As I mentioned in my update post a week ago, I was recently diagnosed with Hashimoto's Thyroiditis. I was kind of relieved when I got that diagnosis, because I've had symptoms of thyroid disease for a long time, but all my TSH blood tests were coming back normal. My regular doctor ordered the TSH every year: in 2012 it was 2.13, in 2013 it was 2.03, and this year it was 2.12 (standard range is 0.45 to 5.10). But some blog readers have, in the past, tipped me off in the comments by telling me there were more detailed, accurate thyroid function tests and that many people who have thyroid disease have a normal TSH. That turned out to be true for me as well. When I finally was referred to an endocrinologist, he looked at my symptoms:
difficulty losing weight/weight gain
and the biggest symptom for me, cold intolerance (I spent this winter in heavy sweaters with the heat turned up to 80 degrees and was STILL cold all the time... this was new).
He ran 4 or 5 tests, and then called and told me I had Hashimoto's. Apparently with this autoimmune disease, the body develops antibodies and starts attacking the thyroid tissue. This shows up in the thyroid peroxidase antibodies blood test; I did have the antibodies, and they are quite elevated. He also told me that once you have one autoimmune disease, you are at higher risk of developing another one, like lupus or rheumatoid arthritis, because the body has learned to attack itself and this cannot be cured. I also tested positive for HLA-B27, which "suggests a greater-than-average risk for developing or having certain autoimmune disorders. An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue." (source link).
Before we even had the results of the blood tests, the endocrinologist recommended an elimination diet (and I cringed. I have been very resistant to the idea of such a thing, like the Whole 30, because it is so restrictive and I thought I'd go off the rails). But this was different. This was no longer about weight loss. This was a recommendation for my health, because of all the symptoms I've been having. He wanted me to eliminate all traces of gluten and dairy, and possibly some other foods. Apparently the protein in gluten is very similar to the structure of thyroid tissue, so if your body is gluten intolerant and you eat gluten, your body may also start attacking your thyroid. You can read more about that here: The Gluten-Thyroid Connection.
So after the tests came back positive, I called and talked to a thyroid specialist about elimination diets and he explained the most problematic foods that may cause inflammation, such as nightshades, eggs, nuts, and processed foods. He also discussed with me the role of environmental toxins and stress in autoimmune disease (discussed more here). I bought two books to help me understand the whys and hows of these changes :Hashimoto's Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, and The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body. Both are really great books full of information, if you want to learn more about these issues.
After making a list of all the things I was told to eliminate, I started doing some research online. That's when I found that this type of elimination diet for autoimmune diseases is called the "Autoimmune Protocol" or the "Autoimmune Paleo Protocol" (because it is like Paleo on steroids). There are lots of sites dedicated to following this protocol for people who have various autoimmune diseases; here are a few that explain the details: The Autoimmune Protocol, Paleo Approaches to Autoimmune Disease, and Changing Your Diet is the First Step in Addressing Hashimoto's. But basically, I am not allowed to eat anything. Kidding... sort of.
Here's a summary of stuff I have to eliminate. First, all gluten has to go, and probably forever because of the thyroid connection. Also no grains whatsoever... no rice, barley, wheat, oats, corn, etc. You can't have any legumes, so no beans, lentils, peas, peanuts, or soy products. As the endocrinologist stated, dairy is another one that might have to be be gone forever... including milk, cheese, butter, cream and all other dairy products. No refined sugar, no processed food chemicals, no artificial colors or flavors or sweeteners (including stevia) and no modern vegetable oils (canola, corn oil, etc). I think at this point you'd be considered Paleo, right?
Keep going. You can't have any eggs, so forget all those egg breakfasts. No nuts either, so ditch the almond milk, nut butters, macadamias, walnuts and other nuts as snacks. And no seeds, so forget seed butters, nut and seed oils, sesame products, pumpkin seeds etc. Also included in the seeds category is (gasp) coffee AND chocolate. This has been the hardest part for me. I loved having a cup of black coffee in the morning and a square of 88% dark chocolate after dinner... no more. Nothing with coffee or cocoa at all. But there's more! You have to eliminate nightshades, so no more tomatoes, peppers of any kind, eggplant, or white potatoes. This was pretty tough too... no salsa. No delicious garden tomatoes. And this also includes spices derived from peppers, so no chili powder or paprika, curry or cayenne (in fact there is a whole list of seed-based and pepper-based spices to avoid... makes things pretty bland IMO and also meaning you have to really read labels of any meats you buy like sausages). Finally, there's no alcohol and no NSAIDS so there are probably some headaches and joint pain in your future if you frequently use NSAIDS for pain relief.
When I read all of this I was SO BUMMED OUT. Basically, I can't eat anything! No more spinach mushroom omelets. No more roasted eggplant, or spaghetti squash with marinara sauce, or chili made with beans or tomatoes. No more cauliflower pizza, or deviled eggs, or chicken salad with mayo. No Greek yogurt with walnuts and blueberries. Oh it made me mad. But then I decided to focus on what I CAN eat.
I can have most vegetables (except nightshades) in any quantity. I can have lots of meat... preferably grass fed. I can have fish! I am encouraged to try to include organ meats (like liver, heart, and kidneys... I haven't yet) for their nutrition, and also to make and drink bone broth for healing. I can have quality fats like avocado, olive oil, and coconut oil. I can use pink or grey salt instead of table salt, and I can have fruits up to 20 grams of fructose per day. I am also encouraged to eat fermented foods like real, fermented sauerkraut, kombucha, and non-dairy kefir.
I started cutting things out immediately, starting with gluten. For the first week I spent a lot of time reading labels and finding gluten in everything! I also bought some gluten free cookies and realized just how much gluten free junk is out there! Tons of it! Next I cut that junk out along with the processed foods. I was already nearly soy free but had to dump my favorite green tea because it contains soy lecithin. I then cut the eggs out and the rest of the grains, including rice. I took it slow because I was going through some stressful life stuff, and didn't think I could handle cutting it all out at once... food is an emotional thing for me. Finally, I was down to just needing to cut out the coffee, some spices, a bit of dairy, chocolate, and tomatoes. I did that last weekend and have been 100% AIP compliant since.
And I hate it so far, and it sucks. I have not been very creative with my eating, so it's basically been:
homemade sausage (pastured ground pork and AIP compliant spices)
baked wild caught salmon
grass fed ground beef
cooked cabbage, asparagus, acorn squash, broccoli, butternut squash, and sweet potatoes
local peaches, plums, berries, and apricots
coconut oil, coconut butter, avocado
fermented sauerkraut, kombucha
For a family birthday we went out to a Mexican restaurant. Really, going out to eat is not happening anymore at all because I just don't want to risk cross contamination. But for this special occasion, I sat there watching the chips and salsa being eaten (that I can't have) and people eating all kinds of yummy cheesy stuff, beans, etc. But even the meats were marinated in spices, like paprika or other pepper based seasonings. So I explained to the waiter and I got this salad. This most pathetic salad I have ever eaten... a plate of iceberg and carrot shreds topped with the most plain, boring, seasonless chicken breast you ever saw. No dressing. I did ask for some fresh sliced avocado to perk it up a bit, but no lie... eating that was depressing. If I was only doing this for weight loss I would have bailed for the chips and salsa. But I am doing this for my health, for my future, and I am too scared to eat anything off the diet. So there it is, I am 100% compliant, but not loving it, and yes it sucks.
There are a lot of websites out there with AIP compliant recipes; I bought this book: The Autoimmune Paleo Cookbook and my goal this week is to make 5 recipes from it. There are websites, too, with plenty of recipes and ideas. I just need to open my mind and branch out and start cooking in a new way. I can do this.
By the way, I don't have to eat like this forever. The doctor said "a month or two" and the standard for this elimination diet seems to be a minimum of 30 days, longer if you feel good on it. Then you slowly reintroduce each of the forbidden foods one at a time and keep a journal watching for any negative reaction or effects. Anything that has a negative reaction has to be eliminated for longer, possibly forever. And the gluten? That has to stay gone because of the thyroid issue.
So I hate it, I won't pretend it is OMG so fun and delicious. Maybe it CAN be, I will find out. I am keeping a notebook of the foods I eat and how I feel. So far: nearly constant headache and sinus drainage, but also feeling calmer. I am also working on the lifestyle parts of healing autoimmune disease, including improving sleep quality, learning to deal with stress effectively (using meditation and other skills), exercising at least 30 minutes a day, and eliminating environmental toxins. More on that in another post!
I'm thankful for those of you still here to listen to me and care how I am doing. I really appreciate your comments and positive thoughts. Hopefully the coming week will be easier!
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