Hashimoto’s Food Pharmacology
Page 6
For those with Hashimoto’s, vegan and vegetarian diets are problematic for a variety of reasons, especially because they may:
Exacerbate blood-sugar issues: People with Hashimoto’s often struggle with blood-sugar issues, which will only be worsened by carbohydrate-heavy vegan and vegetarian diets.
Prevent the gut from healing: Vegetarian protein sources such as legumes (beans), dairy, grains, soy, and some seeds may be incompatible with trying to heal a leaky gut. Pea protein is a vegan alternative that may be easier to digest and is less likely to cause food sensitivities (I developed the Rootcology Organic Pea Protein for people who are looking for a plant-based protein). For vegetarians, eggs, some seeds, and nuts would be the preferred sources of protein, but some people with Hashimoto’s may be intolerant of those as well, especially in the early stages of healing.
Contribute to nutrient deficiencies that may exacerbate Hashimoto’s: Vegan diets put us at risk for deficiency in many nutrients, including vitamin A, vitamin B3, vitamin B9, vitamin B12, vitamin D, calcium, chromium, copper, iodine, iron, magnesium, manganese, zinc, and omega-3s. Vitamin B12 and iron deficiencies are extremely common in those with Hashimoto’s and contribute to many symptoms.
It’s important to point out that the vegan diet is likely to be healthier than the Standard American Diet, but that in cases of Hashimoto’s a diet closer to the hunter-gatherer diet seems to work best for most people.
HOW TO TELL IF YOUR DIET IS WORKING FOR YOU
There is a dark side to using food as medicine that I’d like to share with you. In some cases, we may become so attached to a specific diet that we lose our natural ability to determine whether it is beneficial or detrimental to our health. Orthorexia nervosa is the newly coined term for this condition, where people become obsessed with clean or healthy eating. A key feature of the condition and what makes it pathogenic, is that the eaters lose perspective and do not realize that their diet is actually making them sicker; they have lost the ability to eat intuitively.
* * *
IS MEAT INFLAMMATORY?
Some people are surprised to discover that I recommend a diet that contains meat, since they have heard that eating meat is inflammatory. This is true if you consume meat from conventionally raised animals, which tend to have more inflammatory omega-6 fatty acids than anti-inflammatory omega-3 fatty acids. The reverse is true in naturally raised animals, from which foods higher in beneficial omega-3s and lower in omega-6s are produced. Look for grass-fed, pasture-raised, wild-caught, and free-range options to ensure that you get the quality proteins that will help most with the processes of healing and repair.
* * *
* * *
DIET SELF-ASSESSMENT
Mark the statements that are true for you:
I follow a vegan, vegetarian, or the standard Western diet.
I eat processed or packaged foods.
I have never had food-sensitivity testing.
I’ve never tried an elimination diet.
I have frequent skin breakouts or rashes, or my wounds heal slowly.
I have emotional mood swings and tend to be anxious, depressed, or worried.
My hair is dry and brittle.
I’ve never had a nutritional consult.
I have been found to have iron, ferritin, or B12 anemia.
I eat a low-fat diet.
I’m tired much of the time.
I have frequent bloating, stomachaches, constipation, or diarrhea.
My skin is dull and dry.
I am eliminating more foods from my diet than I am adding.
I feel tired after eating.
I have a history of an eating disorder like anorexia, bulimia, binge eating, or orthorexia.
Give yourself 1 point for each statement you marked. If you scored more than 3 points, there’s a chance your current diet is not working for you and you may benefit from switching your diet or trying additional interventions to get your health back.
* * *
Another feature of orthorexia is an exaggerated faith that inclusion or elimination of particular kinds of foods can prevent or cure a disease or affect daily well-being. They believe that what they’re doing is healthy despite all other evidence. So their thyroid antibodies might be going up, they might have more symptoms, and they might be feeling worse or even be malnourished, yet they still think they’re doing the right thing. Of course good nutrition is vital, and food is very important in our healing journey, but food is not the “be all and end all.”
Although I’ve never had a history of past eating disorders, I had my own experience with orthorexia in my healing journey. After seeing initial significant improvements with the gluten-free and dairy-free diet but hitting a plateau, I decided to try the GAPS (Gut and Psychology Syndrome) diet (the Specific Carbohydrate Diet is similar), which was touted to be helpful for autoimmune disease. These diets can be helpful for many people, but they did not work for me, yet I continued to follow them despite all evidence of the contrary.
I had gone from slightly overweight to very underweight, to the point that people began asking if I had anorexia. My hair grew thinner and thinner, and I had horrible new cystic breakouts. My skin was dull and gray, and I felt exhausted all of the time. I was losing more and more foods from my diet and thought that if I just kept restricting more foods, I would get better. At one point, I was reduced to eating only a few foods and well-cooked meats and veggies.
I lost the ability to eat in a natural, intuitive manner, and I kept getting sicker. The true healing came when I learned to listen to my body’s subtle signals for help, signals that are often communicated as symptoms (you can read more about what your symptoms are trying to tell you in Chapter 3).
Symptoms can mean that you are having a reaction to a food or foods. They could also mean that you have deficiencies in nutrients or digestive enzymes or other root causes like intestinal infections, toxicities, or an impaired ability to handle stress. It’s important to remember that these other factors exist. Some people may get stuck on the idea that “diet can heal everything” and that if they just eliminate more foods, they’ll be healed—but this isn’t always the case. (If you’ve been on a clean diet for three months and you are not seeing results or getting stuck, you should get tested for gut infections ASAP, so you don’t run the risk of losing more foods. The two tests I recommend are: the GI MAP stool test, for parasitic, bacterial, and yeast infections in the gut, and the Bacterial Overgrowth Breath Test, for SIBO.)
The turning point for me came when I began to incorporate nutrients, digestive enzymes, and more healing foods like bone broth, green juices, and green smoothies into my diet. I started to feel and look better and began to tolerate more foods. Continuing to nourish my body, while treating gut infections and toxins, allowed me to incorporate more and more foods back into my diet, and I’ve now been able to include most foods I was once sensitive to. Today, the way I eat is guided primarily by how I feel, by my body’s messages and my intuition.
Although I continue to follow a gluten-free and dairy-free diet, I have incorporated all other foods into my diet, because my body has healed to the point where I can tolerate them. One day I’ll research gluten and dairy reintroductions in greater depth, but for now I am too busy and too happy enjoying life to mess with a good thing! You can read more about my day-to-day diet in Chapter 4.
WHAT ALL HEALING DIETS HAVE IN COMMON
When it comes down to it, multiple diets have been reported to reverse Hashimoto’s. Most commonly, I see success and remission stories from people who followed diets such as the gluten-free diet, the Paleo diet, the autoimmune Paleo diet, the soy-free diet, the dairy-free diet, the iodine-free diet, or an individualized diet developed with the help of food-sensitivity testing. The connecting thread behind these diverse diets is that they all remove various reactive ingredients and are often more nutrient dense than the Standard American Diet. Furthermore, most of the diets do include animal protein.
* * *
&
nbsp; FODMAPS, SIBO, AND HYPOTHYROIDISM
One small study reported that about 50 percent of people with hypothyroidism have SIBO, or small intestinal bacterial overgrowth. SIBO can be a root cause for Hashimoto’s and can lead to intestinal permeability and irritable bowel syndrome. Symptoms such as bloating, gas, diarrhea, and constipation are common in SIBO and may be exacerbated by eating foods that contain FODMAPs (fermentable oligo-, di-, monosaccharides and polyols), which are found in foods such as wheat, soy and other legumes, certain fruits and vegetables, dairy, and sweeteners such as fructose and high-fructose corn syrup. The low-FODMAP dietary approach has been shown to be potentially effective in treating symptoms of SIBO-induced IBS; however, it does not get to the root cause of the SIBO. About 39 percent of people with Hashimoto’s reported feeling better with the low-FODMAP dietary approach, which leads me to believe that the people who benefited from it likely had SIBO.
The recipes in the Cookbook section are not tailored specifically to the low-FODMAP approach, as they contain many foods high in FODMAPS, such as artichokes, leeks, garlic, shallots, onions, peas, cauliflower, mushrooms, apples, cherries, figs, mango, banana, honey, cashews, and black beans. However, many recipes in the book can be modified to low-FODMAP by removing these ingredients (typically just one or two items in any given recipe).
Some low-FODMAP recipes that don’t need any modifications include:
Chicken Burgers and Kale Chips
Citrus Salmon
Duck with Date Sauce
Hashi-Mojito Smoothie
Quail with Grapes
Pumpkin Pie (made with pureed dates)
In addition to the low-FODMAP diet, you may benefit from peppermint oil and peppermint tea—both have been reported to suppress SIBO (try my recipe for Mint Tea). You may also have an adverse reaction to fermented foods and to certain probiotics containing Lactobacillus and beneficial Streptococcus bacteria, and require additional supplementation with B12 and/or iron. Keep in mind that SIBO cannot be overcome through a low-FODMAP diet approach alone and must be addressed with either a pharmacological or herbal approach or a two- to three-week elemental diet (see Hashimoto’s Protocol for comprehensive treatment protocols for SIBO).
If you’d like low-FODMAP meal plans, please visit thyroidpharmacist.com/food.
* * *
Healing Foods
Besides removing potentially reactive foods from the diet, let’s talk about adding delicious, nutrient-dense healing foods! Here are some of the foods I have found to be especially beneficial for people with Hashimoto’s.
Green smoothies: Sixty-eight percent of people who responded to my survey found green smoothies helpful; 82 percent said that the smoothies gave them more energy, 60 percent claimed improved mood, and 40 percent noticed benefits for normalizing weight. Smoothies are a really great way to increase our intake of nutritious food without the digestive stress. As the ingredients in smoothies are chopped up, the food is easier to digest and the nutrients easier to absorb.
Fermented foods: Few foods are better at promoting healing in the gut than fermented foods. Fermentation is a process of food preservation that produces probiotics, or “good bacteria,” that can be beneficial in balancing your intestinal flora and help with symptoms of constipation, digestion, and anxiety. Some of my favorite fermented foods include fermented coconut yogurt, fermented coconut water, and fermented cabbage. If you choose to buy fermented foods, be sure to buy the ones that are refrigerated; probiotic bacteria can only survive a couple of weeks at room temperature. In my Hashimoto’s survey, 57 percent of responders felt that these foods helped, and the benefits were again seen in energy (64 percent), mood (49 percent), and pain reduction (27 percent).
* * *
HOW A GREEN SMOOTHIE CAN HELP YOUR THYROID
I designed the Root Cause Original Smoothie specifically for Hashimoto’s healing. Healthy fat from coconut milk, fiber from veggies, and protein from a hypoallergenic powder combine to create a triple boost in thyroid healing as they help to stabilize blood sugar, fight inflammation, and aid in detoxification processes.
Sensitivities to gluten, dairy, soy, and sometimes even eggs take many popular breakfast options off the table for people with Hashimoto’s. A green smoothie is a delicious and safe alternative that people have said makes them feel calmer, energized, and free from “hangry” mornings! (Hangry = Hungry + Angry)
* * *
Bone broth: Bone broth was found helpful by 70 percent of people with Hashimoto’s. Specifically, 62 percent saw an increase in energy; 57 percent, an improvement in mood; and 32 percent, an improvement in skin. Bone broth provides healing collagen and nutrients to support our gut lining and skin. You can make your own using my Bone Broth recipe or order it (here).
Gelatin: Gelatin was beneficial for 47 percent of my survey responders; almost half saw improvements in skin, 38 percent saw benefits in hair, and 33 percent saw a reduction in pain and improvement in energy. I love to use gelatin in smoothies and gut-healing desserts. I also have a special traditional Polish treat for you in the Cookbook section, my auntie’s Galaretka recipe, which is a chicken soup–like gelatin that is especially helpful for healing your gut! Additionally, the Cherry Berry Gelatin Snacks will help with supporting your gut and joints!
Hot lemon water: Lemon juice can help support stomach and liver detoxification pathways and, thanks to its acidity, aid in absorption of certain medications, including thyroid hormone medications. I encourage drinking hot lemon water in the morning on an empty stomach and have found that most people who start drinking this in place of caffeinated beverages are surprised by not just how much energy they have, but also how much better they feel overall. You can make your own hot lemon water by squeezing the juice of one-half to one organic lemon into a cup of hot water (cool slightly before drinking).
* * *
THE BENEFITS OF BONE BROTH
Bone broth is an essential part of a nutrient-dense, healing diet for Hashimoto’s. Many of its ingredients will directly benefit you and your thyroid:
The gelatin in bone broth helps to seal loose intestinal junctions. It’s also easy to digest.
Chondroitin sulfates and glucosamine in bone broth can help increase energy and reduce pain and inflammation.
Amino acids found in bone broth have immune-boosting properties.
Collagen can support the health of your skin, hair, and nails, reduce wrinkles in the skin, restore shine and body in hair, and make nails stronger and longer.
* * *
Beets: Beets are a good source of phytonutrients, which perform anti-inflammatory and antioxidant duties in the body. If you have the MTHFR gene mutation, beets are especially good for you, as they are rich in betaine, a substance that can help break down homocysteine (individuals with the MTHFR gene mutation have trouble processing the amino acid homocysteine, elevated levels of which have been associated with heart disease, difficult pregnancies, birth defects, and possibly an impaired ability to detoxify). I recommend eating one to two servings of beets a week; because they are naturally high in sugar, though, you’ll want to combine them with a healthy fat or protein source.
Cruciferous veggies: Glucosinolates, found in cabbage, broccoli, cauliflower, kale, and turnips, help increase detoxification in the liver, which is beneficial for individuals with autoimmune thyroid disease. I recommend buying organic crucifers, especially kale, because kale’s hearty green leaves tend to pick up a lot of toxins from the environment. I’ve already mentioned the myth that those with Hashimoto’s should avoid crucifers; however, if you are concerned about the goitrogen potential of crucifers, you can lightly steam or ferment them, since they mostly only affect the thyroid’s absorption of iodine in a raw state.
Cilantro: Fresh cilantro is a natural chelator, which means it will bind to certain toxins and help excrete them from the body. There are other natural chelators, such as chlorella and spirulina, although I do not generally recommend these for people with Hashimoto’s due to
their high iodine content and their potential to modulate the immune system. You can add cilantro to salads, avocados, green juices, smoothies, and salsas and use it as a fresh condiment topper on chili, stews, and soups.
Fiber: Fiber acts like a sponge as it moves through the digestive system and helps sop up toxins and excess hormones, ultimately supporting their path to excretion. It’s best to get fiber from fruits and vegetables rather than from supplements, because supplements have been known to aggravate intestinal permeability and SIBO. I suggest gradually adding fibrous foods into your diet if you don’t normally eat a lot of them.
Green juices and chlorophyll: I recommend drinking green juices for a few reasons: first, they are full of healing nutrients; second, they are in liquid form and are therefore easily digestible; and third, they are a wonderful source of chlorophyll. Chlorophyll, a green pigment contained in plants, has been found to have numerous health benefits; it’s been shown to help support the process of detoxification in the liver, reduce inflammation and oxidative stress, raise iron levels, and even work as a natural deodorant by neutralizing odors. I have included a recipe for Green Juice, but if you create your own combination, be sure that it consists primarily of vegetables with only a small amount of fruit, such as green apples, added for flavor. The best type of juicer to use is a masticating juicer, which “chews” the vegetables instead of cutting them. See Chapter 4 for more info on recommended kitchen tools.
Turmeric: Promoted for its antioxidant and anti-inflammatory effects, turmeric is also antibacterial and antiviral, effective at helping detoxify various metals and toxins and linked to improved mood and memory. These benefits are thanks to a bright yellow chemical called curcumin, the naturally occurring active ingredient found in turmeric. Typically, the effects of curcumin only last about an hour in the body, but I’ve found that combining curcumin with piperine, an alkaloid found in pepper, will keep it in the body longer.