Additionally, around a third of people with Hashimoto’s may also have deficiencies in bile and/or pancreatic enzymes, which can lead to issues with fat absorption. Lastly, up to 80 percent of people with Hashimoto’s may have difficulty digesting plant fibers. The digestive process demands a lot of energy, so when it requires more metabolic work than normal, you may notice yourself feeling tired more often. Utilizing easy-to-digest foods and targeted digestive enzyme supplementation can restore proper digestion and eliminate symptoms like fatigue, virtually overnight.
4. Blood-sugar swings. Many people with Hashimoto’s have an impaired tolerance for carbohydrates. If you are one of these people, you are likely to experience blood-sugar swings characterized by a rapid spike in blood sugar after eating carbs followed by an excessive release of insulin. As insulin surges, your blood sugar will crash in a response known as reactive hypoglycemia. Reactive hypoglycemia can lead to unpleasant symptoms such as nervousness, lightheadedness, anxiety, and fatigue, and it can place stress on the adrenals.
When the adrenals become stressed, they are likely to release an excess of cortisol, which can also lead to an increased production of inflammatory proteins that are associated with a heightened immune response. This pattern eventually leads to altered cortisol release, which can in turn lead to numerous symptoms, including chronic fatigue, mood swings, and muscle wasting. Learning how to eat to promote stable blood sugar is an important part of protecting your adrenals from excess stress and in healing from hypothyroidism. Improvements in mood, energy, brain function, and weight are positive side effects of proper blood-sugar balance!
5. A toxic backlog. We are bombarded with toxins every day—they are on and in our foods, in the water we drink, in the personal-care products we put on our bodies, the cleaning products we use in our homes, and so on. Many of these toxins can interfere with hormone production, affect thyroid activity, and perpetuate autoimmunity. For example, fluoride, found in drinking water, bottled beverages, certain teas, and some supplements and medications, may act as a trigger in inducing thyroid cell death and inflammation, leading to the development of thyroiditis or autoimmune thyroiditis. The toxic backlog can lead to numerous symptoms as well! We can take proactive steps to minimize our toxic exposure, freeing ourselves from symptoms in our very own kitchens, by choosing low-toxin tools and foods (see Chapter 4 for more information) and utilizing foods and nutrients that support our detoxification pathways.
6. Food sensitivities. Food sensitivities represent one of the most common patterns I see in those with Hashimoto’s. Food sensitivities are not the same as food allergies. Food allergies are reactions to food that are immediate and often life-threatening (think the child who stops breathing after eating nuts), and are readily acknowledged and tested for by conventional medical doctors, especially allergists. These reactions are known as type I hypersensitivity reactions and are governed by the IgE branch of the immune system.
Food sensitivities are known as type IV delayed hypersensitivity reactions governed by the IgG branch of the immune system. As the name implies, they do not occur right away. In fact, it can take up to four days for them to manifest, and this is one of the reasons why it’s so hard for most people to correlate food sensitivities with symptoms. For example, you may eat corn on Monday and have a panic attack on Wednesday!
Here’s the connection I’ve made. Hashimoto’s is also considered a type IV delayed hypersensitivity reaction and often presents with IgG antibodies to the thyroid gland. In my experience, whenever we eat foods that cause our IgG system to flare up, this also seems to result in a flare-up of thyroid antibodies and thyroid symptoms. More research is needed to reveal exactly why this is the case, but it could be a result of an opening of the flood gates or perhaps inflammatory food proteins cross-reacting with the thyroid gland. What I have seen is that this overlap gives us an incredible opportunity for healing—most people with Hashimoto’s (88 percent of my clients and readers) will have a reduction in thyroid symptoms and antibodies after removing the most common reactive foods.
7. Intestinal permeability. According to researchers, every person with an autoimmune disorder has some degree of intestinal permeability, or “leaky gut.” A leaky gut has gaps in the gut lining that allow irritating molecules and substances to escape from the digestive system into the bloodstream. This irritation can interrupt the immune system’s ability to regulate itself and put the body into a perpetual attack mode that will be counterproductive to healing.
Intestinal permeability can cause such symptoms as bloating, stomach pains, irritable bowel syndrome, and acid reflux. These same symptoms are commonly experienced by people with Hashimoto’s, although not everyone with intestinal permeability and/or Hashimoto’s will have these symptoms. Both asymptomatic and symptomatic intestinal permeability can lead to a reduced absorption of nutrients required for detoxification and other important functions as well as a reduced output of toxins, which, if not addressed, can interfere with recovery.
There are numerous factors that can initiate or perpetuate damage to the gut lining such as stress, strenuous exercise, surgery/trauma, adrenal hormone imbalances, intestinal infections, toxins, enzyme deficiencies, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, nutrient deficiencies, infections (of the gut, sinus, or mouth), and food reactions. We can support the health of the intestines by addressing nutritional factors, such as eliminating reactive foods; addressing nutrient deficiencies; and replenishing enzymes and beneficial bacteria. These three key steps can be life-changing for most people with Hashimoto’s.
The Hashimoto’s and hypothyroidism lifestyle interventions I have researched and tested aim to dismantle the vicious cycle piece by piece. We repair the broken systems to restore equilibrium, allowing the body to rebuild itself. Nourishing your body will help you shift these patterns and will make you feel so much better! Although the body breaks itself down in Hashimoto’s, through nutrition we can build it back up.
HOW NUTRITION CAN HELP YOU REACH YOUR HEALTH GOALS
Through my work with my clients, I have seen hundreds of people recover their health with my Root Cause Approach, and I have now received hundreds of success stories from people who discovered and implemented the approach in my books Hashimoto’s: The Root Cause and Hashimoto’s Protocol.
Scientists have said that there is no cure for Hashimoto’s, but I believe we have the capacity and knowledge to put the condition into remission for most people. Each autoimmune condition has a different definition of what remission may mean. I like to think of remission as a journey, not necessarily a destination. Remission to me is progress, not perfection. Where you are is an improvement over where you’ve been. Here are the scenic stopping points on the remission journey: feeling better, eliminating most or all of your symptoms, reducing your thyroid antibodies, regenerating thyroid tissue, and experiencing a functional cure (which here means no symptoms, no antibodies, and no evidence of autoimmune thyroid disease in your body or on your thyroid).
Many people will be able to see a reduction in their thyroid antibodies, and some may no longer test positive for Hashimoto’s. A small subset may even be able to regenerate thyroid tissue and discontinue thyroid medications (under a doctor’s supervision).
I’ll share the full nutritional plans and some success stories from readers just like you who were able to take back their health using the nutrition guidance in Chapter 3 of this book!
WHAT DIET CAN AND CAN’T DO
Optimizing your nutrition can do wonders for your health. This is why following a nutrient-dense diet that is free of reactive foods is one of the first steps I recommend in an approach to healing. A lot of people have had great success by taking this step alone, even going into complete remission from Hashimoto’s. But this isn’t always the case. Although dietary modifications are powerful, there are limitations to what they can accomplish, and although most will see improvement with nutrition, many may need to dig deeper into the other r
oot causes and interventions to continue improving.
I mentioned that Hashimoto’s can be caused by food sensitivities, nutrient depletions, an impaired ability to handle stress, an impaired ability to get rid of toxins, and intestinal health issues as well as chronic infections. A person may have anywhere from one to all of these root causes! In my work with thousands of Hashimoto’s patients, I’ve found that diet modifications can usually help address and/or heal food sensitivities, nutrient deficiencies, adrenal issues, some gut imbalances, and certain toxic imbalances. In other cases, diet can sometimes help with profound nutrient deficiencies, although supportive supplements and/or digestive enzymes may also be needed to fully address deficiencies. In more complicated cases, nutrient deficiencies can result from infections or toxins that require additional treatment.
In certain cases, food sensitivities may be improved by nutrition and elimination of foods; in other cases, food sensitivities can be caused by infections, and the infections can result in the loss of more and more foods and the need for a progressively more restricted diet. Please note, diet can sometimes help manage the symptoms of a gut infection, but no amount of food restriction will heal most gut infections, and many gut infections can produce ongoing food sensitivities and reactions to whatever foods we’re eating. Most infections require treatments such as antimicrobial, antiparasitic, antifungal, and/or antiviral herbs or medications.
Severe toxicity may require supplements, medications, and other advanced treatments to clear. Current stress or past traumatic stress can leave our bodies in the “break it down” mode that no amount of good nutrition can solve, but stress reduction or working with a therapist can help here.
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THE STANDARD OF CARE VS. THE ROOT CAUSE APPROACH TO HASHIMOTO’S
If this is the first time you are hearing about any proactive strategies (or any strategy other than medication) that may help address your Hashimoto’s, you might feel overwhelmed, frustrated, and even angry. But I encourage you to feel empowered instead. My Root Cause Approach is different from the current standard of care offered through conventional medicine, which generally overlooks opportunities for healing. Let’s review the key differences.
The standard of care approach to Hashimoto’s is what I consider to be a lab-number, T4-centric, and reactive model that consists of primary reliance of the TSH test for diagnosis of Hashimoto’s and determining the need for more or less thyroid hormone:
Levothyroxine is the thyroid hormone of choice prescribed to most people with Hashimoto’s, although it’s not the only thyroid hormone that’s missing with Hashimoto’s.
Often patients are not given appropriate doses of medication, because outdated and cookie-cutter lab reference ranges are used that measure the levels of one thyroid hormone in the pituitary, but not in the rest of the body.
Patients who continue to be symptomatic are referred to other specialists for additional medications, such as dermatologists for hair loss, psychiatrists for depression, and so on.
There are no lifestyle recommendations and no attempt to find triggers for the autoimmune response against the thyroid, and thyroid antibodies are rarely tracked, though patients are offered testing for additional autoimmune conditions.
In contrast, my Root Cause Approach to Hashimoto’s is a patient-centered approach that looks at the underlying issues and the person’s individuality. The Root Cause Approach to Hashimoto’s includes:
Utilizing comprehensive thyroid tests to determine diagnosis and the need for thyroid-hormone therapy.
Using optimal and functional ranges of thyroid hormones instead of outdated reference ranges.
Optimizing thyroid hormones utilizing the T1, T2, T3, and T4 hormones when necessary (all are produced by the thyroid gland, but only T4 is present in levothyroxine, the most commonly prescribed thyroid drug).
Optimizing nutrition through eliminating reactive foods and addressing deficiencies and digestion.
Addressing the stress response.
Addressing the health of the detoxification system.
Addressing the state of the gut.
Identifying the person’s unique triggers such as chronic infections, toxins, or traumas.
Tracking thyroid antibodies every three months to see if the interventions are making the condition less aggressive.
Appreciation of the person’s experience and always utilizing the person’s symptoms as a guide for adjusting treatment.
For a detailed overview of my full approach, check out Hashimoto’s Protocol and Hashimoto’s: The Root Cause.
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Additionally, when damage to the thyroid gland has occurred and the person can no longer produce adequate amounts of thyroid hormone, supplemental thyroid hormone will be needed. Proper nutrition can prevent damage to the thyroid gland and in some cases thyroid tissue can regenerate, but this is not a quick or even certain process—it’s much easier to prevent tissue damage than to grow a thyroid back. No amount of food or special diet will provide thyroid hormone to a damaged thyroid.
I share this information with you about the limitations of diet because I have met plenty of people with Hashimoto’s who have locked on to the idea that diet can heal everything. With this belief in place, they continue removing more and more foods from their diet with the expectation that this will lead to healing. My recommendation is that if you’ve been on a clean diet for three months and you’re not seeing results or you are getting stuck, you likely have an undetected infection or other underlying issue that is causing inflammation within your body. I recommend utilizing the full Root Cause Approach shared in my books Hashimoto’s Protocol and Hashimoto’s: The Root Cause and working with a functional-medicine practitioner to get on the right path.
THE NOURISHING NEXT STEPS
My goal in writing this book was to create a one-stop, nutrition-centered resource for cooking and nourishing your way to recovery from Hashimoto’s. When we begin to see foods for their healing or harmful potential for our bodies, we acknowledge the power of our diet to change our lives. This is food as medicine. To take the reins of this power, we have to dig a little deeper and see the foods that make up our diet for their chemical properties, for it’s not just the whole, but the parts of the whole that interact with our internal systems. This more granular understanding of food is what I call food pharmacology.
The only way to see how you will respond to optimizing your nutrition is to take the leap into strategic dietary modifications, which you’ll learn more about in the next chapter and will easily be able to implement when you follow the recipes in the Cookbook section.
Now that you have a greater understanding of Hashimoto’s, including the tests that can help with diagnosis, the stages of the disease, common triggers and patterns, and how you can use nutrition to promote healing, it’s time to take a deeper dive into the specifics. In the next chapter, you’ll discover the factors that create an optimal diet for autoimmune thyroid disease!
2.
Fundamentals of Nutrition
A lot of people ask the question: “What is the right diet to heal Hashimoto’s?” This question is very complicated, since nutrition is the only science in which multiple answers can be both right and wrong. In other words, there is more than one way to skin a cat, and one person’s medicine may be another person’s poison. We are all different, and although we may have the same condition, different interventions may be required for each of us to heal.
You may have seen success stories and even perhaps heard what I like to call “diet dogma” from various personalities in the media or online about the best type of diet that everyone should follow. Some claim to have “cured” everything with their dietary plan; others make the same claim about a completely conflicting diet plan.
I love seeing success stories of people who take back their health and inspire others, but it’s important to remember that something that worked for one person may not work for others. What works for most people may al
so not work for you as an individual.
As a health-care professional and scientist, I consider myself to be diet-agnostic and I try not to form too many attachments to any dogmas, whether they are about diets, herbs, medications, or other treatment modalities. My goal is to simply try to find the most successful solutions and to show my clients and readers what works!
I personally don’t have a preference for any specific diet. In fact, if I were to develop my ideal diet, it would largely consist of mojitos, margaritas, croissants, tiramisu, and menthol cigarettes (my diet during spring break in college!). Although you may see some elements of my preferred diet in the Cookbook recipes, such as my modified mojito recipe, rather than promoting my own views on diet or adhering to a dietary dogma or the latest food fad, I derived the recommendations for Hashimoto’s in my books from clinical data of the diets that are most helpful to most people with Hashimoto’s.
In this chapter, I’ll introduce to you some of this science—for the science and health nerds (like me!) among you—along with some key diet concepts, including how to optimize macronutrients and micronutrients for Hashimoto’s and which healing foods will be vitally important to your recovery.
MY EARLY EXPERIMENTS IN NUTRITION
In 2011, I realized that my own health significantly improved with the use of nutrition, and I had a hunch that I was not the only person who could see improvements in Hashimoto’s symptoms with diet, though I wasn’t fully convinced that one particular diet was the answer for every single person with the condition. When I began working with clients with Hashimoto’s, however, I noticed that most clients got better with a dietary approach that was very similar to my own.
Hashimoto’s Food Pharmacology Page 4