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

Hi, 

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

Sarah,

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

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

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

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

Some questions you should be asking yourself and your doctor: 

• Is my medication doing it’s job?

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

• What is my diet like?

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

  • Are you sensitive to any other foods?

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

• How is my stress level?

• How is my sleep?

• Am I on a blood sugar roller coaster?

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

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