The thyroid gland is a 2-inch butterfly shaped organ located at the front of the neck. This is often times the gland a physician is checking during an exam when they are touching your neck. It is small in size compared to other organs, however it is a major command center in terms of hormone health and metabolic health. It affects nearly every organ in the body. It helps to regular fat and carbohydrate metabolism, breathing, body temperature, brain development, blood calcium levels, menstrual cycles, skin, integrity, cholesterol levels, and MORE.
The thyroid gland is often one of the big players wreaking havoc in my patients’ bodies as an underactive thyroid has a profound impact on the ability to lose weight. It is an important organ to pay attention to as those with underactive thyroids are at an increased risk of heart disease and diabetes. 27 million americans have one form or another of thyroid disease. The most common condition being hypothyroidism, or an underactive thyroid. In the US this is most commonly caused by an autoimmune response known as Hashimoto’s disease. Essentially, your body creates antibodies that target the thyroid and decrease thyroid function significantly. Other conditions include hyperthyroidism (overactive), goiters (not enough iodine intake), or thyroid cancers. Since hypothyroidism is the most common we will focus on lifestyle and nutrition factors that can help an individual with hypothyroidism.
How do I know if I have an underactive thyroid?
This requires blood testing and is a diagnosis your physician will provide for you. Often physicians will check TSH (thyroid stimulating horomone), T3 and T4 levels. I always recommend a patient ask their physician to also check for the thyroid antibodies such as TPO antibody, Anti thyroid globulin antibodies and thyroid stimulating immunoglobulin. Often times if the thyroid is underperforming, there is a link to adrenal function so checking DHEA-S and cortisol levels is helpful. If your physician is ordering labs, ask them to include these adrenal markers as well.
What symptoms accompany an underactive thyroid?
Potential causes of hypothyroidism
Inflammation that goes haywire causing an immune response that leads to an attack on your bodies own organ.
Leaky gut syndrome
Pregnancy (causes postpartum thyroiditis)
Certain medication interactions
High levels of stress (persistent)
Toxic burden (heavy metals)
What medications will a physician prescribe?
Typically the first line of treatment is with a synthetic drug called synthroid. This supplies only T4. Many, many people are on this drug and see some benefits in symptoms and ability to lose weight, increased energy levels, etc. There are more “natural” forms of medication, the most popular is called Armour, it is sourced from porcine (pig) thyroid glands. It contains both T4 and T3 in a ratio more similar to what a human produces. It is worth asking your physician why they prescribe one over the other. Most will not even consider Armour.
Lifestyle and diet are two of the biggest factors that contribute to healing your thyroid, and if healing it is no longer available, we can support it allowing the most optimal functioning.
Let’s consider lifestyle factors first.
SLEEP MORE, aim for at least 8 hours of sleep at night. I know this sounds like a lot, but your body needs it when your thyroid is underperforming. It will allow for optimal healing.
AVOID STIMULANTS, caffeine in any form is best to be avoided. If you can’t avoid it, I recommend choosing a green tea, so that you get the antioxidant benefits.
MOVE YOUR BODY, but not too much. Choose gentle exercise activities until your medication and stress levels are lowered. Try longer low impact walks or an activity like yoga.
Be patient with yourself and inform your family members what you are dealing with so they can be patient and understanding with you too.
Food and Nutrition
You can do a lot in terms of supporting your thyroid with the right food. Let’s get down to it.
AVOID EXCESS SUGAR. I am serious. Your body doesn’t need it, and your immune system most importantly, doesn’t need it. Cut out cakes, cookies, candy, soda, sugary coffee beverages, etc. A little maple syrup in the oatmeal is fine, but really, take this seriously. It’s the most important food choice to help you recover.
COOK CRUCIFEROUS VEGETABLES (goitrogenic foods). Your body needs iodine for optimal thyroid function, however these vegetables in the raw form have an incredible ability to block iodine from being absorbed. To combat that, cook these vegetables. Broccoli, Kale, Cauliflower, Brusell sprouts, Bok Choy, Kohlrabi, Mustard and Mustard greens, Cabbage. If you are one to add greens to your smoothie, choose something other than Kale, like spinach or arugula.
ADD SEA VEGETABLES OR NATURAL SEA SALT. This will help increase your mineral and iodine intake.
CHOOSE ORGANIC PRODUCE WHEN POSSIBLE. These have higher levels of trace minerals and significantly lower levels of pesticides, which are known endocrine disruptors.
INCORPORATE FOODS RICH IN TRACE MINERALS AND VITAMINS YOUR THRYOID NEEDS TO CREATE THRYOID HORMONE AND CONVERT FROM T4 to T3.
ZINC: red meat, poultry, beans, nuts, seafood
VIT E: liver, eggs, nuts, seeds, sweet potatoes and avocados
B2, B3, B6: meat, seafood, green vegetables, mushrooms, eggs, almonds
Selenium: brazil nuts
Vit C: veggies and citrus
STICK TO WHOLE FOODS. Avoid processed foods as much as possible. Choose fruits and vegetables as snacks throughout the day with a handful of nuts.
What about supplementation?
There are some antioxidants that research has shown improve thyroid function, they include vit C, vit E, turmeric(curcumin) and glutathione. There is a place for supplementation with thyroid issues. However, it’s important to seek the help of a qualified professional. For instance, if you have Hashimoto’s you do not want to supplement with iodine, it can increase the rate of thyroid destruction. This is not the condition to play around with, I would not consult the vitamin clerk at your local healthfood store, speak with a physician or dietitian to get evidence based, proven solutions.
If you suspect Hashimoto’s you most likely have leaky gut and would benefit from food sensitivity testing and an immunocalm diet. You would also consider as a first line of defense, decreasing gluten in your diet as it has been shown to affect hashimoto’s thyroiditis.
Recently I had a blog reader inquire about migraines that reoccur each month a day or two before the start of her next cycle. I used to get migraines 2-3 days before the end of each cycle too, so this question really hit home for me. These migraines are called menstrual migraines and often occur 2 days before the end of your cycle up through the first 3 days of your period. Because of the timing of these migraines, they can be difficult to treat and may not respond to the same medicines that other severe headaches and migraines respond to.
The cause of these migraines is likely one of the following reasons:
The natural drop in magnesium towards the end of your monthly cycle. If this is the cause it can respond to administration of magnesium from the midpoint of your cycle (day 15 for most women) until the second day of your next period. I recommend a form of magnesium that is chelated like: magnesium glycinate, magnesium threonate or magnesium malate. You can start at 400 mg and gradually increase to between 800 and 1000 mg/ day. This can be administered before bedtime to help with relaxing and more sound sleep (magnesium has that effect). While administering magnesium monitor for changes in your stool consistency. Your bowel movements may become more frequent and more soft with magnesium intake. This is not concerning unless you begin having more than 3 bowel movements per day.
The natural drop in estrogen that takes place at the end of the cycle. A natural remedy is to take phytoestrogens in the 7-8 days leading up to your next cycle/period. You can try to add more estrogen rich foods like soy, take a supplement or use an estrogen cream or skin patch.
You can try adding both the magnesium and the phytoestrogens in the same cycle or try one remedy and if no relief is found within 3-4 cycles, try adding in the other. It may take 3-4 cycles for the migraines to respond.
Food! Women tend to crave certain foods in the days leading up to their period. Often times these are the only times they eat these foods or eat high quantities of these foods. Migraines can be triggered in response to the introduction of offending foods or (ENOUGH) of these offending foods [that is to say, it can be dose dependent, one bite may not trigger, but 10 just might].
If you only ever drink red wine or eat chocolate the few days leading up to your period, it could actually be that instead of the hormones or magnesium, and it just happens to be that your patterns match the hormonal shift. Below is a list of foods that tend to trigger migraines. There is some other advice in there too like sleeping and exercise (Surprise).
I always recommend tracking food, lifestyle patterns and symptoms leading up to your period to see if some months you get the headache and others you don't, then compare what may have been different in your diet, etc.
Here is a list of foods that can trigger migraines:
MSG and high-glutamate foods/additives in all forms
All fermented foods including yogurt, sour cream and vinegar
All protein supplements
Peanuts and all nuts
All leftover meats that are more than 36 hours old
The above list reduces some of the bigger sources of tyramine and histamine. During those days leading up to your period, your focus should be on simple foods that have been minimally processed. Additionally, I suggest you focus on regular sleep and hydration with at least a gallon of water per day.
As with many other conditions, migraine triggers “stack.” So, you may be able to have wine and cheese on a pleasant day in the early part of your cycle, but may find that wine and cheese while the barometer is dropping and your period is imminent crosses the pain threshold.
While not homeopathic, if you are open to Over The Counter medications pain relievers like Excedrin migraine or Aleve are best taken as soon as the pain starts. Taking Benadryl seems to enhance the effect of the NSAID and often brings faster relief. MANY migrainuers have a problem with histamine so Benadryl sometimes helps with that. Sometimes the pain is just too much and taking something to get rid of the pain as fast as possible is necessary. If you have to take something don’t kick yourself, just take it and look for the relief.
Often with a few extra pounds to lose hormones are affected. Adipose(fat) tissue play a role in hormone regulation. Sometimes even a small amount of change, namely 10-15 pounds can have great affect on hormones and through the cascade of change, can affect migraine occurrences.
Be patient with yourself when these migraines happen, try laying in a cool dark room, relaxing, finding someone to rub your neck, a cool wet cloth on your forehead, and perhaps some peppermint essential oil to rub on your neck and temples. If you are having migraines throughout your cycle, it may be time to consider having your blood tested for food sensitivities. Your immune system creates chemicals that are pro-inflammatory (make more inflammation) in response to foods you are sensitive to. Eating these foods can trigger migraines, finding out which foods these may be can give you the knowledge and buy you freedom from these painful migraines.
PCOS stands for polycystic ovarian syndrome. It is a syndrome (a combination of symptoms) named for one of the main symptoms experienced by individuals affected, which is many cysts on the ovary(ies). I have a very personal experience with the condition as I was diagnosed with it about 10 years ago, and I remember the gut-wrenching moment I diagnosed by my gynecologist as she explained it is the number one reason why women have fertility issues in America. It can be a very confusing and emotional diagnosis, and it’s one that is somewhat complicated to arrive at.
How is it diagnosed?
Only women will be diagnosed with this condition. One of the following must be present for a clinical diagnosis:
Do I have PCOS?
Your physician (Primary Care or OB/GYN) will likely check your thyroid, skin, hair, breasts, and belly. They will likely check your blood pressure and order an ultrasound of your ovaries. They will also likely order some blood panels to check hormone levels, thyroid, and rule out any other conditions that could cause these same symptoms.
What causes PCOS?
This is the billion dollar question, because well, we don’t know. Most experts think that several factors play a role including genetics and diet. Women with PCOS are more likely to have a sister or mother with PCOS also. One of the main underlying problems with the condition is a hormonal imbalance. The ovaries make more testosterone than normal, high levels affect the development and release of eggs from the ovary, and also affect normal levels of estrogen and progesterone in women. There is also a metabolic issue associated with the syndrome where insulin is not as effective in the body. Insulin is a hormone that controls changes in sugar levels in the blood and if you store or burn the sugar for energy. Many people with PCOS have chronically high levels of insulin because their bodies have trouble using it, so they make more and more and more.
Why do I need to manage this syndrome if I have it?
Women with PCOS have higher risk for developing diabetes, ovarian cancer, and increased rates of infertility. It can also be an embarrassing condition with acne, being overweight or obese, abnormal hair growth, or loss of hair. It can also have psychosocial implications due to body image and confidence.
What should you do if you think you may have PCOS?
Manage controllable lifestyle factors. Even without seeing a physician there are practices you can incorporate that are important for general well-being, but in a woman with PCOS these practices are non-negotiable.
How does western medicine treat PCOS?
Most clinicians will prescribe oral birth control pills to manage the hormone irregularities associated with the condition. They will also prescribe metformin (or it’s generic Glucophage) to help manage the insulin sensitivity factors – this is a drug developed and prescribed to individuals with diabetes. Women will also be advised by fertility experts to have minor surgical procedures called laparoscopic ovarian drilling. What takes place is the ovaries are treated with heat or a laser to destroy the tissue that is producing androgens. I would like to state that oral birth control pills are not the only option for contraceptives and educating oneself on all of your options is important before starting the pill. I wish someone had told me some of the side effects of the pill and downsides to coming off of the pill before I was ever started on it long ago.
Are there more natural forms of treatment?
YES! The best thing you can do for yourself is diet, exercise, stress management and good sleep habits. Managing your weight will be a natural product of these efforts. Having a normal weight will be important for controlling insulin and hormone levels throughout your entire life.
There are also natural remedies like N-acetyl cysteine, inositol, and other hormone regulating supplements like chasteberry extract (also known as vitex). Before starting any of these herbs and supplements, I recommend speaking with a practitioner or dietitian familiar with these treatment approaches who can advise and monitor you.
In terms of fertility options, before feeling destined to taking metformin and clomid, consider other options with a natural practitioners, whether it is a few of the supplements above or acupuncture, there are other ways to improve your fertility beyond pharmaceuticals. These are not hippy, wacky, close your eyes and take it on blind faith approaches either. There are scientific studies that have been performed that provide options for treatment of infertility in this population that have yielded successful pregnancies without invasive methods.
Let me know if you have any questions or think this may be you. I can help you develop a well balanced diet and manage the symptoms of this syndrome.
I'm hoping this is my most read blog of the year. Come on, it's a sexy topic, most nutrition professionals wouldn't talk about, or perhaps even research.
Hormone imbalances, low thyroid function and autoimmune conditions provide daily reminders of illness and fatigue. These conditions can influence all aspects of our life both work and play, fun and LOVIN’. Many are too embarrassed to talk about certain life matters like poop and sex. I am not. And today I’d like to talk about hormones, libido and some foods you can incorporate into every day to boost the health of your sexual organs.
In high states of inflammation adrenal glands release more cortisol (the stress hormone) in an attempt to reduce this inflammation. Adrenals also play a major role in synthesis of DHEA, aldosterone, testosterone, estrogen and progesterone. All of these hormones depend on a common precursor, pregnenolone. The problem is when cortisol is increased, pregnenolone decreases. This results in a hormonal shift that has a cascade of results. For women, high cortisol production can lower progesterone production. Low progesterone causes an estrogen dominance. This cascade continues, high estrogen can lead to decreased amounts of thyroid hormone. This can cause fatigue, aches and pains, lower mental acuity and low libido.
It sounds so dismal right? With high inflammation, high stress, hormone dysfunction, low energy, then a low sex drive. You might even call it a vicious cycle. It’s actually quite incredible. If you have high inflammation or stress levels that are chronic, maybe it isn’t a great time to get pregnant. This is just your bodies natural way to defend you from a situation which will be taxing to an already compromised body system.
What to do? Try to lower stress and feed your adrenals.
How to lower stress? Sleep more, go for a walk, breathe, sweat, take some yoga, start saying "no" rather than going to every party and friend outing, PRAY.
How to feed the adrenals? Adequate vitamin c, B vitamins, and magnesium daily. Vitamin c is often easy to get with some oranges or tomatoes. Magnesium isn’t too rich in our western diet and may require supplementation. A quality B complex also may be necessary to assist your body and help energy levels.
Food first is a major part of my nutrition philosophy. It takes a level of determination to feed your body for optimal health. Isn't it worth it? When we are talking hormone balance, libido, and sex organs it is crucial that your body has good circulation, so nutrients can make it to these cells and organs. It is also important for long term health to have a healthy amount of antioxidants in the diet to fight exposure to free radicals and help prevent oxidative stress and cancer in these organs. Many of the foods that help with circulation listed below help support healthy blood supply to the sex organs, but some have also been shown to support optimal hormone balance and even increase sexual desire. So let's get down to it....
Foods To Help Circulation, Nutrient Distribution, Hormone Balance, And Libido
Pumpkin Seeds- Zinc is essential for hormone production for men and women. Zinc intake is associated with higher sex drive in both men and women. It is also helpful in quality and quantity of sperm production (if you are working on fertility factors). Pumpkin seeds are a great natural source of zinc. I like to grind them and add to oatmeal, smoothies or homemade granola.
Maca- This is a root found in South America. It is difficult to source in America as a food, however it is easy to find in supplemental form. It is known for enhancing sexual desire in both males and females. It has been known to improve sperm motility, improve erectile dysfunction and balance hormones. It is a supplement to start small with and work up to 2-3 grams per day. If you are interested in this supplement shoot me an email I am happy to share where I recommend sourcing it from.
Dark Chocolate – Bioflavonoids that are found in dark chocolate help keep blood vessels healthy and allow for optimal blood flow to your sexual organs. This blood flow is essential for arousal, lubrication, and achieving orgasm. Dark chocolate (more than 70% cacao) also boosts dopamine, a neurotransmitter in the brain found in pathways of motivation and pleasure.
Garlic – I know this one doesn’t seem intuitive or synonymous with romance, but an active compound found in garlic, allicin, has been shown to improve circulation by thinning the blood. This aids in tissue receiving nutrients and can increase physical sensation. Perhaps both partners will have to agree on a garlic filled meal, we wouldn’t want intake of garlic for these purposes to be counter-productive.
Celery- This vegetable contains a compound called androsterone that helps your body produce pheromones. You know what those do.
Pineapple- This delicious fruit contains bromelain which is an important enzyme for men increasing testosterone and libido. It also has the added benefit of decreasing inflammation in the body.
Ginger – This herb boosts circulation and thus, sexual sensation. Add some ginger to that cocktail this weekend.
Lentils and Nuts – All contain arginine, which can help boost female libido through the dilation of blood vessels near female organs.
Spinach – High in folate, which helps produce histamine, a compound released from mast cells during sexual arousal.
There is much that may also play a role in low sexual drive that may not have to do with hormones,eating or your physical health. Emotional health and relationship issues and even trauma can play a role in these symptoms. Remember to be patient and understanding with your partner and if you feel this is a persistent problem seek help from a qualified family counselor.
Hormones fluctuate dramatically throughout our lifetimes, and for women especially, they fluctuate dramatically just monthly. Hormones going hay-wire can contribute to weight gain, mood swings, and depression. There are actions within our own individual control that have significant effects on hormone production and metabolism. You guessed it: Diet and Exercise (and perhaps one you didn't guess or often overlook!) SLEEP. Today I will focus mostly on diet. We will keep it pretty simple too, eat more of these... and less of these... got it? Let's go.
Cruciferous vegetables (1-2 servings per day)
- cabbage, broccoli, cauliflower, bok choy, brussel's sprouts
Leafy greens (1-2 servings per day)
- spinach, kale, swiss chard, collard greens, beet greens
Berries, melon and citrus (1 serving per day)
Raw nuts and seeds (1-2 servings per day) - consider soaking
Ground flax seed (1 Tbsp daily)
Beans (at least 1 serving per day)
Whole grains (2 servings per day)
Fish (2 servings per week)
Healthy fats: avocados, olives, olive oil, and those mentioned above.
Artificial sweeteners (diet soda, etc)
Trans fats and saturated fats
Sleep at least 7 hours per night
Get out in the fresh air and breathe
Get into full spectrum sunlight as quickly as you can upon waking
Maintain a healthy weight
Consider supplements that may help (ask a qualified health practitioner)
Take time to relax
Okay, maybe it has everything to do with diet, but perhaps not quite so directly. People always want to know that quick fix to losing weight and especially belly fat. I can tell you, a quick fix doesn't exist that will keep weight off. Sometimes people will ask me, "what's the number one thing you would have me do to lose weight?". When I respond, "sleep more", I often think people want to slug me or at the least they think I'm crazy. Admittedly, I am no sleep expert. However, I do know how poor sleep slows down weight loss.
The average American adult does not sleep enough. Most studies show that an individual needs 7-9 hours of sleep per night, which by and large, we are not getting. In 2013 the average American adult got 6.8 hours of sleep per night, in 1942 7.9 hours per night. So what?! You may be thinking. What could that have to do with weight loss, metabolism, or weight maintenance? SOOOO MUCH!
If you have sleep problems, you really have 24 hour problems. Your cognitive ability from storing and accessing memories is compromised. Your ability to be creative is impacted. It can affect your physical safety, social interactions, mental health, and for the purposes of this post: YOUR PHYSICAL HEALTH. People with sleep difficulties are more likely to be obese, they have an increased risk of cardiovascular disease, and higher levels of inflammation.
I know you are saying, come on, why is this the 1st thing you will recommend? Let's talk hormones. You have a hormone called 'Leptin', this is secreted to say "I'm full, I'm satisfied, You don't need any more food". It's your satiety hormone. And in sleep deprivation, you have LESS OF IT. That means your body has a decreased ability to know when you have eaten enough. You also have a hormone called 'Ghrelin'. I like to remember it as 'yellin ghrelin'. It's your hunger or "hanger'' hormone. It is secreted when your body is telling you, I need MORE food. This hormone is increased with sleep debt. That means you have more of it telling you eat, EAT, EAT! You also have an increase in the hormone cortisol. This is a stress hormone, and your body secretes more of it when you are stressed, or when you are sleep deprived. It tells your body to STORE BELLY FAT!
So poor sleep = hormones telling you YOU HAVEN"T EATEN ENOUGH, YOU NEED TO EAT MORE, AND STORE BELLY FAT. No wonder this is the first thing I will recommend to someone.
Simply by adding 30-40 minutes of sleep per night will affect a cascade of hormones that help you decide when and how much to eat. Aside from hormones, motivation to exercise is shown to decrease with lack of sleep, and poorer performance with less sleep. One study showed sleep deprived people eat an average of 263 calories (for men) and 329 calories (for women) more per day than their less sleep deprived selves. At the end of a week that could be the difference of an additional pound gained.
That 30-40 minutes of extra sleep may pay more dividends in terms of weight goals than 30-40 minutes at the gym. What! Yes, you read that right, if I had to choose between gym time or sleep, Sleep would win every time. You will be rewarded with better hormone balances, better food choices, and being more effective with tasks at hand.
Here are some tips to improve your sleep hygiene.
1)limit light at night, set your phone to limit blue light or take it out of the room altogether
2) take time to wind down, do relaxing activities before bed, and limit conversations about stressful things in your life, avoid task oriented activities
3) set up an ideal bedroom (cool, dark, quiet, clean, no clock, good mattress, no pets)
4) When you wake up, try to get in full spectrum light for 30 minutes first thing in the morning like 1-2 hours of waking up (get outside in the sun)
Sleep and stress management is a HUGE part of weight management. If you have any more questions about sleep or weight loss, please consider my weight loss coaching program. We will train your metabolism to chug along at the fastest pace possible.
Caitlin Johnson is a dietitian, wife, lover of ice cream, chef wannabe, California-girl, Christian, liver eating, "food-avore."
110 N McClelland Street
Santa Maria, California 93454
Hours: Tues and Thurs 10-5 PST