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Month: September 2016

Doctors and Hashimoto’s

Doctors and Hashimoto’s

If you’ve been struggling with this diagnosis for any time at all, you’ve probably figured out that most doctors out there are not very well informed when it comes to this condition. I have realized through the years that most doctors respond according to the way they were trained and they tend not to question that process, even when confronted by patients with failing health. A lot of them simply do not have the time to do outside research (especially primary care doctors), but many of them just cannot find it in themselves to be flexible enough to go outside their traditional medical training.

A prime example of this problem lies in the choice of thyroid medication usually prescribed for Hashimoto’s. If you go to a traditional endocrinologist or even your primary care doctor, they will, more than likely, put you on Synthroid or Levothyroxin, even though there are thousands of patient reports stating that Natural Desiccated Thyroid (NDT) works better for many, many people. 

Because big pharma has such an enormous influence on what doctors ultimately decide to prescribe for many conditions, treatments such as NDT, which proved its efficacy long ago in the latter part of the 19th and first part of the 20th centuries, are considered “antiquated” and/or “bizarre”.

If you’d like to read an interesting history of NDT, click here.

Don’t get me wrong – there are people out there who do just fine on these medications, but most of them are dealing with simple hypothyroidism, not Hashimoto’s. If you would like to know why Synthroid and Levothyroxin generally do not work well for Hashi’s, click here. 

Whatever happened to “Do No Harm”??

I don’t believe that doctors set out to harm their patients. But I do believe the medical community, as a whole, exerts a ton of pressure on conventional doctors to stick to traditional approaches to treatment, regardless of outcome. It’s difficult for me to understand how they can continue to do this, when it’s pretty obvious that their patients are not getting better. This approach harms everyone – the patient gets sicker and angrier at a system that seems to have no interest in learning new approaches that might help, and the doctor gets angry at patients who come to appointments and question them about everything. But, I will say this:

It is your right to question your treatment. You are paying for it.

Ultimately, with today’s insurance restrictions requiring one to stay inside provider networks, the best I have been able to do for myself is to find a primary care doctor who is willing to support the work of my functional medicine doctor, for whom I have to pay out of pocket. I’m fortunate enough to be able to do that. A lot of people are not. However, there does seem to be a small trend toward more integrative and functional medicine doctors taking insurance.

Where to start when looking for a thyroid/Hashi’s doctor?

Mary Shomon has a page on her site where you can look for thyroid doctors that have been recommended by thyroid patients. You can find that here. Keep in mind that not all thyroid doctors are experienced or knowledgeable about Hashimoto’s. There’s a lot of difference between hypo/hyper-thyroid conditions and an autoimmune condition that affects the thyroid gland.

The first rule of finding a supportive thyroid doctor: don’t give up. An individual looking for a new doctor has to approach this problem as an employer.

You are literally looking for the right person to “hire” for your care.

As I said before, you are paying for this care, and you have a right to determine whether or not the doctor is meeting your standards.

When I tell people this, I usually get very strange looks. But, it’s true. We are consumers and we are paying for a service. For too long, doctors have treated themselves as experts who cannot be questioned by “uninformed” patients. Those years are long gone with the advent of the internet because we ALL have access to a lot of information now, good and bad.

It will be up to you to do proper research and educate yourself about this condition so that you understand what kind of care you need. This can be hard, because a lot of us with Hashi’s just don’t feel up to doing much of anything a lot of the time. If you’re currently dealing with a lot of fatigue, you will have to decide how long you can stand to do this kind of research every day. But you will need to do it if you have any hope of finding a practitioner who can help you to heal.

I have personally found that the doctors who are best equipped to deal with Hashi’s are usually doctors of integrative medicine or functional medicine. These are practitioners who are willing to look outside traditional medical treatments and add alternative treatments to their practices because they feel that is the only way they can truly help their patients. The doctor I’m seeing now told me that the reason he went into functional medicine was because he was tired of feeling totally powerless in the face of patients who were becoming sicker every day.

What is the difference between integrative and functional medicine, you ask?

As taken from The Institute for Functional Medicine’s website:

Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.

The Functional Medicine model considers the diagnosis, of course, but also seeks to answer the question, “Why does this person have this illness?” The answer to this question is revealed by discovering the antecedents, triggers, and mediators that underlie symptoms, signs, illness behaviors, and demonstrable pathology. 

You can look for a functional medicine practitioner here or here.

You can search for an integrative medicine practitioner here.

Dr. Kharrazian, who is one of the foremost practitioners specializing in Hashimoto’s, also has links on his site to assist in finding a practitioner here.

Alternatively, you can just do a search for “functional medicine” or “integrative medicine” plus the name of the city/town where you live and see what comes up.

It can be really easy to lose hope in this quest for a good doctor, especially if you’re not located in a large metropolitan area. But, you will find someone eventually, even if you end up doing treatment long distance over the internet. There are several good practitioners out there offering long distance consultations and treatment programs and a lot of people are doing this now because it’s the only way they can access care from people who know about this condition. Here is a short list of people I have run across who are offering long distance consults:

Marc Ryan, L.Ac. – Marc is a licensed acupuncturist and has Hashi’s himself. He has an enormously informational site at Hashimotoshealing.com.

Eric Osansky, D.C. – Eric is a chiropractic physician who specializes in natural treatments for endocrine problems. You can find him at Naturalendocrinesolutions.com.

Dr. Isabella Wentz – Dr. Wentz is a pharmacist with Hashi’s. Her site has a ton of useful information at Thyroidpharmacist.com.

Dr. Sarah Ballantyne has assembled a stellar group of people with whom you can make appointments and get guidance. You can find them here.

Amy Myers, MD – Amy practices functional medicine and has several online programs that you can choose from here.

This list is by no means exhaustive. If you have had a good experience with an online practitioner whom I haven’t mentioned, I would love to hear from you!

Hang in there, keep looking and don’t settle until you find someone who will work with you as a team and listen to you and your symptoms.

My best hopes for you all,

Vanessa

Vanessa Gunter, D.M.A., M.A.

 

Hashimoto’s and Exercise

Hashimoto’s and Exercise

I have been dealing with chronic muscle pain for about 20 years now. As I mentioned in another post, I believed for a long time that this pain was simply due to repetitive stress injuries from playing the flute professionally for 35+ years. However, I found out a few years ago that this, along with joint pain, is actually a fairly common symptom for Hashimoto’s people.

I don’t really know how many different forms this chronic pain may take for people. In fact, I would love to hear from you out there about that because I haven’t found too many people talking in depth about this problem. My pain comes in the form of muscle knots and spasms which alternate between my left and right sides. I seem to always have tension or knots in my trapezius muscles (these are the muscles which go from your neck to your shoulders) and the muscles around the rotator cuff on my left shoulder. These, I believe, are rooted in my many years of flute playing, but they are “maintained” by the Hashi’s. I also have a group of knots on my right hip which seem to always be there. Sometimes I also get knots on my left hip and in the middle of my back.

When I am in a situation where I am able to care for myself well, meaning I can eat when I need to, rest when I need to, pace myself with work, then these knots/spasms are usually fairly easy to manage. You can read about what I do here.

However, when life becomes too stressful and I am not able to give myself the space I need, then I experience what I call “episodes”. The latest one involved spasms in the entire upper right quadrant of my body, and I simply had to stop everything I was doing and just rest.

Where does exercise fit in to this, you ask? Good question. There are people out there who advocate regular, sometimes strenuous, exercise for Hashi’s people, but if you’re dealing with chronic pain issues like I am, this is simply not possible.

I have to gauge, each and every day, what my body might be capable of on that particular day.

I love to walk, so I try to do this as much as I can, but I am always mindful of how my body is reacting to any activity I am doing. If my hips start to bother me while walking, then I slow the pace and head home. Every day can be totally different. Walking is great for everyone, but you have to figure out what works for you.

I also do a lot of stretching. I have found this to be a lifesaver. I have a set of stretches I do every morning before I get out of bed and another set that I do in the evening. If I’m having a day where things aren’t feeling so great, then I do another set in the middle of the day. Stretching can really help to keep your muscles long and more flexible.

The muscle symptoms associated with Hashi’s are apparently similar to fibromyalgia symptoms, so when I look for routines that might be helpful, I usually look for those that have been constructed for people with fibromyalgia. To get an idea of what kinds of stretches you might be able to do, click here.

I do specialized yoga moves. With my particular set of muscle issues, twisting is a bad thing, so I am not able to just “do yoga”. I also have to be very careful about how much strain I put on my upper body, which really eliminates anything involving a “downward dog”. Sarah Bates has some very gentle yoga routines for people with fibromyalgia that work pretty nicely for me. I have had to modify some of the poses for my own issues, but overall, I’ve found it works pretty well. You can find the routine I use here. Sarah has fibromyalgia herself, so she knows what muscle pain is like. She has a complete DVD set on Amazon if you find that you like this routine.

I use the MELT method. This is a group of specialized moves that helps to rehydrate the body’s connective tissue and I have found it to be quite helpful with moving toward a state of “renormalization” with my muscles. You will have to progress carefully and slowly with this in order not to overwhelm the body, but it does work. I noticed changes from the first time I tried this method. If I’m having an “episode” with a particular muscle or group of muscles, it’s usually better for me to take a break from this until things are calmed down a bit. But, once again, this is all very individual. You will have to work with your own body and decide what is best for your particular set of issues. To learn more about this method, go here.

I also use an Aeropilates machine from time to time. As usual though, I have to be very selective with the moves I do on this machine and be careful not to overdo. I find it to be very helpful in getting a bit of cardio on days I can’t go outside. It also provides a good set of exercises for the entire body, if you’re up to that. Go here to find out more.

I will also be investing in a treadmill soon because, unfortunately, I am not the kind of person who likes to go out in cold temps to walk. I’ve put this off for long enough and I do not want to “sit out” another winter with very little walking.

So, for me, walking and stretching have been my two mainstays and I rotate the other methods depending on how my body is feeling on any given day and/or whether or not I can get outside. Would love to hear about what has worked for you!

In health,

Vanessa

Vanessa Gunter, D.M.A., M.A.

Please remember, I am not dispensing medical advice, only sharing my own experiences. Nothing stated on this page should be construed as medical advice. Be sure to consult a health professional before beginning any exercise program.

Hashimoto’s and Chronic Pain

Hashimoto’s and Chronic Pain

I never knew until a few years ago that my muscle pain was a part of my Hashimoto’s. As I mentioned in an earlier post, I spent most of my life playing flute professionally and I had been told that the pain I was having in my neck and shoulders was simply repetitive stress injuries from playing and practicing 8 hours a day for 35+ years. This made some sense to me, as I had always struggled with physical tension as a player and had never really found a satisfactory way to remain relaxed while playing. I tried beta blockers, and they worked great, but for a person with already low blood pressure, it was not wise for me to use them regularly.

I found out about the connection between my pain and Hashi’s quite by accident. The functional medicine doctor I was seeing at the time prescribed low dose naltrexone for me.

All he said as he was prescribing it was:

“Now we are going to deal with your Hashimoto’s.”

What??  What do you mean “deal” with it? I didn’t realize there was a way to “fix” this!  

He explained that this medication was an immune system modulator and that I could find out more at www.lowdosenaltrexone.com.

Upon arriving home from that appointment, I immediately went to the site and found out that this medication actually supports the body in doing what it should be doing naturally: supplying endorphins to the system through the blood in order to assist with immune system functions. You see, it seems that a common denominator in autoimmune conditions is a low supply of endorphins. This medication blocks the opioid receptors for a number of hours after you take it, which causes more endorphins to be released into the bloodstream, thereby giving the body more immune support.

When I first started taking it, I slept better than I had in decades. The first two weeks were filled with glorious, deep sleep. Then that deteriorated a bit, which is common with this medication. But, as you continue to take it and find your best personal dose, your sleep once again becomes quite good. This takes some patience and willingness to experiment with your dose for a while.

After those first two weeks, I noticed that my muscles were not bothering me as much as they had been…and this continued to get better with time.

Now, I will admit that I have never gotten to the point where I am completely pain free. I believe that part of the reason for this is that I have never really given myself a chance to rest until recently. I have always been a fairly driven, competitive individual with really high standards. These characteristics have not served me well in dealing with Hashi’s because it has been extremely hard for me to slow down and take care of myself. I have always wanted to be out there in the professional world accomplishing something.

Well, my last episode of muscle spasms/knots forced me to stop completely and re-evaluate. So now, I am resting and simply working at giving my body what it needs to get better.

Moral of the story: Stress is THE enemy.

When you have Hashi’s, pretty much all of your systems are compromised and struggling, especially if you are dealing with gut problems. For me, this struggle has been most obviously expressed in chronic muscle pain. For you, it may be joint pain. Both are common in this condition. Stress exacerbates everything about Hashi’s, so it is important to do everything in your power to lessen any stress that you have in your life, because it will make your condition worse. I’ll be writing more on this in another post.

I have used all of the following to help with alleviating the pain:

  • Magnesium lotion or oil, whatever works best for you
  • Magnesium supplements in an absorbable form – citrate, malate, taurate
  • CoQ10
  • Epsom salts baths – every evening
  • Massage therapy – if you cannot afford this, some people use therapy balls and Theracanes for self-massage. But, I have found the cost of massage to be worth every penny. It may take time to find just the right massage therapist because everyone prefers something different when it comes to this. Be sure to seek out a licensed professional.
  • Chiropractic care – I have also found this to be indispensable. When my muscles decide to tighten up and go into spasm, then my bones are pulled out of alignment, which causes even more problems. I have a great chiropractor, but you have to be careful in seeking out this care, because a less-than-stellar practitioner can cause you even more problems. Even personal references didn’t work out all that well for me in a couple of instances because, once again, what’s great for one person may not work so well for the next. There is a good article on how to find good chiropractic care here.
  • Acupuncture – I cannot say enough about the benefits of acupuncture in relation to Hashi’s. I will be writing a separate post on this. It has been a tremendous help in reducing my anxiety which plays directly into muscle tension. Acupuncture can also be used to directly decrease pain, increase flexibility in muscle and joints and even address allergies and food sensitivities. Some insurances are paying for acupuncture now, so I would definitely recommend checking into this. Be sure to seek out a licensed practitioner. I was lucky enough to find one who also had Hashi’s, so she completely “got it” when I talked with her about my issues.
  • Anti-inflammatory supplements – turmeric, fish oil, borage oil, vitamin C, quercetin, mangosteen, just to name a few. Check out my supplements post for more info on this.
  • Anti-inflammatory foods – diet is a huge issue with Hashi’s. It’s important to say here that eating as many anti-inflammatory foods as possible will definitely help you heal. Think greens, lots of greens, low-glycemic fruits and veggies (no nightshades) that have lots of antioxidants. For a detailed discussion of this kind of eating, click here.

Hope you’re finding this information  helpful…

In health,

Vanessa

Vanessa Gunter, D.M.A., M.A.

The Hashimoto’s “Diet”….or what food is left to eat??

The Hashimoto’s “Diet”….or what food is left to eat??

Figuring out what to eat when you’re dealing with Hashimoto’s can be incredibly hard, frustrating and downright depressing because, depending on how badly you’re feeling and how many sensitivities you have, you may feel as though there is literally nothing left to eat. This can also be dangerous, because elimination is not always the answer. Too much elimination can put you in a serious state of malnutrition. I actually got to this point before deciding that I had to pick my battles. I couldn’t eliminate everything that might be causing me a problem. So, in this post, I’m going to talk about the “biggies” associated with autoimmune disease, as well as the approach I’ve taken with my own diet.

My current diet has been decades in the making, largely because no one seemed to have a clue as to what was causing my fatigue and brain fog, which were my earliest symptoms. I began with going on a low-carb diet, mainly cutting out bread and potatoes, which did help my energy levels for a while. But, I didn’t think about the carbs I was ingesting as a result of sugar intake: alcohol, snack foods, and the fact that sugar is in almost all processed foods.

Get Rid of the Sugar

This is a biggie for everyone. Sugar is at the root of so many problems for so many people that, if you value your health and longevity, you owe it to yourself to do this. Remember that your body is already compromised and struggling from the Hashi’s. Sugar compromises your systems even further.

I am a sugar (and chocolate) addict. I think there are a lot of people out there who struggle with this. We are constantly confronted with yummy, sugary foods every where we look in this culture and the temptations are monumental.

My cravings for sugar began when puberty set in. It was like having a constant itch that needed to be scratched. When I was a teenager, I remember going into the kitchen cabinets when my  mom wasn’t home and looking for anything sweet to eat. Sometimes she would have baked goods in the pantry, but more often than not, I would have to improvise, like eating brown sugar right out of the box with a spoon. After I moved away from home, I would eat cans of frosting or the sweetest candies I could find. My mother used to remark on the fact that I never got sick from consuming these things, but it was as if my body just couldn’t get enough.

I was in my late forties before I began to seriously try to curb my sugar intake. In an attempt to abstain, I refused to keep anything in the house with sugar in it, but I would still have desserts if I ate at restaurants…and I was still drinking wine with dinner.

Finally, in my early fifties, I just got tired of feeling lousy every time I would have something sweet to eat, so I cut out all sugar. But, the cravings were still there. It wasn’t until I also cut out all grains (I had already been gluten-free for a long time at this point) that my cravings went away completely.

So, if you’re struggling with sugar addiction, you will need to take a serious look at your sources of sugar – these will include the obvious sugary items in addition to all grains, starchy foods, and fruits.

I also think, in hindsight, that my sugar addiction was connected to hormone imbalances that set in during puberty which resulted in a lack of endorphins and dopamine. I have struggled with depression for most of my life, beginning in adolescence, but since finding ways to supply my body with more endorphins, this has gotten much better. A magnesium deficiency was also probably at work here, since I have also always craved chocolate. I still do, but have found healthy ways to deal with this: lots of magnesium through supplements and lotion, and eating small amounts of very dark chocolate sweetened only with stevia. My personal favorite is from Dante Confections. This chocolate takes a little getting used to because it is very intense, but I love it now, and a little goes a very long way.

Gluten is a Problem with Hashi’s

A lot of changes have occurred since the 1950’s to the baking products we use now. Things have been added to wheat flour to make it more stretchable and elastic so it can be used in any number of foods like sauces, soups or even wine. Unfortunately, these additions or changes to our food have caused adverse reactions for many of us, including leaky gut and an activation of the immune system which causes the body to form antibodies to gluten. These antibodies are put on high alert every time you eat anything with gluten in it. What you have to do is read labels carefully and be knowledgeable about what foods might contain gluten. For a list of foods and products that contain gluten, go here. For more general info on this topic, go here.

Another Issue With Baked Goods…

Back in the good ol’ days (1950’s – 60’s), they used to add iodine to flour as an anti-caking agent. This was great because it meant pretty much everyone was getting adequate iodine in their diets. Then, they decided to used bromide instead. Since then, thyroid-related problems have been on the rise. You see, bromide is an endocrine disruptor which attaches to the same receptors as iodine. So not only are you not getting the iodine from your baked goods, but the bromide is actually interfering with the endocrine processes in your body and preventing your body from absorbing what little iodine you might be getting from your food. So read those labels and don’t buy any baked goods containing anything related to “bromide” or “bromine”. This lovely ingredient can also be found in certain soft drinks and pesticides used on fruits, among other things. For a detailed discussion on this, click here.

Are Goitrogenic Foods Our Friends?

Good question. For years, many of us with thyroid issues were told “Don’t eat that broccoli!” along with anything else related to it because these foods suppress the thyroid. This approach excludes a whole family of veggies that have a ton of health benefits. The goitrogenic food family includes items which contain soy, cruciferous veggies, and a few other foods such as strawberries, peaches and millet. The list includes:

  • Broccoli
  • Brussel sprouts
  • Cabbage
  • Cauliflower
  • Kale
  • Kohlrabi
  • Millet
  • Mustard greens
  • Peaches
  • Rutabaga
  • Strawberries
  • Turnips
  • Peanuts
  • Radishes
  • Soybeans
  • Spinach

It is now thought that cooking these foods dramatically reduces the goitrogenic effect. I make a practice of eating cooked greens regularly due to their incredible health benefits, and kale is a part of that regular practice. I have not noticed any adverse effects from doing this. I do stay away from peanuts and peanut butter except for the occasional indulgence, because I have experienced adverse effects from these foods. Soy has become so prevalent in our vegetarian/vegan culture that it would be really easy to negatively affect your thyroid with these products if you’re not careful. Once in a while is fine, but not daily. So, just remember: cooked and in moderation, and you should be fine. Always, always monitor yourself to be sure you’re not experiencing any negative effects.

For more information on how soy relates to thyroid health, click here.

The Problem With Nightshade Veggies

Nightshades are another group of vegetables that are usually avoided by people with Hashi’s. They contain saponins, lectins, and capsaicin, all of which can be problematic for digestion, leading to various food sensitivities and leaky gut.

Saponins are a protection device utilized by plants against microbes and insects. These compounds can resemble detergents and cause inflammation in the body. Foods containing saponins include peppers and tomatoes.

Lectins are found in grains, legumes, nightshades, and oils made from seeds. They are incredibly hard to digest and can penetrate the protective mucus of the intestinal lining, leading to leaky gut.

Capsaicin is a potential irritant to the intestinal lining and may also contribute to leaky gut. It is found in chili peppers.

Some of the more common veggies that belong to the nightshade family include:

  • tomatoes
  • eggplant
  • white potatoes
  • sweet and hot peppers
  • chili-based spices (including paprika)
  • goji berries
  • pimientos

I make a practice of avoiding these foods altogether because I can tell when I eat them that they are not my friends. I usually end up with some kind of digestive distress. For a more complete discussion of this issue, click here.

More About Lectins

Lectins are found in grains, legumes, nightshades, nuts and seeds. I already mentioned above that lectins can be a problem as they can agitate the lining of the intestinal wall and possibly cause leaky gut and autoimmune reactions.

However, choosing to eliminate these healthy foods completely can lead to  a lack of certain nutrients, notably the B vitamins, which are crucial in staying healthy. I did go off of these for a while, but I was even more tired and lost more hair and muscle tone, so I decided to incorporate small amounts back into my diet.

I tend to stick with seeds more than nuts, and I avoid grains altogether because they cause sugar cravings and many of them contain gluten. I also avoid beans because I simply can’t digest them well. I eat a small amount of sunflower and pumpkin seeds several times a week and it doesn’t seem to bother me. In fact, I can tell a difference in my energy levels when I do this. On the days that I don’t do this, I make sure I have some other kind of high protein snack, like dried beef. This helps with my iron and B12 levels.

So, you will need to experiment a bit to see what might work for you. If you are experiencing adverse effects from any of the members of this group, then you should probably avoid them for a while and try again in 6 weeks or so to see if they still affect you.

If you would like to read more on this topic, click here.

Give Up Dairy (?)

Yes, here’s another “enemy” food group and this one hurts almost as much as giving up sugar.

I was born lactose-intolerant, so I probably never should have been consuming dairy at all during my life. The doctors took me off of dairy as a newborn and put me on soy formula (which also did not do me any favors), but at some point, my mother put me back on it. Then, when puberty hit, out came the acne. My mother took me to the dermatologist and I was fully expecting to be taken off of everything fried and sweet, but he simply said, “No more milk”…and it worked!

So, I stayed off of it again for a while, but eventually went back to eating cheese and ice cream. I never had much of a reaction to cheese, but the ice cream always left me bloated and gassy, so I didn’t eat much of it. As I continued to have problems with fatigue, brain fog and allergies, I realized that these foods were actually producing more mucus in my body. Now I never have any dairy….ever.

Here’s the thing about dairy: milk proteins are similar to gluten, so it can cause the same kind of reaction from your immune system that gluten would. These reactions fall into several categories known as IgE, IgA and IgG.

IgE reactions happen immediately and it is these reactions that people are usually referring to when you talk about food “allergies”. Think peanuts, for instance.

IgA reactions happen in the intestines every time you eat a particular food and can lead to intestinal damage. Celiac disease is probably the most well known IgA food reaction.

IgG reactions are more subtle and can occur some time after eating something. It is harder to “connect the dots” with these reactions because there is a span of time between eating and reacting. Symptoms can include headache, nausea, memory problems, bloating, just to name a few.

For detailed explanation of all these reactions, click here.

Dr. Osansky at Natural Endocrine Solutions believes there are other reasons to stay away from dairy:

  • Cow’s milk has hormones that were not intended for humans
  • The pasteurization process has the potential to alter milk proteins in a harmful way
  • Homogenization has the potential to alter the natural structure of milk
  • Sensitivity to casein and whey protein

For more details on all of this, click here.

There seems to be a difference of opinion out there regarding dairy and Hashi’s.  Many people say you should always be 100% dairy-free, while others say eating those things that don’t seem to cause a reaction is probably ok. I have chosen to stay away from it just to be safe and because I have a long history of reacting to it adversely. Since inflammation is a major part of dealing with Hashi’s, I believe it’s always better to err on the side of safety.

Other Issues

I have other sensitivities that are often not addressed in the typical Hashi’s diet. I am currently struggling with histamine intolerance and salicylate sensitivity which force me to eliminate a ton of foods that normally would be very nutritious and helpful. I’ll talk more about this in another post, but for a start on dealing with these issues, check out The Low Histamine Chef. She has tons of great information and recipes.

Which Diet to Follow?

There are several diet options out there to help you construct a daily plan for dealing with inflammation and the autoimmune responses that come with Hashi’s:

  • Autoimmune Gut Repair Diet – this diet comes from Dr. Datis Kharrazian who has become one of the leading figures in Hashi’s treatment and research. You can take a look at this diet here. The diet is very restrictive and may include things that you might still react to, so you may need to customize it for your own sensitivities, as I did.
  • Autoimmune Paleo Protocol – this is very similar to the gut repair diet, but may be slightly less restrictive as it is a maintenance program for people dealing with various autoimmune diseases. Mickey Trescott and Angie Alt have created a great website with tons of recipes and cookbooks. They are dealing with autoimmunity themselves and have worked tirelessly to bring delicious meals to those of us who feel we have nothing left to eat. Check it out here.
  • The Autoimmune Protocol – Dr. Sarah Ballantyne is another great source of information on autoimmune disease and diet. You can take a look at her ideas here.

I hope the information here is enough to get you started on an interesting journey in structuring a diet that will support your system and lead to healing.

Best,

Vanessa

Vanessa Gunter, D.M.A., M.A.

Supplements Which May Be Helpful With Hashimoto’s Thyroiditis

Supplements Which May Be Helpful With Hashimoto’s Thyroiditis

Please remember, these choices are very personal and I am listing mine simply to show you what has worked for me, not as medical advice.

I’ll be honest with you: I am on a truckload of supplements. Why? Because I was not able to find knowledgeable practitioners in time to avoid a long list of food allergies, which led me to a place where I was on a ridiculously restricted diet. This meant that the only way I could really get the vitamins and minerals I needed was through supplements because I would react to practically every kind of food that went into my mouth.

I am still struggling with this situation, but it is slowly getting better, thank goodness. But I will tell you that patience is key to this process. I have to keep telling myself that I didn’t get this way overnight and I am not going to get “well” overnight, either.

I talk more about diet and food allergies in this post. Here I just want to provide you with a list of what I’m currently taking and why, in order to give you an idea of where you might want to start your own research regarding your own supplements.

Please remember: this is not medical advice, only my own experience. You should consult with a knowledgeable practitioner as you go through this journey. I am listing the brands I use only as reference. I am not being compensated for this information.

I’m going to divide my supplements into categories according to what each is trying to address so that I can discuss each in a more coherent way. I am continuing to try new and different things, so I will try to keep this information updated as I make changes to my regimen.

General Support

  • Multivitamin: I use a heavy-duty multivitamin called Ultra Preventive III by Douglas Laboratories because of my restricted diet and inability to absorb my food very well. I feel like my ability to absorb nutrients is improving, as I have been able to reduce my dose of this supplement recently. This multi has a broad range of vitamins and minerals in it that are ideal for people struggling with gut problems. Whatever multi you decide to use, be sure that it is a comprehensive one.
  • Vitamin D: it seems that people with Hashi’s very often have a deficiency in vitamin D. For me, this has been a result of my gut problems and also my inability to get outside much and exercise as a result of my muscle issues. I take 5000 IU daily and I use the Jarrow brand.
  • Fish oil: fish oil is great for a lot of things as it is a good source of Omega 3. Apparently the tendency in America is to get too much Omega 6 and not enough Omega 3, since many processed and fast foods use Omega 6 oils. Fish oil can help with anxiety, depression, arthritis, cancer, diabetes, hair growth and gut health, just to name a few. I use wild salmon oil (Natural Factors brand). For a detailed discussion of the benefits of fish oil, click here.
  • Evening Primrose oil: I began taking this to help with hair loss and it has definitely made a difference. This oil has a reputation for aiding in balancing hormones in women, helping with fertility, hair loss, skin health and even rheumatoid arthritis. I use Barleans brand. For more info on this oil, click here.
  • Borage oil: this oil has more GLA than Evening Primrose and so may help more with inflammation and issues connected to healing, which is why I added it to my regimen. There are also people online who swear by it for hair loss. I use Barleans brand. For more info, click here.
  • Monolaurin: my doctor put me on this supplement after he took me off of iodine and I was getting sick all of the time. It is really great for boosting the immune system. I immediately felt better after I started taking it. Since then, I’ve resumed my iodine supplement (you can read more about this below), but decided to keep taking this until my system has had a chance to heal more. I use the Ecological Formulas brand. For more info on monolaurin and its precursor, lauric acid, click here.
  • Ultra Benfotiamine: this is a form of thiamine and apparently, Hashi’s people are usually deficient in thiamine. I discovered this wonderful supplement as a result of Dr. Isabella Wentz at thyroidpharmacist.com. It has made a lot of difference in my energy levels. Be sure to read her information on this supplement here. I use the Douglas Laboratories brand.
  • Calcium Lactate: I am lactose intolerant, so getting calcium into my diet can be a challenge. I began this supplement via a naturopath that I was seeing some years ago and, while I thought it would be beneficial to my bones, the biggest change I noticed was in my thinking. I was able to think much faster and clearer once I started taking this. It makes sense, because calcium is one of the electrolytes that your body needs in order to pass messages from the brain to the body and back again. I use the Standard Process brand. You can read more about calcium and the brain here.
  • 5-MTHF: this supplement is necessary for people who have a problem with methylation, which is a process involved in protein synthesis, detoxification, formation of transmitters, and hormone regulation, among other things. People with Hashi’s often have issues with methylation, either as a result of a genetic mutation, leaky gut, lousy diet, or exposure to environmental toxins. You can get tested for gene mutations to find out if you’re at risk. I was tested several years ago, there was a mutation, and my doctor immediately put me on this supplement. I take Metabolic Maintenance brand. This whole methylation thing is very involved, but there’s a good explanation here.

Digestion

  • Probiotics: these are critical for anyone with gut issues. I had to try quite a few before I found one that seemed to work for me. I wasn’t able to tolerate prebiotics very well and a lot of these supplements have inulin which is a definite no-no for me. So, if your body doesn’t like what you’re taking, be sure you don’t force the issue. I use Probacto probiotics and I feel like this product has really worked well for me. It is an “anti-Candida” probiotic, but you don’t necessarily have to be diagnosed with Candida to use it and get benefits from the way it works.
  • Digestive Enzymes: I take these with all meals and snacks. They break down your food and make it possible for your intestines to absorb nutrients. Some people are deficient in these enzymes from birth, others develop deficiencies due to bad dietary habits. There is some evidence that individuals who were not breast fed are deficient in enzymes because mother’s milk acts to provide the infant with numerous enzymes after birth. Go here to find out more. I use Pancremax by Karuna for meals and Prozymes by GIProHealth for snacks. Why two different kinds, you ask? Because the Karuna is pretty expensive and I know the Prozymes are also safe for me, but a little cheaper.
  • Hydrochloric acid: most people with Hashi’s have low stomach acid, which means your food will not be broken down or digested properly. It’s important to supplement with Betaine Hydrochloride with Pepsin for optimum results, so be sure whatever supplement you choose has both. My doctor advised me to start with a small dose and gradually increase until I felt some stomach discomfort, then decrease the dose slightly from there. I used to use a Standard Process supplement for this that I liked very much, but then it became ridiculously expensive, so now I’m using Hydrozyme by Biotics Research Corporation.
  • L- Glutamine: this is an amino acid which supports the intestinal lining and may help with repairing a leaky gut. I use Jarrow brand.
  • Ginger tea: this has been a lifesaver for me. No more Pepto-Bismol for stomach aches. I go straight for the ginger tea and I keep drinking it until my tummy feels better. I also drink it after every meal because it helps so much with digestion. Warning: it will make you feel warm and, if you’re like me and you’re dealing with hot flashes, it will make them worse, but only for a little while. The digestive support is worth the extra heat to me. I always try to drink organic, plain ginger tea when possible, although sometimes I splurge and have a cup of lemon-ginger tea instead.

Thyroid/Adrenal Support

  • Adrenal cortex: this supplement supports the adrenal glands and supplies the body with extra energy and mental clarity. I use Pure Encapsulations brand.
  • Coconut oil: this supports the thyroid, brain function and contains a lot of caprylic acid, which is great at fighting fungus in the system. I use Health Support brand.
  • Vitamin C: I have been off of fruit for a long, long time because my body just cannot process any form of sugar properly. I am still trying to sort out this problem, but in the meantime, it has been necessary to supplement with lots of vitamin C. The adrenals must have vitamin C in order to function properly and anyone with an adrenal deficiency will need to take lots of it in order to help those tiny organs do their jobs. I use the American Health brand with bioflavonoids. I have noticed I feel much better on this brand than others and this supplement comes in tablet, capsule and vegetarian formulas.
  • Selenium: many people with thyroid problems are deficient in selenium and, if you are taking in any iodine at all, you need to balance it out with selenium in order to keep your antibodies from going up. I have tried plain selenium in the past, but I find that Life Extension Super Selenium makes me feel better. You need to be sure you are getting 200 mcg daily.
  • Iodine: this is a highly controversial area when it comes to Hashimoto’s. Suffice it to say that there are people out there who will tell you not to take in any iodine at all if you have Hashi’s, not even in your food. I can tell you I tried this and I felt like total crap. My allergies became much worse and I just felt generally bad. If you know anything about iodine at all, then you know that it cleans your blood and that your thyroid gland has to have it to function properly, so I am at odds with anyone who says you shouldn’t have any at all. There are studies out there that show that iodine can be taken successfully by people with Hashi’s as long as adequate selenium is taken with it. I am currently taking 1/2 of a 12.5 mg tablet of Iodoral. I have found that, if I take more, depression sets in, and, if I take less, my allergies flare up badly. There are other brands of iodine out there, such as New Iodine and Lugol’s, which people use with great success. If you have never taken iodine before, be sure to do so with a doctor’s supervision and begin at very low doses and work your way up to what seems best for you.
  • B12: this powerful little vitamin is crucial for adrenal, muscle and brain health. Symptoms of a deficiency can include chronic fatigue, depression, anxiety,  and muscle aches and pains, to name only a few. I’m currently using sublinqual drops by Pure Encapsulations. The jury is still out on this as I have only just started using it, so I may be updating this choice in the future. For more info on B12, click here.

Muscle Health

  • Magnesium malate: in general, I find that I need pretty high doses of magnesium in order to keep my muscles from knotting up and going into spasm. I take two kinds: magnesium malate by Designs for Health and magnesium citrate/malate by Pure Encapsulations. Altogether, I am taking between 1200 and 1500 mg a day. I have found that magnesium malate works best for me, but this is a personal thing. I cannot eat any fruit at the moment, so I am not getting any malic acid from much of anywhere and your muscles need this to function properly. I have found, however, that if I take too much of the magnesium malate by Designs for Health, or if I take just plain malic acid, that I get a headache. So, I am constantly working with how I combine these two magnesium supplements. There are other forms of magnesium out there. It’s important to get one that the body can absorb easily. I started with magnesium citrate years ago in order to help with constipation. My functional medicine doctor put me on magnesium malate in order to help with my muscle problems. Since then, I have just been tweaking the doses as needed.
  • CoQ10: this supplement is widely known to help with muscle health. I use the Jarrow brand, 200 mg.
  • Epsom salts baths: every evening, I soak in a bath of epsom salts. I use this time to do some self massage on my neck, shoulders and arms, and anywhere else that might be giving me trouble. I find this really helps my muscle tissue stay more flexible and it also helps me sleep better.
  • Magnesium lotion: I have just started using this, but I can already tell it’s helping. I recently had a bout with my left hip flexor muscles and found that my usual supplements were not enough to ease the pain. I had tried magnesium oil in the past and didn’t really get much relief from it, but the lotion I’m currently using is definitely making a difference. I put it on at night before sleeping. It not only helps with muscle pain and knots, but it helps with sleep as well. If I’m having extra muscle issues, then I also use it during the day. I’m using Life Flo Health Products brand.

Histamine Intolerance/General Inflammation

  • Turmeric: this is a wonderful anti-inflammatory and has also been connected with brain health. I put in almost everything I eat, in addition to taking it as a supplement. I take the Organic India brand.
  • Antronex: this supplement is by Standard Process and I have found it to be very helpful with sinus conditions associated with histamine problems. It is made from bovine liver extract which helps to cleanse the blood. You can see a detailed description of this supplement here.
  • Quercetin: this is a wonderful anti-histamine antioxidant with many talents. It occurs naturally in several types of foods. I use the Jarrow brand. To find out more, you can go here.
  • Mangosteen: this is actually a tropical fruit, popular in Southeast Asian regions. It’s known for its anti-histamine and anti-inflammatory properties and is being studied for its anti-cancer properties. I use the Source Naturals brand

So that’s it for my list for now. I hoping this list will become shorter very soon. As I change things, I will update you.

May we all find healing,

Vanessa

Vanessa Gunter, D.M.A., M.A.

 

Medications Often Associated with Hashimoto’s Disease

Medications Often Associated with Hashimoto’s Disease

There are various approaches to medications that may or may not be helpful with Hashimoto’s. I will attempt to give you an overview here.

Synthroid/Levothyroxin

As I stated in a another post, the “go to” medication for Hashimoto’s is often a T4-only medication like Synthroid or Levothyroxin, unless you’re fortunate enough to be seeing a holistic practitioner when you’re diagnosed. Some people do fine on this, but many people do not, mainly because it does nothing to address the autoimmune component of the problem and it only provides one of the five hormones that the thyroid needs to function.

I was on Synthroid for a little over 10 years, but I started feeling really lousy (translates as: always tired, sick a lot) about 6 years after starting it. When I started trying to talk with doctors about this problem, they usually just wanted to increase my dose. When I would try this, my heart rate would go up, along with  my anxiety levels, and I just generally did not feel right. I knew that something else was amiss, so I began to seek out practitioners with a more holistic approach. I was on Synthroid plus Armour for a while (strange combo and not recommended), and it did increase my energy, but only at very high doses, which was really ramping up my heart. I was told I had adrenal fatigue, but was not given any direction as to what to do about this. Finally, I found a doctor with experience with this and he prescribed cortisol and took me off of Armour.

Then, of course, we moved to another state and I had to start all over again finding practitioners who were knowledgeable about any of this. For a time, I was on Synthroid plus Cytomel (a T3-only medication), which did help my energy levels, but, without any support for my adrenals, I was still exhausted and depressed most of the time.

For a more detailed discussion of why these meds don’t work well for Hashi’s, click here.

Natural Desiccated Thyroid (NDT)

During all of this time, I was doing a lot of reading and research, trying to figure things out on my own. As I continued to search for knowledgeable practitioners, initial appointments with these people became interviews because I was, in fact, interviewing them for a job as my doctor. I will talk more about “hiring” doctors in another post.

I finally found someone who was willing to work with me as a team to try to figure things out. It was at this point that I decided to try natural dessicated thyroid (NDT). I have been on it since and have found it to be very helpful in combination with other supports. Since it is made from thyroid tissue, it has all the thyroid hormones in it, which we all need. There are several “flavors” of NDT out there. I happen to use Nature-throid. For a thorough discussion of what’s available in the category of NDT, click here.

Adrenal Support

Now, all this time, my poor adrenals were completely ignored when, in fact, they probably pooped out before my immune system went kerflooey. One of the most frustrating things I have discovered about this is that before a doctor prescribes Synthroid to anyone, he/she is supposed to determine if the adrenals are faltering, because prescribing Synthroid in the presence of weak adrenals can worsen the problem. Well, based on patient report and conversations on forums, I can tell you this just is not happening very often. So, a lot of people are ending up with adrenal fatigue when it could have been avoided. Grrrrrrr.

I use a combo of low dose cortisol and adrenal cortex to support my adrenals. There is still a lot of controversy out there regarding the use of cortisol, but I have found it to be very helpful. Many conventional docs won’t prescribe it based on a history of horrible side effects at high doses. But only physiologic doses (up to 30 mg a day) are typically used to treat tired adrenals. I did wean myself off of it at one point at the direction of a naturopath with whom I was working, but I found that I was, once again, tired all the time and couldn’t think well. When another doctor prescribed it for me later, the relief I felt was almost instantaneous.

You can find a ton of info on cortisol, NDT and a million other things regarding thyroid treatment over at Stop The Thyroid Madness. Great site, great book!  The best reference I know on using cortisol safely is the book Safe Uses of Cortisol by Wm. Jeffries. Definitely worth a read. You can buy a copy here.

Low Dose Naltrexone (LDN)

A relatively new medication that is making major waves in the Hashi’s and autoimmune world is low dose naltrexone (LDN). I discovered this a few years ago only because the functional medicine doctor I was seeing knew about it and prescribed it for me. Wow! What a life-changer. By the time I started using this medication, I had been dealing with chronic pain for a long time. My pain always came as a result of knots and spasms in my muscles (usually in the neck and shoulders) and, as a I noted in another post, I thought that this was all connected to repetitive stress injuries from my 35+ years as a professional flutist. Well, about 2 weeks after I began taking LDN, I started noticing a decrease in pain and, after 5-6 weeks, the pain was greatly diminished. Unfortunately, I have never been able to get back to a place where I can play flute regularly again, but at least I’m not in constant pain all day. Of course, that isn’t the end of the story. In order to keep the pain at bay, you need more than just LDN. You can read more about that here.

LDN works by modulating the immune system through blocking opioid receptors, which forces more endorphins into the blood. You see, a common denominator with all autoimmune disease is a deficiency in endorphins. LDN actually assists the body in repairing itself by giving it what it lacks. It’s a great thing. For more detailed information, click here.

Lufenuron

Since so many people with Hashi’s have gut problems and many of those gut problems are related to things like parasites and Candida, I have noticed a lot of people turning to Lufenuron for help with this. Lufenuron works by preventing the chitin in the Candida and/or parasites from forming, thereby killing both. It is totally benign in the body and, in addition to taking care of these problems, it helps LDN to work more efficiently in the body. I tested negative for both Candida and parasites some time ago, but decided to do a course of Lufenuron anyway, just to be sure. I did feel better while taking it and it did seem as though my LDN was working better. For more information on Lufenuron, click here.

It’s important to keep in mind that medication choices are personal and should be tailored toward what works best for the individual. People with Hashimoto’s have a lot of symptoms in common, but we all experience this condition in a unique way according to our particular physiology. This is why it’s so important to find a practitioner knowledgeable in Hashimoto’s and all of the available approaches that may be useful.

Best,

Vanessa

Vanessa Gunter, D.M.A., M.A.

Disclaimer: This blog is a representation of my personal views and opinions and not those of any associations or organizations to which I may belong or with which I may volunteer. The contents of these pages are informational only and must not be construed as medical advice, opinion, diagnosis or treatment. The information provided here should not be used for diagnosing or treating a medical problem and should not be viewed as a substitute for professional care. If you feel or suspect that you have a medical problem, you should consult an appropriate health care provider.

 

Addressing Hashimoto’s Symptoms – Where to Start?

Addressing Hashimoto’s Symptoms – Where to Start?

Depending on how long you’ve been dealing with Hashimoto’s disease, you may have only a few symptoms or everything that was on the list in my earlier post. Obviously, it’s easier to manage if you have only a few, but it’s really important that those first symptoms are managed properly, so that your condition doesn’t worsen.

In my case, as I mentioned before, symptoms were ignored for literally decades until, finally, a thyroid antibody test (which no one had ever thought to do prior to that time) returned a positive result. People are now starting to talk about the fact that by the time you are actually diagnosed with this condition, it may have been around for a very long time and you may already be in a pretty severe stage of the disease.

Thyroid Meds

When you’re diagnosed with this condition, you are diagnosed as being hypothyroid (underactive thyroid). Conventional doctors will inevitably prescribe medications such as Synthroid or its generic equivalent Levothyroxin. Unfortunately, this approach simply attempts to support the thyroid gland without addressing any component of the autoimmune problem. This is why we all get sicker over time. For more on this issue and some alternatives, click here.

Digestive Issues

Digestion is a huge issue with a lot of people who have Hashi’s. Many of us have never had good digestion for whatever reason and some of us have created a hostile digestive environment through bad eating habits. In either case, the end result is usually leaky gut. There is still skepticism about this condition among many conventional doctors, but I am definitely a believer. Given my own struggles with digestive issues my entire life, I now firmly believe that this was the shaky foundation that helped to set me on a path to Hashimoto’s. Simply put, leaky gut allows food particles that would normally stay in your digestive tract to escape into your blood stream. This not only causes problems with nutrient absorption, but it causes your body to become sensitive to a wide variety of foods, since it is no longer being protected by the usual barrier between your gut and your bloodstream. This results in becoming allergic to a long list of foods and not being able to absorb nutrients from food, so you literally become malnourished. At my lowest point, my hair was falling out, I had become very thin, and my muscles were basically just hanging off of my bones because I was on a horribly restricted diet and I was absorbing very few nutrients from my food. For a detailed discussion of leaky gut, you can go here.

As if this weren’t enough, many people also struggle with Candida, SIBO (small intestine bacterial overgrowth) and/or parasites. Any of these can cause brain fog and fatigue, along with digestive issues. You can find more info and resources on this topic here.

All this leads to the question: What can I eat?  I used to joke some years ago, when I was gradually eliminating first one food and then another and another and another, that by the time I was 60, I would be subsisting only on saltines and water. Well, that turned out not to be true, because I can’t even eat saltines!!  All joking aside, this is a serious issue, given the above-mentioned problems with malabsorption and malnutrition. For my take on this, go here.

Supplements become a primary concern for those of us struggling with this condition, usually because of malabsorption problems in the gut which can ultimately lead to malnutrition. However, you need to be very careful about the quality of the supplements you use and the extra ingredients that may be included. Sometimes these can worsen your condition, especially if you have multiple allergies and sensitivities. I have a post detailing the supplements and medications I use here. Please remember, these choices are very personal and I am listing mine simply to show you what has worked for me, not as medical advice.

Sleep…or the lack thereof

Most people with Hashimoto’s will deal with insomnia at some point. This can present in several ways. Sometimes people have difficulty falling asleep, sometimes it’s hard to stay asleep, and sometimes it can be both. Issues with falling asleep very often point to a badly regulated thyroid gland and issues with staying asleep can be related to adrenal, kidney, or liver issues. When you have both of these, then trying to get any decent sleep at all becomes a real challenge. Food sensitivities also play into this because if you’re eating foods that your body is having difficulty processing, then your body is probably going to wake you up in the middle of the night to let you know it is not happy. You can find an in-depth discussion of this problem here.

Chronic Pain (and Attempting to Exercise)

I didn’t know this until well after I was diagnosed, but chronic muscle and joint pain is also a common symptom of Hashimoto’s. For me, this presented as knots and spasms in my muscles which were incredibly painful, so much so that I have had to walk away from several jobs as a result. For now, my pain is pretty manageable, but I have found that removing stress is critical to keeping the pain at bay, along with taking copious amounts of magnesium and getting a prescription for low dose naltrexone (LDN). Read more about this here.

One of the most frustrating things for me about the muscle pain has been the inability to do much physical exercise. There are people out there who will advise certain things about Hashi’s and exercise, but the bottom line is, you can only do what you can do. So don’t push yourself to do exercises that are going to worsen your condition, regardless of what anyone says. I talk more about this here.

Brain Fog

Another common complaint among Hashi’s people is brain fog. If you’ve experienced this, you know. You can’t concentrate, you forget easily, you really feel like you can’t do anything but just sit in front of the TV, and, even then,  you can’t concentrate on what you’re watching. It’s a horrible feeling and it’s scary, especially with increases in diagnosed cases of Alzheimer’s and other forms of dementia. There seems to be a very strong connection between brain health and thyroid function, as well as a healthy gut. You can learn more about this here and here.

Depression and Anxiety

And lastly, I have to mention the emotional toll this condition takes on everyone who has it, because it is a large one. Depression and anxiety are common not only because you are constantly battling the various facets of this disease, but also because they are a physical part of this condition. Hashimoto’s screws mightily with your hormones and your hormones have a fundamental part to play in endocrine health, which regulates your emotions. So, it’s important to remember that these are symptoms, not some personal failing because you “can’t handle” your condition.

As I mentioned before, I have walked away from numerous jobs due to my Hashi’s and when/if you have to do this, it can bring all sorts of questions to your mind: What’s wrong with me? Why can’t I work like a normal person? Will I ever have a normal life again? How will I live? and the biggie, especially if you’ve been doing work you identify heavily with: Who am I now? Am I this disease? 

On top of this, you will inevitably encounter people who won’t believe you are struggling as much as you are because “you look fine”. This can be infuriating and hurtful, but just expect it, because it will happen. I will be devoting considerable resources to a discussion surrounding the psychology of Hashi’s.

So, this gives us a start at identifying core features of Hashimoto’s and a few resources with which to begin the journey of educating ourselves about this condition. More soon.

Best,

Vanessa

Vanessa Gunter, D.M.A., M.A.