Help for Hashimoto's Episode 35- cold hands and feet

Welcome to Episode 35. I’m coming to you from the frozen Tundra of MN where schools are closed and the high temps for the day will be around -15 and the low -31 with windchills reaching -50. When I got up the outdoor temp was -26.

 It is cold here and when you have thyroid problems and you are already cold, this can be an issue for you. Cold hands and feet can’t get warm and sometimes you might even be cold to the bone. 

A few years ago there were nights where I could not get warm enough to fall asleep without a heating blanket, wool socks, a sweatshirt and flannel pajama bottoms with at least 3 blankets on top of me, one of which was down. 

The struggle is real my friends. If you feel like this, you are not alone- cold weather or not.  

I got a question in my inbox about this very issue. Here it is: 

I was diagnosed with Hashimoto in 99, but given no info beyond that.  Had many problems with medication so ended up not using RX but went to Thyrophin PMG but always being ill.  Have been gluten and corn free, low dairy for years.

The past few weeks my feet have felt like they are in ice water, and my temperature has often been 95 degrees, with a hot home and heating pads and baths I can sometimes get up to 97.2 degrees.

I had been forgetting the Thyrophin frequently.

I did get a chill New Years Day.

Do you think the Hashimoto could be why I am so cold?

Unfortunately my MD moved away and there will not be a replacement for some time and I am in a remote area without much for functional medicine.

I will listen to more podcasts tomorrow.

I am taking undenatured whey to reduce hydrogen peroxide,  but can’t get catalase where I am, have upped the Thyrophin and drinking lots of ginger tea,  and bone broth and wondering what else I can do.

Thanks for any advice you can give me,


Thanks for your question Sandy. No doubt you will be helping many people by having wrote in and asked me this. It is a common problem. 

I would like to know what kind of problems you had on your medication. Perhaps you just didn’t feel great? Maybe you had heart palpitations? Maybe it made you feel worse?

The possible scenario here is that your adrenal health or HPA axis is not functioning properly which is leading to adrenal issues and if you have adrenal issues you may not feel well on medication. I discuss this in Episode 34 but the idea is that your adrenal health affects your thyroid health and vice versa so if you are not dealing with stress well, not sleeping well, having blood sugar issues, then your adrenals are working overtime and you are either in a state of hypoadrenia (things are working slower) or hyperadrenia (things are in overdrive) and your thyroid along with TSH and Free T3 and Free T4 output are also being affected. 

Thyrotrophin PMG is a supplement from Standard Process that is similar to the GTA from Biotics except it has magnesium citrate and bovine thyroid extract that has been processed to remove thyroxine or what we call T4. GTA  Forte II which is what I take has zinc, selenium, copper, rubidium, porcine glandular concentrate and some enzymes. 

Natural Desiccated Thyroid Hormone prescription pills are made from porcine or pig glandulars and the Thyrotrophin is made from bovine or cow thyroid glands so maybe this is partly why you are not feeling well. 

I am assuming you needed medication because you were on it but didn’t feel well on it so it might be time to have your labs done again at a doctors office or order them yourself through someone like Direct Labs, depending on where you live. Some states don’t allow consumers to order lab work. 

You probably need T3. Denis Wilson, MD has coined the term Wilson’s Temperature Syndrome which means that you can have a low body temperature and other symptoms that will respond to T3 therapy. 

I found this to be the case for me. I still have a lower body temperature but once I started on GTA, I no longer have frigid hands and feet. My hands are still a little cool but I am no longer freezing before bed and my overall comfort is much better. This, I believe is attributed to the T3 in GTA. 

It is almost like your body is able to reset itself and you may find that even after stopping a T3 treatment that you will remain more temperature stable. 

Symptoms of Wilson Temperature Syndrome (WTS) include typical hypothyroid symptoms and things like asthma, hives and migraines along with a lower body temperature. You may also have fatigue that lasts and stays, anxiety, depression, headaches, insomnia, muscle aches, brain fog, carpal tunnel syndrome, overall lack of well being. 

Low body temperature is the main symptom and is easily measured because as a whole, our body temp needs to be within a certain range to properly function. If you don’t have low iron or iron deficiency anemia, kidney disease or liver disease, and you have all these other symptoms, you might want to check in to Wilson Temperature Syndrome. 

Don’t expect to go to your regular doctor and expect them to even know what this is. You can learn more by googling Wilson’s Temperature Syndrome. 

I would make a plan to remember to take your Thyrotrophin. Find a time of day to take it where you can make it a habit. Also, don’t buy it off Amazon. Find a practitioner to buy it from. 

It is definitely you thyroid issues as to why you are so cold. 

You say you are taking undenatured whey to reduce hydrogen peroxide. 

Undenatured whey is whey that has not been heated enough to denature it or basically kill all the enzymes and good stuff that might be in it. Heat will destroy the immunoglobulins and break the peptide bond (broken down protein). It has glutyl-cysteine which is a peptide. Your cells use it to make glutathione which is our big antioxidant. From what I understand undenatured whey is supposed to raise glutathione levels and fix anemia. 

If your thyroid issues are due to a mercury toxicity from environment, amalgam fillings or anything else, you may not want to be taking this type of whey. Too much cysteine can suppress your thyroids ability to function so there may be a possibility of consuming too much undenatured whey that could be making you feel worse. 

The other issue I have with whey in any form is that the proteins in dairy products are similar to protein structure in your thyroid which can be an issue for your immune system. It can get confused and attack your thyroid tissue which can create more problems like hyper thyroid symptoms and tissue or cell death. 

Hydrogen peroxide is naturally produced by the body when we convert iodine in the thyroid. When TSH rises, more TPO or thyroid peroxidase enzyme is released which then releases hydrogen peroxide. This will cause damage to the cells in the thyroid if there is not enough selenium and glutathione. If you have Hashimoto’s you may have had a TPO antibody test done. The more peroxide in the body the more TPO antibodies may be created. The immune system may see the rise in TPO enzyme as the problem and so creates antibodies against it. 

The more iodine in your diet, the more it will need to be converted, the more hydrogen peroxide there will be which can decrease how much selenium and glutathione you have to deal with it. 

You might likely be deficient if you are eating more processed foods rather than real whole foods as well. 

You also said that you can’t get catalase where you are. I want to explain what that is for you guys. 

Catalase is an enzyme that will break down the hydrogen peroxide keeping it from damaging our cells much like glutathione does. You make catalase in your liver but maybe you are not making enough. 

Selenium also helps to form glutathione which will remove excess hydrogen peroxide. You can supplement with anywhere from 50mg to 200mg per day of selenium but no more. 

Before you do that though, look closely at your diet. Remove dairy completely for a couple of months to see if it is causing an immune response for you. Stay gluten free and find out what foods you are sensitive to. Sugar, alcohol, soy, caffeine, eggs and even other gluten free grains can be a problem for many of us. You may also want to consider if nightshades are a problem by eliminating them. They are quite anti-inflammatory for many people. 

Ginger is good for heating up the body so keep up with the ginger tea. Bone broth is excellent. Make sure you are eating enough. 

Eat foods that love the liver. Much of our T4 is converted to T3 in the liver. 

Foods with vitamin C like acerola cherries, greens, parsley, cruciferous veggies like cauliflower, broccoli, cabbages, brussel sprouts. Remember these are only a problem as a goitrogenic food if you are eating them raw in large quantities on a daily basis. 

Foods with vitamin E which will be protective to the liver and have antioxidant properties. Asparagus, Avocado, leafy greens. 

Zinc is an antioxidant and is in abundance in oysters, ginger root, many nuts and peas. 

Selenium works with vitamin E as an antioxidant. Molasses, brazil nuts, brown rice, turnips, garlic, red swiss chard, oranges and shellfish.

Most of us are deficient in magnesium and this is important for so many things in the body from helping cells to create energy to helping our liver detoxification pathways work properly.  It is found in a lot of grains and nuts but also coconut and brown rice. 

If you are following an elimination diet, this may not work for you and you might have to supplement with magnesium. My favorite is magnesium glycinate. 

There are many more things that are great for your liver- B vitamins, turmeric, milk thistle and amino acids. Remember that amino acids are coming from protein being broken down in our digestive tract. 

So eating and digesting protein is helpful as well. 

I would recommend you find a way to have your thyroid tested again and be diligent with taking the supplement for your thyroid. 

I hope this helps you Sandy. Thanks so much for writing in. 

I have had some people try to contact me about working with me one on one through DM’s on Instagram. It took me about a month to even notice they were there. I try to just pop on and off of my social media accounts so the best way to reach me is through my website by filling out the contact page there. 

Someone also asked me to talk about lunch ideas and I am going to put that in my newsletter along with a recipe for a pizza hotdish (as we call it here in MN)/casserole. So head on over to to sign up for that. 

You can find me on social media at out of the woods nutrition-help for hashimoto’s on facebook and @stephanieewalsntp on instagram. I have been less active there so again, the newsletter is the place to get the good information from me. There is also the help for hashimoto’s facebook support group so you can go ask to join that. 

thanks so much for tuning in. Until next week! 

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- 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!


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 

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  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

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 30

Thanks for joining me. Today we are going to talk about the immune system again. It is important for you to know how your immune system works when you have an autoimmune disease. That way you can make more informed choices about how you live your life and what you eat. 

When I work with clients who have autoimmune disease we have to look at what is causing the immune system to be out of balance. The key to that is looking at how your digestion is. 

In order for your immune system to function well and serve you rather than harm you, you must do the work to strengthen the defense system and remove what is causing it stress. 

Your immune system, as I have discussed works really hard to keep you healthy and keep your body in balance or in homeostasis which basically means in balance. That is it’s job. 

Another way to look at what I said last week and the week before is that your immune system is always asking if you are safe. If it could talk it would say “are you safe? is this safe?, are you me?”

We are kind of like a bucket. We take in things, let other stuff fall out of the bucket. Sometimes our bucket (immune system) will overflow. When this happens we get inflammation and eventually that inflammation leads to symptoms. In the case of Hashimoto’s that means your thyroid is getting attacked and damaged. 

In order to support your immune system you must support your digestive system and your body with the nutrients it needs to operate optimally. Your body will maintain good long term health this way. 

Let’s talk about inflammation.  The scientific description of inflammation is described as a complex response within the body tissues to things that are harmful. Things like pathogens, bacteria, viruses, toxins, chemicals or tissue damage. 

The immune system will respond to any of that by creating a way to get rid of it (inflammation). Clearing out damaged tissue like when you cut yourself. If you typically have cuts that heal slowly and/or you tend to scar easily- this means your immune system, your body doesn’t have the tools to properly clear out that damaged tissue. 

In fact, slow wound healing is a sign of zinc deficiency. Zinc is an essential mineral to the body providing our body the ability to heal wounds, enhance the immune system, provide anti-inflammatory action and it promotes the conversion of T4 to T3. 

You can’t just go out and supplement with zinc though and think that will take care of it. If your gut is not healthy, if you’re low on stomach acid, your body won’t be able to assimilate it. 

This is why we have to go back and look at how your digestion is working and more importantly, what kind of food you are eating. 

You can’t inflame and anti-inflame well without the tools provided by your diet. This is why I am always preaching to you what to eat. It is that important. It is medicine. 

You will find lots of practitioners who will tell you supplementing with zinc or other supplements will be essential to your healing. They might even be. BUT- what good do they do you if your digestion isn’t working properly. What good do they do you if you are not changing your diet along with taking the supplements. Supplementation might be needed in therapeutic doses for a time period but they should not be something you have to take all the time for the rest of your life. I kind of look at them as something to help speed up the healing process or provide your body with what it is severely deficient in and then once you get your stores up, you should be able to use food. This, is ideal to me. 

So before you go supplementing with 20 pills a day, let’s get you eating right first. With that said, you can get some immune boosters in to your diet as long as you are digesting food well. 

You can get vitamin A from carrots (actually beta carotene which converts to vitamin A), cod liver oil, eel, egg yolks, grass fed dairy (not recommended for autoimmune clients), kale, sweet potato and liver. 

Vitamin B6 is found in basil, bay leaf, dill, garlic, liver, pistachios, lots of herbs, shiitake mushrooms, sunflower seeds, and tuna. 

B12 you can get from clams, fish eggs, herring, kidney, liver, octopus, sardines and trout. There is some in red meat too. 

Vitamin C- a good immune booster found in citrus, acerola cherries, broccoli, Brussels sprouts, kale, kiwi, parsley, rosehips, herbs and triphala. 

Copper which is needed in conjunction with zinc- they work together.  This can be found in cacao, liver, oysters, shiitake mushrooms and spirulina. 

Vitamin D which most of us with Hashimoto’s are deficient in is found in fish, cod liver oil, oysters, and pastured lard

Vitamin E can be found in almonds, chili powder, curry powder and sunflower seeds. 

Zinc is found in oysters, pumpkin seeds and red meat. 

Our bodies produce something called reactive oxygen species- they are oxidants and are basically reactive chemicals that carry oxygen. They are formed in the body as a byproduct of the metabolism of oxygen or the use of oxygen in the body. 

With stress, the levels of these reactive oxygen species can increase and cause oxidative stress. When the body can’t keep up with breaking down reactive oxygen species, you also get oxidative stress. This causes damage to our cells and tissue in our body. 

We also have things called free radicals which are basically an electrically charged molecule in the body with an unpaired electron in the outer shell- this makes them a little dangerous so to speak and can be very damaging to other molecules that are close by. We get free radicals from our environment but also from inside the body like when we eat too much sugar, over exercise or when our cells make energy. But most important is when our immune system is active. 

This is a very normal part of our daily life and they are not all bad- we just have to make sure they don’t get out of control. 

One way to do that is to bring in the antioxidants that will help neutralize the free radicals which will make those dangerous or unstable free radicals, stable so they don’t damage our cells or tissue. Glutathione is the biggest anti-oxidant but things like Vitamin A, C, E, plant chemicals, selenium and zinc are very helpful. 

Making sure to include berries, citrus, cloves, green tea and even prunes in your diet are a good way to get your antioxidants in. Research seems to show that food based antioxidants are best. 

Other things that are helpful for your immune system to work properly are prebiotic fiber from apples, bananas, berries, broccoli, cabbage, chicory, garlic, Jerusalem artichokes, jicama, kale, onion, and root veggies. 

Some other good immune boosting foods are elderberry, ginger, manuka honey, bone broth, mushrooms, nettles and rhodiola. 

I’m starting an online RESTART program starting January 9th from 7:00-8:30 pm central time for five weeks. It is a food based sugar detox with nutrition education and support all in one. If you are not sure where to start to get your healing on track, this is the class for you. 

You can find out more at outofthewoodsnutrition/restart or you can email me for more information by going to my website and filling out the contact page. 

Thanks so much for listening. Please leave a review and a rating on iTunes if you don’t mind. It will help more people with Hashimoto’s find it. 

You can reach me on my website by filling out the contact form at or I’m also on Instagram at stephanieewalsntp and please join our help for hashimoto’s facebook group. 

Interested in working with me one on one. I am accepting new clients right now- people who have no idea where to start in this health journey. I can’t wait to help you feel better.

Help For Hashimoto's Episode 29

So I believe I am in the beginning stages of hashimotos diagnosis, upon my research I came across your podcast. I have not seen my primary care physician yet for a follow up visit after blood work, but my TSH came back at 4.14, she did do a blood test for celiac which was negative, but my food allergy came back as borderline level for wheat and low level allergy for sesame. 

My mother has hypothyroidism (never told hashimotos) and my aunt has been diagnosed with hashimotos. I started discovering my symptoms after I got my BSN  and had my labs tested which were normal. Now I’m discovering that I can get the antibodies and it affect my thyroid before it even shows up on my labs. 

At this point I know that I need to clean up my diet. I am getting a little anxious about it, although I eat fairly healthy I just am so afraid that this diet modification is going to run my life. But all of these symptoms (including reoccurring yeast infections) are what I’ve been feeling for the past 6 months severely, and 6 years not as severely. So I am wondering if the celiac test did not come back positive because I am possibly in the early phases still? 

I am on the second podcast and I love it so thank you for all the advice!


Hi Katie, 

Thanks for your question!  I will start with the question about Celiac disease. I am not sure what blood test you had that tested for Celiac Disease. Here is what I know at the moment. Some labs test for alpha-gliadin in the blood and about half of people who have this test done that actually have celiac disease will have high antibodies against alpha-gliadin. Alpha-gliadin is a protein that the immune system would be on the lookout for and attacking. Half of those with celiac disease also do not test positive for these antibodies.  The tests that are looking for just alpha-gliadin are only getting that one portion of the proteins in gluten that your body is having trouble breaking down. Apparently there are around 60 plus different protein components to gluten that your immune system can launch an attack against. 

You should ask your doctor if their lab tests for more than just alpha-gliadin. Look for a test that will test for transglutaminase antibodies, intestinal transglutaminase as well as skin and brain tissue glutaminase antibodies. It will be a much more thorough test and give you a better picture of whether or not you may have celiac disease. 

What some research is showing is that most, if not all of us have some issue with digesting the proteins in wheat and other gluten containing grains (they actually all have gluten in them just in varying amounts). Just because we don’t feel bad when we eat a food containing gluten doesn’t mean we are not sensitive to it or have an intolerance.  If you regularly have headaches, brain fog, blood pressure, anxiety- things you don’t necessarily associate with your meal from the day before- these are things that could be caused by an intolerance to gluten or any food really. 

Symptoms to a food sensitivity or intolerance are not always digestive. This is something to really think about in your life. What symptoms are you having that have started to just seem “normal” or part of your daily life? Food sensitivity symptoms can show up anywhere in the body, not just in your digestive tract with bloating, diarrhea or constipation, gas, stomach upset etc. They can show up in your skin, joints, in your brain in the form of brain fog, inability to think well. 

Not so long ago the only way to find out if you had celiac disease was to do an endoscopy which is a procedure where a device is inserted into the GI tract to look for damage or inflammation. The damage to your gut would be classified as Marsh I, II or III with each one being progressively worse from inflammation in your intestines but the microvilli are still there in I to some damage in II and in III your microvilli are severely damaged.  You can have symptoms of gluten sensitivity and not have any damage to your microvilli. That doesn’t mean you shouldn’t remove it from your diet. 

If you have positive blood work but no damage to your microvilli, you should probably still avoid gluten. If you have or had things like anemia, chronic anxiety or depression, joint pain, gut issues, chronic fatigue, liver or gallbladder issues, loss of feeling in your hands and feet, skin rashes especially on the back of your upper arms you might want to ask your doctor to test you for celiac disease. 

It sounds like you have the genetic predisposition to thyroid issues with your family members also having it. This means that you have the genetic susceptibility to the problem and it will be your diet and lifestyle that determine whether or not you develop disease. 

I got this from Katie this morning: 

Good Morning! I just had labs drawn on 11/29- 

tsh 3rd gen was 4.14;

triglycerides slightly elevated 155; 

low level wheat allergy, 

low level sesame allergy detected on a food allergy panel. 

labs drawn again on 12/17 

tsh 3rd gen was 5.98, 

tpo 38.8, 

t4 free 0.95,

t3 total 0.99, 

tg <15.

Energy is poor, muscle aches, joint pain/stiffness, unable to lose weight despite healthy eating and exercise, poor recovery for exercise, hair is thin and brittle and I lose a lot but everyone tells me ‘it’s a normal amount’, haven’t really noticed a change in amount, but the outer third of my eyebrows are thin, my bowel movements used to be regular until about a year ago, now I might have one once every 2-3 days, sleep isn’t great and I feel like I need 10hours almost. I am cold regularly, but I also get very hot easily too.

The doctors office called and said it was "subclinical hyptothyroidism and that I don't need to be treated with medicine". I have been symptomatic severely for the last year, and intermittently for the last 7 years. In your opinion should I be on medicine? 

I plan to go gluten free in the new year, I hope that will help with my antibody levels, but will that help my tsh level go down? 

Here is the deal with labs. Often times the lab values that are established for a testing lab come from the population of people that are tested. This means you have healthy people, people who are like you, sub-clinically hypothyroid and people taking medication so you were at a TSH of 4.14 on November 29th and now at 5.98 and they are saying that is not “sick enough” to treat with medication. 

This is complete BS- clearly your TSH is getting higher which means you are feeling worse probably. When I quit taking my meds so I could get a good “baseline” number after being on the GTA Forte from Biotics Research, my digestion stopped completely about a month after not taking any meds. 

When you deal with a functional medicine practitioner they have a functional range anywhere between 1-3 TSH. Personally, I feel best at 1 or below which is where my free T3 is optimal. 

Hopefully the wheat issue will have been answered by the celiac info but you should definitely be gluten free, 100%- always. 

The functional range for free T4- the amount of active T4 in your blood, should be around 1-1.5 ng/dL- you are at .95 which is a little low for functional medicine. This means you don’t have enough Free T4 in your blood for your body to convert to free T3.

Your free or total T3 is .99. I don’t know what value of measurement that is in so check your labs against what I am saying here and again, you can see the transcript on my website to make it easier to see numbers and amounts. If that is in pg/mL then you are quite low. This means your cells are not getting enough free T3 which is why you feel the way you do. 

Free T3 is the best indicator of what is available for your cells to use. The functional range is around 300-400 pg/mL and if the measurements are not the same you can find a converter for pg/mL on google. 

You have antibodies which means if I were a medical professional I would diagnose you with hashimoto’s which is autoimmune in nature and means your immune system is the problem causing your hypothyroidism or subclinical hypothyroidism as they are calling it. I am not a medical professional though which means I do not diagnose or treat anyone for anything. I do however help people bring their body back in to balance so that it can operate properly and bring you back to a state of health.

It may be possible that you can handle this with diet and lifestyle changes if there has not been significant damage to your thyroid. This might be your first step in trying to feel better especially if your doctor won’t put you on medication.  You may want to try GTA from Biotics Research at using code DFILC163- this is my account with them. I would take one capsule 1 time per day to start and see if it makes you feel better. GTA has porcine glandular or thyroid gland tissue from pigs in it with the T4 removed and selenium. Both nutrients that can be helpful to thyroid. I would not supplement with much more until you know your digestion is working well. No point in taking a bunch of supplements if your gut is not healed and you don’t really know what will work for you as we are all bio-individuals. If you take GTA you must have your thyroid tested regularly. 

Here is the thing with taking thyroid medication with hashimoto’s. You might feel better initially- like for a couple of weeks to a month. Your TSH might be brought in to the normal range but your symptoms will come back and you might even feel worse. This is what happened to me- I think I needed medication for sure because upon initial diagnosis my TSH was at 150- that is all that was ever tested on me until I worked with a naturopathic doctor. 

Hashimoto’s is an immune system issue first and is not a thyroid condition- it causes the thyroid condition. If the immune system is not addressed, you will certainly develop other autoimmune conditions as time goes on. 

The last episode- episode 28 discusses the immune system but we will go over some components right now. I’m going to use the analogy from Datis Kharrazian’s book Why Do I Still Have Thyroid Symptoms.  

You are a house. A house has walls to protect you from the outside- windows, doors and a roof. You too have things that protect you from the outside world. Your skin, your digestive tract, your lungs and brain. If our house has a leaky roof, the window are cracked so that wind and bugs and rain get through them and you have some holes in your walls where elements from the outside can get in quite easily. 

The same thing can happen when your body’s protective barriers have holes, cracks or leaks in them. Think of a cut on your skin- that is allowing the outside world direct access to your insides.  Your immune system reacts pretty quickly to a cut to work to keep invaders out of your body by clotting your blood and creating inflammation and then a scab which eventually heals and the cut is gone. 

When your gut or small intestine has cracks or holes it is leaky or permeable. Things called antigens come through the holes and your immune system is activated. Antigens are things like undigested food particles, bacteria, parasites, mold, toxins. You have immune cells called macrophages that are in your tissues waiting to eat up things that don’t belong. When a macrophage engulfs the antigen it sends a signal to the rest of the immune system to help it out. T-helper cells come first and organize the rest of the immune system in the attack on the antigen. Natural killer cells and cytotoxic T-cells arrive next and kill the invader. T-regulator cells make sure there are enough T-helper cells that help regulate the immune system and T-suppressor cells that stop the attack once the antigen has been destroyed. The B-cell antibodies are enlisted to remember all the information about that antigen so that when or if it invades the body again, it can remember to attack it. 

When you have autoimmune disease, somewhere along the line, something with these immune cells has gone awry. If you don’t make enough of the T- suppressor cells, the immune attack will continue and in the case of your thyroid, it can be mistaken for the antigen that was originally supposed to be attacked. 

This is just one scenario of many that can be the issue and is certainly part of why diet is so important. Removing inflammatory foods like gluten and dairy, managing blood sugar, ensuring your adrenals are optimal, managing sleep etc. It is multifaceted and about the whole body, not just one thing. 

So after the long answer, the short answer is yes, a gluten free diet can help your antibodies go down. They are not super high so that is good but you certainly don’t want them to get higher and it is clear with your TSH going up that you are needing to do something. Once you go gluten free I would go back in 30 days for labs that include all you had before and possibly even Reverse T3 which will tell you if stress is causing some of the issue of T4 and T3 being so low. 

Thanks so much for writing in Katie. I hope you start to feel better soon. 

Okay. I got a request for me to talk about what I eat. It seems that meals are a struggle for a lot of you, including me. Some days I don’t eat very well and some days are low on veggies so you know, no one is perfect with their diet and that is okay. I do notice I feel so much better with an extraordinary amount of vegetables in my diet and a smaller amount of meat. 

I have been watching The Paleo Way with Chef Pete Evans on Netflix. It is really good and so inspiring to me when it comes to getting vegetables in my diet. Check it out if you have Netflix- I am sure he worked pretty hard to get Netflix to take his show. 

What have I eaten in the last week?  I have been doing a green juice most mornings blended in my vitamix. I have had that blender for over 10 years- when the second George Bush was in office. It still runs like new. I have had to replace my canister and they have excellent customer service. This is not an ad. I really just love my blender. Anyway, I put chopped celery, about ⅓ of an English cucumber sliced, parsley which I buy and freeze and just pull a chunk out, a lemon- whole but peeled, a chunk of ginger (to your liking) and a handful of greens- lately I have been using Power Greens which is a bunch of baby dark leafy greens like spinach, chard, and kale. I blend that with some ice and water and drink it almost daily. It makes me feel light and energized. 

I tried just a couple pieces of celery all by themselves with some water and ice and it was horrible. I got a gag reflex from it but finished it and then felt nauseous for about an hour afterward. This might be a sign that my liver or gallbladder was getting some benefit and clearing out some toxins. 

So I have that- I do have breakfast which consists of leftovers. Things like hamburger patties on a bed of lettuce with onion dressing from Nom Nom Paleo’s Ready or Not cookbook. So good.  Or I will have leftover soup. 

I made roasted chicken for dinner last week and turned the leftovers in to soup with chopped carrot, celery and onion sautéed and then I added in the leftover chicken, pulled off the bone and shredded a bit with a zucchini chopped in to bite sized pieces and bone broth.  

I bought some pastured local mild Italian sausage and sautéed that in coconut oil with an onion and half a small butternut squash cut into bite sized pieces with some dried sage- about a Tablespoon. I had that for breakfast after my celery juice and then some green juice and a whole bunch of homemade chocolate bark- cocoa powder, coconut oil, some honey, sea salt with pumpkin seeds and goji berries. I can’t stop eating that stuff. I don’t make stuff like that often because I don’t have a lot of self control with sugar. 

We had burgers last night and I had mine on a salad. I will put almost any leftover meat on a salad and if you like fish you can do canned tuna, sardines or salmon on a salad. I am not a fan of fish at all so that is not for me. 

I did chicken breast sautéed with lots of garlic, broccoli and carrot “noodles” and coconut aminos for lunch yesterday and will eat that for lunch today too. 

I love the Thai Beef Stew from Against All Grain. You can find that on her website if you google it. I will make a big batch of that and eat it for lunch and breakfast. I was away from home most of the day last Saturday so I had lunch and dinner at the same place because they have some good gluten free meat options which I knew would fill me up. I had pulled pork- like a pound for lunch and dinner and it was a little too much meat with no veggies so I ate way more veggies on Sunday. I don’t feel great eating too much fat and meat so I have to work harder at eating more veggies. 

I like veggies roasted best- the rest of my family hates when I do that. So I usually make a sheet pan of roasted veg just for me. Broccoli, cauliflower, and cabbage are my favorites roasted with olive oil and sea salt or Redmond Real Salt. 

I will do a segment in my newsletter of meals I’ve eaten over the week if that would be helpful. Head over to my website and sign up for my newsletter. 

If you have questions about todays episode go over to my website under Epidsode 29 and leave a comment on the blog post for this episode. I will do my best to answer it as quickly as possible. Was this information helpful? Do you need something clarified? Let me no so I can help you out. 

If you have a question you want addressed on the podcast you can fill out the contact form on my website. I can’t wait to hear from you. 

You can find me at or they are the same website, on facebook at Out of The Woods Nutrition and join my private facebook group Help For Hashimoto’s to get support on your journey. You can also find me on Instagram as @stephanieewalsntp

I’m going to do some live group coaching in January- does that sound like something you would be interested in? I also have room for a couple of new clients working on diet changes, seeing where your body is out of balance and addressing those imbalances so you can feel better. Reach out to me on my contact page if this seems like something you might be interested in. We can chat to see if we are a good fit for working together. 

Thanks so much for listening. See you next week. 

Help For Hashimoto's Episode 28

Welcome to episode 28. I kind of feel like I left you in the dust last week by cutting things off at intestinal permeability. I’m still working on getting my TSH in normal range and my brain had had enough. It felt like too much work to dive deeper and so I ask you to have patience with me as my brain and body get back up to speed with all that I want to share with you. I had some kind of bug last week where my body ached which didn’t help me feel like doing much but lounging around. I did some research for a client and that was about it. I am fighting fatigue for a number of reasons, and am honoring my body’s need for rest. 

I want to say something about medication. It is not a bad thing to have to take thyroid hormones. Sometimes the damage done to the thyroid is so great that the gland just can’t make enough hormone for your cells. Some of us will need lifelong hormone replacement even after all the diet and lifestyle changes we have made and that is okay. It doesn’t mean you are a failure. It’s okay to need medication. All the diet and lifestyle stuff will help. It might even help you need less medication- just don’t feel bad if you still need to take it. 

Ok so lets dive more in to Hashimoto’s and the things that can affect it. You know you need to heal your gut if you listened last week. How do you do that? You have to lower inflammation. This starts with changing your diet and your lifestyle. An elimination diet or autoimmune protocol diet - AIP- can be very helpful. I’ll cover that more in detail in another podcast. 

Before I talk about the gut let’s talk a little bit about the immune system. When you have an autoimmune disease such as Hashimoto’s, your immune system is attacking self. It is attacking proteins in your body that are part of you. Our immune system is supposed to protect us from invaders like bacteria and viruses. In autoimmune disease it is attacking our tissues, like the thyroid. This means that autoantibodies have been created. Antibodies against our own tissue. 

Antibodies are important parts of our immune system where they recognize proteins in things like bacteria, viruses or parasites. The autoantibodies or antibodies hang on to the invader and signal the immune cells to launch an attack. In autoimmune disease, your body mistakenly makes antibodies to our own tissue as well as to the things that don’t belong like the virus or some bacteria.  

When your body creates antibodies against proteins in your own tissue this is called molecular mimicry or being cross reactive. This is the beginning of how you develop an autoimmune disease. 

Your genes will predict the probability of your immune system creating the autoantibodies and it will be your environment (diet and lifestyle) that cause the immune system to actually create them. How many genes you have that say you have susceptibility to autoimmunity will determine how quickly your autoimmune disease is triggered by your environment and how severe it will be. 

Your autoimmune disease likely happened or manifested because the autoantibodies formed and your body wasn’t able to determine the difference between the antibodies formed against your own tissue and the antibodies that formed against foreign invaders. Then your immune system launches the attack against both the foreign invader and your own tissues which eventually causes enough damage to your own tissue that will result in you having symptoms of disease. In the case of Hashimoto’s the symptoms result in what would look like hypothyroidism or a slow thyroid or it could trigger Graves disease which is a hyperthyroid state. 

You don’t have any control over your genes but you have a lot of control over your diet and lifestyle or what would be referred to as your environment. In order for you to understand why your body has essentially began an attack on you it might be a good idea to understand how your immune system works. 

We are all made up of various types of proteins. They are what are called the building blocks of the body. The bricks your house is made of so to speak. Proteins are broken down in to amino acids which form all kinds of things in the body. Some amino acids are essential, building everything we are made from. When some of these amino acids get strung together, they create proteins.  Our DNA is made from proteins and so is pretty much everything else in our body.

Antibodies created by our immune system are also a protein and they are called immunoglobulins. You may have been tested for IgA, IgE or IgG antibodies. What these immunoglobulins do is look for certain amino acids that are strung together a certain way in some proteins. They then attach themselves to these amino acids strung together and keep the protein from working properly. Once it binds to this protein and basically deactivates it, it lets the immune system know that this protein does not belong and should be attacked. 

Your immune system will then attack the whole thing, not just that little protein that was recognized. So if it is bacteria, the whole bacteria gets attacked. The same thing happens to our thyroid when there is a case of mistaken identity. The thyroid tissue gets attacked and the immune system remembers that the proteins in our thyroid are something that need to be attacked just like it would remember to attack the same bacteria if it invaded our system. So when you have an inflammation in your body, your immune system may be on constant high alert and attacking thyroid tissue because its protein structure is similar to something else being attacked. One common issue is foods that have similar protein structure like the protein in wheat or gluten- called gliadin. 

There is so much more to this- this is a vey simplified version of what is going on in our body. 70-80% or so of our immune system lies in our gut and the lining in our gut being in tact is crucial in the prevention of autoimmune disease. 

The small intestine also is where about 90% of absorption of nutrients happens through the microvilli. The microvilli are little fingerlike projections that line the small intestine also called the brush border. The microvilli  take up the nutrients from the food we eat and helps to transport those nutrients into the blood stream.  This is how your cells get the nutrients they need to work well. 

The adult small intestine is about 16 feet with a diameter of about 1 inch but the microvilli increase the surface area to be 500 times greater than that.

There is a mucosal layer- and that is just what it sounds like. A layer of mucous that lines the cell wall of the intestines keeping the outside contained to this area. What that means is, like I stated last week, our digestive tract is exposed to the outside and it protects the rest of our body (the inside) from harm. 

The wall of the intestines can become damaged in a number of ways- toxins, bacteria or pathogens and even from proteins found in grains, beans and even nightshades like tomatoes and potatoes. They can actually cause microscopic holes to be formed in the small intestines which allows undigested food particles, proteins and toxins to leak in to the blood stream causing inflammation and immune system reactions. 

The tight junctions formed in the wall of the intestine are one of the lines of defense that keep the inside protected from the outside. They are supposed to open up to our insides for certain nutrients to get absorbed properly.  Zonulin is a protein in our gut that acts like a gate keeper and will monitor the opening and closing of the tight junctions. 

One study describes the workings of zonulin quite well. The study done by Alessio Fasano in 2012 found that zonulin played a role in increased intestinal permeability (leaky gut) which “may be influenced by the composition of the gut microbiota” which contributes to autoimmune disease when antigens are present. Zonulin is a protein in our intestines that regulates the tight junctions in the small intestine which means it basically controls when or if there will be openings created/permeability in the small intestines where things from the outside can have access to our insides. 

The biggest triggers for zonulin to cause the small intestine to loosen the tight junctions (again, giving access to our insides) are exposure to bacteria and gluten. The bacteria discussed in the study were infections that trigger an immune response.  The protein gliadin which is in wheat was the other big trigger for zonulin to cause the tight junctions to open or create intestinal permeability/leaky gut. 

This may be partially why a gluten free diet is so helpful for people with autoimmune disease. There is some thought that all of us with autoimmune disease may have a gluten sensitivity.  Once the immune system recognizes a protein in a food, it can recognize similar proteins in other foods which can lead to multiple food intolerances. Gluten and proteins in dairy, oats, yeasts used in baking and in brewing as well as in many other grains are all similar enough that there can be a likelihood that you may be sensitive to one or more of these foods in addition to gluten. 

It doesn’t mean that you are but that there could be a likelihood of developing additional sensitivities to those foods. 

Hopefully I have established that the health and or integrity of the small intestine is important for your health when dealing with autoimmune disease. Diets like the autoimmune protocol are very helpful in determining which foods are giving you trouble and are cheaper than food sensitivity testing which isn’t always the most reliable.

Other things that can affect intestinal permeability are things like NSAIDS- ibuprofen or acetaminophen, hot peppers like cayenne, alcohol, the wrong types of bacteria in your gut, stress, exercising too hard, surgeries and food allergies. 

If it is not clear to you yet, you need to fix your gut in order to calm your immune system. It starts with digestion. You need to have good digestion, you need to have regular bowel movements that are about a 3 or 4 on the bristol stool chart. Your eliminations should be daily, 1-2 times a day. Your stool should be about the length of your forearm from your wrist to your elbow. It should come out with ease, and there should be little to nothing on the toilet paper when you are done. 

Eliminations should be about 16-24 hours after you eat- that means that what you ate should come out of you about 16-24 hours later. You also want to have a good balance of bacteria in your gut. You can feed the “good” guys by consuming lots of vegetables and fermented foods. 

We have more bacteria living in our digestive tract that we are made of cells. There are trillions of them and there are hundreds of different species of bacteria that make up those trillions. Usually though, you have a portion of bacteria that dominate your gut- these guys kind of run the show.

They help us digest sugars, starches and fiber in our food so we can absorb the nutrients from them. These bacteria provide us with certain chemicals that help us with energy production and help regulate our metabolism. They also make B vitamins and vitamin K and increase our ability to absorb our fat soluble vitamins A, D, E and K. 

A good or healthy gut bacteria help our immune system operate properly or keep it operating as it should. When we experience what is called gut dysbiosis or having the bacteria out of balance, we start to see dis-ease or symptoms of digestive upset. 

Feeding the bacteria the proper foods helps keep in balance the good and bad bacteria  which keeps your immune system operating properly. What you put in your mouth directly affects the amount and type of bacteria living in your gut. This is why diet changes are so important when you are looking to heal your gut or bring your body back in to balance. 

I will cover the diet changes needed in a future episode so please stay tuned for that. Do you have any questions about this episode? Go to and look up Episode 29 on the blog. You can read the transcript there and you can leave a comment or question under the blog post. 

Be sure to sign up for my newsletter there and get your free ebook 5 Things Your Doctor Won’t Tell You About Hypothyroidism. 

Join me on facebook in the Help For Hashimoto’s facebook group and on Instagram at @StephanieEwalsNTP. 

If you like what you are hearing I would appreciate it if you left a review on iTunes so more people can find the show and be helped. 

Look for information coming soon about a live group coaching program for those of you who don’t even know where to begin with the diet and lifestyle changes. The program will be live video calls and I will walk you through how to make the changes you need in order to feel your best. You will get nutrition and thyroid education as well as support from the group. Please let me know if this is something you would be interested in. 

Thanks so much for listening. See you next week. 

Looking for a way to exercise with chronic illness? Check out Autoimmune Strong

Help For Hashimoto's Episode 27

Welcome to Episode 27 of Help For Hashimoto’s. I’ve got some lab work to share with you today. In the past weeks I had been talking about how I went off my medication and had been feeling pretty good. That feeling lasted for only a couple of weeks. Last week I started to feel slow. I could feel my muscles having to work extra hard just to walk or write. I didn’t have a lot of energy. I pushed my lab appointment up by a week because I knew things were not okay. I started to feel like I could just lay in bed all day.

My digestion also had virtually stopped working. I felt bloated and was gassy and was not having eliminations at all. So then I didn’t feel like eating because I was so plugged up which affected my energy levels as well. I’m sure if you have dealt with or are dealing with hypothyroid symptoms, you can relate.

Some of you may be very sensitive to your medication or to a higher than normal and if you have a TSH that is 4, 5 or 7 or 9 and your doctor is telling you that you are fine but you are having symptoms like I just described then you are not fine. Maybe you can manage things with diet alone- that is possible.

Clearly for me, that was not possible. So either, I was dealing with way too much stress over the last nine weeks or there has been too much damage to my thyroid gland and I will always need medication. For now, I am back on medication and starting to feel a lot better. 

My TSH went from being suppressed at below 1 to being 119 in just eight weeks after being off all medication completely. I will have my actual lab results posted in the show notes for this episode on my website. Taking the Biotics Research GTA supplement had suppressed my TSH and so we could not get an accurate reading of where my body was at. I decided on my own to go off all medication to see if my body could do it on its own after all these years. 

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Clearly it cannot. I need the medication.  There was some talk with Aimee Raup in the episode on her book Body Belief about believing you can feel well. I want to be clear that you cannot think yourself in to remission but what you believe about your body’s ability to be well can affect how well you feel. I hope that makes sense. Even at a TSH of 119, feeling sluggish, and tired and like I didn’t want to get out of bed I remained positive about what this meant. I truly wanted to be able to tell you I didn’t need my medication any more. For now, that is just not the case. I need it and I am okay with that.

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 I don’t like feeling like I am walking through sludge with 100 pound pack on my back all day long. I don’t like only having enough energy to get dressed and then need to take a nap. So, if medication helps me feel at my best everyday along with a continued clean diet and good lifestyle management then this is how it is. I will make the best of it and live my best life because I am not going to let Hashimoto’s control my life. You don’t have to either. 

With that said, let’s dive in to the topic of Hashimoto’s and what that really means. I talked about hypothyroidism last week and how that is a symptoms of Hashimoto’s which is an immune system problem first. 

What exactly does this mean? 

When you have a diagnosis of Hashimoto’s this means that your immune system has launched an attack on your thyroid gland and is destroying it. It is the most common cause of hypothyroidism in the United States. Usually you have to fight for it to be tested mostly because the treatment of the disease is the same as it is for hypothyroidism. It is expected by your doctor that your thyroid will continue to be killed off with the immune attack so your medication will be adjusted over time as the thyroid is destroyed. 

Over the years as you continue to feel bad, you may be offered antidepressants as I was or you may be offered pharmaceutical solutions to your racing heart or treatment for your high cortisol output or lack of cortisol output. Maybe you will be offered the option of removing the thyroid altogether. 

These treatment options are frustrating for us, the patient, at best. You may be told there is nothing you can do. That a gluten free diet will leave you nutrient deprived or that it won’t help you. 

Here is the thing. Doctors receive about 40 hours or less of nutrition training in medical school. If they get extra training in nutrition they will be taught what the government and the USDA food pyramid teaches. They are not trained to look any further for answers to your problems when it comes to chronic health conditions. It isn’t their fault. It is frustrating, but it isn’t their fault. So your doctor is doing what he or she thinks is best for you. I want to be clear on that. I am not bashing them. I am frustrated with the way we are treated in our current health care system and things do need to change but that is for another episode. 

Okay. You may or may not have a Hashimoto’s diagnosis but you have gotten a hypothyroid diagnosis and they are not testing for thyroglobulin or thyroid peroxidase antibodies because the treatment for you is no different. 

Common treatment for other autoimmune diseases is to be put on an immune system suppressing drug like prednisone. Hashimoto’s isn’t aggressive enough of an autoimmune disease to warrant being on a drug like that- and frankly, you should not want to use that as your treatment. It is a bandaid. This disease and most other autoimmune diseases are very well managed through diet and lifestyle. 

If you are looking for a bandaid as a permanent fix for your autoimmune disease, this is not the place to get it. 

I don’t want to go through the rest of my life with a bandaid that doesn’t really make me feel good. Prednisone’s side effects are things like insomnia, mood changes, increased appetite, gradual weight gain, acne, dry skin, slow wound healing, headache, dizziness, nausea, stomach pain and the list goes on. 

Doesn’t sound fun- in fact is sounds like more crappy symptoms on top of all the crappy symptoms that come with a mismanaged thyroid condition. 

Even if you are put on thyroid medication, like me, with a combo of T4 and T3 and even the supplement with the porcine glandular in it- the immune system is not being addressed.

Hashimoto’s disease is named after the Japanese doctor, Hakuro Hashimoto who was the first to describe the disease in 1912. Our autoimmune disease was the first ever to be recognized as an autoimmune disease. 

About 50 million people suffer from some kind of autoimmune disease in the US and about 30 million of those people are women. Hashimoto’s and Graves disease are some of the most common autoimmune diseases with about 8% of the US population having a diagnosis. Most of the cases of hypothyroidism are due to Hashimoto’s. 

If you have hypothyroidism and are on medication but still feel symptoms or you continue to feel worse over time, then you are probably dealing with Hashimoto’s disease. You might be showing lab tests of normal TSH because you are on medication but your immune system may be on fire and so you present with symptoms. 

You also might be having symptoms of both hypothyroidism and hyperthyroidism which can fluctuate from week to week, day to day or month to month. This is a clue that your immune system is needing attention. Your TSH levels can be all over the place so if you happen to go in for your labs at a time when your TSH is in the normal range- you will not be given medication. In the case with Hashimoto’s medication in the form of thyroid hormone replacement is a band aid. You may need it for a time period until you get things under control but you may not need to be dependent on it for the rest of your life. There is even some evidence to show that it might be possible for your thyroid to regenerate once you get the immune system calmed down. 

In my case, I probably had Hashimoto’s when I was first diagnosed with hypothyroidism in 2002 but because I went for 8 years thinking all I needed was to take my levothyroxine there was probably enough damage to my thyroid that I will likely need medication for the rest of my life. Who knows. I’m still hopeful. I went through times of having hypo and hyper symptoms and could not figure out what was going on. One of those times was when I was pregnant in 2004 and lost my baby at 34 weeks. You can read more about that in Five Things Your Doctor Won’t Tell You About Hypothyroidism which you can get from my website when you sign up for my newsletter. 

What is happening in your body when you have those hypo/hyper symptoms? Essentially the immune system is attacking your thyroid, killing off some tissue. As that tissue dies, the thyroid hormone is released in the blood stream giving you symptoms of hyperthyroidism such as heart palpitations or racing heartbeat, you may have this feeling of inward trembling, you may feel nervous or moody/emotional, you can have insomnia and night sweats (I had night sweats for years), you may be losing weight for no reason at all. 

You can confirm you have Hashimoto’s by asking for a Thyroid Peroxidase Antibodies test (TPO Ab). This will verify that your immune system is attacking the enzyme that allows your body to produce T4 and T3. 

You can also ask for a Thyroglobulin Antibodies test (TGB Ab). Thyroglobulin is what your thyroid uses to make thyroid hormone. You can have a negative antibodies test. This is common because as with everything else in the body, your immune system can yo-yo. It may not be acting up at the time of your test. So you either have to go in and ask for the test when you know you're in a flare (having symptoms). 

What are the triggers for Hashimoto’s or autoimmune disease in general?

As has been said, “Your genes load the gun and your environment pulls the trigger”. 

You may be genetically predisposed to your disease- like me. My mom, her siblings and their mother all had or have some kind of thyroid condition. One of my Aunts and my Uncle have Grave’s disease. My Uncle also has an autoimmune kidney disease for which he is on an immune suppressant. My other Aunt has hyperthyroid symptoms and my mom has hypothyroidism. I’m pretty sure she has Hashimoto’s because she has spent her whole life not really feeling well. She has never been tested. 

So, genetics were there for me and I pulled the proverbial trigger of that genetic gun with my lifestyle and environmental factors. 

Things like gluten intolerance, estrogen dominance, blood sugar dysregulation, PCOS, being deficient in vitamin D and other nutrients, toxicity in the body from environment or heavy metals, chronic infections or inflammation, stress in any form. All of these or any one of these can lead to the breakdown of your body and the beginning of autoimmune disease. 

The good news is that you can definitely control your disease with diet and lifestyle. You maybe have figured that out already and that is why you are here. If not, you are in the right place to learn about how you can manage your disease and feel your best. 

If you are on medication, you need to start paying attention to how you feel on it. You may need to have it adjusted and hopefully you have a doctor who is willing to treat you by your symptoms and adjust or switch your medication as needed. The medication is kind of a Goldilocks type medication. It can take some time to find what is just right for you. Some people do fine on synthetic medications that are T4 only like Synthroid or Levothyroxine. Some people do better on Natural Desiccated Thyroid Hormone like Armour, Naturethroid, WP Thyroid or compounded thyroid powder.  If you don’t feel well on one type of medication ask to try a different one. 

One thing all autoimmune conditions have in common is intestinal permeability or what you may have heard of as leaky gut. Your intestinal wall is the only thing protecting your body from the outside world. It’s entrance is essentially your mouth and its exit is your anus. If it becomes permeable or leaky- having tiny microscopic openings in it- then the outside has access to your insides where your immune system is ready to protect you at all costs. 

We have a protein called zonulin which allows our intestinal wall to become permeable or causes the tight junctions in our intestinal wall to open which will allow proteins and bacterias to have access to our insides- our blood stream. This causes our immune system to go on high alert and launch an attack on these so called invaders. 

One of the bigger triggers for this in autoimmune disease can be gluten- the protein found in larger amounts in wheat, barley, rye and other grains. This is why you hear so many practitioners talking about being on a gluten free diet. It can help your immune system calm down. Next dietary change would be to take dairy out. It has proteins similar to gluten and can confuse your immune system and remember we are trying to calm the immune system. 

You also need to look at other factors like stress, sleep, nutrient deficiencies like vitamin D and healing the gut is a must. You can’t absorb nutrients if you are not first digesting your meals well and have a healthy gut. Gut means your small intestines. That is where about 80% of your immune system lies and that is where the majority of your nutrient absorption is. 

This is a lot of information and hopefully not too overwhelming. If you have questions or want something covered in more detail, please drop me a note at or go to my website and fill out the contact form. I’m here for you and want to help so send me your questions. 

Please head on over to my website, and sign up for my email list. You will get recipes and content not shared anywhere else. 

Like what you are hearing? Please leave me a review on iTunes so more people can find the podcast. I would really appreciate it. Also, share about it on facebook to help spread the word. 

Thanks so much for listening. See you next week.  

Help For Hashimoto's Episode 26

Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less. - Marie Curie

Welcome to Episode 26. Today, inspired by someone in the Help For Hashimoto’s Facebook group we are talking about how the thyroid works. You are getting a hopefully easy to understand lesson in thyroid anatomy and physiology. I’m keeping it simple here so don’t worry. 

If you are dealing with hypothyroid symptoms then you know, this tiny little gland runs the show. It rules our body and when it isn’t functioning, we really feel it. 

The symbol for the thyroid is the butterfly and with good reason. It is shaped kind of like a butterfly and it wraps itself around our trachea and sits just below our voice box. It has these little sacs within it where the thyroid hormones are produced. 

The thyroid is part of our endocrine system and it is responsible for increasing our basal metabolic rate which is our ability to gain or lose weight. Our basal metabolic rate rises when we make cellular energy (called ATP) which provides us with heat causing our body temp to rise.  This is why when our system of producing thyroid hormones breaks down somewhere along the way, we can end up with cold hands and feet or just feeling cold in general. You might literally feel cold in your bones. 

Thyroid hormones stimulate the creation of proteins at the cellular level which involves making DNA which is part of how we copy and make new cells. Remember we are cellular beings. Our cells make up tissue which make up organs which make up systems which make up us as an organism. 

Thyroid hormones help us use glucose or sugar and fats for energy and they help break down triglycerides so they can be eliminated as needed. 

Thyroid hormones help us grow as kids and particularly help in the growth of the nervous and skeletal system. 

So you can see, this little gland has a big job. 

The thyroid gland is really sensitive and will respond to messages pretty quickly when called upon as long as it is working properly. It kind of speeds things up or slows things down as needed. So if you are cold, its job is to tell the body to create more heat so you can be warmer. 

If your hands and feet are always cold or you have that cold bones feeling, then something isn’t working right along the way. This is not happening because your body wants it to, but rather because it doesn’t have the tools to do it properly. Or something is broken down along the way. 

What can break things down? Well, chronic stress, poor diet, blood sugar dysregulation, the wrong medication or the wrong dose or the inability to process the medication, not enough- you get the idea. 

You must ask yourself WHY this pathway has broken down somewhere instead of what can I take to make it feel better. 

How is your thyroid supposed to work?

It starts in your brain. The hypothalamus works in concert with the pituitary gland. The hypothalamus is the controller here. The very tiny part of the brain controls much of the function between our nervous system and our endocrine system. In fact, all that the hypothalamus and pituitary do together control most of the growth, development, metabolism and balance throughout the body. The two are attached in the center area kind of under the big parts of the brain. 

Through a negative feedback loop like the furnace or air conditioner in your house, your body sends a message that it needs some regulation. We are using the example of being cold and needing to warm up. 

Your hypothalamus sends out a hormone called Thyroid Releasing Hormone or TRH which gets sent to the pituitary gland. 

TRH tells the pituitary gland to release Thyroid Stimulating Hormone or TSH which you will be familiar with because that is probably what your doctor tests for. Funny they don’t test for actual thyroid hormone in our blood. Just this stimulatory hormone. TSH gets sent to your thyroid where it tells the thyroid to make thyroid hormone. 

In the thyroid, some chemical reactions occur and Thyroid Peroxidase gets a message to make T4 and T3. Thyroid Peroxidase is one of the things that creates antibodies in Hashimoto’s. Remember Hashimoto’s is first an immune system problem rather than a thyroid problem. We are going to cover that next week. 

T4 and T3 are being produced in the thyroid. Mostly T4 and a small amount of T3. This gets taken through the blood on a binding protein and is held captive until it gets where it needs to be when it is released or free.  Much of the T4 our thyroid makes needs to be converted to T3 before our cells can use it so about 60% of what is made in the thyroid goes in to the liver and is converted to T3 there and about 20% is converted to T3 in the gut or small intestine area. 

Again, once they get to the cells they are released as free. This is the hormone your cells can use. See why it makes sense to test the free levels or hormone?

Your liver has a big job. It works hard for you every day.  It has to help manage blood sugar, it makes bile so we can break down and use dietary fats. Bile also carries toxins out of our intestines and eliminates them in our waste. The liver processes hormones like excess estrogen, and it processes toxins or chemicals for elimination as well, not to mention processing alcohol. Do you think your liver can work on your hormones if it is processing toxins and chemicals and managing blood sugar all day long? I think it gets backlogged and has to prioritize things and guess what- converting thyroid hormone is not always at the top of the list. 

I mentioned conversion of T4 in the gut. Those good gut bacterial are vital to our health in a lot of ways, one of which is conversion of T4 to T3 for our cells to use. What if those gut bacteria are destroyed due to antibiotic use or there are more bad guys than good guys? How much conversion of thyroid hormone is happening? Antibiotic use is not the only thing that affects our gut bacteria. Remember that stress, especially chronic stress can alter the gut bacteria population which will affect our ability to convert T4 to T3. 

When things are working properly, the Free T3 will get to your cells and turn on or off the genes needed for each situation presented- in our case today, we want to feel warmer or be warmer so we are turning on the metabolic process of creating more heat with the tiny increase in TSH happening all the way back at the brain and pituitary gland. 

Let’s do a quick review of these hormones. 

TRH- Thyroid Releasing Hormone

The body sends a message it needs something- like to warm up- this is a message to kickstart your metabolism. The message goes to the hypothalamus which talks to your nervous system (important for adrenals health) and to your endocrine system (thyroid, blood sugar regulation, sex hormones) and releases TRH as a message to your pituitary gland which releases: 

TSH- Thyroid Stimulating Hormone

This is released in response to the message from TRH. TSH goes to the thyroid gland with iodine where Thyroid Peroxidase, an enzyme that is made in your thyroid gland does some chemistry and makes T4 and T3 with a protein called thyroglobulin. 

T4- Thyroxine

Is called T4 because it has 4 molecules of iodine attached to it. It is bound to thyroglobulin until it reaches its final destination at your cells where it is released and is Free. 

T3- Triiodothyronine

This is the main thyroid hormone used by the cells. 

What can go wrong?  A lot. Are you on hormonal birth control?  If so, this can interrupt the functioning of your thyroid. Very simply explained, your body ends up overloaded with estrogen which will cause confusion in your pituitary gland. The pituitary is where the TSH is released and the excess estrogen will create extra binding proteins so your thyroid hormone will be bound instead of free which means less for your body to use. You can then have labs that look like you are releasing enough TSH but it is all bound up so it isn’t getting to the cells and this creates symptoms when labs look fine. 

Even if you present with high enough TSH to get put on medications you and your doctor should be asking WHY is the TSH high? Where is the malfunction at? Where is the breakdown? 

The breakdown could be in the hypothalamus/pituitary axis. Some sort of dysfunction there. It could be in the gut, maybe in the liver.  Maybe your body is overloaded with toxins from the environment- either poor quality foods with high amounts of chemicals in them, body care products and makeup or you work around chemicals. We live in a toxic world, it is just a fact of life. We need to make sure our liver can keep up with the chemical burdens we face daily. If not, thyroid function can be affected. 

Chronic stress- physical or emotional stress can reduce the amount of T4 in the cells without the pituitary gland being affected much at all- again- this would mean you have symptoms but blood tests might look normal. Remember we convert T4 in our tissue mostly and that might not be happening under conditions of chronic stress. What are the stories you have going on in your head? 

Iodine deficiency- I am not an expert in this area so I will only touch on this briefly. We need iodine to make T4 and T3. If you eat real food and you eat high quality food, you are likely getting all the iodine you need to make thyroid hormones. Not everyone agrees with this and you can check out Dr. Brownstein for more information. He believes iodine therapy can be very helpful. Dr. Kharrazian believes iodine therapy is like fueling the fire, especially if you have hashimoto’s. I don’t feel knowledgable enough to comment one way or the other on it. There have been some people who suffer with low body temperature and therefore are cold all the time that have benefited from iodine therapy and have also found an increase in their energy. Do not supplement with iodine unless you are under the care of a knowledgeable practitioner. 

Childbirth- this is where I was diagnosed with hypothyroidism with a TSH of 150. This happens in about 5-10% of new mothers. I also had a genetic predisposition and I epigenetically turned on these genes with poor diet and lifestyle. So this was the beginning of my knowledge of thyroid problems for me. I likely began the breakdown of my body long before that. 

Heavy metals- cadmium, lead and mercury have all been linked to thyroid dysfunction and mercury in particular with thyroglobulin antibodies which is significant in showing a relationship between mercury and hashimoto’s. I had a mouth full of mercury fillings. 

Chlorine, fluoride and bromine are halogens. They all affect the thyroid in different ways. Chlorine keeps iodine from making T4, fluoride decreases T3 and T4 while increasing TSH in the blood. Bromine displaces iodine increasing TSH in the blood and keeps the thyroid from functioning well. Getting a filter for your shower at the least can help with the fluoride/chlorine issue. Bromine is in bread products.  You need a lot of exposure to these chemicals to really be affected. It is just one small piece of the puzzle. 

There is so much going on here and so much that is at play. This is why there is no one quick fix. No one supplement, no one thing that will work to make you feel better. There are general recommendations, of course that will definitely get you on the road to feeling better but you have to remember that it took time for your body to get to the point of breakdown where you are noticing symptoms and so it will take time for things to get back to normal. 

As always, I start with diet and very little supplementation. Get cooking, eating real whole foods, manage blood sugar and stress. Get good sleep. These are things you can do before you seek the help of functional medicine testing. Save yourself some money on supplementing with things you aren’t even sure you really need but think you do because someone has said that selenium or zinc is good for your thyroid. I’ve even said it- these things are needed for good thyroid function but maybe you don’t need them. Try cleaning up your diet first and then hire someone to help you figure out what might be best for you. In the long run you will save yourself thousands of dollars. 

Ok. That is it for me for today. Next week we will talk bout Hashimoto’s and why it is first an immune system problem with consequences for the thyroid. 

Until then, head on over to my website and get my ebook- Five things your doctor won’t tell you about hypothyroidism. Join the facebook group, Help For Hashimoto’s and please tell other people about the podcast so they can stop getting bad information from people in these support groups. I see so many people being told such bad information and it breaks my heart. 

I would really appreciate it if you could leave a rating and review on iTunes so more people can find the podcast. I do this for you guys so you don’t have to go through what I have. 

Find me on Instagram @stephanieewalsntp and at Out of The Woods Nutrition on Facebook. I should streamline all that stuff so it’s all the same. Anyway, I sent out a recipe in the newsletter this week. If you are not on the list, that is the place to be. I am done with biochemistry now- whew. I survived and so I will be putting more time in to better content in the newsletter. That is the best place to be. 

See you next week. Thanks for listening.