been diagnosed with hashimoto’s by a doctor of natural medicine and I’m expecting to get my food sensitivity panel along with extensive blood work back in the coming weeks. after listening to almost all your podcasts and doing my own research, I believe that I’ve been suffering from it and adrenal fatigue for about 10 years. I’ll give you some background on my medical history first. 

For about 6 years I was seeing my doctor and others numerous times for fatigue, joint pain, severe allergies to any and all chemicals/fragrance as well as to pollen, vision problems, blood sugar management, depression, brain fog, digestion problems, unexplained and extremely difficult to lose weight gain and frequently becoming so weak and exhausted/sick that I couldn’t get out of bed... I was given prescriptions to address the symptoms, and getting bloodwork done to check my vitamin and mineral levels but I was left with no results or answers. 

I’ve been dairy free for about 3 years (self diagnosed based on symptoms) and gluten free (suggested by a different doctor) and both those things helped with many of my symptoms but didn’t fix everything going on in my body. In September 2019 I began eating vegan. The first few months were great because I was eating loads of vegetables, curries, and other nutrition packed meals but about 6 months in I got lazy with my meals and began to feel my thyroid “swell”. I finally went to see a Natural med doctor and got some answers.

As I’ve been waiting for my follow up apt I began the AIP to get a jumpstart on healing my body. I've been off coffee for 2 weeks now, 1 week full AIP and I’m feeling rather lousy and fatigued. I even have slight pain in my thyroid area. I’m eating lots of veggies (every meal) and meat (organ meats even), balancing meals, sleep, and light exercise. Could this be because my body isn’t used to eating meat or could it be something else?
What kinds of questions should I be asking my new doctor at my follow up appointment?

Thank you so much for any advice you can give! Your podcast has been incredibly helpful in my understanding of this disease and the things to be vigilant about.

Best wishes,
Ciera
I really appreciate

Thanks for writing in Ciera. I’m so glad you did and I appreciate you telling me that the podcast has been helpful because it is a lot of work to make! :) I’m grateful you listen! 

I am guessing that your natural medicine doctor did an antibodies test and that is how you were diagnosed with hashimoto’s. If this is the case, make note of your antibody levels and use this as your baseline.  As we know already, autoimmune thyroid disease is the cause of around 90% of hypothyroid cases in adults. Some of the symptoms of hypothyroidism are dry hair, loss of eyebrow hair, mostly on the outer third of eyebrow, a puffy face, enlarged thyroid, slow heart rate, arthritis, intolerant to cold, depression, dry skin, fatigue, forgetfulness, menstrual disorders, infertility, muscle aches, weight gain, constipation and brittle nails. This is not an extensive list but some of the more common symptoms that can wax and wane with your disease. 

Many of us go to the doctor with complaints of fatigue, depression, brain fog, chronic constipation and GI disfunction and the feeling that no one believes we are sick. No one believes you are sick, including your doctor because in the early stages of this disease, a clinical exam will show things are normal.

Conventional diagnosis and treatment will test TSH and maybe T4 if you are lucky. If you have elevated TSH you get thyroid replacement hormones and are sent on your way. If you have “normal” TSH you will be offered antidepressants, anti-anxiety meds, birth control or some other band aid for treatment because you are otherwise “fine”. 

With alternative practitioners such as myself and hopefully your natural medicine doctor, you are given suggestions for diet, nutrition, lifestyle and other therapies. One thing you can look out for with your doctor is whether or not they are treating the whole you and not just the thyroid disease because it affects basically most if not all of the systems in your body so the whole body has to be looked at, not just the thyroid. Inflammation throughout the body must be considered, how it affects the brain, blood sugar management, liver function, immune system, endocrine system, your gut health and more. 

Did your doctor run a full thyroid panel? Does your doctor take in to consideration that TSH levels fluctuate in Hashimoto’s? TSH can be different every time you get tested. This is why you need more than just a TSH test. When there is tissue destruction (autoimmune attack on the thyroid) this will increase the amount of T4 and T3 in your system but your TSH will be normal or low. The best diagnostic tool for Hashimoto’s is TPO antibodies though getting both TPO and TgAb tested is a good idea. 

Remember I said that your antibody test is a good baseline for you. This is because the level of antibodies you have is not associated with how severe the disease is for you. You can know if you are in a relapse if your antibodies go up from your baseline. 

Other things to consider are whether or not your Hashimoto’s is stable- no fluctuations in your TSH (low TSH) with normal T4 and T3 or high T4 and T3 (hyper). Once your condition is stable, you should not see your TSH levels rise above 3 (ish) or go much below 1. 

If you are in an active and more aggressive state of Hashimoto’s you may need to continually increase your dosage of hormone replacement. When you are not getting enough hormone it can lead to all kinds of issues that include brain issues, GI problems (including gallbladder sludge and stones, less production of digestive enzymes and slower motility), breakdown of bone and muscle with less energy, exercise intolerance, blood sugar problems, temperature regulation issues and immune system dysfunction. 

Potential triggers for autoimmunity:

• gluten

• intake of salt

• intake of iodine

• lectins

• no diversity in your diet

• glyphosate

• inflammation causing foods (fried foods, etc)

• grains

• casein (dairy protein)

• egg whites

• cross reactive food proteins

• insomnia, lack of rest

• sedentary life, over exercising

• smoking, alcohol consumption, drug use

• poor relationship status, stress

• environmental chemicals like BPA or BPA alternatives, mercury, etc. 

• GI infections like H. Pylori, candida overgrowth, lyme 

There is no one perfect protocol for this disease and where you start working on it for you is different than how someone else will need to be treated. So in other words, the protocol is not linear. Ask your doctor if they have a specific protocol they use for Haashimoto’s. If they do and they use the same protocol for everyone, then you might not be getting the care you need. You may still have to see them though if they are your prescribing physician.

Be sure they are not throwing a bunch of supplements at you as well. You definitely will need some but you don’t need 10. The naturopath I saw when I was first diagnosed was, I think, just out of school and she used supplements like conventional doctors use medication. There was not a lot of dietary suggestions other than what came from my food sensitivity testing and I needed so much more. She was applying bandaids with supplements and you really want to avoid that unless it is something that needs a bandaid until you can really work on it. 

It sounds like you are really sensitive to chemicals which is usually an issue with your liver being really overwhelmed and not able to process those chemicals very well which causes you to be really sensitive to them. 

The inability to lose weight can be related to blood sugar dysregulation, or insulin or cortisol issues. These are the likely culprits though systemic inflammation or liver issues can also be the problem.  You said you are feeling lousy and fatigued on AIP- my first inclination is that you might be eating too much protein and fat and not enough vegetables though you said you are eating veggies at every meal so I wonder if there is some sort of detoxification going on that is making you feel poor. And good for you for doing organ meats. I am not there myself- no desire at all. If you don’t feel better soon, take a look at how much you are eating- maybe not enough protein? This one is tough to answer without looking at a food journal. 

You said you felt your thyroid swell while on a vegetarian and vegan diet - there is not a lot of research to support the idea that goitrogenic foods are the cause. You can cook your vegetables before eating them which can reduce the goitrogenic activity if you are concerned though. These foods, the goitrogenic foods, reduce oxidative stress which is what we want. You may want to look at how much salt you are consuming as that may be an issue for thyroid swelling and make sure you are not taking in any iodine. So watch the shellfish, seaweed and iodized salt intake. 

I guess I didn’t give you any specific questions to ask your doctor which may be a bit of a bummer for you. Just be sure they are not using a protocol they use on everyone else and that their plan is individualized for you. There are just so many factors at play here and everyone is different in what they need. I hope this helps and I wish you all the best of luck in your health journey. 

The average person sees their nutritionist 1.8 times. Maybe that is all you need to start feeling better? Maybe you need more. I can help you either way. The Covid-19 special is over but I’m still doing those one off consults because they were so popular. The price and the amount of time I spend with you has changed though. Instead of 15 minutes (which really turned out to be 30 minutes for most people taking advantage of the deal), you are getting an hour with me to go over your results and recommendations for $153. Follow up appointments will still be $37 for 15 minutes.

Here is what Ashley had to say about her results. 

“Hello Stephanie!

Just an update. You gave me a consult two months ago. I've been following your guidelines. Well, I have lost 16 pounds so far and my painful bloating is completely gone!

I have energy and feel very clear-headed most of the time!

Thank you!  I will send you another update in two months.

Just thank you so much!”

I’d say that speaks for itself. If you are someone who can take my advice and run with it, you may also have results like this. You have the power to change your health and your life and I am here to help you do that! Book now at www.outofthewoodsnutrition.com, go the to the Work With Me tab and scroll down to purchase the 60 minute consult with no package purchase for $153.00.  

Please send me your questions at outofthewoodsnutrition.com by filling out the contact form or just email me at helpforhashimotos@gmail.com. 

Until next time! 

I love you guys. 

Should I take iodine to support my thyroid?

The short answer is no. Here’s why. 

It is considered a trigger for Hashimoto’s and for thyroid autoimmunity in general which would include Grave’s disease. There have been several large studies that show people consuming iodine have higher thyroglobulin antibodies. People who have iodine deficiency to begin with have a 4x higher chance of increasing their thyroglobulin antibodies when they take in more iodine. Just 500 mcg of iodine triggered or provoked autoimmunity in previously healthy people when iodine was added to the diet. 

If you have long term exposure to iodine, it can have long term effects on regulation of your immune system, again, triggering autoimmunity. 

Iodine increases oxidative stress and promotes inflammatory reactions. Oxidative stress and destruction of thyroid cells within the thyroid leads to your body’s inability to make thyroid hormones and leads to destruction of your thyroid gland over time. 

Some examples of what it looks like when you supplement with iodine are: 

1. You have high TSH and have hypothyroid symptoms so you supplement with iodine which causes destruction of the thyroid gland but will give you a normal TSH and improve your symptoms for a while. 

2. You have normal TSH and no thyroid symptoms but you are consuming a fair amount of iodine through your diet or supplementing (it’s in all processed foods). You get thyroid gland destruction which will raise your TSH and maybe cause you anxiety and insomnia. 

3. You have normal TSH (all of these normals are according to conventional medicine) and are on thyroid hormone replacement. You have no symptoms. You supplement iodine, you have destruction of the thyroid gland and you get depressed TSH (around 0.01), high T4 and T3 and you have hyperthyroid symptoms. 

4. You have normal TSH, no symptoms, positive TPO antibodies (called silent autoimmunity), you supplement iodine, thyroid is being destroyed, you end up with normal TSH, no symptoms and TPO antibodies become elevated. 

Iodine is a goldilocks nutrient. Your intake needs to be just right. According to Datis Kharrazian you need about a pin drops worth each day which amounts to about a tablespoon a year. That isn’t a lot. I guarantee you are getting much more than that in a year if you eat a standard American diet or take a thyroid supplement with iodine in it. So if you are taking a supplement with iodine, I might consider stopping it. If you are prescribed iodine by your doctor, I don’t even know if that is a thing, then I would not stop without talking to your doctor. 

Another study, “Effect of small doses of iodine on thyroid function in patients with Hashimoto’s thyroiditis residing in an area of mild iodine deficiency”, states that just 250 mcg of iodine to people with euthroid status (meaning their thyroid is working fine) but that had silent autoimmunity showed significant changes to their thyroid hormone function. One woman in this study had a TSH that went from 2.5 to 43.3 after supplementation. Most of the other people in the study saw their TSH double but antibodies were all over the place from a 900 point increase to very minimal proving that this disease and anything else in health and nutrition is very bio-individual or personalized. 

A study on salt content in Slovenia showed that when the iodine in regular table salt there was increase from 10mg to 25mg of potassium iodide per kilogram of salt their rates of Hashimoto’s more than doubled. 

It also has been shown to increase nodular goiter in people. 

Iodine restriction may be a way to combat some of the thyroid disease plaguing the world. One study on this topic showed that 78% of subjects had normal thyroid function with just restricting their iodine and had no need for thyroid hormone replacement in just 3 months. Restriction in this study was less than 100mcg per day. 

In subclinical hypothyroidism which is when you have high TSH but no symptoms, iodine restriction is thought to normalize or decrease TSH levels and these iodine levels are correlated with urine iodine concentrations. It is thought that iodine restriction could be a major or preferred treatment option for some people. 

Where do we get most of our iodine? 

• Iodized salt is probably the biggest and that is in every processed food that has salt as an ingredient unless it is specified. 

• Seasoning mixes made with salt or things like onion salt, celery salt etc. 

• Seaweed and the snacks made from seaweed

• Foods containing iodates, iodide, algin, alginates, carrageen, agar

• All processed bread products

• Milk (1 oz a day is allowed)

• Egg yolks

• Seafood minus freshwater fish

• Many supplements, especially multi vitamins and thyroid supplements

• Anything with Red Dye #3

• Most restaurant and processed foods

• Soy products: edamame, tofu, soy burgers

Goitrogens on the other hand, we have long been told to avoid and that may not need to be the case. 

A study on broccoli sprouts in thyroid patients found that it was completely safe for thyroid patients to consume. The thyroid was not negatively affected at all. In fact, in this study, the broccoli sprouts were shown to activate Nrf2 which protects us against toxins and oxidative stress related conditions. 

Bottom line for goitrogens from food are that they do not cause goiter or affect how much T3 or T4 is produced.  They actually increase our levels of glutathione, our major antioxidant and protect our thyroid from oxidative stress/damage. 

Goitrogens from chemicals do cause goiter and do negatively affect the thyroid and should be avoided when possible. These are things like PCB’s and Phthalates. So cleaning up your environment including getting rid of plastics might be helpful which I have talked about on the detox podcasts. 

So bottom line, consider how much iodine you are getting in your food. If you are not feeling well or you can’t get your antibodies down, you might consider a low iodine diet to see if it helps. We also need to remember that there is an ebb and flow to this disease. We will always have to mind things like stress and food in order to feel our best. If you are in a place where normal to you is tired, moody, stressed, irregular bowels please know that is not normal, that is your body telling you something is off. 

Did you know the average person sees a nutrition professional only 1.8 times? That statistic is very disheartening but I get it. Diet and lifestyle changes can be really challenging, especially right now. If you are the type of person who can take information and run with it, the Covid-19 special might be just what you are looking for. It is an exceptional value at $37. For that price, you get to take the state of the art Nutritional Assessment Questionnaire (NAQ) which will show me where your body is out of balance. This allows me to make a personalized protocol for you and your unique situation. 

This is for you if you need a boost in the right direction for your health, not if you are dealing with multiple chronic health conditions. Now more than ever, we need to take control of our health and well being and this is a great way to get started. Once you do, you will be invited to join Nutri-Q and take your assessment and fill out a health history. Then we will meet by phone or Zoom for 15 minutes to go over your results and discuss your plan. I look forward to working with you on your health journey. 

You can learn more at outofthewoodsnutrition.com and click on covid-19 special at the top. This deal is going away at the end of June so now is a great time to get a kickstart on your well being and feel your best. 

Take care.