One of the biggest problems with eating out is that most restaurants use unhealthy oils. And because you don’t have control over the oils these places use, you want to try to avoid consuming these oils as much as possible, and of course when you are cooking at home you want to use higher quality oils. Olive oil and coconut oil are two of the healthier oils, and in this blog post I’ll discuss many of the health benefits of coconut oil, and the next blog post I will focus on olive oil. In the next post I will also mention a few other healthier oils, and I will also discuss some of the oils you should try your best to avoid.
So let’s go ahead and talk about coconut oil…
Basic facts: coconut oil is extracted from the meat of coconuts. It is an excellent source of medium chain triglycerides (MCTs), which have numerous health benefits. There are a few different components of coconut oil, but three of the main ones include lauric acid, capric acid, and caprylic acid. Approximately 50% of coconut oil consists of lauric acid. Let’s take a look at each of these compounds:
Lauric acid. This is also known as dodecanoic acid, and as I mentioned above, it compromises approximately half of the fatty acid content in coconut oil. One study looked at the antimicrobial effects of virgin coconut oil on Clostridium difficile (1). The study showed that while exposure to lauric acid, capric acid, and caprylic acid inhibited its growth, lauric acid had the greatest inhibitory effect (1). Another study showed that lauric acid can be an alternative for the antibiotic treatment of acne vulgaris (2).
Capric acid. This is also known as decanoic acid, and like lauric acid, it’s a type of saturated fatty acid in coconut oil. Like lauric acid, capric acid also has numerous antimicrobial properties, as while a study I mentioned earlier showed that lauric acid had the greatest inhibitory effect on C. difficile, the study showed that capric acid also had inhibitory properties (1). Both capric acid and lauric acid demonstrate bactericidal and anti-inflammatory activities against Propionibacterium acnes, which might be involved in acne inflammation (3). Another study showed that capric acid caused the fastest and most effective killing of three strains of Candida albicans, although lauric acid was the most active at lower concentrations and after a longer incubation time (4). Another study showed that capric acid has inhibitory effects on osteoclast development (5). Osteoclasts break down bone, and so capric acid might be useful for the treatment of bone resorption-associated conditions (5).
Caprylic acid. This is also known as octanoic acid. Caprylic acid also has antimicrobial properties. In fact, one study claimed that caprylic acid is superior to Diflucan, which is a potent prescription antifungal (6). The same study also claimed that caprylic acid has potential application for anti-cancer, anti-aging, anti-Alzheimer’s disease, anti-autism, anti-infection, and general circulatory improvement (6).
Uses: Coconut oil has many different uses. Here are just a few of them:
- It’s a great oil for cooking. Because of its high saturated fat content it is slow to oxidize, and thus is less likely to become rancid like most other oils.
- Add coconut oil to your smoothies (like I do!). I usually rotate between coconut oil and avocados, and when I add coconut oil to my smoothies I’ll add approximately one tablespoon.
- Use it as a lotion or moisturizer for dry skin
- It’s great for oil pulling. This is something I commonly do, as I will put a little less than one tablespoon of coconut oil in my mouth a few days per week and swish it around. And there is a study which shows that oil pulling with coconut oil can decrease plaque formation and gingivitis (7).
- Many people use coconut oil as a carrier oil for essential oils
- Coconut oil can also be used as a hair conditioner, although I can’t say that I personally have used it in this manner.
What Type Of Coconut Oil Should You Use?
Coconut oil needs to be extracted from the coconut. Virgin coconut oil is the least refined type. Virgin coconut oil has a higher antioxidant status than non-virgin coconut oil (8). I add virgin coconut oil to my smoothies. However, some sources claim that you want to use refined coconut oil when cooking at very high temperatures, as it has a higher smoke point than virgin coconut oil. The smoke point of an oil is the temperature under which volatile compounds and other potentially harmful products are released. If you are using coconut oil as a carrier oil for essential oils then you want to use either virgin coconut oil, or fractionated coconut oil.
Other Research Studies on Coconut Oil
Although earlier I discussed some of the research with regards to the individual components of coconut oil (lauric acid, capric acid, and caprylic acid), there are many other studies which discuss the health benefits of using coconut oil.
Cardiovascular health. Coconut oil can benefit cardiovascular health, and one study showed how virgin coconut oil has cardioprotective effects (9). Another study showed that virgin coconut oil prevents blood pressure elevation and improves endothelial function (10). Another study shows that coconut oil can lead to a beneficial lipid profile (11).
Candida. Coconut oil has antimicrobial properties, and can be especially effective against Candida species. I mentioned some of the research regarding Candida earlier, and one study discussed the problems with drug-resistant Candida species, and suggested that coconut oil should be used in the treatment of fungal infections (12).
Insulin resistance. Can coconut oil help with insulin resistance? One study showed evidence that virgin coconut oil might prevent the development of insulin resistance (13). Another study showed that coconut oil can lead to lower glucose and insulin concentrations (14).
Alzheimer’s disease. One study showed that the medium-chain fatty acids of coconut oil might be beneficial in Alzheimer’s disease by converting to ketones, which are an alternative energy source in the brain (15).
Anti-inflammatory and analgesic properties. One study I came across showed that virgin coconut oil has anti-inflammatory and analgesic properties (16).
Bone density. A rat study I came across showed that rats who consumed virgin coconut oil had greater bone volume, and the study concluded that virgin coconut oil was effective in maintaining bone structure and preventing bone loss (17).
Can Coconut Oil Increase Thyroid Hormone Production?
Can coconut oil have a direct effect on thyroid health? Well, some sources claim that coconut oil can raise basal body temperatures and increase metabolism. And because of this some feel that coconut oil can benefit people with hypothyroid conditions, and if you do some searching on the Internet you’ll find some websites which claim that taking coconut oil can help to boost thyroid function. And if this is the case, then those with hyperthyroidism and Graves’ Disease might be concerned that taking coconut oil can be harmful by increasing thyroid hormone production. Well, there are no studies I’m aware of which show that taking coconut oil can improve thyroid function. In addition, I commonly recommend coconut oil to those with both hypothyroid and hyperthyroid conditions, and I can’t say that I’ve seen problems with people with hyperthyroidism and Graves’ Disease taking coconut oil.
So hopefully you learned some valuable information about coconut oil in this blog post. Although it is questionable as to whether coconut oil has a direct effect on thyroid health, it seems to have many other health benefits. One of the greatest benefits is that it has antimicrobial properties. Coconut oil is also a great oil for cooking, it can be used for oil pulling and as a carrier for essential oils, it can be used as a lotion or moisturizer, and it can be added to your smoothies. Virgin coconut oil is the least refined type, and it has a higher antioxidant status than non-virgin coconut oil. In the next blog post I’m going to talk in detail about olive oil, and I’ll also briefly mention a few other healthier oils you can consume.
Occasionally someone will ask me what the difference is between Hashimoto’s Thyroiditis and Graves’ Disease, and so I figured I’d write a brief blog post which discusses the main differences and similarities between these two conditions. First of all, both Graves’ Disease and Hashimoto’s Thyroiditis are autoimmune conditions that affect the thyroid gland. However, they both affect the thyroid gland differently, and because of this the treatment for managing the symptoms are also different.
Let’s take a look at the similarities and differences between Graves’ Disease and Hashimoto’s Thyroiditis:
Here Are The Similarities Between Graves’ Disease and Hashimoto’s Thyroiditis:
1. Both Graves’ Disease and Hashimoto’s Thyroiditis are Autoimmune Thyroid Conditions. Both of these are autoimmune conditions which affect the thyroid gland. And so while managing the thyroid symptoms frequently is necessary, the overall goal should be to restore the health of the immune system.
2. Both Graves’ Disease and Hashimoto’s Involve The Triad of Autoimmunity. The triad of autoimmunity involves 1) a genetic predisposition, 2) an environmental trigger, and 3) a leaky gut. To be honest, it hasn’t been proven that everyone with an autoimmune condition has a leaky gut, although the evidence is very strong. But assuming this is true, then the goal with both Graves’ Disease and Hashimoto’s Thyroiditis should be to detect and remove the environmental trigger, along with doing things to heal the gut. Of course nothing can be done for the genetic predisposition, but the good news is that the autoimmune component can be reversed if the trigger is removed and the gut is healed.
3. Most Endocrinologists Don’t Address The Autoimmune Component. Unfortunately, most endocrinologists focus on the thyroid gland, while not doing anything to improve the health of the immune system. This comes down to the training they receive in medical school.
4. Both Graves’ Disease and Hashimoto’s Can Be Treated Naturally. Even though there isn’t a permanent cure for autoimmune thyroid conditions, following a natural treatment protocol can help to reverse the autoimmune component. And so it is possible to get into remission and then maintain your health thereafter.
Here Are The Differences Between Graves’ Disease and Hashimoto’s Thyroiditis:
1. Graves’ Disease and Hashimoto’s Thyroiditis Affect the Thyroid Gland Differently. Most people reading this know that Graves’ Disease is typically associated with hyperthyroidism, while Hashimoto’s Thyroiditis is usually associated with hypothyroidism. And the reason for this is because the immune system attacks different parts of the thyroid gland with different autoimmune conditions. So with Graves’ Disease the immune system attacks the TSH receptors, which causes the thyroid gland to secrete an excess amount of thyroid hormone. Here is an article I wrote on the symptoms of hyperthyroidism. “On the other hand, Hashimoto’s Thyroiditis involves damage to either thyroglobulin, which is a protein of the thyroid gland, or thyroid peroxidase, which is an enzyme involved in the production of thyroid hormone. Here is an article I wrote on the symptoms of hypothyroidism.
2. Graves’ Disease and Hashimoto’s Thyroiditis are characterized by different thyroid autoantibodies. I mentioned how with Graves’ Disease the immune system attacks the TSH receptors, and because of this, most people with this condition will have TSH receptor antibodies, with the most common type being thyroid stimulating immunoglobulins. On the other hand, Hashimoto’s Thyroiditis typically involves either thyroglobulin antibodies, thyroid peroxidase antibodies, or in some cases both of these antibodies are elevated.
Can Someone Have Both Hashimoto’s Thyroiditis and Graves’ Disease At The Same Time?
It is possible for someone to have the antibodies for both Graves’ Disease and Hashimoto’s Thyroiditis. This is actually common, as a lot of people with elevated thyroid stimulating immunoglobulins also have elevated thyroid peroxidase antibodies. Some people have elevated thyroid stimulating immunoglobulins and elevated thyroglobulin antibodies. And there are some people who have all three thyroid antibodies elevated.
This doesn’t necessarily mean that people with the antibodies for both Hashimoto’s Thyroiditis and Graves’ Disease will have symptoms of both hypothyroidism and hyperthyroidism. For example, many people with elevated thyroid stimulating immunoglobulins and thyroglobulin antibodies will primarily experience hyperthyroid symptoms initially. However, if the autoimmune component isn’t addressed then they very well might become hypothyroid in the future due to damage to the thyroid gland. With that being said, there are some people with both types of antibodies who do experience a fluctuation of hypothyroid and hyperthyroid symptoms.
Keep in mind that if someone does have the antibodies for both Hashimoto’s Thyroiditis and Graves’ Disease then the treatment approach will be similar to someone who only has one type of antibody. In other words, the primary goal is to reverse the autoimmune component. However, the symptom management will of course differ depending on whether the person is experiencing hyperthyroid or hypothyroid symptoms.
So hopefully you understand some of the similarities and differences between Graves’ Disease and Hashimoto’s Thyroiditis. Both of these are autoimmune conditions that affect the thyroid gland, and both involve the triad of autoimmunity. However, these conditions affect the thyroid gland differently, and they are characterized by different thyroid autoantibodies. And it is possible to have the antibodies for both Hashimoto’s and Graves’ Disease. The good news is that it is possible to reverse the autoimmune component of these conditions.
I’d like to wish you a happy Thanksgiving! I want you to know that I sincerely appreciate you! Thank you so much for reading my articles and blog posts. I’d also like to thank all of the other healthcare professionals who educate their patients, email subscribers, etc. Even though we still have one more month to go in 2016, I’m already preparing to share more great content with you in 2017!
Best of health,
Last month I wrote a blog post entitled “What’s Your Experience With Gluten?” Not surprisingly, many of the comments received were from people who felt better upon eliminating gluten from their diet. While not everyone who gives up gluten notices an improvement in their symptoms or labs, many people do. And the same is true with dairy, although I will say that in general people seem to be more resistant to give up dairy. And while having pasteurized and homogenized milk might not be healthy for you, other forms of dairy do have health benefits.
For example, many people do well when consuming raw dairy. Others do fine eating fermented forms of dairy, such as kefir. And many people do well when eating grass fed butter and ghee. But if someone is following a strict autoimmune paleo diet, or even a standard paleo diet, then all forms of dairy should be excluded.
Anyway, I’d like for you to share your experience with dairy. You can talk about milk, cheese, butter, ghee, etc. You can talk about pasteurized dairy, raw dairy, and fermented dairy. If you have been dairy free for awhile and feel like it has benefited your health please let me know! And if you consume dairy regularly and are doing well please let me know! Thank you in advance for participating!
Today’s blog post includes an interview of Jen Wittman, who reversed her Hashimoto’s condition through diet and lifestyle. Jen is a holistic health care expert and a thyroid/autoimmune coach who has degrees in culinary arts, psychology, transformational coaching, nutrition, and Italian. She spent a year honing her cooking skills in Italy and is passionate about physical rejuvenation, family, laughter and helping people craft the life of their dreams.
Dr. Eric: When reading your book it looked like you had a similar diet to myself growing up! Chips Ahoy, Spaghetti O’s, Hostess cupcakes, Pepsi, etc. How hard did you find it to make the transition from eating junk food to eating a clean diet?
Jen: At first, I found it terribly challenging to transition from eating junk food to eating a clean diet not because the changes were difficult but because I had a lot of emotional ties to certain foods and my general mindset around changing my diet. I wanted to see if I could reverse Hashimoto’s without altering my diet at all…and I tried…but it didn’t work. I tried every other healing modality I could find just so I could avoid making any dietary changes, but over time, it became clear that if I didn’t change my diet, my health wouldn’t improve either. In fact, I realize now that I stayed sick an extra year and a half because I was unwilling to change my diet. Once I changed my mindset and looked at changing my diet as a gift I was giving myself, my health improved immediately. Each nourishing dietary change I made gave me more energy and helped me to get my thyroid and antibody levels back to optimal.
Dr. Eric: How challenging was it to give up gluten?
Jen: As a trained chef, foodie and Italy lover, it was especially challenging at first for me to give up gluten. I didn’t want to give up any of my favorite foods like biscuits and gravy, fried mozzarella sticks, pastas and pastries. I just didn’t want to do it. But one day, I felt so awful that I decided I’d had enough. Was eating a donut more important than having the energy to play with my son? Was having a croissandwich more important than feeling fit in my body and having my hair back? Was it worth it to feel crummy everyday just so I could eat foods with gluten? No! In the end, I decided my health, my energy, my mood and my body were more important than gluten. Once I put the emphasis on feeling my best by eliminating gluten, it was easy to make the switch.
Dr. Eric: When you moved from Los Angeles to Italy you spoke about the “Italian lifestyle” and compared it to the “United States lifestyle”. Can you please elaborate on this?
Jen: Yes! The Italian lifestyle was so eye opening for me. I was used to the Type-A go-go-go lifestyle of the U.S. – fast food, lots of doing, lots of multi-tasking and an overwhelming schedule. When I got to Italy, I was so surprised at how different it was from the U.S. First, food is really valued there. The ingredients are high quality, unprocessed, simple, and fresh. People really honor their meals by sitting down and taking time to eat together (not alone, in the car or standing up!). One eats at home usually for all meals and eats “slow” food. In general, everything is done at a slower pace in Italy. “Being” with friends and family is more of a priority than “doing” a million things. It really helped me understand the importance of balancing work and life in healthier way.
Dr. Eric: You developed Hashimoto’s Thyroiditis during your pregnancy. Can you explain why it’s common for women to develop Hashimoto’s when pregnant?
Jen: So many major shifts happen during pregnancy – changes in hormone levels and immune function can play a role. Sometimes, pituitary function changes as well. And many women are now going into their pregnancies already stressed by demanding work/life schedules, or physical challenges like food sensitivities, autoimmune conditions, gut infections or blood sugar imbalances. These challenges coupled with the enormous hormonal changes during and post-pregnancy make women’s bodies the perfect storm for Hashimoto’s (and post-partum depression) to occur.
Dr. Eric: In your book you mentioned that “love” is what allowed you to heal and reverse the symptoms of your condition? Can you please talk about this?
Jen: Yes, I was really awakened (by one of my doctors) to the fact that as women, we tend to nourish, care for and serve everyone else in our world but we don’t often apply that same love to ourselves.
As I learned more about thyroid and autoimmune conditions, it became clear that my needs weren’t being met…and I wasn’t allowing them to be. I often didn’t speak up when I needed help and I rarely reached out for support. I wasn’t showing myself the same love I was giving to others. And when you think of what an autoimmune condition is, it really is the body attacking itself. And with Hashimoto’s, the body is attacking your thyroid, the seat of communication. So, if you’re not speaking your mind and your truth, and you’re holding on to a lot of stress, anger, shame, guilt and you’re not asking for help, your body is manifesting symptoms in your thyroid to get your attention. For Hashimoto’s, I see it time and time again with my clients, the message your body is screaming at you is that you need to love yourself, care for yourself and speak your mind. You have to nourish yourself first before you can take care of everyone else.
Dr. Eric: In your book you discussed how you started a self-love practice every single day. How did this benefit you? Also, I assume this is something you recommend for others to do?
Jen: Yes, I’d absolutely recommend this practice to do. It has benefited me enormously by allowing me to put myself first at some point every day. It has helped me to reduce my stress levels and have more energy throughout the day as well.
Dr. Eric: You spoke about how your thyroid levels were always within the “normal” range, but not within the optimal range when you were dealing with Hashimoto’s. Can you talk about this, and why people can’t rely on the lab reference ranges?
Jen: Yes. This is the single most prominent reason thyroid conditions go undiagnosed and misdiagnosed so often. The lab reference ranges for normal thyroid levels are way too large and aren’t even based on people with thyroid conditions. So, a person can have all the symptoms of a thyroid condition but their thyroid levels look normal because the range is so large. Instead, the key is to focus on the optimal functional levels for your thyroid. For most people, being just outside the optimal ranges in one direction or the other indicates that the thyroid isn’t functioning optimally and this is why you’re having so many symptoms. When we look at symptomatic clients/patients, we can see that those with symptoms often fall outside of the optimal ranges but within the “normal” ranges. And, the medical community/insurance companies need to start diagnosing thyroid conditions when they fall outside of the optimal range so that more people can catch the condition in its early phase; making it easier to reverse.
Dr. Eric: Can you please talk about the three transformative phases of healing?
Jen: Sure! When it came to healing thyroid and autoimmune conditions in my practice, three stages began to emerge consistently. I called them The Caterpillar, The Cocoon and The Butterfly.
The Caterpillar is the phase of nourishment – nourishing your body and mind with healing foods and self-care. In this phase, you are putting the most focus on your healing.
The Cocoon is the phase of restoration. It is a time of rest so your body can repair itself. It’s also the optimal time to go within and address stresses, obstacles and getting the support you need from others. During this phase, your body is rebuilding and rebalancing itself.
The Butterfly is the phase of freedom. This is when you emerge from the cocoon whole again and ready to fly. You can put less focus on healing because your symptoms are gone and the thyroid or autoimmune condition has been reversed.
To discover which phase you’re in, there’s a free assessment on my site. Click here.
Dr. Eric: Can you explain why having a healthy thyroid is necessary to have a healthy gut, and vice versa?
Jen: Poor gut health is intricately connected to low thyroid function and additionally, can trigger Hashimoto’s disease. When your thyroid isn’t functioning optimally, it causes inflammation and immune dysregulation which in turn causes a leaky gut. The leaky gut then causes more inflammation and immune dysregulation which then further harms the thyroid. Press repeat. The cycle of destruction is endless if it is not addressed.
Dr. Eric: You mentioned how limiting sugar is one of the fastest ways to see results when you’re trying to heal from Hashimoto’s. Why is this?
Jen: Sugar is so incredibly inflammatory to the body. When there’s a lot of sugar in your diet, your body spends a lot of time and energy dealing with the inflammation and not repairing itself. Also, oftentimes, women with thyroid conditions also have issues with candida and sugar feeds candida. It also promotes weight gain and blood sugar, insulin and leptin imbalances.
Dr. Eric: I’m always encouraging my patients to eat more veggies, and in your book you also said that you believe in “veggie heavy Paleo eating”. How many servings of vegetables per day do you recommend?
Jen: I’m lazy about counting calories (which I never recommend) or servings…instead, I like to make things quick and simple and encourage folks to look at their plates. At each meal, make sure 75% of your plate is filled with veggies. I recommend 50% cooked veggies and 25% raw (like a salad) and then 25% a high quality protein. That’s just a simple way to eyeball it. I also encourage fruit smoothies with greens and fresh green juices as a way to get more veggies in your diet. I am personally not a veggie lover. I wasn’t raised to be…so this is my simple way to make sure I’m getting enough veggies in my diet.
Dr. Eric: What are some of your favorite techniques for managing stress?
Jen: For me, it’s singing. Singing massages the thyroid, it helps regulate breathing and it immediately puts me in a less stressed mood. Other techniques I love for managing stress are EFT (Emotional Freedom Technique), acupuncture, massage, epsom salt baths and journaling. Really though, anything that brings you joy and helps you refocus your energy on giving time and care to yourself, is a great tool for managing stress.
Dr. Eric: Thank you for this interview Jen. Please tell my readers where they can find out more about you.
Jen: You can find me at Thyroid Loving Care www.ThyroidLovingCare.com and right now, I’m able to give away free digital copies of my book, Healing Hashimoto’s Naturally. And, if you’re a food lover like me, follow my adventures at The Gluten-Free Food Crawl, where I go all over the globe in search of the best gluten-free meals out there.
I have been recommending adrenal saliva panels to most of my patients for approximately seven years. There are numerous reasons for this, which I will explain in this blog post. On the other hand, some natural healthcare professionals don’t do any adrenal testing. They instead assume that most of their patients have adrenal problems and simply recommend general adrenal support to all of their patients. So is it best to test the adrenals, or since most people have adrenal issues is it best to just treat the adrenals, and not do any testing?
When I was diagnosed with Graves’ Disease I obtained an adrenal saliva panel. The results showed depressed cortisol and DHEA levels, along with a depressed secretory IgA. Even though I didn’t think that stress was a factor, after seeing the results of my adrenal saliva panel it made me realize that stress probably was one of the biggest factors, and perhaps the main factor in the development of my Graves’ Disease condition. But this of course was just my experience, and so this doesn’t necessarily mean that everyone should get their adrenals tested, right? Well, what I’d like to do is discuss why I choose to test the adrenals in my patients, and then for arguments sake I’ll also list some reasons why you might not want to have the adrenals tested.
Why Do I Choose To Test The Adrenals In Most Of My Patients?
Here are the main reasons why I recommend for most of my patients to obtain adrenal saliva testing:
1. Most people have adrenal problems. Of course everyone deals with stress, but the main problem isn’t the actual stressor, but one’s perception of the stressor. Unfortunately most people don’t do a good job of handling stress. As a result, most of the patients I work with have adrenal issues.
2. Not all adrenal imbalances are treated the same. While some natural healthcare professionals offer general support for the adrenals, the problem is that not all adrenal problems are the same. Sure, everyone should manage their stress levels, and regardless of the state of your adrenals it usually won’t hurt to take adaptogenic herbs and some nutrients such as vitamin C. But this doesn’t mean that everyone with adrenal problems can or should be treated the same way. As an example, when I was dealing with Graves’ Disease, I took herbs and nutrients which helped to increase cortisol production, which made sense since I had depressed cortisol levels. However, many people have elevated cortisol levels, and when this is the case they of course want to do things to decrease cortisol production. And the only way to know for certain if someone has elevated or depressed cortisol levels is through testing.
3. Blood testing doesn’t look at the circadian rhythm of cortisol. Some doctors will test the morning cortisol levels through the blood. And while this has some value, blood testing doesn’t look at the circadian rhythm of cortisol. This is important because even if the morning serum cortisol looks good, this doesn’t mean that the person has a normal circadian rhythm, as it’s possible for cortisol to be depressed or elevated at other times during the day. Plus, remember that cortisol increases during stressful situations, and many people get stressed out when getting blood drawn, which can lead to a false high or normal reading of cortisol.
4. Seeing is believing. What I mean by this is that some people need to see that they have compromised adrenals before they will start to make the necessary lifestyle changes. This definitely described me, as before I received the results of my first adrenal saliva test I didn’t expect the results to show depressed cortisol and DHEA levels. Prior to doing the saliva test I always thought I did a good job of handling stress, but the results of the saliva test proved me wrong. And without seeing the results I probably wouldn’t have worked on improving my stress handling skills, which is not only a big factor when it comes to restoring one’s adrenal health, but is also important when it comes to maintaining healthy adrenals.
5. The saliva panel I recommend doesn’t just evaluate cortisol and DHEA. In addition to looking at cortisol throughout the day, along with DHEA, the company I use looks at a few other useful markers. One of these is 17-OH progesterone, which is a precursor of cortisol. This can provide some value, as depressed 17-OH progesterone levels are common with weakened adrenals. Secretory IgA is also evaluated, and I spoke about the importance of this marker in an article entitled “How Does Secretory IgA Relate To Thyroid Health?”
Why Shouldn’t You Test The Adrenals?
Let’s look at a few of the reasons why you might not want to do an adrenal saliva test.
1. Most people have adrenal problems. Of course I used this same argument as a reason why most people SHOULD get adrenal testing, but as I mentioned earlier on, some healthcare professionals use this as a reason NOT to get the adrenals tested. They just recommend for all of their patients to do things to improve their stress handling skills, give their patients general adrenal support, etc. And while some people will do fine with taking some general support, others need more specific support based on their individual adrenal state.
2. Adrenal saliva testing can be expensive. The truth is that most testing is expensive, and you therefore want to prioritize the testing that you obtain. I’m pretty conservative when it comes to testing, but at the same time I will recommend those tests I feel are necessary.
In summary, different natural healthcare professionals will take different approaches with regards to testing the adrenals. Some natural healthcare professionals won’t do any adrenal testing, but instead will recommend general adrenal support. On the other hand, I have most of my patients obtain an adrenal saliva panel, and I gave a few reasons for this in this blog post. While it is true that many people have adrenal issues, different adrenal imbalances shouldn’t be treated the same say, and seeing compromised adrenals on a saliva panel can serve as further motivation to do what is necessary to improve the health of the adrenals.
A few years ago I wrote a blog post on the 4-R protocol. Since then it’s been updated to the “5-R Protocol by the Institute for Functional Medicine”, and I figured it would be a good idea to update and expand on the original post I wrote on this topic. If you’re not familiar with this protocol then you’ll quickly realize that it relates to the healing of the gut, and a leaky gut is a factor with most, if not all autoimmune conditions, including Graves’ Disease and Hashimoto’s Thyroiditis. And while the information in this post will focus greatly on thyroid autoimmunity, even if you don’t have an autoimmune thyroid condition, I feel that a lot of people can benefit from this information.
So let’s dive right into the protocol and discuss each of the five components
1. Remove. Although genetics is a factor with most, if not all autoimmune conditions, in order for someone to develop autoimmunity they must be exposed to an environmental trigger. And in order to reverse the autoimmune component and restore the person’s health it is necessary to find and remove the trigger. The same is true with regards to healing a leaky gut. While many people with a leaky gut will take supplements such as L-glutamine, and eat gut-healing foods such as bone broth, you won’t be able to heal your gut if you don’t detect and remove the leaky gut trigger.
This of course is easier said than done at times, as it’s not always easy to find out what the trigger is. However, these are some of the common factors which can cause a leaky gut:
Food allergens. Although many food allergens can potentially cause an increase in intestinal permeability, in the research I was able to find evidence for gluten (1), corn oil (2), and red wine (3) being factors which can cause a leaky gut.
Gut infections. In the literature there are numerous infections which can cause an increase in intestinal permeability. This includes candida (4) (5), H. Pylori (6), Blastocystis hominis (7) (8), and giardia (9). There is also evidence that small intestinal bacterial overgrowth can cause an increase in intestinal permeability (10) (11).
Systemic Inflammation. I also came across a study which showed that systemic inflammation can cause an increase in intestinal permeability (16).
Finding the trigger is arguably the most difficult component of the 5-R protocol. But once this has been accomplished you can move onto the next four components, which I’m about to discuss.
2. Replace. The next component is to replace certain factors which play a role in digestion. Many people reading this have taken digestive enzymes. These include enzymes to break down protein (proteases), carbohydrates (amylase), and fat (lipase). Many people with low gastric acid (stomach acid) can benefit from taking betaine HCL with meals. Gastric acid consists mostly of hydrochloric acid, which is released from the parietal cells of the stomach. It plays a role in activating pepsinogen into the active enzyme pepsin, which in turn breaks down proteins.
Some people can also benefit from supplementing with bile salts. This is especially true for those people who have had their gallbladder removed, as getting gallbladder surgery doesn’t address the bile metabolism issues commonly associated with these conditions. But some other people can also benefit from taking bile salts, such as those who have problems emulsifying fats.
Although dietary fiber doesn’t fall under the same category as digestive enzymes, betaine HCL, and bile salts, many people don’t consume enough dietary fiber, which is important for numerous reasons. First of all, fiber helps to feed the good bacteria of the microbiota. In addition, having sufficient dietary fiber is important for having regular bowel movements.
3. Reinoculate. Many people take probiotic supplements, which is one method of reinoculating, or repopulating the gut flora. And of course there are ways to accomplish this through diet as well. But why do people have to reinoculate in the first place? Well, there are many different factors which have a negative effect on the microbiota, including the foods we eat, taking antibiotics, being exposed to other environmental toxins, and even chronic stress can have a negative impact on our gut flora.
So what is the best way to reinoculate? To be honest, we’re still in the beginning stages of dealing with probiotics, and so the approach we take now very likely won’t be the approach we take five to ten years from now. I commonly recommend a probiotic supplement to my patients, but even this comes with some controversy, as not all probiotic supplements are created equally. And some healthcare professionals like myself will recommend formulations with specific, well-researched probiotic strains, while other doctors won’t pay as much attention to the strains included, but instead will focus more on the diversity. In other words, some will recommend a probiotic which has many different species, without worrying about the specific strains.
While it can be beneficial to take a probiotic supplement, it also is a good idea to take some prebiotics, and eat food sources of probiotics. With regards to prebiotics, one can take a prebiotic supplement such as inulin or larch arabinogalactan, or you can eat prebiotic foods such as Jerusalam artichokes, asparagus, onions, chicory, bananas and other fruit, and even green tea is considered to be a source of prebiotics (17) (18). The reason why prebiotic foods are important is because they feed the good bacteria such as bifidobacteria and lactobacilli, and these foods also are good sources of short chain fatty acids.
Probiotic Supplements vs. Food Sources
But why take a probiotic supplement when there are some excellent food sources of probiotics? After all, foods such as sauerkraut, kimchi, kombucha, kefir, and a good quality source of yogurt can all be good sources of probiotics. Well, I recommend getting probiotics from both supplements and food sources, and the reason for this is because the supplements you take will have different strains than the food sources. Plus, many people simply don’t eat enough food sources of probiotics.
What About Soil-Based Probiotics and Fecal Transplants?
Over the past year I’ve had a lot of people ask me about soil-based probiotics, and I only recently started using these in my practice, and so I can’t say I have much experience with these. Some examples of soil-based probiotics include bacillus subtilis and bacillus coagulans. These are also known as spore-based probiotics. These not only are more resistant to the gastric acid of the stomach than some other probiotic strains, but some sources claim that they colonize the gut more effectively. If anyone reading this has had a positive experience while taking spore-based probiotics please feel free to share your experience in the comments section below.
I don’t get asked as much about fecal microbiota transplants, but I figured it was worth mentioning this here because this can potentially help with many different conditions. This essentially involves transplanting healthy bacteria from one individual to another individual. It seems to be very effective in helping people with Clostridium difficile, and while it hasn’t been approved for other conditions in the United States, this probably will change in the future.
4. Repair. Many people reading this are familiar with a “leaky gut”, which I briefly spoke about earlier. This is when the intestinal barrier is compromised, which allows larger proteins to pass into the bloodstream, where they normally shouldn’t be. As a result, the immune system sees them as being foreign and mounts an immune system response. Some claim that in order for autoimmunity to develop you need 1) a genetic predisposition, 2) an environmental trigger, and 3) a leaky gut. I briefly spoke about this earlier when I discussed the “remove” component of the 5R protocol. And of course this component is focusing on repairing the gut.
But before talking about how to repair the gut, it probably is a good idea to explain how one can determine if they have a leaky gut in the first place. There is testing available, as there is a test called the Lactulose/Mannitol test that can determine if someone has an increase in intestinal permeability (a leaky gut), and there is also a test from the company Cyrex Labs called the Intestinal Antigenic Permeability Screen. I have used both of these tests in the past, but these days I usually just assume that my patients have a leaky gut, especially those with Graves’ Disease and Hashimoto’s Thyroiditis.
As for how to repair the gut, this can be accomplished through a combination of supplementation and diet. One of the most common nutrients recommended by healthcare professionals is L-glutamine, which is an amino acid that serves as fuel for the cells of the small intestine. Vitamin A and zinc can also play important roles in gut healing, and herbs such as slippery elm, licorice, and marshmallow root can also help to support the gut. Foods which can help heal the gut include bone broth, cabbage juice, and fermented foods such as sauerkraut.
5. Rebalance. This used to be called the “4R protocol”, but not too long ago the Institute for Functional Medicine added a fifth component, which is to rebalance your body through sleep, stress management, etc. I’m not going to discuss this in detail here, but this of course doesn’t mean that this component isn’t important. I’m always talking about the importance of stress handling, as doing a poor job of managing your stress can have a profound effect on your health. And most people are aware of the importance of getting sufficient sleep, although in some cases it is necessary to improve other aspects of one’s health in order to help them sleep better.
Can You Address More Than One Of These Components Simultaneously?
Some people might wonder if they can address more than one component at the same time. In other words, if someone has a gut infection, can someone take digestive enzymes and probiotics at the same time that the infection is being eradicated? Without question the answer to this is “yes”, as most healthcare professionals address different components simultaneously, including myself. And so it isn’t necessary to focus on one of these components at a time.
In summary, the 5-R protocol relates to the healing of the gut, and a leaky gut is a factor with most, and possibly all autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis. The first, and perhaps most important component is removal of the trigger, which can include a food allergen, an infection, environmental toxin, and even stress. The remaining four components of the 5-R protocol are replace, reinoculate, repair, and rebalance.
Last month I wrote a blog post entitled “What’s Your Experience With Iodine?”, which was very popular and received a good number of comments. And so I figured I’d run a similar blog post, but this time focus on gluten. Unlike iodine, most people who go on a gluten free trial don’t experience negative results, and many people feel significantly better upon avoiding gluten. However, there are also people who avoid gluten for a prolonged period of time and see no improvement in their symptoms, blood tests, etc.
So what I’d like for you to do is please share your experience with gluten. If you avoided gluten and it helped improve your symptoms or blood tests please let me know! And if you avoided gluten and you didn’t notice any improvement in your symptoms or tests please let me know! And if you are one of those rare people who went on a gluten free trial and had a worsening of your symptoms please let me know!
Also, please feel free to be as specific as possible. So for example, if you experienced gas and bloating, brain fog, daily headaches, skin problems, or any other sign or symptom that improved upon eliminating gluten please share this with everyone. Or if you noticed a significant improvement in your thyroid hormone levels, thyroid antibodies, or any other test markers please share this with us as well. Thank you in advance for participating!
Although many people with thyroid and autoimmune thyroid conditions are trying to lose weight, some people with these conditions are actually trying to gain weight, or at the very least, don’t want to lose any additional weight. This is especially true for those with hyperthyroidism and Graves’ Disease, but it’s also true for a small percentage of people with hypothyroidism and Hashimoto’s Thyroiditis. And following an autoimmune paleo diet can make this even more of a challenge, as while the goal of following this diet isn’t to reduce calories, it still is a very restrictive diet.
So if you are following an autoimmune paleo diet and are looking to gain weight and/or maintain a healthy weight, then here are a few things you can do:
1. Decrease the thyroid hormone levels. This mainly applies to those people with hyperthyroidism and Graves’ Disease, although if someone with hypothyroidism is taking too high of a dose of thyroid hormone medication then it also can apply to them as well. Either way, having high thyroid hormone levels will usually make it very difficult to gain weight. It’s not uncommon for one of my patients with hyperthyroidism to tell me how concerned they are about their weight loss, and while some of the other advice given in this blog post might help to prevent them from losing additional weight, in many cases they will need to address the thyroid hormone levels before the weight loss subsides.
This described my situation when I was dealing with Graves’ Disease, as I lost over 40 pounds. And I didn’t gain any weight until my thyroid hormone levels started to decrease. Of course some people who take antithyroid medication have the opposite problem, as the medication will make them hypothyroid and cause them to gain weight. This weight gain usually can be minimized by not taking too high of a dosage of antithyroid medication. Sometimes taking too high of a dosage of bugleweed can also cause weight gain, although it’s not as common as taking higher doses of antithyroid medication.
2. Eat nutrient dense foods. Although the autoimmune paleo diet is restrictive, it is also very nutrient dense. And while I understand the concern about not getting enough calories, it is better to consume less calories consisting of nutrient dense foods rather than eating a lot of high calorie, low nutrient dense foods. With that being said, eating a good amount of protein, along with a lot of healthy fats when following an autoimmune paleo diet can help you maintain a healthy weight, and might even cause you to gain weight.
Most people who follow such a diet focus more on the protein, as for example, they might eat meat with every meal. But don’t underestimate the benefits of eating a lot of healthy fats and oils. Avocados and coconut oil are two main sources of healthy fats to consider consuming, but other healthy fats and oils include olive oil, tallow, and coconut milk.
3. Heal the gut. Problems with digestion or absorption can cause someone to have problems gaining weight. So for example, while most people with a high TSH and low thyroid hormone levels will have problems losing weight, if you have a high TSH and low or depressed thyroid hormone levels and are losing weight, then I would suspect absorption issues. For example, if someone has inflammatory bowel disease then this can cause weight loss. Celiac disease can also result in malabsorption of nutrients, and cause weight loss.
4. Eradicate infections. Having certain infections can cause some people to lose weight. So for example, having a condition such as small intestinal bacterial overgrowth, or a parasitic infection can cause someone to have problems losing weight. In some cases H. Pylori can cause weight loss. Certain viruses can also result in gastroenteritis and make gaining weight difficult. And so you want to make sure to eradicate any infections.
5. Do things to increase muscle mass. Another way to gain some weight is to do things to increase muscle mass. While eating a healthy diet consisting of a good amount of protein and healthy fats is important, physical activity is also important, and this includes weight bearing exercises. For example, engaging in some light weight lifting three times per week is a good way to increase muscle mass. This doesn’t necessarily mean joining a fitness club, as you can get some light weights and exercise from the comfort of your own home.
So if you are having problems gaining weight when following an autoimmune paleo diet, then hopefully some of the strategies given in this post will help you to overcome this. If you have hyperthyroidism or Graves’ Disease, then in many cases you will need to decrease the thyroid hormone levels before you can gain weight. But other things that can help you to gain weight include eating nutrient dense foods, doing things to heal the gut, eradicate any infections, and increase muscle mass.
Every now and then I’ll have someone ask me if I followed an autoimmune paleo (AIP) diet when I was dealing with Graves’ Disease. The reason I get asked this question at times is because I commonly recommend for my patients with Graves’ Disease and Hashimoto’s Thyroiditis to initially follow an AIP diet. And so they want to know if I followed a similar diet when I was taking a natural treatment approach.
I’m assuming most people reading this know what an autoimmune paleo diet includes. But just to play it safe I’ll briefly distinguish between a “standard” paleo diet and an “autoimmune” paleo diet. A standard paleo diet allows the following foods to be consumed:
Meat (i.e. beef, pork, poultry)
Nuts and seeds
Green tea and herbal teas
So a “standard” paleo diet excludes foods such as dairy, grains, and legumes. And of course it also restricts refined sugars and oils, fast food, etc. Without question it’s a restrictive diet, and while some people struggle following a standard paleo diet, for many people it’s not difficult at all. As for an autoimmune paleo diet, this is even more restrictive than a standard paleo diet, as an autoimmune paleo diet also excludes eggs, nuts and seeds, and the nightshade family of vegetables, which includes tomatoes, eggplant, white potatoes, and peppers.
But why are these foods excluded? Well, the reason why eggs, nightshades, and nuts and seeds are excluded from an autoimmune paleo diet is because they include compounds which can potentially increase the permeability of the gut. And some theorize that a leaky gut is a factor in all autoimmune conditions. I spoke about this in greater detail in a past blog post I wrote entitled “Is a Leaky Gut Present In All Autoimmune Thyroid Conditions?”
Do I Have All Of My Graves’ Disease and Hashimoto’s Patients Follow an AIP Diet?
Initially I recommend for all of my patients with Graves’ Disease and Hashimoto’s Thyroiditis to follow an autoimmune paleo diet for at least the first 30 days. This isn’t to suggest that some people won’t need to follow this diet for a longer period of time. But I don’t think that there is a “one size fits all” diet, and I spoke about this in a past blog post entitled “Should Everyone With Graves’ Disease and Hashimoto’s Thyroiditis Follow an Autoimmune Paleo Diet?”. Although I do think the AIP diet is a good starting point for those with autoimmune thyroid conditions, not everyone needs to follow this diet for a prolonged period time, and not everyone with an autoimmune condition does well on this type of diet.
What Diet Did I Follow When I Was Diagnosed With Graves’ Disease?
So let’s go back to the original question, which asked if I followed an AIP diet when I was diagnosed with Graves’ Disease. First of all, when I was diagnosed with Graves’ Disease I’m pretty sure there wasn’t an official “autoimmune paleo diet”. Back then it was referred to as a “gut repair diet”. Just as a reminder, when I was treating my Graves’ Disease condition naturally I was working with a natural healthcare professional who had experience working with endocrine conditions. And initially she recommended for me to follow a standard paleo diet, and not an AIP/gut repair diet.
As a result I didn’t eliminate the eggs, nightshades, nuts and seeds from my diet. While I was progressing well, on my first saliva test my secretory IgA was depressed, and this marker didn’t improve when doing a retest (although my cortisol and DHEA levels did show some great changes). As a result, the natural healthcare professional I was working with suggested for me to follow a strict gut repair diet, which I did. I don’t remember if this involved giving up eggs. Truth to be told, I’ve never been a big consumer of eggs, as I usually add a couple of raw egg yolks to my smoothies a few times per week, but I usually don’t eat eggs for breakfast on a regular basis like many people do. On the other hand, giving up nuts and seeds was a big challenge for me, as I’ve always loved eating all types of nuts and seeds.
A few months after following the gut repair diet I had another saliva retest, and my secretory IgA had greatly improved. Was following the AIP/gut repair diet responsible for this improvement? I’d like to think so, although I will admit that I’ve had some patients with a depressed secretory IgA not give up nuts and seeds and a few months later this value improved. The truth is that everyone is different, and what works for one person doesn’t always work for the another person with the same condition. In addition, those following a natural treatment protocol are almost always doing multiple things to help improve their health, and so sometimes it can be challenging to know if a specific factor was responsible for the person’s improvement.
Should YOU Follow An Autoimmune Paleo Diet?
If you have Graves’ Disease or Hashimoto’s Thyroiditis (or any other type of autoimmune condition), then you might be wondering if you should follow an AIP diet. As I mentioned earlier, I currently recommend for all of my patients with autoimmune thyroid conditions to at least follow an AIP diet initially. Then after 30 days if they are struggling with the diet I’m open to them reintroducing other foods. Of course some people don’t follow an AIP diet at all, even for the initial 30 days. And some of these people still end up receiving good results, while others don’t progress well.
Even though one can make the argument that not everyone with an autoimmune condition needs to follow a strict AIP diet, it is impossible to know who will progress well without following such a diet. And so if you have Graves’ Disease or Hashimoto’s Thyroiditis you have a few different options, but I’m going to focus on two options here. The first option, which as you now know is the one I recommend, is to play it safe and strictly follow the AIP diet. A second option is not to follow an AIP diet, but to still eat whole healthy foods, avoid refined foods, and see how you progress.
If you choose not to follow a strict AIP diet I would at least encourage you to follow a standard paleo diet for awhile. If you don’t follow an AIP diet and your symptoms, blood tests, and other tests continue to improve then you probably are fine following the current diet. On the other hand, if your health doesn’t improve when following a standard paleo diet then it probably is best to try following a strict AIP/gut repair diet for at least a month or two. Sure, perhaps there are other factors responsible for the lack of progress, but since one’s diet can definitely play a role I think eating well is essential to receive optimal results, even if there are other factors to consider.
In summary, I usually recommend for my patients with Graves’ Disease and Hashimoto’s Thyroiditis to follow an autoimmune paleo diet initially. However, when I was dealing with Graves’ Disease I initially followed more of a standard paleo diet, although I eventually made the transition to an AIP/gut repair diet due to the secretory IgA remaining depressed. While some people with autoimmune thyroid conditions don’t need to follow a strict AIP diet, it’s impossible to know who will do well and who won’t do well when not following such a diet. As a result, I think it’s a good idea to try to be as strict as possible initially, and then as your health improves you should eventually be able to reintroduce other foods.