S2 E1 Q + A #1 – Thyroid medication, Hashimoto’s remission, and finding balance with AIP

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Welcome to The Autoimmune Wellness Podcast Season 2! We’ve created this podcast as a free resource to accompany our book, The Autoimmune Wellness Handbook: A DIY Guide to Living Well with Chronic Illness.

Season 2 Episode 1 Q + A #1 is the first installment of our new Q + A format. In these episodes, we’re answering questions you submitted to us via social media! This season, the podcast will alternate between Q + A episodes like this and interview episodes featuring the voices of real AIPers just like you.

We cover a lot of ground in this first Q + A episode! Topics discussed include thyroid hormone replacement, AIP dogma, our personal reintroduction journeys, balance over perfection, adrenal support, and diet modifications for neurological disorders. Scroll down for the full episode transcript.

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Mickey Trescott: Welcome to the Autoimmune Wellness podcast, a complimentary resource for those on the road to recovery. I’m Mickey Trescott, a nutritional therapy practitioner living well with autoimmune disease in Oregon. I’ve got both Hashimoto’s and Celiac disease.

Angie Alt: And I’m Angie Alt, a certified health coach and nutritional therapy consultant, also living well with autoimmune disease in Maryland. I have endometriosis, lichen sclerosis, and Celiac disease. After recovering our health by combining the best of conventional medicine with effective and natural dietary and lifestyle interventions, Mickey and I started blogging at www.Autimmune-Paleo.com, where our collective mission is seeking wellness and building community.

Mickey Trescott: This podcast is sponsored by The Autoimmune Wellness Handbook; our co-authored guide to living well with chronic illness. We saw the need for a comprehensive resource that goes beyond nutrition to connect savvy patients, just like you, to the resources they need to achieve vibrant health. Through the use of self assessments, checklists, handy guides and templates, you get to experience the joy of discovery; finding out which areas to prioritize on your healing journey. Pick up a copy wherever books are sold.

Angie Alt: A quick disclaimer: The content in this podcast is intended as general information only, and is not to be substituted for medical advice, diagnosis, or treatment. Onto the podcast!

Topics:
1. Thyroid hormone replacement [6:29]
2. Dogmatic AIP; elimination and reintroduction [11:54]
3. Weaning off thyroid hormone replacement [17:21]
4. Mickey and Angie’s personal reintroduction journey [21:37]
5. Iodine supplementation for thyroid [28:13]
6. Balance over perfection [29:32]
7. Non-AIP fillers in medications [33.10]
8. Adrenal support [35:23]
9. AIP and autoimmune neurological disorders [43:11]

Mickey Trescott: Hey everybody! Mickey here, and welcome back to the Autoimmune Wellness podcast, season two. We had some really awesome feedback from you guys; it was really overwhelming on our blog posts, our Instagram accounts, and also the reviews in iTunes. So thank you guys so much for sharing. And we decided to bring things back for another round, since you guys told us that it was so helpful. So we’ve got a little bit of a program ready for you. Angie; should we tell everyone what we’ve been up to since the last season of our podcast ended?

Angie Alt: Yeah, sure. We’re trying not to get too chatty on you guys for this podcast. We’ve had a pretty fun few months, and we wanted to update you. The Autoimmune Wellness Handbook came out in November; woot, woot! And we had a great time on our 5-city book tour. We’re so grateful for everyone’s support; it was a great experience getting to meet so many of you, and hearing your stories, and watching your local communities kind of take shape and seeing you meet each other and sharing stories together at those book signings. Mickey, what was your favorite part of the tour?

Mickey Trescott: I loved the events with the food. So of course, I liked all the events; but enjoying AIP food with an AIP community is such a rare thing, that it was just really fun, those bookend events. So our first event was at Mission Heirloom and they just made this delicious meal for us, which is so fun to hang out with a bunch of other AIP people. I actually think that those two events; so then we did Hu Kitchen in New York City; both of them had almost 100 people, which I’ve never had the experience to hang out with 100 of my friends that eat like me, so that was really powerful.

Angie Alt: {laughs}

Mickey Trescott: And really fun. What about you, Angie?

Angie Alt: Yeah. A big, big thank you to Mission Heirloom and Hu Kitchen; that was amazing. We really appreciated that support for our peeps. I don’t know what my favorite part was. I think getting to hear everybody’s stories, and see the way our work is impacting real live people out there; that’s really exciting. Getting stranded on train tracks was pretty fun; do you remember that, Mickey?

Mickey Trescott: {laughs}

Angie Alt: {laughs}

Mickey Trescott: Yeah, we almost didn’t make it to D. C., but we made it happen.

Angie Alt: Yeah. Let’s see; what else have we been up to since the book tour?

Mickey Trescott: Yeah, so you know, the first thing we did was take a chill period. You know, we spent some time resting and relaxing, taking care of ourselves; because we spent the better part of two years writing that book, and it was a big labor of love, but I think we needed to have a little season of kind of coming down off of that epic workload situation.

Angie Alt: Right. But, we did put in a little bit of work. One of our big projects that we worked on for the beginning of 2017 was relaunching our website under the brand Autoimmune Wellness. Hopefully, you guys are seeing that out there. We just think that the name really suits our mission, and will help us take our message to a more mainstream audience; viva la revolution, people.

Mickey Trescott: Woot, woot!

Angie Alt: We’re really focused on eventually making AIP this mainstream option for folks with autoimmune disease, and we feel like Autoimmune Wellness will help us get there. Let’s see; what else have we been up to, Mickey?

Mickey Trescott: So, we have recently been working on a special project that those of you that are health coaches; so nutritional therapy practitioners, or other kind of practitioners in the natural health scene, will be really interested in. so make sure that you guys are on our email list to be the first to hear about it. You can sign up at our website; www.autoimmunewellness.com, or the old website, www.autoimmune-paleo.com, will redirect there, and you can opt in and you’ll be the first to hear about it. And I’m sorry we can’t share any more details, but it’s going to be really fun.

Angie Alt: Super secret squirrel.

Mickey Trescott: Secret squirrel; that’s one of Angie’s favorite phrases. So back to the podcast; we want to tell you guys a little bit about what to expect this season, because our format is going to be a little different this time around.

Angie Alt: Yeah, so this season we’re going to be alternating between Q&A episodes, where Mickey and I are just going to take as many of your questions as we can and answer them for you guys. and then we’re going to be doing interview with real people who are going to share their journeys to autoimmune wellness, and what it’s actually been like for them. Just regular people out in the community who are using this method of working toward healing.

Today is our first Q&A episode, and we asked you guys to submit your questions; I think we took these mostly on Instagram, right Mickey?

Mickey Trescott: Yep.

Angie Alt: And boy; you guys gave us a lot of questions.

Mickey Trescott: A lot of questions. {laughs}

Angie Alt: We’re going to do our very best to get through as many as we can, so let’s get started. Let’s see; so we have some thyroid questions. Mickey, let me ask you this first one. It looks like Hannah asked, “At what point should you ask to start taking thyroid hormone; especially if you feel good about 25% of the time and your labs are within normal range, and you’ve followed the protocol for a while. And once you start taking it, do you have to continue for a while? “

Mickey Trescott: Yeah, so this is a really good question for anyone with thyroid issues or Hashimoto’s, listen up. The autoimmune protocol does a really great job for most people taking out that inflammatory process, and taking out all those foods that are irritating to the gut. It does not reverse the damage that has been done to your thyroid, and it is not a replacement for thyroid hormone therapy if you need it.

So, a lot of us; if you have thyroid disease, it’s possible that you have Hashimoto’s, which is an autoimmune thyroid disease. And Hashimoto’s is actually the cause of 80% of hypothyroidism. So if you’ve been diagnosed at any time in the past with hypothyroidism, and you haven’t really been told about the cause, but you’ve been told to take thyroid hormone, it’s very likely that you have Hashimoto’s. and you haven’t ever had your antibodies tested, it’s a good idea to get those checked.

So what happens in Hashimoto’s is your immune system starts to destroy your thyroid slowly, over time. For a lot of people, it can take decades before they even start to get symptoms. But by the time people get diagnosed, and they notice the symptoms, and they get their labs done and their thyroid is suboptimal, they usually get on thyroid medication. And this medication is to replace the thyroid hormone that their thyroid would normally be making. So a part of the casualty of Hashimoto’s; there are some other reasons for thyroid dysfunction, but a lot of the time, it just means that your thyroid is not making enough hormone. And that thyroid hormone is needed by every cell in your body. So it’s really important if you need it to get a prescription and take it.

So, I would encourage anyone who is on the autoimmune protocol, who knows that they have Hashimoto’s disease or thyroid dysfunction, if they’ve tried the elimination diet for a little while; like it sounds like Hannah, she’s been on the protocol for a while, and she is only feeling well 25% of the time. The catch here is she says her labs are within the normal range. Now, a lot of people are told their labs are within the normal range, when they aren’t.

so this is probably a situation where Hannah, you should find a more open minded doctor that is willing to do thorough testing. So for thyroid disease, you really want to be testing free hormone levels; so free T3, free T4, in addition to the usually ordered TSH, sometimes reverse T3 can be helpful; and then again those antibodies to kind of tell how the autoimmune process is going. And then, you want to find a doctor who doesn’t believe in the conventional ranges, but who treats based on a little bit more of a narrow, functional range. And this can be hard to find; it doesn’t have to be a functional medicine doctor. It can be a savvy regular medical doctor; it could be a naturopath.

But I’ll tell you; I went to 6 doctors who told me my levels were normal before I found the one who said; “You know what, they’re not.” And that thyroid hormone replacement, that medication, was the difference between me feeling 60-70% better and 90-95% better. So it can make a really big effect, even if you’re doing the diet and everything.

So, I don’t think that people should be denying themselves thyroid medication. Like I said, it is something that every cell in your body needs, and if you need that and you need to eat a certain way to feel well; that’s what I do personally, there is no harm in that. And you should continue as long as your doctor, and your labs, and your symptoms indicate that you should. So, I know that’s kind of a long answer, but the thyroid stuff can get kind of complicated. And a lot of times, it’s not either/or; a lot times, that’s just another tool that we have in our tool box to live well with thyroid conditions.

Angie Alt: Yeah, right. We’re fans of the both/and, right?

Mickey Trescott: Yeah, totally. I mean, if you know that there is something you can do that’s going to help you feel better, why would you not use it? A lot of medications have side effects, but thyroid medication is actually a lot of times bioidentical to what your body would actually be producing. And so it doesn’t have the same mechanism. Most medications work by inhibiting something, or stopping something. But thyroid medication, it’s almost like a nutrient in that way. Your body needs a certain amount, and if you’re not getting enough, you’re just going to have symptoms. So I’m very pro- working that out.

And you know, some people might not need thyroid medication. But if you think you might need it, it’s really worthy of investigation. So, let’s move on to a question for you, Angie.

Angie Alt: Sure.

Mickey Trescott: So we have a question from Jay, and it’s about balance, which is one of your awesome expertise. “I’d love to hear the benefits and problems with staying on AIP with no reintroductions. I’m hoping AIP is a bridge to healing, and that I can add back a lot of the foods I’ve eliminated. Eggs, nightshades, and occasional grains. But the AIP community at large seems so dogmatic about this being a lifestyle, and a forever thing. What’s the point of forever elimination?”

Angie Alt: Oh boy.

Mickey Trescott: Who are you talking about, Jay? {laughs} Hopefully not us.

Angie Alt: Jay, you need to give us their name and number, and we’re going to go tell them what we think about that. No, I’m just kidding. I’m really sorry that you’ve encountered this feeling in the AIP community that it’s dogmatic, and that we believe that you should be in the elimination phase forever. That’s definitely not what we’re hoping to promote in the community, and it’s definitely not how the protocol is laid out. So the protocol is an elimination AND reintroduction protocol; so that’s really important to understand that part of the healing process is reintroducing foods.

I think it could be maybe a little bit of a misunderstanding of the idea “lifestyle”, of making AIP a lifestyle. By that, it’s more talking about healing in general, and incorporating more than just diet into your autoimmune wellness journey. So hopefully it’s just a misunderstanding and you’re not, hopefully, running into too many people that are being super dogmatic about staying in elimination forever.

So, you know you wanted to hear about the benefits and problems of staying in AIP with no reintroductions. I honestly don’t think that there are benefits to staying on the elimination phase of AIP forever. I think, actually, you’re really limiting diversity in your diet, and it’s also psychologically really hard. Not to mention, in our modern world, it’s not the most convenient thing to have to be in that kind of restricted zone that long.

Generally, you’re looking to stay on the protocol; the elimination part of the protocol, for at least 30 days. That’s enough time to kind of clean your slate, and make it so that you can understand foods that are a problem for you as you begin to reintroduce, versus foods that really work for your body. Ideally, it would probably be better if you shot for more like 60 to 90 days. Most folks need a little more time than 30 days, so it’s not unusual to stay in that zone for another month to two months past the 30-day process.

If you get to 90 days, and you’re not having the kind of progress you would have expected with AIP, it’s a good time to get some people on your team who you can collaborate with. Doctors or other kinds of practitioners that can help you dig a little bit deeper, and see if there are some root issues that are kind of preventing progress with the protocol. You know, for instance, a really common example