Six Types of Thyroid Dysfunction

Welcome to Episode 39. I’m so happy you are here. 

I spend a good couple hours cooking several things last night so I would have food to eat over the next week or so. I’ve been trying to double up on meals when I cook so we have stuff to freeze for nights I don’t want to cook. 

I made two whole chickens on Sunday night so I had leftover meat for making soup and for putting on salads. I made a double batch of chili on Monday and Tuesday was a big batch of Thai Beef Stew, braised cabbage and I tried out a meatless dish of grape tomatoes, garlic, basil, chickpeas and spaghetti squash. If you tolerate legumes it was an okay dish. I was hoping for more flavor from the chickpeas. I just sautéed the tomatoes in olive oil, smashed them, added the garlic and chickpeas and sautéed a bit longer. Then I added the spaghetti squash and basil and mixed it through. 

We are having venison chops tonight with sautéed mushrooms and roasted cabbage. 

What are you making for dinner these days?  Head over to my website and comment on this post to let me know what your cooking. Look for Episode 39. 

Today we are talking about the six types of thyroid dysfunction that cause or result in hypothyroidism so let’s get started. 

The thyroid gland is super sensitive to any changes in the biochemistry in our body. It’s job is to perceive even the tiniest of changes in the body and make up for that by changing how much thyroid hormone is released in the body. 

This is one reason you can see such different lab values over time. 

When these changes in our biochemistry become something that is chronic or constantly happening in the body then there begins to be problems with the thyroid gland and the communication between the hypothalamus and the pituitary gland. 

Things like constant blood sugar dysregulation, constant or chronic inflammation in the body, deficiencies in nutrients, poor liver function, toxic burden, low stomach acid, intestinal permeability, poor eliminations and even the use of hormones including thyroid hormones can cause thyroid problems. 

Hypothyroidism or low thyroid function can fall into six different types. Some of these may occur at the same time, and it may be that only one of these will require permanent hormone replacement. 

1.Primary Hypothyroidism. 

This is when there is decreased hormone production by the thyroid gland. So it isn’t making enough T4 or T3. One cause and the most common cause in the US is Hashimoto’s. Worldwide the most common cause of Primary Hypothyroidism is iodine deficiency. (ref)  It is also caused by removal of the thyroid gland. 

This is a dysfunction of the thyroid gland and this is the one type of hypothyroidism that needs to be treated with thyroid hormone replacement. 

If you have Hashimoto’s, you may need medication due to the destruction of your thyroid gland but you also need to understand that this condition is an immune system issue first and a thyroid issue second. 

If you catch Hashimoto’s before too much damage is done, you might be able to support your thyroid nutritionally. Sadly, for me, I am still in need of medication.  If you do not have success bringing TSH down with diet and lifestyle changes, you will likely need hormone replacement. 

Your labs might look like this if you have primary hypothyroidism: 

  • high TSH

  • normal or low Total T4

  • normal or low Free T4

  • normal or low Free T3

  • normal Reverse T3

2. Secondary Hypothyroidism

This deals with your thyroid not putting out enough thyroid hormone due to an issue in the pituitary gland. Remember that the thyroid is regulated by the pituitary gland and the hypothalamus. When these two glands are not communicating and the pituitary doesn’t secrete Thyroid Stimulating Hormone (TSH) like it is supposed to. You may find your TSH at or around 1.8 but still having symptoms of hypothyroidism. 

Chronic stress in the body is usually at the heart of this one. Stress fatigues the pituitary and it can cause a failure to signal the thyroid to produce thyroid hormone. 

Stress: too busy all the time, not enough sleep, living off of coffee and processed foods, inflammation, viral or bacterial infections. All of these will mess with your adrenal function and your thyroid function and remember those two go hand in hand.

You can also have low thyroid function after pregnancy. This is a stressful time for women who tend to be the ones suffering with most thyroid conditions. Pregnancy in and of itself will put a high demand on the pituitary gland. 

If your blood tests come out normal but your doctor puts you on thyroid medication anyway, it can help you feel better for a couple weeks but then you might start to feel worse. You can develop thyroid hormone resistance at your cells much like insulin resistance. 

So your cells are refusing thyroid hormone because there is too much in the blood and you might be given a higher dose making things even worse. You have all this hormone running through your blood so your pituitary gland gets a message it can stop making TSH or it just stops talking to the thyroid altogether. 

You might need medication after enough damage has been done between the communication of the pituitary and the thyroid.  

If you have Hashimoto’s but it doesn’t get addressed, this can become you.

Your labs might look like this: 

  • 1.8 or less TSH

  • 6 or less T4

  • symptoms of hypothyroidism. 

3. Your T4 is not converting to T3

This happens when you have tons of chronic stress and high cortisol. So you are making T4 but your body isn’t converting it to T3 which is what your cells need. When cortisol is high, you will likely have some of this going on. 

If your body is dealing with infection or inflammation your cell walls can be damaged by that which also affects T4 to T3 conversion. 

You need to damper the inflammation or infection and support your body in dealing with cellular stress (free radicals). 

T3 levels won’t affect your TSH so your labs might look like this: 

  • Normal TSH

  • Normal Total T4

  • Normal Free T4

  • Low T3

  • Low Free T3

  • Low or normal Reverse T3

4. Your conversion of T4 to T3 is too high.

This would mean you have too much T3 being made and you also have less thyroid binding globulin (TBG). 

Too much T3 will overwhelm the cells and you find yourself in thyroid hormone resistance again. It is common in women with insulin resistance and PCOS. It is often caused by too much testosterone in the body.  If you have developed Type II Diabetes and are taking insulin for this, you may also find yourself in an over conversion of T4 to T3.

If you are using a testosterone cream you can over convert T4 and T3. 

You will have hypo symptoms with this one. 

A big help here will be to reverse the insulin resistance to reverse the thyroid hormone resistance and begin to feel better. 

You may have labs that look like this: 

  • Normal TSH

  • High or high normal Free T4

  • High or high normal Free T3

  • Normal Reverse T3

5. High Thyroid Binding Globulin

Thyroid Binding Globulin is a protein that carries thyroid hormones to the cells so they can use them.  You can develop antibodies to this protein in Hashimoto’s. 

You can find yourself in this situation if you take hormonal birth control or estrogen replacement therapy. 

If you are on birth control, you may have high levels of estrogen you will make too much TBG and thyroid hormones are carried to the cells on TBG so if you have too many TBG proteins in the blood bound to them, you can have less thyroid hormone getting to your cells. 

You have to work to get the excess estrogen out of the body. 

Your labs might look like this: 

  • Normal TSH

  • Low Free T4

  • Low Free T3

  • Normal Reverse T3

6. Thyroid Hormone Resistance

Again, similar to insulin resistance with a root cause being stress. Your pituitary gland and thyroid gland may be making just the right amount of hormone but it just isn’t getting into the cells. It feels like hypothyroidism to you and it is the high amount of cortisol in your body that is causing your cells to resist the thyroid hormone. 

You absolutely must manage your adrenals with this one. 

Your labs might look like this: 

  • Normal TSH

  • Normal Free T4

  • Normal Free T3

  • Normal Reverse T3

You have to make sure your labs are being tested regularly in all cases. 

Ok. That’s it for me. 

I want to remind you all that I have openings in my practice for a few more clients right now so if you are needing help navigating diet and lifestyle changes head over to Help For Hashimoto’s and fill out the contact form. You can also get my report on Five Things Your Doctor Won’t Tell You About Hypothyroidism. 

One last thing, part of the diet and lifestyle changes are to look at what you are putting on your skin. I found Beautycounter to be a trusted source for skin care and make up for me. They ban over 1300 chemicals in their products while the US only has a ban on around 30 ingredients. So, you don’t have to think about safety with their products and I really like that so I became a consultant last year. I don’t work too hard at selling it because my focus is really on nutrition but if you have any interest in checking them out go to beautycounter.com/stephanieewals to shop. I would sure appreciate your support. 

I’m still on a social media break and have no desire to get back on anytime soon. I’m checking the Help For Hashimoto’s facebook group once a day. You can join that if you would like but all the action is in the newsletter which you can sign up for on my website. 

I’m grateful to you all. Please leave me a rating and review on iTunes so more people can find the show and get help. 

Until next time. 

Your immune system and Hashimoto's; Adaptive vs. Innate immunity in Hashimoto’s Episode 38

Welcome to episode 38.

I am 3/4’s the way through a year of podcasting. Thanks for sticking with me and hanging out. I really appreciate it. My end goal is to help as many people as possible have a great quality of life with autoimmune disease.

You can help me with that by sharing this podcast with people you know dealing with thyroid issues and by leaving a rating or a review. I have enjoyed reading the reviews and honestly avoided them for awhile because I didn’t want to see if there were any bad ones. Thankfully there weren’t any. Anyway, I am grateful to those of you leaving reviews. 

Someone in Denver who rides the train to work listens and I want to thank you! I do this for you! So you can begin to feel your best. 

I’ve had a busy week and didn’t do so well with eating enough last week. I had not prepped any food which always makes for days where I just skip a meal which is so bad for my adrenals and my blood sugar. My blood sugar is so sensitive which I think is keeping me from losing the 5-10 pounds I have gained over the last year or two. I have not done anything different with my diet but menopause and insulin resistance have made of mess of my body. I have regularly done the autoimmune strong workouts over the last month- I’m getting them in at least three days a week. I hate working out but I want to be strong as I get older so I just do it anyway. 

I ate out a lot this past weekend but we are so fortunate to have some really cool restaurants that serve at least Paleo type foods. I had a green curry with pastured chicken and organic veggies twice in the last week from a great restaurant called French Meadow in Minneapolis. They have a lot of gluten free options which is so nice and the food is good. It tastes like it is made from scratch.  

I had a yucca crust pepperoni pizza with a cheese made from pumpkin seeds and a chicken curry dish to bring home from another place called Sassy Spoon. They are 100% gluten free which is nice. They are another from scratch type restaurant. 

This weekend I was at a party for a family member and there were gluten free cookies for dessert and I had at least one whole cookie if not a little more. I could feel the effects of that right away on my neck and my face began to itch like crazy. So, despite wanting to devour a ton of them, I didn’t. I didn’t want to suffer the physical consequences. That party had a taco bar with corn tortillas but I skipped the tortilla and just had the meat, lettuce and guacamole with a little salsa- so basically a taco salad. Pretty easy to modify that one if you can tolerate tomatoes. 

On Saturday morning I made my breakfast soup and chicken and veggie stir fry with lots of garlic to eat for the week. As long as I have food to eat during the week, every thing seems to go better for me. My moods are better, sleep is better, energy is better. It is just a matter of taking the time to make the food. 

Monday I ate at a place called Foxy Falafel which even has Autoimmune Protocol menu items. I tolerate chickpeas so I had their falafel which is such a treat. We even got their egg free, gluten free, dairy free brownie and chocolate chip cookie. I over indulged but I have not been to that restaurant in 2 ½ years so it was okay with me. They also sold Hu chocolate which is pretty darn good. 

After all that indulgence over the last week, I filled up on my green juice made in my vitamix which consists of a lemon, 2 stalks of celery, ¼ of an english cucumber, a handful of parsley, water and ice. I always feel really good after drinking that and it kickstarts my digestion for the day. 

Sauerkraut has been in regular rotation too. That helps my digestion work better as well. We have our old refrigerator full of it and everyone complains about the smell. It is sort of infiltrating the whole refrigerator. I love it! 

I’ve been doing hamburger patties on a bed of lettuce too. Quick and easy. 

Okay- let’s get started on todays subject. It is an important one to understand because it plays a big role in your autoimmune disease. 

Today we are talking about your immune system and Hashimoto’s. This episode has some scientific terms in it but I think I have broken it down to make it easier to understand. It is important for you to know how your body works and the immune system is a pretty big deal.

It is our biggest line of defense with many kinds of cells, antibodies, proteins and chemicals all working together like a country’s military defense system works to protect a nation. 

The immune system is divided in to the innate immune system aka the non-specific immune system. This side of the immune system is highly involved in inflammation- like when you hurt yourself and you get a bruise or a bump. When you cut yourself and the area gets all red and becomes scabbed. The job of the immune cells in innate is to keep pathogens out. It acts quickly and does not specify or target any one thing. For the most part, it cannot tell the difference between an invader, damaged cells or healthy cells so healthy tissue sometimes gets damaged. So if you have chronic stress causing inflammation or some kind of infection that won’t go away, this side of the immune system produces chronic inflammation. 

The other side of our immune system is the adaptive immune system which is very specific about the attacks it launches. We will talk a little more about this side in a minute. 

Your immune system needs to be regulated in order for your Hashimoto’s disease to be managed. 

Our immune system is on guard for antigens. Antigens are toxins or other foreign substance which causes an immune response in the body and can create antibodies against it. 

Things like a specific food, mold, bacteria, a chronic virus such as EBV or a parasite. These things irritate the immune system leading to an attack.  Now in Hashimoto’s, gluten is a big antigen which induces an attack on the thyroid gland every time you eat it. Remember that gluten is a protein found in all grains to some degree but the biggies that can be more of a problem for most people are wheat, barley and spelt. 

You can also have an immune response to environmental chemicals or heavy metals but not everyone will develop an immune response to these things.  You might be someone who doesn’t have a huge heavy metal burden or you just don’t react to foods. The exception would be gluten and possibly dairy because the proteins are similar to those of your thyroid so I always recommend people remove those two things from your diet. 

Your immune system might be reactive to bacteria. Many people with Hashimoto’s have antibodies to the bacteria Yersinia enterocolitica. 

Whatever your issue is you need to remove the antigen either by removing the offending food, detox the heavy metal or get rid of the bacteria to calm the immune system and manage Hashimoto’s. 

When dealing with autoimmune disease and specifically Hashimoto’s we want to look at TH-1 and TH-2 cytokines which can be high while T-suppressor cells will be low. 

A cytokine is a category of tiny proteins that work to signal cells of the immune system and are produced by cells in the immune system and a number of other places. They have many jobs in the body one of which is to work with the immune system to protect us. 

T-suppressor cells are also known as regulatory T cells which work to modulate or regulate the immune system and help us maintain tolerance to antigens against our self which helps prevent autoimmune disease. The T regulatory cells are immunosuppressive- they suppress the immune system. 

So, if we have high cytokines and low T-suppressor or T-regulatory cells then you have an immune system that is all out of balance and giving you symptoms of Hashimoto’s and maybe even causing destruction to your thyroid gland. 

Now let’s look at TH-1 and TH-2 cytokines specifically because most of us fall in to either TH-1 dominance or TH-2 dominance. 

TH-1 are T helper cells involved in an innate, or immediate immune system response. This is the adaptive immune system which is a part of the immune system that creates memory after dealing with an antigen. This means it will always remember that particular antigen whether it is a food, mold, heavy metal or parasite or bug. Every time that substance enters your body your innate/adaptive/acquired immune system will attack. It is very specific about what it reacts to. This is the part of our immune system that, once we have measles, will protect us from ever getting it again.  It is the line of defense against the pathogens.  

Sometimes it doesn’t distinguish the difference between an invader from non invader when it enters the body. It gets confused which can result in things like hay fever, asthma or an attack on the thyroid. 

When you have TH-1 dominance your immune system is overactive in the TH-1 pathway.  The majority of people with Hashimoto’s have TH-1 dominance but there are some Hashimoto’s patients with TH-2 dominance. 

You might also switch back and forth between the two depending on what your body is needing or getting too much of. Maybe you are deficient in some minerals or or getting too much of a mineral. These can trigger either TH-1 or TH-2 dominance. 

The best way to manage this is to focus on the whole body. Reduce inflammation throughout the body. Remove the triggers for your immune system. 

Once you have an autoimmune disease, you can put it in remission but you will have it forever and will have to work to manage your diet and lifestyle so your immune system can relax a bit. You must restore balance to the body. 

High TH-1 or TH-2 immune cells block thyroid receptors on your cells so your thyroid hormone cannot get in and do its job giving you symptoms of hypothyroid. 

Type 1 Diabetes, Hashimoto’s, MS and chronic viral infections are associated with TH-1 dominance. 

Lupus, dermatitis, asthma, and chemical sensitivities are mostly associated with TH-2 dominance. 

This is not always the case- remember that. As with everything there are exceptions. 

TH-2 are T helper cells involved in a delayed immune system response. Helper cells work to direct immune system activity as do the regulator cells and suppressor cells stop an immune reaction when needed. 
There are some different ways these immune cells could be affecting you. 

    • You might not make enough of the T-suppressor cells that regulate your immune system and tolerate antigens. Not enough T-suppressor cells keeps the immune system on high alert and attacking self. Your thyroid gland can be a victim of this problem. 

    • Maybe you make too much of the chemical messenger Interleukin-2 (IL-2) that tells other immune cells to attack and kill an invader. Too much of this one puts tissue not involved in the attack at risk of being an innocent bystander that gets attacked. 

    • You might make too many Interleukin-4 (IL-4). This releases B cells that look for intruders and mark them for death. Again, here your thyroid tissue can be damaged. 

    • Not managing your blood sugar or not being able to handle increases in insulin due to consuming sugar and refined carbs can send those B cells in to over production. 

    • Having food sensitivities and eating those foods anyway or dealing with a parasite will increase Interleukin-4 and increase production of the B cells. 

    • A chronic virus such as EBV will increase the Interleukin 2 creating more natural killer cells and cytotoxic T cells. 

Let’s get to know what these terms mean. 

Interleukin- these are a type of cytokine. Cytokines are chemical messengers within the immune system cells. Some cytokines kill pathogens on their own. 

B cells- a white blood cell that is circulating in the body and is on the lookout for for antigens that they have antibodies to. When these cells activate, they are quick to divide and grow. Some of these have memory and will forever recognize an antigen when it enters the body. 

Natural Killer cells- white blood cells that go to an infection site to destroy cells infected by a virus. They play a role in the adaptive immune system having a memory to viruses. They do not need to be activated to kill cells in the body. 

Cytotoxic cells- T cells that attack cells infected with a virus and certain bacteria. They release chemicals called cytotoxins which cause infected cells to die. 

Our ultimate goal here is to bring the immune system back in to balance. 

You need to support your immune system and you can start with Vitamin D in the form of cholecalciferol. This specifically supports the T regulatory cells so they can do their job right. Remember these are the ones that help regulate the immune system. 

Make sure you are taking an emulsified version which means it is mixed with some kind of oil so that your body can use it. Poor quality vitamin D supplements with be mixed with soybean oil or with canola oil. Look for one with MCT oil (a form of coconut oil) or I have seen them with olive oil too. Biotics makes a nice one called Bio-D Mulsion Forte. 

Fish oil will also support the T regulatory cells but taking any fish oil in large amounts isn’t a good idea. 

There are some studies to show that people with Hashimoto’s are not able to process vitamin D naturally so they may need higher amounts than the average person. If you have a Vitamin D test that shows normal levels yet your immune system is still struggling and you are doing everything else right to reduce inflammation and immune responses you may think about raising the amount you take. Having high normal levels is best for thyroid patients. 

You may need a therapeutic dose and should have your levels checked by your doctor once a year or more to make sure you don’t over do it. 

Excess vitamin D can cause calcification of the heart, kidneys or lungs and you can have too much calcium circulating in your blood. 

Glutathione (a big antioxidant in the body) in a cream form and superoxide dismutase (an enzyme that acts as an antioxidant to protect your cells). These will both help regulate the immune system. 

Don’t waste your money just trying these to see if they help. Work with someone who can first help you get your diet and lifestyle dialed in, get your digestion working well and making sure you are able to digest fats and absorb vitamins and minerals. 

Back to TH-1 and TH-2 Dominance. It is helpful to know which way you go here so you can know which things will continue to stimulate your TH-1 or TH-2 cells. 

Things that stimulate TH-1: Echinacea, Maitake mushrooms, glycyrrhiza from licorice (so if you take licorice for adrenal health and you feel worse because of it then it could indicate TH-1 dominance), lemon balm. 

Things that stimulate TH-2: caffeine, green tea extract, grape seed extract, pine bark extract, white willow bark, lycopene (found in tomatoes) , resveratrol. Taking any of these will stimulate the immune system further and cause you to feel worse. 

Again, work with someone who can help you with monitoring these things. 

Things that regulate TH-1 and TH-2:  probiotics, vitamin A, vitamin E and colostrum. 

Things that quiet interleukin one that would activate TH-1 or TH-2: Boswellia (frankincense is a species of the Boswellia species), pancreatic enzymes (often sold as digestive enzymes), Turmeric or its compound curcumin. 

It is probably best if you have some sort of immunologic testing done to find out if you are TH-1 or TH-2 dominant before messing around with the things mentioned, aside from Vitamin D. 

You also will want to work on diet, keeping your blood sugar stable, get your adrenal health dialed in and make sure your digestion is working top notch. 

After all of this is completed and you know where your body stands, where your immune system stands then you can work to find those specific antigens, the things triggering the immune response. A gluten free diet is very important because gluten is one of those foods that is inflammatory as I stated in the beginning. 

Healing leaky gut or intestinal permeability will be important too but we can discuss that in another podcast if I haven’t covered it. I don’t remember what I did yesterday hardly and being 38 episodes in, I cannot remember from week to week what I have covered. 

Thanks so much for listening. Again, if you could leave me a review on iTunes, I would really appreciate it. 

I am on a social media break and not sure when to return. I am checking the Help For Hashimoto’s facebook group once a day, otherwise I’m avoiding all social media.  

If you have a question, you can email helpforhashimotos@gmail.com or you can go to my website and fill out the contact form. 

Have a comment or question about this episode? Leave it on the blog post on my website helpforhashimotos.com under episode 38. I’d love to hear from you. You can also get my free ebook 5 Things Your Doctor Won’t Tell You About Hypothyroidism while you are there. You’ll get a weekly recipe and some nutritional nugget of information each week. 

I’m taking new clients right now so if you are in need of help navigating your autoimmune disease and especially Hashimoto’s, I am here to help. You can reach out to me on my website. You can make an appointment for a 15 minute free call to see if we are a good fit for working together. 

Until next week my friends. 

Can hypothyroidism affect your heart? Episode 37 Help For Hashimoto's

Welcome to episode 37. Thanks for joining me. Today I am diving in to our heart health and what it means to our heart health when we are dealing with hypothyroidism. 

Do you have: 

High or low blood pressure?

Fast or slow pulse?

Irregular heartbeat?

Heart skips a beat?

Palpitations

High cholesterol?

Heart Disease, plaque buildup, heart attack?

These are all things that can be affected by thyroid disease. 

Our heart uses thyroid hormone. Our heart is affected by changes in our medication or by the amount of medication we are taking. It is affected by low levels of T3. How many of you have a doctor that will only test TSH? 

This could be affecting your heart. 

When you don’t have enough thyroid hormone your heart can beat too slow or it can beat irregularly meaning it can flutter or miss beats. Long term consequences of this is that your tissues don’t get enough oxygen or nutrients which will make you feel physically bad. Our heart and the entire cardiovascular system is dependent on adequate levels of T3 for proper function. T3 helps improve how the heart contracts so when you are low you will have less cardiac output. Cardiac output means the amount of blood the heart pumps through the circulatory system in one minute. 

You can also end up with plaques developing in your arteries and high blood pressure. Hypothyroidism can effect how blood is pumped in and out of the heart, how the lining of the arteries functions, cholesterol levels in the blood and more. Low T3 can increase the amount of cholesterol and fat circulating (technically called lipids) in the blood.

T3 is the main regulator of gene expression in the heart muscle. Gene expression means how genetic information is transferred in the cells of the body. It is the effect of a gene on the body.  It is thought that low T3 levels are associated with increased death in patients already dealing with heart disease. 

Hypothyroidism is associated with higher cardiovascular risk factors. This means that we have a higher chance of cardiovascular disease. The heart cells do not convert T4 in to T3 very well if at all so if T3 is low then the heart tissue feels the effects and doesn’t function as well as it should. 

Treatment with thyroid medications is supposed to improve all risk factors but the problem is if you are treated with T4 only medication and you are not converting T4 to T3 for whatever reason, you may be at higher risk for issues with your heart. 

There are not a lot of randomized controlled studies in this area but hopefully some will be done soon. 

Bottom Line:  Hypothyroidism affects the whole body. It has a negative impact on the heart and almost everything else when it isn’t treated. 

You might hear from your doctor that NDT like Armour or Westhroid etc will cause a high heart rate. If this is the case for you then you must look at your adrenal health and/or iron levels. If you have high reverse T3 which is usually the case with cortisol or iron problems or even chronic inflammation you can see an issue with your heart rate.  You could have a high heart rate if you are having a flare up of Hashimoto’s where tissue is being killed off and thyroid hormone is being released. 

If you think your medication is causing heart palpitations, discuss it with your doctor and you may also want to try to take it in smaller doses. I am currently on Armour which my body doesn’t love as much as the compounded thyroid powder so when I take one whole pill I get palpitations throughout the day. I have to take half a pill 4x a day to get my body used to it. I also have adrenal issues and low iron which is not super responsive to iron supplementation so once those things are fixed, I should be good. 

OK.  I want to explain more about heart disease so you know what you are dealing with and how you can optimize your life choices so you can give your heart a fighting chance. 

Heart Disease or Coronary Heart Disease are conditions that affect the heart muscle, valves or rhythm. 

Cardiovascular Disease are conditions that affect blood vessels- usually that they are narrowed or blocked which can lead to a heart attack. 

Heart disease is caused by atherosclerosis- a disease of the arterial wall that leads to the narrowing and obstruction of the artery. The narrowing is because of sclerotic deformation of the artery and the development of raised patches called atherosclerotic plaques in the inner lining of the arterial wall. Depending on which organ in the body the artery feeds, atherosclerosis in those arterial walls will impair blood flow to that organ. 

The two major types of Coronary Heart Disease are angina pectoris and myocardial infarction (heart attack). 

AP happens when the space inside the coronary artery is narrowed but not closed off completely.  At rest your body will be able to deal with less blood flow but any physical activity will cause the heart to have to work harder, the artery with the build up can’t supply enough blood to feed the heart muscle which can result in a gripping chest pain that can radiate to the neck and usually the left arm. 

Heart Attack or MI happens when the coronary artery closes up all the way and blood flow to the heart muscle stops. This causes a portion of the heart to die or causes death. 

About half the people who have a heart attack die in the first 2-3 hours and if you make it through a heart attack will take some time to recover and may suffer complications such as an abnormal heartbeat. 

How do we prevent these conditions?

We first prevent the build up in our arteries- the atherosclerosis. 

We avoid: smoking, obesity, diabetes, high blood pressure, physical inactivity, stress, anxiety, anger and the big ones- poor sleep and the standard American diet (SAD). 

For 60 years or more we have been told to avoid fat and cholesterol in our diet. To eat margarine and cook with vegetable oils. That we need to be on statin drugs to manage our cholesterol. 

We can thank the Diet Heart Hypothesis which states that dietary fats, including cholesterol, cause heart disease. A correlation was shown in a diagram of 6 countries (carefully selected out of 22 countries that had the same data available) that fat consumption and death from heart disease were related. When all 22 countries were put in the diagram the correlation between fat and heart disease wasn’t plausible. It actually shows there is no correlation at all between fat consumption and dying from heart disease. 

A lot of money was thrown at scientific research in the US to prove this correlation to be true. The data that did not support the hypothesis was thrown out and the data that did was promoted and advertised. Studies in other countries that were done were proving this hypothesis to be wrong. 

Many of the studies proving the correlation between dietary fat and increase in heart disease or death were funded by companies that proved to benefit from this idea that fat is killing us. We were being sold a false bill of goods and we have been believing it and paying for it with our health for years. 

Is cholesterol really a bad thing?

The short answer is no. 

The longer answer-  We will die without cholesterol. Our bodies are made of billions of cells and almost every one of those cells produces cholesterol all the time. Why is this? Every cell uses cholesterol for structural integrity. 

Saturated fats and cholesterol are used by our cells to make the cell walls firm. If they are flabby and fluid we would be structured like a worm. 

Cholesterol is needed in different amounts all over the body depending on the purpose or function of the cell in that area. 

Protective barriers like our skin will have much more cholesterol because we need a strong sturdy barrier to protect us from any invasion. If a cell needs to be softer and more fluid it will have less cholesterol. 

Our cells communicate with each other and and transport molecules in and out of the cells-they need cholesterol and fats to do that. 

Our brain uses about around 25% of all the cholesterol in our body. 

Most of the cholesterol in our body does not actually come from the food we eat. Many studies have been done to show that dietary cholesterol does not have a huge effect on the cholesterol in our blood. 

Our body was made to make it on its own. It makes about 85% of our cholesterol and the rest comes from food. When we eat more foods containing cholesterol our body makes less of it. We eat less of it, our body makes more. 

Low cholesterol has been shown to produce emotional instability,  problems with behavior, aggressiveness, violence, low self control and more.

Sex hormones are made from cholesterol too- low libido, adrenal issues, high or low estrogen etc. 

Our liver produces much of our cholesterol and regulates its levels. 

When our skin is exposed to sunlight, we make vitamin D from cholesterol. 

Why do some people have high cholesterol and others don’t? Why will it be higher when we are under stress or have surgery? Why is it higher in winter and lower in summer?

Cholesterol plays a healing role in our body. It goes up when we need something to be healed. It’s higher in the winter because we have less sun exposure. 

Damaging molecules end up in our blood stream and we have this layer of cells in our blood vessels that can be damaged by things going through our blood. These cells send a message to our liver that there is damage. The liver makes cholesterol and sends it to the damaged area in the form of LDL cholesterol to repair the damage. Once the damage is repaired/the wound is healed it goes back to the liver in the form of HDL.

If you have high LDL cholesterol you should be asking, what is causing damage in my body instead of how do I lower my cholesterol. Get to the root of the problem and the cholesterol will take care of itself. 

Atherosclerotic plaques in your body are sources of inflammation in the body. Inflammation is the way our body responds to any injury. It is there to get rid of whatever is causing the problem so the body can begin to repair itself. 

Plaques in your arteries are the body's attempt at dealing with chronic, never ending damage that has been done to the blood vessels. The body is basically forming scar tissue in your arteries. 

What causes all of this?

Processed foods is a big one, poorly managed blood sugar and sugar in the diet in large amounts. Remember that women should only have around 22grams of sugar per day and men should only have 24 grams per day. High blood sugar on a regular basis creates an inflammatory environment within the body. 

Really quickly- some other things that cause inflammation in the body are the chemicals in products we use everyday- personal care products, household products, prescription drugs, exposure to smoke and pollution, pesticides, chlorine, microbes and parasites and even disrupted gut bacteria. Certain nutrient deficiencies, lack of sun exposure, no exercise and high stress are also big problems for our health in general but also in managing inflammation in the body. 

How do we manage to have good heart health and good cholesterol?

Consuming high quality healthy fats: 

Note it is NOT any particular fat that is good or bad but the way it is processed that makes it bad for us. 

The types of fats we need to know and understand: 

Saturated fat: a stable fat, doesn’t go rancid easily and our body can make it so it is considered non- essential. It is usually solid or semi solid at room temperature. 

Monounsaturated fat: pretty stable fat, won’t go rancid easily, our body can make it so it is considered non essential. Liquid at room temperature but if refrigerated should become somewhat solid. Found in olive oil, olives and oils from almonds, pecans, cashews, peanuts and avocados. 

Polyunsaturated fat: very unstable, goes rancid easily, never heat them or cook with them. Always in a liquid state, even if refrigerated. Two of these are considered essential meaning we have to get them from the diet. Flax and other seeds, nuts and fish and fish oil. Omega 6 and 3 are from these types of fats. 

All fats and oils are a combination of these three types of fats. They are categorized by which fat is most prevalent. 

We need all three types of these fats in order to have proper function in the body and to make sure that we can manage any inflammation in the body. 

We must have good digestion, proper liver function, zinc, magnesium, vitamin B6, vitamin E and C in order to have proper repair of inflammation in the body. 

Consume a mixture of about 30% saturated fat, 10% polyunsaturated fats (Omega 3 and 6) and 60% monounsaturated fats like olive oil as a very general guideline: 

  • Animal fats from pastured, well raised animals if possible

  • High quality butter such as Kerry Gold, Organic Valley or a locally made butter

  • Ghee which is the butter fat with the whey removed- used in Indian cooking a lot

  • Coconut or Palm Oils

  • Cold Pressed extra virgin olive oil

  • Other cold pressed oils from nuts or seeds

Cold pressed oils are expensive and more difficult to make. They are the most fragile oils as they are easily damaged by light and heat. They are the seed oils and oils made from nuts. Canola oil is a seed oil and is processed with high heat, chemicals and is a rancid and damaged oil before it hits the grocery store shelves where it then sits on a shelf exposed to light all day long- remember seed oils are polyunsaturated and are damaged by light and heat. 

Avoid hydrogenated fats, partially hydrogenated fats and those highly processed “vegetable” oils and of course trans fats. 

Other things that can be helpful: 

Vitamin C can help the body repair itself when under stress or when other factors are present that might otherwise cause damage to the lining of the blood vessels. Best choice is whole foods that are high in vitamin C (listed in order from highest amount of vitamin C per serving to lowest) like papaya, bell peppers, broccoli, brussels sprouts, strawberries, pineapple, oranges, kiwi, cantaloupe and cauliflower. 

Staying well hydrated will keep your blood free flowing and thinner. The thicker and more viscous your blood is, the more damage can be done to the lining of your blood vessels because there is more friction. Aim for about half your body weight in ounces a day but no more than 100 oz a day. That is a lot of water and even I find it tough to get that much water in each day. 

Cardio Protective Nutrition: 

  • Consuming and digesting animal proteins which are the best source of vitamins A, D and the B vitamins. 

  • Again, vitamin C

  • Potassium- helps us maintain healthy blood pressure. Fruits and veggies in general but Swiss Chard has 1000mg of potassium per serving. Recommended amount is 4700mg per day. 

  • Fill your dinner plate (and lunch and breakfast plate) with vegetables, especially cruciferous veggies like broccoli, cauliflower, cabbage, brussels sprouts

  • Consume wild caught fish, pastured eggs

  • Fermented foods like sauerkraut, kimchi, fermented pickles, miso or natto

Lastly, high cholesterol in the elderly population is associated with longer life and life expectancy in general increases with higher cholesterol. Cholesterol is protective against infections, lower cholesterol levels associated with memory issues. 

Okay. That is it for today. Thanks for listening. Please leave me a rating and review on iTunes so more people can find the podcast. Let’s get as many people as possible the information they need to heal. 

Have a question or comment about today’s episode? Head on over to helpforhashimotos.com and ask it on this weeks episode blog post. Search for Episode 37 and you will find a transcript of todays episode. 

Need help figuring out how to navigate your thyroid condition? I am taking new clients right now and would love to help you out. Go to my website and fill out the contact form. 

I’m taking a facebook break. I will be checking in to see if anyone wants to join the Help For Hashimoto’s facebook group but beyond that I am trying to stay off it. I’m not a fan of putting out a bunch of content there when Facebook owns it all. 

I am focusing more of my energy on putting really good content out in my newsletter and here on the podcast so if you have a topic you want covered contact me through my website. 

I forgot again to send the lunch ideas in my newsletter. I’m so sorry about that. I was pretty stressed out last week with lack of sleep and worrying about passing the grad school entrance exam. I got a middle of the road score which is what my school was looking for so it looks like I’m going back to school at almost 48. Am I crazy? I don’t know. I am little scared though. it is kind of daunting to be a student at my age. I am also freaking excited to learn about functional medicine! More excited than scared the more I think about it. Maybe it will be fun for you all to learn along side me! 

Go sign up for my newsletter. For sure each week you will get a new recipe to try and so far the feedback on the recipes I’ve sent out has been really good. 

All right, see you next week! Take care! 

https://endocrinenews.endocrine.org/hypothyroidism-and-the-heart/

https://www.ncbi.nlm.nih.gov/pubmed/17923583

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512679/

https://www.ncbi.nlm.nih.gov/pubmed/17093250

Episode 34 Adrenals and your medication

Welcome to Episode 34. I’m so glad you are here. Today we are talking about adrenal health and why it is soooo important to have healthy adrenal function when you have hashimoto’s or other thyroid conditions. 

The adrenal glands are little walnut sized glands that sit right on top of our kidneys. We would die without them, they are that important. These little glands help us deal with stress in our every day lives and with chronic stress which is a part of most people’s every day lives. 

Your ability to be resilient, have energy and endurance all depend on our adrenal glands ability to do their job. They secrete cortisol, adrenaline (epinephrine) and noradrenaline (norepinephrine) and impact how your body uses carbohydrates and fats, how well you convert your food into energy and if your body will store fat, how your blood sugar is managed, and helps your cardiovascular system and gastrointestinal system work as they should. 

The adrenal glands also make your sex hormones after menopause and andropause. They have anti-inflammatory properties and help to minimize the effects of alcohol, drugs, foods and toxins. 

All this said, they are pretty important and they manage a lot of stuff in our body which means they can “wear out” or become fatigued. This is what many now call HPA axis dysfunction or dysregulation. 

Basically this means that when our body perceives a stressful event our brain signals our adrenal glands to release cortisol, adrenaline or noradrenaline to deal with the stress. 

As this happens more often in our body due to chronic stress, food sensitivities/allergies, inflammation, mismanaged blood sugar etc., our adrenal glands become less able to recover and respond again and they become depleted. The adrenals are not able to respond and this affects all parts of our body in a physiological way. 

This disrupts how much cortisol is released and when it is released which will affect our sleep patterns as well as the production of some hormones and neurotransmitters but not necessarily the levels of cortisol put out by the adrenals. 

It is the brain that signals the adrenals to release their hormones, the adrenal glands don’t do it on their own, so it is believed that the problem is in the brain and the signaling in the nervous system. 

The package insert for your thyroid medication will specifically state that you should not use your medication. Here is what the package insert says for Synthroid (Armour says something similar)

  • Do not use SYNTHROID if you have uncorrected adrenal problems.

  • Taking too much levothyroxine has been associated with increased bone loss, especially in women after menopause.

  • Once your doctor has found your specific SYNTHROID dose, it is important to have lab tests done, as ordered by your doctor, at least once a year.

  • Foods like soybean flour, cottonseed meal, walnuts, and dietary fiber may cause your body to absorb less SYNTHROID from the gastrointestinal tract. Grapefruit juice may cause your body to absorb less levothyroxine and may reduce its effect. Let your doctor know if you eat these foods, as your dose of SYNTHROID may need to be adjusted.

  • Use SYNTHROID only as ordered by your doctor. Take SYNTHROID as a single dose, preferably on an empty stomach, one-half to one hour before breakfast.

What does this mean for you?

Here is a list of symptoms that will tell you if you are having an issue with your adrenal health:

  • You tend to be a night person

  • You have a hard time falling asleep

  • You are a slow starter in the morning

  • You might feel keyed up and have trouble calming down

  • Your blood pressure is higher than 120/80

  • You get a headache after exercising

  • You feel wired after drinking coffee

  • You clench or grind your teeth

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

  • You get dizzy if you stand up too fast from sitting/lying 

  • You crave salt

  • You have afternoon yawning, afternoon headaches

  • You have a tendency towards shin splints 

  • You tend to need sunglasses outside even if it isn’t sunny


You may also see lab work that shows high T3 yet you are feeling like you are still hypo or if you are on a natural desiccated thyroid medication and just not feeling well or you’re having symptoms that make you feel hyper like heart palpitations, racing heart or even anxiety. 

This can be because the cells are not getting the T3 and it is just sitting in your blood stream which can cause the feeling of anxiety or a racing heart among other things. 

Your thyroid function often is affected by how well functioning your adrenal glands are. 

Chronic adrenal stress will affect how your brain is able to tell the adrenals to work so they will have extra output of adrenal hormones at certain times and at others you will have very little leading to the symptoms listed earlier. 

When your adrenals are not functioning well, aside from keeping T3 from getting in to the cells, you will also have trouble converting T4 into T3, your cells can become less sensitive to your thyroid hormones which is probably what is happening when your T3 is high yet you feel hypo. 

Hashimoto’s can be triggered by chronic adrenal stress because adrenal stress will wreak havoc on the immune system which can result in the antibodies against your thyroid being made. 

What causes adrenal stress? 

So much. 

Your diet- consuming too much processed food, too much sugar and having food intolerances or food allergies. Your adrenal glands, cortisol especially, play a major role in blood sugar management. Food intolerances cause inflammation and an immune system response so continually eating foods you “shouldn’t” will cause an issue for your adrenals and can raise reverse T3 which means your body is converting your needed free T3 into Reverse T3 leaving you feeling hypo. 

Your body makes less Progesterone which is needed to even out the effects of estrogen in our body when we are dealing with chronic stress. 

Too much estrogen in your body binds up your thyroid hormones in your blood. High cortisol contributes to estrogen dominance in your body. 

Your adrenal function is affected by your ability to deal with stress of all kinds. We turn on that stress response when we: 

Don’t get enough sleep. Sometimes we can’t control getting enough sleep if we work a night shift or we have young children or whatever. Being deprived of sleep is not good for your adrenal health which isn’t good for your thyroid health. 

Make sleep a priority. Sleep in a dark, cool room. Go to bed at the same time every night and wake up around the same time every morning. This will help to reset your internal clock and will help you sleep better and deeper in the long run. Also, keep electronics out of your room, wear the blue blocking glasses after the sun sets- this will help increase your melatonin production allowing you to feel tired but also fall asleep. 

Do something to help deal with mental and emotional stress. Therapy, meditation, journaling. Find what makes you feel better and do it. Lose the things in your life that are contributing to your stress. Sometimes we have to see less of those toxic people in our lives. Take care of you first. You are no good to anyone else if you are not well cared for first. 

Manage your blood sugar! So important. This is second in importance to sleep. If you want to see improvements in your hashimoto’s or adrenal issues then you have to manage your blood sugar. Consuming large amounts of sugary processed or high refined carbohydrate foods will affect your adrenal health for the worse. Even consuming too much fruit at one time can be hard on your blood sugar. If you get hangry then you have an issue with blood sugar. If you wake up between 1 and 3 am then you have an issue with blood sugar. 

Inflammation in any form will stress your adrenal glands but most especially the chronic inflammation that most of us with hashimoto’s are dealing with. Chronic inflammation is increased by all the things I have just talked about along with things like parasites or infections you might not be aware you have. 

Exercise, gently. Autoimmune Strong is a good place to start. They have the most gentle exercise program I know of for chronic illness and it won’t tax your adrenals. 

Your thyroid health and your adrenal health go hand in hand. If one is not working well, the other one won’t be either. 

You can have your cortisol levels tested by a salvia test that measures your levels throughout the day. It will give you a good picture of what time of day you are lacking or having too much cortisol and then you can make a plan with your practitioner to fix it. I don’t recommend doing this on your own.  You might not find a conventional doctor who would test this or even know what to do with it so it might be a good idea to find a functional medicine practitioner who can help you. 

Some things you can do on your own to help your adrenal function are: 

Eat protein and fat at every meal, including the first meal of the day and do so within an hour of waking. This will make your blood sugar stable and your adrenals won’t have to get busy raising your blood sugar right away in the morning. Eating protein and fat in the morning will also help keep your blood sugar stable all day. 

Until your body starts to get back on track, you may need to eat some protein every few hours to help stabilize your blood sugar. If you are dealing with insulin resistance or blood sugar issues, this will help your body adjust and remain in a stable state. If you tolerate a small amount of nuts, seeds or eggs or even a can of tuna or sardines. These would be great options for you. A protein shake made of just a single ingredient protein powder (I like Designs For Health Pure Paleo Protein Powder) or even high quality beef jerky. 

You will need to figure out how well your body tolerates the starchy or more sugary carbohydrates. As I have said before, I don’t tolerate starches well, especially at lunch time so I tend to have a small amount at dinner which helps me to sleep better. If you feel sleepy after eating you know you have eaten too many carbs. Avoid grains, potatoes, sweet potatoes, winter squashes, parsnips, beans and sugary things.

Avoid fruit juices and instead consume the whole fruit so the fiber keeps your blood sugar stable by slowing down how quickly your body absorbs the sugar. 

Avoid coffee or caffeinated teas, no decaf coffee either- it usually has some caffeine in it. These stimulate the adrenals- if you are dependent on caffeine to get you going in the morning, you likely have some adrenal issues. 

Eat lots and lots of vegetables, high quality protein and high quality fats. Stick to a palm sized portion of protein, a thumb sized portion of fat and fill the rest of your plate with veggies- greens, fibrous veggies like broccoli, cauliflower, cabbage, asparagus, brussels sprouts, carrots, celery, radish, onion, garlic and so on. 

Find out if you have sensitivities to foods and eliminate them. An elimination diet is particularly helpful and a cheap way to figure out which foods cause inflammation in your body. 

Don’t fast if you are dealing with any blood sugar dysregulation and/or adrenal stress. This will only make things worse. You may want to stick to a 12 hour window of opportunity for eating and make sure you are eating enough. You need more than 1200 calories to sustain yourself and to ensure your body can heal. Eat until you are full and satisfied- this will ensure you don’t have blood sugar issues as long as you are eating as suggested. 

You may want to supplement with magnesium. It is needed for so many biochemical reactions in the body and the adrenal glands are no exception. Magnesium can act like a spark plug in the body and stress depletes it. Magnesium citrate can be found in a product called Natural Calm which is readily available. It can loosen your stools though so be aware of that and back down how much you take if you need to. 

B vitamins are essential for your body and play a role in energy production. A high quality B complex is recommended. Know your source when you buy it. I don’t recommend Amazon as a place to buy supplements. 

Vitamin C is good for your adrenal glands but it also stimulates the immune system so if you are dealing with high or elevated antibodies for thyroid, you might want to be cautious. 

Licorice root is great for sluggish adrenals. It is stimulatory so don’t take it after 1 or 2 pm. It can increase energy and endurance and helps to manage low blood sugar issues. 

Ashwaganda is an herb that is known as an adaptogen which means it will help your body get or stay in a more balanced state and it can help stabilize your cortisol if it is either too high or too low. It is also a nightshade and can be inflammatory to some or stimulate your already overactive immune system. 

Ginger root also helps to keep your cortisol levels even and balanced. You can make a tea by grating 1 teaspoon of ginger and let it steep in hot water for about 10 minutes. You can strain it or just drink it. 

I think this is a good place to stop. Thanks for joining me. Have a question about your thyroid or how to manage it? Go to my website- helpforhashimotos.com and fill out the contact form. 

Please leave a rating and review on iTunes so other people can find the podcast and be helped. There are 14 million people just in the US that are diagnosed with Hashimoto’s. That is a lot of people. The more you share about the podcast, the more people that can be helped. I’d really appreciate your help on that. 

You can find me on social media at stephanieewalsntp on instagram and at Out of the Woods Nutrition-Help For Hashimoto’s on facebook. I also created a facebook group for the podcast called Help For Hashimoto’s which is a positive support group but all the action is happening in my newsletter where I send out recipes and tips for living well with Hashimoto’s. You can sign up on my website. I was thinking of making a grocery shopping list or a guide to understanding your thyroid labs to give you when you sign up for my newsletter. Will you let me know which one you prefer?

Talk to you soon! Have a great week! 

Help For Hashimoto's Episode 33 Perimenopause and Menopause with thyroid issues

I'd be interested in hearing you discuss hashimoto’s and thyroid medication during perimenopause and menopause, and/or how those hormones can affect your thyroid and the way your body absorbs thyroid medicine. I'm 51 with Hashimotos, Armour Thyroid (90mcg), with levels considered normal by the endocrinologist. 

I am gluten and dairy free and eating well. But I still struggle with constipation, weight gain, insomnia, facial puffiness etc--hypothyroid symptoms. In November I had the first period that I have had in about 8 months. In the weeks after that, everything seemed to be in good working order...lost the weight, digestion was great, puffiness went away. Now a few months later (with no periods), all those same symptoms are returning.

I had been on Armour from June until I saw the endo in November .  I saw the endo on 11/19 and my TSH was 4.6, Free T4 0.81 (those are the only ones they gave me and there isn't a patient portal where I can peek at others that might have been taken).  

They advised me to go up to 90mcg at that time as he likes the TSH lower.  The period that I had was on 11/13 and so when I saw him everything was going GREAT...had dropped 6 pounds without trying, sleeping well, digestion good.  Have been on 90mcg since November and am creeping steadily upwards, digestion sluggish, insomnia, etc.  Ahhh!

Michelle. 

Thanks for your question Michelle- it is quite likely there are hundreds of thousands of women in your shoes. Before I forget to mention it- work with your doctor to at minimum add in a Free T3 test. TPO and TgAb antibodies tests and Reverse T3 would also be helpful. 

This is a complicated issue and I can give you some good general information but as with everything- we are all bio individual so you will have to experiment to find what works for you. 

Women start to make less estrogen and progesterone as we near our 40’s. This alone can trigger our thyroid to slow down. It sounds like you might be on a hormonal roller coaster here which is totally possible as you approach menopause. 

I like seeing that your endocrinologist likes to see your TSH lower than 4.6. Ideally it should be around 1-2. But upping your medication might not be the solution. That is not to say you shouldn’t take it as prescribed- I’m just saying there might be things you can do that will allow you to take a dose and stay there without having these fluctuations like you are. 

You say you are eating clean and gluten and dairy free. That sounds good, but what does clean eating mean to you? 

How much sugar or starchy foods are you eating? Once we hit a certain age, those starchy carbohydrates can be a problem for some of us when we are looking to maintain or lose weight. 

Those of us with hypothyroidism whether caused by Hashimoto’s disease or not can encounter issues with insulin resistance. Our body cannot process and tolerate sugars like it used to- my body certainly can’t. This means that you will have to be very mindful of what you are putting in to your body and even what time of day you do it. 

Maybe you feel tired an hour after eating lunch- even a paleo style lunch. If it had some starches in it, and you are feeling tired- like a sugar crash- then you likely are not tolerating starchy carbs at that time of day. 

If you struggle with sleeping- falling asleep or staying asleep a bit of starch in the evening meal might help you sleep better. The only way to know is to try it for a couple of days. 

Let’s talk about what perimenopause and menopause are before we dive in to what might be happening with you. 

During perimenopause (the 2-12 years before you reach menopause) 

It can start in your late 30’s but is more commonly occurring in your 40’s. You can have hot flashes, sleep problems, mood swings, and heavier than normal periods (this part is the worst if you ask me) and these symptoms can wax and wane for a good 10 years. 

Your estrogen during perimenopause will be fluctuating significantly to the point that you will have more than you’ve ever had circulating through your body at some times and other times it might be low. It is much like the blood sugar roller coaster but is called the perimenopause roller coaster. 

Symptoms include: 

  • heavy flow that is new to you or longer flow (high estrogen)

  • cycles that are less than 25 days long

  • changes in breast tissue: lumps, sore, swollen (high estrogen)

  • waking in the middle of the night and you didn’t before

  • worse or more cramping

  • start of night sweats, especially before a period (low estrogen)

  • migraines that are new to you or are worse

  • mood swings before a period (high estrogen)

  • gaining weight without changing what you are doing

You may have some or none of these symptoms. About 20% of us will have dramatic changes during perimenopause. The rest of us are lucky to have minor issues. 

Progesterone is gradually lost during this time which is kind of like a cruel joke from mother nature because it is the progesterone that helps counteract the affects of estrogen. 

It also helps us deal with stress and the loss of progesterone makes us feel more anxious, depressed and have poor quality sleep. 

Managing your diet and allowing some self care. 

  • Don’t kill yourself in the gym- over exercising or doing too intense of a workout will affect your energy levels for days to come, especially if your adrenal glands are worn out or confused about what to do for you

  • Learn to let stuff go- like dishes and cleaning the house. 

  • Avoid alcohol- this alone can wreak havoc on your hormones at this stage in the game. It keeps us from getting rid of that excess estrogen AND lowers progesterone.

  • Manage your blood sugar. Journal your food so you can see just how much starchy food and sugary foods you might be eating. 

  • Take magnesium- it calms our brain, helps us sleep and regulates our brain communication with our body

  • Exercise gently, especially if you are dealing with Hashimoto’s. Autoimmune Strong is a great place to start. 

If you are dealing with heavy bleeding, you need to avoid dairy which Michelle already is, avoid alcohol, eat fermented foods and lots of veggies to help keep your gut bacteria healthy. Gut bacteria clear estrogen from your body and so does fiber so eating more veggies than you already are can be really helpful. I also find my energy to be better when I eat more veggies- like 7-8 servings or more a day.  

If your hypothyroidism is not being managed well (meaning your TSH and free T3 are not optimal)  then you may have heavier periods as well. Work to get your TSH around 1-2 and some doctors think it is okay if it is a little below one (.3 to .5)— especially if you are on a natural desiccated thyroid hormone replacement- When T3 is optimal you might find a suppressed TSH. Finding a doctor that will allow your labs to look this way is another story. 

Also keep in mind that you might feel great at a TSH of 2 and someone else might feel good at .3. This is bio individuality. It is so important to know your body and learn how to tell when things are off. 

Your thyroid medication may need to be adjusted seasonally too. If you live in a climate with winter- even all for seasons then your TSH may rise in winter and fall during summer. Another reason to really be in tune with your body and its signals. 

Part of my job as a Nutritional Therapy Practitioner is to help you learn how to do this. 

Menopause starts one year after your last period and symptoms should be better. 

You will have much less estrogen and progesterone at this point. Your adrenal glands will be making estradiol in your cells and this is supposed to be enough to keep you feeling good. BUT- if your adrenals were taxed for years before this happens then you may have some issues. 

Your endocrine system is made up of the pineal and pituitary glands in your brain, the thyroid and parathyroid glands, the Thymus (works with the immune system), Adrenals glands, pancreas and your ovaries. All of these work synergistically together as a system and when one is off, they will all be off. 

You can’t just take a supplement for your adrenals and think that it will fix your issues. It will help in the short term but it is a band-aid and not getting at the root cause of your problem. 

If you have gained weight around your middle, you are more than likely dealing with insulin resistance. This means that your cells are not accepting glucose or sugar from insulin as it travels through your blood stream to bring your cells sugar. Your liver and your muscle cells are not accepting the sugar so it just stays in your blood stream and eventually gets transported to fat tissue for storage. This is why we gain weight.  

The best way to combat this is to quit sugar completely. No dessert, no sweet anything. Every time you eat sweets it makes your insulin resistance worse. Even fruit- so keep your natural sugars to below 25 grams of fructose

High fructose corn syrup in soft drinks is 55% fructose, sugar cane is 50% fructose and honey is 40% fructose. Eight ounces of orange juice has 18 grams of fructose.  So pay attention to what you are eating. If it is sweet tasting, it is likely contributing to your weight at this point. 

Starchy foods like potatoes and rice are mostly glucose and very little fructose but you might find you still have a problem with those as well and will need to test your carb tolerance with a glucose monitor. Start with sugar though. It is more important at this stage to remove sugar from your diet and then look at the starches. 

Hormone fluctuations during perimenopause and menopause can affect how your thyroid functions. 

You might end up with estrogen dominance (the highs on the rollercoaster) which can keep thyroid hormone from attaching or making their way into the receptors on your cells. This means your cells are not getting thyroid hormone creating hypothyroid symptoms. 

Thyroid hormones are similar in chemical make up to estrogen. Too much estrogen or eating too much soy can block the receptor sites as well leaving you with less thyroid hormone in your cells and hypothyroid symptoms. 

As we lose our progesterone, we may see or feel a need for more thyroid hormone. We need progesterone to get T3 which is what our cells use and need. 

Our thyroid naturally slows down as we get older and therefore will not be able to get enough hormone to our cells affecting not only our energy but creating all the other symptoms we have talked about before. 

If you are dealing with chronic stress, and most of us are, this will also affect our ability to make enough thyroid hormone. 

When your thyroid is not working optimally or you are not medicated optimally, all of your hormones will be disrupted. 

It will be important to know if you are in menopause or if you’re having a thyroid problem. If you take estrogen thinking you are in perimenopause or menopause and it is actually your thyroid causing the problems, you might end up feeling worse and the estrogen will affect your thyroid function. Vicious cycle as with so many things in our body. One can’t work well without the other. 

If you have crazy periods during your 30’s and 40’s it is more likely an issue with thyroid than perimenopause. Thyroid problems are often the cause of early perimenopause. I’m a textbook example of this. 

They make the symptoms of perimenopause and menopause worse, affect blood sugar, make you depressed, affect your ability to handle stress. 

You have options: 

  • start with journaling your food to pinpoint

    • are you eating enough

    • are you eating too much sugar

    • is your ratio of protein fats and carbohydrates where it should be

    • are you eating a lot of processed foods or a whole foods diet?

  • exercise

    • reduces hot flashes

    • better mood

    • lessens depression, less anxiety

    • higher sex drive

    • sleep is better

    • more energy

    • lowers insulin resistance

    • increases bone density

    • helps manage weight

  • natural supplements- introduce 1 at a time and wait 2-3 weeks before adding another one

    • maca powder

      • will help your hormones adapt and balance as needed

      • can reduce hot flashes

      • supports the entire endocrine system, including adrenals and thyroid

      • can regulate menstrual cycles

      • can increase energy and stamina

      • don’t take it if you are on estrogen

    • soy- is supposed to be helpful as a phytoestrogen to help with menopausal symptoms. I’m not sure how I feel about this. Don’t supplement but get it in food form. I would go for tempeh and miso and NOT genetically modified. 

    • Black cohosh

      • helps to reduce hot flashes

      • helps insomnia, fatigue, anxiety, depression

      • helps with joint pain/body aches

    • Damiana- tea or tincture (2-3 ml 2 to 3x/day)

      • helpful for hot flashes, low sex drive and general well being

    • Dong Quai

      • hot flashes, insomnia, fatigue, anxiety

    • Vitamin D

      • helps regulate endocrine system

      • supports sleep

    • Chasteberry or Vitex

      • helpful for breast tenderness

      • balances progesterone

      • water retention

      • headaches, irritability, depression, fatigue

      • sleep issues

The Period Repair manual is a must read for every woman

Supplements suggested can be bought through this trusted source (my fullscript store)

Help For Hashimoto's Episode 32 Thyroid talk with Ginny and Danna from Thyroid Refresh

Help For Hashimoto's Episode 32 Thyroid talk with Ginny and Danna from Thyroid Refresh

In todays episode I am talking with Danna Bowman (Thyroid Nation) and Ginny Mahar (Hypothyroid Chef) who have teamed up to create a really cool interactive program on their Thyroid Refresh® website called Thyroid 30®. We talk about how they found each other to team up and create a positive space for thyroid patience to be supported, what some of the biggest mistakes thyroid patients make, how lifestyle choices make a difference in your recovery and more. Use code TryThy30 for $5 off their program starting January 13, 2019.

Read More

Help For Hashimoto's Episode 31

Welcome to episode 31 and Happy New Year. 

I spend a lot of time between Christmas and New Years reflecting on my year and always being really hard on myself for not accomplishing more than I did. 

I had a great year, I have good relationships with people in my life that matter and while they are not perfect and not always great, I am working hard to show up better in those relationships. So here is to a new year full of health and great possibilities in all areas of my life and in yours too. 

I am really grateful you are here. 

I teach a class called The RESTART Program as a Nutritional Therapy Practitioner and it falls right in line with the subject matter of today’s podcast. I am discussing managing blood sugar in relation to thyroid health. They go hand in hand and one out of balance puts the other out of balance. 

My class is all about managing blood sugar and about Restarting with a new outlook on food and nutrition. It is a real food sugar detox where you learn how to eat real food to manage your blood sugar, you get nutrition education and you get support from me and from the members of the class. We have a private facebook group and we meet each week for five weeks with the detox starting on the second week.

There are no shakes, no pills- just real food. This class has been life changing for so many people and I really love teaching it. Learn more at www.outofthewoodsnutrition.com/restart 

Susan O.  “RESTART® gave me the tools to reverse pain, lose weight, increase energy, and best of all, the common sense of how we should be living and eating. Thank you for helping me make a difference in my life and my family.”

Tina T.  “I came to the RESTART® class just wanting to learn how sugar affects the body. I left class feeling better and with a ton of knowledge. It’s a lifestyle change I can do. Stick with this class, you won’t regret it.”

Melissa M.  “I now understand what I need to heal myself and my family. This class changed my attitude towards food and health. If you are sick and tired of being sick and tired all the time, I highly recommend taking RESTART®.”

You can register for class now at www.outofthewoodsnutrition.com/restart  Cost is $147 for the entire five weeks and will be taught via zoom which is free for you to download. 

Okay- on to the show. 

Why is maintaining healthy blood sugar levels or keeping your blood sugar balanced so important for your thyroid?

Most if not every organ and tissue in the body needs glucose or sugar. It is what helps us make energy in our cells so if you are lacking in sugar your cells are not getting the materials they need to produce energy so your cells will not have energy, your organs won’t and you definitely won’t have any energy. 

When you have a low level of glucose, your blood sugar is low and your thyroid won’t be getting enough energy or enough sugar to turn into energy to function. It will be sluggish and not able to produce enough hormone for you. 

When you have higher levels of glucose in the blood or high blood sugar on a regular basis, you end up with something called insulin resistance. Say you eat a meal that is pretty carbohydrate heavy of maybe pasta or bread or pizza and that gets broken down into little particles of sugar. It will cause your blood sugar to rise and your body says “I’ve got to get rid of this sugar in my blood. There is too much in here and it can damage my blood vessels. So it releases the hormone insulin which is supposed to lower blood sugar in the blood by bringing the sugar to the cells so it can use it for energy production. 

The problem when we eat all that refined carb garbage is that you are eating too many carbs for your body to handle so you are dealing with this higher blood sugar issue with the quick rise of insulin to help manage the levels of sugar in your body. It’s not good and your body- your cells eventually get tired of receiving the sugar from insulin so they become resistant to it. They are like- “No more. My cell door is closed. Go away!” 

So you have this sugar with no where to go because the cells don’t want it. It is just floating around in your blood stream. But it has to go somewhere so what does your body do?

It stores it in your fat tissue or creates fat tissue to store it. 

Now your thyroid is looking for nutrients but the cells are resistant because of the insulin resistance. The cells are refusing the sugar being transported by insulin.  No fuel for the thyroid means it isn’t going to produce enough hormone for you and you feel sluggish. You might have the TSH of 5 or 7 or 9 that your doctor says is fine when you know it isn’t fine because you feel like crap. 

Now keep in mind this is a very simplified explanation of things because I want you to be able to get the idea. 

When your blood sugar is high either from insulin resistance or because you are constantly eating all day long or because you eat the Standard American Diet then you probably are experiencing some inflammation.  We are all bio individuals- where you experience inflammation may be different than someone else.  If you have inflammation in your thyroid due to autoimmune attacks or because of something else- your thyroid cells are not able to take in the nutrients they need to function well. 

Two important nutrients are iodine and the amino acid tyrosine.  If you have an inflamed thyroid, that doesn’t mean you should supplement with these two nutrients. That is a band-aid. The root cause might be the mismanaged blood sugar and you should be able to get both of those nutrients from your diet.  

Missing these nutrients through mismanaged blood sugar is one way you can get  to an autoimmune diagnosis. 

Here is the kicker. People with high blood sugar levels in their blood and insulin resistance tend to have low thyroid hormone production which will increase your TSH. When TSH goes on the rise it can make insulin resistance worse. 

I think I can attest to this- when I experimentally went off my medication I felt and actually still am pretty puffy. I ate three cheesecake flavored M&M’s last Saturday and a couple hours later had a small patch of psoriasis on my palm and the back or nape of my neck is itchy. It can mess you up. It is a vicious cycle. 

When you have a high TSH because your body can’t make enough on it’s own, as your blood sugar lowers the cells in your thyroid are affected. We need the proper amount of T3 and T4 to maintain healthy blood sugar. The more out of control our blood sugar gets, the more our thyroid can’t function properly. It is sluggish and that contributes to insulin resistance even more. 

The best way to fix this is to fix your blood sugar balance. To keep it balanced and reset things. So obviously diet is a huge factor and that is what the RESTART Program is all about. There are other things you can do as well. 

Sleep is huge. One night of bad sleep, loss of sleep can create insulin resistance in a healthy person so for those of us suffering from insomnia, you are in that vicious cycle again and so having diet dialed in will be really important. We repair our body at night and cortisol is supposed to be low at night- if you are not sleeping both of those things are going to be messed up. No repairing of tissues, and cortisol can be high which means insulin resistance and fat storage/creation. 

Exercise. When your muscles are worked or exercised and trained, if you will, they become insulin sensitive which will lower your insulin resistance. For many of us with autoimmune disease we need to go slow and I can’t recommend enough the Get Autoimmune Strong Program. Please go to the show notes and use my link to check it out so I get credit for sending you. It helps me pay for the podcast. 

A lot of experts will recommend burst training where you do something intense for 30-60 seconds and then rest for a few minutes and do it again. I am not in the place where I can handle that so if you get exhausted from working out- autoimmune strong is for you. 

You can also use a standing desk instead of sitting desk. I got one on Amazon that sits on top of my cheap Craigslist desk for about $80-$90. It was a good investment. 

Manage stress. This along with sleep is sometimes more important than eating well. That’s not to say you shouldn’t eat well but these other two are really really important. When you are experiencing a lot of stress- mental/emotional or physical, your cortisol levels go up. When the cortisol is high, your liver will create sugar to increase your insulin and again we have a cycle we don’t want to be in. 

Cortisol is in our body to give us a burst of energy to escape danger. Our primitive mind doesn’t know the difference between actual physical danger and what goes on in our mind, or even between a close call on the road and running from a bear. It is all the same to our body. So chronic stress- not good for our body fat and our blood sugar. Unfortunately, our body prefers to get its energy or sugar from our muscle rather than our fat so we end up losing muscle and getting fatter in this scenario of unbalanced blood sugar.  

So we have this high blood sugar because of high cortisol and we have resistant cells, they don’t want any more sugar so more and more sugar gets released either through you eating something because your body has told you you need more energy so you crave some kind of sugary carb food or because you are stressed so the blood sugar levels are higher and higher- your body thinks there isn’t enough sugar because the cells are refusing it and so the levels get higher and higher in the blood and that gets shuttled to fat because it needs to get rid of it. 

When you eat matters and what you eat at night matters too. When you eat before bed, if it is a carb heavy food like a cookie or a bowl of cereal, your blood sugar will be high when you go to bed and you will have a crash around 1-3 am when cortisol is released to raise your blood sugar. Ever wake with a start or have heart palpitations at that time and then you can’t get back to sleep? That is a blood sugar issue. Then you pile on lack of sleep because you couldn’t fall asleep and you have more insulin resistance. 

Eating protein at breakfast or your first meal is important to keeping your blood sugar stable all day long. If you aren’t eating protein and you have insulin resistance and issues with cortisol, your body will take what it needs in the form of sugar from your muscles- creating less muscle and more fat. 

You may need to eat every 3 hours for a short time to get your blood sugar balanced, but don’t eat a bunch of carbs every 3 hours. Eat some healthy fats and proteins with veggies to keep your blood sugar stable and then eventually you will be able to make it from meal to meal without needing a snack. Eating all the time, snacking all the time will keep your insulin levels high all day long which means more fat storage, inflammation and stress on the body and on your thyroid. 

All this stress affects your pituitary gland and TSH is secreted from the pituitary gland. When your adrenals and cortisol are working hard to manage stress and blood sugar, there isn’t much room for your thyroid to be helped out so it takes a hit and becomes sluggish or you develop autoimmune disease.  Cortisol inhibits production of T4 and of TSH (will show up as a high TSH on a lab). 

So we have a thyroid that isn’t working. This causes a decrease in the rate the cells take in sugar (glucose). The receptors on your cells don’t know what is going on so they can’t take in the right amount of anything.  Your blood sugar is out of whack and T4 and T3 are not being secreted from the thyroid like they are supposed to either. You are dealing with inflammation because insulin overproduction will also produce inflammation. 

You are dealing with a blood sugar rollercoaster here. Sometimes too high blood sugar due to a meal you ate or stress or whatever and then low blood sugar because of the rise in insulin, too much insulin which causes a crash- when you get really tired after a meal or after a bunch of sugar. Cortisol gets involved to try to fix the problem and it starts all over again. Not good. You crave the sugar to get you out of the crash. 

The solution here- besides taking my class is to heal your gut, remove some of these foods that are causing your blood sugar to be so out of control. Figure out if certain foods are causing you inflammation, get some good nutrients in to your diet. Get some omega 3 fats, fiber and protein in your diet.  You might need chromium, magnesium, cinnamon can be really helpful in lowering your blood sugar and testing your blood sugar. I am working on getting someone on the podcast who is an expert in finding your carb tolerance. It involves pricking your finger- I’m not so good at that. I have to have my daughter do it for me so I don’t mess with it- I really need to do that though. I know there are certain foods that really spike my blood sugar and the thing of that is- it can be different for everyone. You might really react to an apple whereas someone else won’t be affected at all. I’ll work on getting a good guest to help us figure that out. 

Ideally you want your blood sugar levels to stay somewhere in between 80-100. This would be on a blood glucose monitor. You can get a good picture of your blood sugar from a Hemoglobin A1C test. This will measure the sticky proteins of sugar that are attached to your red blood cells. This causes your red blood cells to become brittle and cause damage to your blood vessels. This is how we end up with plaques in our veins. 

In The RESTART Program we don’t use any sweeteners on the sugar detox. Some safe alternatives if you are going to have sugar keeping in mind that sugar is sugar and will affect your blood sugar the same -are honey, maple syrup and maybe coconut sugar. Again- these all will do the same damage if you eat too much of it. You shouldn’t be having any more than 22-24 grams of sugar a day according to the world health organization. That is not a lot when you figure 4 grams of sugar is = to 1 teaspoon of sugar. 

Stay away from aspartame, splenda and other artificial sweeteners. Some people think stevia in green powder form or the liquid drop forms are okay- I don’t care for the taste and I don’t know that my body loves them either. Some people do okay with erythritol or xylitol- they can cause bloating and irritate your gut. Avoid agave as it is pure fructose. It will for sure spike your blood sugar. 

The bottom line here is that you cannot address your thyroid without addressing your blood sugar and your diet. 

Diet changes alone can result in weight loss, more energy, better sleep, lessened cravings, better skin, and a better functioning thyroid. 

I’d love to have you in my class. Learn more or register at www.outofthewoodsnutrition.com/restart

Check out autoimmune strong here. 

Thanks so much for joining me today.  I’m glad you are here. Please leave me a review on iTunes and share this podcast with anyone you know who might be helped by it. 

I’m sending out a recipe for breakfast soup in my newsletter next week so go sign up for the newsletter on my website if you want that. It is really good. You will also get an ebook called 5 things your doctor won’t tell you about hypothyroidism. 

Join the Help For Hashimoto’s facebook group to get ongoing support from other members and from me. 

You can find me on instagram at stephanieewalsntp but all the action will soon be in the newsletter. 

See you next week! 

Study on blood sugar and hypothyroidism

Help For Hashimoto's Episode 17

ITunes Review: 

Stephanie, Thank you so much for a wonderful podcast. I love that you keep it real while answering difficult questions for us. You have a very calming and peaceful voice and I am always so encouraged listening to your podcasts. Keep them coming. We are listening and learning. 


What do you do if you forget to take your medication? 

Half life- a half life in the world of medications means the amount of time it takes for the concentration of the medication in your blood plasma to reduce by half.  Said another way- it is how long a drug stays in your system or the amount of time it takes for the effectiveness of a drug to reduce by half. 

If you are taking levothyroxine, the half life is 6-7 days and up to 9 or 10 days if you are dealing with hypothyroid conditions. If you have hyperthyroid conditions then it can be as little as three days. Nothing seems to be easy with this disease. 

Levothyroixine is a common treatment and most likely what your doctor will prescribe unless you have a doctor open or more knowledgeable in thyroid health. 

For practical purposes we will go with a 7 day half life for levothyroxine. When you take this medication, around 80% of it goes through your system over a longer period of time, like several hours. 

According to the Williams Textbook of Endocrinology, missing a day shouldn’t have a big effect on you. They also say that T4 is absorbed very well by the body so waiting an hour to take your medication before eating might not necessarily be required. Taking it on an empty stomach will give you a more stable TSH reading though. But since we all know that TSH should not be the gold standard, that maybe shouldn’t matter. 

The reason you usually have to wait 6 weeks to have your labs tested is because of this long half life. It takes about 6 weeks before your body has adjusted to a dose. 

However, if your digestion is not working well and we are going to talk about that in a minute, then you may have issues with absorption and of creation of T3 from your T4 only medication. 

There can be an issue in concentration of medication between manufacturers which can mess with your body. So, be proactive and let your pharmacy know that you do not want them to switch your medication without your knowledge. Remember that getting this dose right is like goldilocks- it needs to be just right. 

This same textbook also says that NDT is not a good choice for treatment and that TSH is the gold standard so- take it for what it is worth. 

A NDT like Armour has a half life of 2-7 days with the T3 having a half life of 4-6 hours. So if you take your medication with T3 in it at 8am then sometime between 12pm and 2pm you have about half of the original dose of medication in your system. Your cells will have used the rest of it. But it should last you about a day. This means half is gone in 4-6 hours, another half of the half (a quarter more ) will be used in another 4-6 hours and so on. 

T3 is used up faster because your body doesn’t have to convert it like it does T4. This is why it is a good idea to take a partial dose in the morning and a partial dose in the afternoon. 

Now let’s talk about what happens when our digestion isn’t working well because this is very important for our thyroid to work well. 

Thyroid peroxidase is an enzyme. It makes thyroid hormones by cleaving off an iodine molecule and adding it to the amino acid tyrosine on thyroglobulin which then makes T4 and T3. In order for this to happen, we need to have available to us: selenium, copper, magnesium, B vitamins, zinc, vitamin A. 

You should not just go and willy nilly supplement with these vitamins and minerals. There are many factors involved here and supplementing with some of these may make things worse in the long run. So it is a good idea to either do a lot of your own research or work with someone who knows how to work with your condition. 

Our gut or gastro intestinal tract is an important factor in our thyroid health but even before that, what we eat and how we break it down in our stomach is a key factor. 

Before we even talk about what you are eating, let’s talk about how you are eating it. Are you running through the drive through before or after your kids activities? Are you eating in the car or eating while you are doing something else?  Are you relaxed or stressed while you are eating?

Any of those scenarios will mean you are going to struggle with breaking down your meal before it even gets to your small intestine where most of the nutrients are absorbed. 

Digestion actually starts in the brain. We smell our food cooking and our brain signals the production of saliva so we can break down some of that food in our mouth while chewing. Are you chewing your food well? Like 20-30 chews per bite? Really breaking it down so the enzymes in your saliva can begin digesting the carbohydrates in your meal?

Once you have chewed well, you swallow and that ball of food goes in to your stomach and stomach acid and pepsin get to work digesting or breaking down proteins. 

Do you have acid reflux after eating? (there is more about this in the audio)

Once it is broken down in the stomach and reaches the right pH then the valve between your stomach and your small intestine opens and fats are broken down by the release of bile and nutrients are extracted in the small intestine and absorbed in to the blood stream. 

Here is where your gut health comes in to play since leaky gut or Intestinal Permeability are what contributes to autoimmunity. 

We need a balance of gut bacteria in our intestines to help us convert T4 to T3 there. If we are not eating right or digesting well then we will have an imbalance of bacteria and intestinal permeability. 

We can end up with parasites, overgrowth of candida and constipation- all with their own contributions to our failing health. 

When we have hypothyroid- we have a sluggish gallbladder which means we might struggle to digest our dietary fats and then we are making thick and viscous bile which further messes up the gallbladder function. When this is not working well, we are not detoxifying as well either. so we can’t break down hormones or toxins from our environment. 

How are you pooping? No one wants to talk about it but you must be moving stool through your body and going every 16-24 hours. Your BM should be the size of your forearm from your wrist to your elbow, it should come out with ease and you should feel relieved when you are done and not like you still have to go. 

Being constipated further contributes to the “bad guys” overgrowing in your Small Intestine and causing bacterial infections, you may experience chronic pain, inflammation, digestive issues, food intolerances and Hashimoto’s. 

With all of this happening, we can also have issues dumping estrogen and so it can accumulate. This can cause hypothyroidism that you won’t see on a blood test according to Datis Kharrazian in Why Do I Still Have Thyroid Symptoms. This excess estrogen will keep the thyroid hormones from getting to the cells- causing hypothyroid symptoms. 

So you see, taking supplements without first healing the gut is pointless. It is a band aid at best. The only supplement you may need at this point is some stomach acid- Betaine HCl so you can start to break down your food and get those nutrients to your cells, kill off some of the bad guys and bring things back in balance. 

You will see improvement in chronic inflammation from changing what you eat and the way you eat it. Start with your plate. With breakfast. Make some bone broth. That is the next recipe to go out in my newsletter so sign up for that. 

So reduce inflammation by cutting out gluten, dairy products, eggs, most other grains, soy products and yeast. Yeast can feed an already out of control candida overgrowth. These are some of the big allergens, in other grains it is best to avoid corn for sure. 

This gives your body a chance to calm down so it can properly react to foods. 

You need to be on an elimination diet for 3 weeks to 3 months depending on how sick you are, how inflamed, or how long you went untreated for Hashimoto’s. In addition to this, you can do something called a FIT test

What can you eat?  There are no notes for this. It’s only on the audio. 


Why Do I Still Have Thyroid Symptoms?

Against All Grain

Meals Made Simple


Help For Hashimoto's Episode 14

I was on this facebook group today for people with Hashimoto’s and autoimmune disease. Someone newly diagnosed was wondering about fatigue and being completely drained after workouts and wanting to nap even after 9 hours of sleep. I responded with take the exercise down a notch by trying to just walk for now and google the Autoimmune Protocol. Someone else responded with how they can eat what they want and exercise and that they get down sometimes and maybe a little tired but doesn’t everyone. She said she chooses to live her life, not her diagnosis.   

Article on green med info talking about using selenium and Myo-Inositol being used to put hashimotos in to remission and euthroidism which means your thyroid is working on its own. 

Selenium:

Before 1970 it was considered toxic but has since been classified as an essential nutrient needed in small amounts. It functions as an antioxidant. 

It is hard to get from foods because soil levels are varying so you never really know what you are getting especially if you are not eating local produce that is harvested in soil that is being managed properly. In the US the western part of the country may have higher levels than the eastern part with South Dakota having the highest levels and Ohio the lowest (According to Staying Healthy with Nutrition by Elson Haas.

We have less than 1mg of this mineral in our body and most of it is stored in the liver, kidneys and pancreas. Men need it more than women due to it being in their testes so it may have a function in sperm production. 

We lose selenium through eliminations and we should be able to absorb it through our intestinal tract at a rate of about 60%. This, of course will be dependent on your ability to digest your food well and also whether or not your gut is healed. We absorb it better when it is combined with amino acids- this means you have to be eating protein and breaking it down. 

Most selenium in foods is lost when they are processed like in white rice or flour. Food sources are liver, butter, fish and lamb, whole grains (out for most of us dealing with autoimmune disease), nuts- especially brazil nuts, shellfish, salmon, garlic, onions, mushroom, broccoli, tomatoes, radishes and Swiss chard can have good amounts of selenium if the soil is good where they are grown.  Many experts believe that Brazil nuts have such a varied content of selenium that we can’t necessarily rely on them. If you supplement, selenomethionine is your best bet at around 100-200 micrograms a day. Some suggest 200 mg for about a month and then a maintenance dose of 100 mg. Learn to listen to your body and if you are interested in knowing your levels, getting the plasma selenium test is ideal. Serum and whole blood will work too so if your doctor is able to test it, have them do it. 

Toxicity and deficiency symptoms are similar. Liver damage, hair loss, brittle nails with white spots and streaks. They can even fall out. These would be due to high soil levels.  If the supplement you are taking is formulated wrong, you can have muscle cramps, nausea, diarrhea, irritability, fatigue, loss of the hair and nails, pain, numbness or tingling of the hands and feet.  Deficiency will make you more vulnerable to infections, toxins, and other nutrient imbalances- again- this is where good digestion is key.  If you are taking anything to reduce stomach acid you will be deficient in selenium as well as many other vitamins and minerals. Most birth control pills will also deplete you of it as well. 

When you are NOT deficient you may tolerate cigarette smoke better as well as alcohol and poor quality fats. 

How does this relate to the thyroid? We need selenium to convert T4 to T3 which is the usable form of thyroid hormone that our cells need. Also, when TSH is produced and released, your body gets a message to make more hydrogen peroxide. This is needed to help make thyroid hormone in a round about way. It is needed to make some things happen in your body so the hormone gets made. We need antioxidants to neutralize the hydrogen peroxide after it does its job. Selenium is part of the process of helping glutathione neutralize the peroxide. 

In Isabella Wentz’s first book, Hashimoto’s Thyroiditis, she explains that if you are taking in too much iodine, more hydrogen peroxide needs to be produced which will mean you need more selenium to neutralize it. When you are already deficient in Selenium, you can end up with too much hydrogen peroxide which can cause inflammation around your thyroid tissue which creates an immune response, antibodies are produced and you have autoimmune disease. 

She recommends taking a selenium supplement on an empty stomach with vitamin E which helps our body absorb selenium better. 

Inositol 

Myo-insoitol is the same thing as inositol and is found in lots of fresh fruits and veggies so supplementing with it may not be necessary. High amounts are found in oranges, grapefruit and limes with blackberries, kiwi, cherries, peaches, apples being up there too. You can get it from brussels sprouts, beans, artichokes, cabbage, asparagus, dark greens, zucchini, bell peppers. As long as your digestion is working well you should have no problem getting enough from your diet as long as you are eating real whole foods. 

It was once considered B8 but since our body can make it, that distinction was taken away. Some still consider it to be part of the family of B vitamins though. It actually can help your body break down fats for digestion. It helps keep our cells firm so nutrients can get in and wastes can get out. It also helps brain cells work better. 

Caffeine can produce deficiency which can look like constipation, hair loss, high cholesterol and even eczema. Again, you can get enough from your diet so you don’t need to supplement. 

Link to Green Med Info article

Learn more about the nutrients our body needs here.

Help for Hashimoto's Episode 13

Q.  How do you push through the fatigue? I just want to get my life back on track.

 

Q.  I’ve got hypothyroidism/Hashimotos. Around noon I start getting tired and it can get to the point of dozing off. I've had every thyroid level possible checked and it's within normal range. We've actually checked it numerous times. I've had my b12 and folic acid checked along with my hormone levels, vitamin levels, and had a CBC done. Everything is good. I'm wondering if maybe we are missing something. Could I have something that we haven't checked for yet. I've also got bipolar2, depression/anxiety and ptsd which I take Topamax for. I also take Levothyroxine for my hypothyroidism.

First let’s talk about Topamax. I want you to know what you are on.  Your doctor should be testing your kidney and liver function and your blood should be tested to be sure you are able to process the drug well. They can become toxic very quickly.  

You should not drink alcohol while on this medication as it interferes with the effectiveness and it can make you sleepy as well as slow your heart rate. 

Antacids will keep you from being able to absorb this medication as well as any nutrients from your food. 

Fiber supplements can reduce the effectiveness of this medication. 

This drug will cause you to be low in folate or deficient in it. 

It has not been approved to treat PTSD but is endorsed by the National Alliance on Mental Illness to treat bipolar disorder and other mood disorders. 

Common side effects: 

Diarrhea, Dizziness, Double vision, Fever, Hair loss, Loss of appetite, Mood changes, Nausea, Reduced perspiration, Sinusitis, Stomach upset, Taste changes, Tingling or prickly skin sensations, Tremors, Uncontrollable eye movements, Urinary tract infection, Weakness, Weight loss.

 

With that being said, let’s move on and talk about fatigue. 

 

This is a super common issue for those of us dealing with thyroid issues and there are a number of reasons why fatigue could be your issue. 

Anemia.

You can have anemia from a deficiency of B12, Iron or folic acid. Your doctor may check your iron levels but do they check B12, folic acid and ferritin? Any one of these can contribute to fatigue.  And just because your lab says you are in the normal range doesn’t mean you are in the optimal range. j

Normal ferritin levels are between 12 -150 ng/mL. Mine is currently at 17 and I struggle with energy often. Some thyroid experts would say that optimal ferritin levels should be at 90-110 ng/ml for good thyroid function.  If you are still losing your hair- it could be an iron deficiency. 

And B12 values from your doctors lab may include values from people who were deficient in B12 so you can’t always rely on the lab values. “normal” is between 200-900 pg/mL but under 350 can give you neurological symptoms.  

Food sensitivities, not food allergies which is when your immune system reacts to protect you like when someone’s throat closes off in a nut allergy.  This alerts the IgE part of your immune system and happens as soon as a food is ingested. The IgA and IgG sections of the immune system will react to foods in what I would call a sensitivity or intolerance. These can cause us to be fatigued. 

IgA reactions happen in the intestinal tract which can cause inflammation there each time we consume a particular food. This will damage the intestines and can cause us to be unable to absorb nutrients from our diet. You may have symptoms like diarrhea or looser stools, constipation, reflux or you may not have any symptoms at all. You can end up with conditions like IBS, gas, rashes on your skin, acne, asthma, headaches, irritability and fatigue.  Celiac disease is in this category. 

If your T3 is low and you have high Reverse T3, this will affect your energy. T3 helps our cells make more energy. Reverse T3 makes T3 ineffective so that we are slowed down a bit. If Reverse T3 is high, we will not have any energy and one of the biggest reasons this might be high is due to stress. Another problem could be that you are not converting T4 into T3. This can be due to stress, or even nutrient deficiencies either due to low stomach acid or a compromised gut. You might find you need to be on a medication that has T3 in it. 

If your TSH is high, you will not have energy. Not all lab values are created equal here. You need to make sure that you are in a good range. Lab values for TSH are made up from a population of all kinds of people- those who are seemingly healthy and those who have undiagnosed thyroid problems and even the elderly who often have lower functioning thyroids.  The best reference range for most people is to have a TSH around .5-2 uIU/L. Personally,  mine is lower than .5 and I feel pretty good on that.  If you are taking NDT you can have a TSH that might look hyper and if your T3 is in normal range you probably feel pretty good. This can cause alarm with your doctor but try to have a conversation with them about it. 

How is your blood sugar?

This is a really really big one because it affects our adrenal glands which also have a role in energy. The good old blood sugar roller coaster will cause your adrenals to become weaker or cause the signaling between your brain and your adrenals to not work well leading to what is called adrenal fatigue or HPA axis dysfunction. For people like us with Hashimoto’s we may not tolerate those refined carbohydrates very well at all. Sometimes we get a big release of insulin when we consume sugary or refined “white” foods that others might not. So our blood sugar goes up really fast and we may have too much insulin in our blood which causes us to crash with fatigue and even anxiety or nervousness. This stresses our adrenals and leads to more fatigue.

Adrenal health is important for energy. If you are suffering from Adrenal fatigue you likely don’t have much energy to speak of even if this is the only thing you are dealing with. This is such a big deal and it takes some time to bring your adrenal health back in good standing. You need to avoid caffeine, keep your blood sugar balanced, make sure you are sleeping well and resting when you can, managing stress and probably supplementing. You can listen to Episode 7 of this podcast for more on adrenals. 

Having good digestion is key to energy. 

Many of us will be nutrient deficient and usually deficient in those nutrients that help our thyroids to function well. Just having hypothyroidism makes it harder for us to get our nutrients out of the food we are eating. This means the digestive system has to work a little harder to break down our foods and this can cause a lot of fatigue. We often have lower levels of stomach acid and most of us don’t eat when we are relaxed and we certainly don’t take the time to chew our food well. Right there is three strikes against us in the energy department. 

When we are not relaxed when we eat, we are not in “rest and digest” mode or what is called parasympathetic mode. This means we are in fight or flight mode which is not a good environment for good digestion. We already are not making enough stomach acid because we have symptoms of hypothyroidism, then we are not relaxed so we make even less. Then we are not chewing our food well- like 20 chews per bite to break it down. So, we have all this food in our stomach, not enough stomach acid and it is not being broken down. Our digestive system is working extra hard to try to break this stuff down- using all kinds of extra energy and that makes us tired. Then you have undigested food going through your intestines. You have leaky gut or intestinal permeability and these undigested food particles are then getting in to your blood stream causing your immune system to go on alert and inflammation occurs in the body. Fatigue is going to be a factor here. 

If you have low vitamin D, you can have fatigue. Get some sun. Lay in the sun for 10-15 minutes or go for a walk on a sunny day and expose as much skin as possible. Take a supplement of D3 if needed and make sure to have your levels checked by your doctor. Low D is a factor in autoimmune diseases like Hashimoto’s. 

A good diet will go a long way to helping you with your energy problems. High quality proteins and veggies along with a small amount of fruit. The big foods to eliminate for us are going to be gluten, dairy, eggs, nuts and I would try to eliminate nightshades to see if you feel better. This is basically called an elimination diet and is important for you to start to feel better, have more energy and bring your body back in to balance. 

You can find Hydrozyme at www.getbiotics.com use code DFILC163 to access.