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20 Tips for Starting the AIP

20 Tips for Starting the AIP

I often hear the question “what are your best tips for starting the AIP (Auto-Immune Protocol)?” Dramatically changing up your diet and lifestyle can be daunting, that’s for sure. So, as requested, here are 20 tips for starting AIP. First, the food part: 1) BABY […]

What To Say To People Who Don’t Understand.

What To Say To People Who Don’t Understand.

Wondering what to tell people who don’t understand your need to go gluten-free or change up your diet?  Been there, done that.  It can be so frustrating when people don’t understand (not always their fault) or don’t care (not much you can do there).  You […]

Basic Thyroid Labs

Basic Thyroid Labs

Folks often ask “what tests should I get?” when it comes to thyroid labs.  Here’s a good basic list to request from your doctor:

Free T3
Free T4
TSH
Reverse T3
TPO and TgAb (antibodies for Hashimoto’s) and TSI (antibodies for Grave’s).

Note that upwards of 80% of those with hypothyroidism also carry elevated antibodies that indicate Hashimoto’s.  So while it’s good to check those, if for some reason you can’t afford the tests or your doctor won’t check them, assuming you DO have Hashi’s may not be a bad idea, just to err on the side of caution.

Free T3 and Free T4.

Free T3 and Free T4 labs measure the free or unbound T3 and T4 hormone in the body.  Total numbers measure the free and bound hormone, and those aren’t as helpful for determining thyroid med dosage.

Unfortunately, many insurance companies will not cover a Free T3 test, so many doctors will not order it, thinking they are doing their patients a favor.  If your Free T3 is low, you may be fatigued, have poor gut motility (having a bowel movement every 3-4 days instead of 1-3x per day), have low body temps/feel cold all the time, I could go on and on here.  Many feel best with their Free T3 lab in the top part of their lab’s range.  Get it tested.

Self-order those labs if you must, I do it all the time.   Lots of places online to help you do this, Google is your friend!  More info on the importance of that Free T3 lab here from Tired Thyroid.com.

TSH is a Pituitary Hormone, NOT a Thyroid Hormone.

A word about TSH:  While initially, this test may be helpful for diagnosis, it is not that helpful in determining thyroid med dosage (that is where the Free labs come in!).  TSH may, in fact, become quite suppressed on T3-containing meds like Cytomel, Armour, Naturthroid, etc.

TSH is a pituitary hormone, not a thyroid hormone.  So if ones TSH is still quite high while the Free labs are optimal, this may be indicative of pituitary issues, not thyroid issues.  A good functional medicine doctor should know this.  Unfortunately, many GP’s and even endocrinologists do not know this, which is why I stress the importance of finding a doctor who understands functional medicine!

Antibodies.

A word about antibodies:  They go up and down and up and down all the time.  Some have antibodies in the 10,000’s, some have them only in the 100’s.  The actual number doesn’t matter *that* much.  Let me repeat that, the actual number doesn’t matter.

What does matter is two things:

One, that you monitor your symptoms.  Some can have antibodies in the 10,000’s and feel great!  Some can have slightly elevated antibodies and feel terrible.  This is because you can have tons of antibodies and they won’t be doing anything.  Just hanging out and… waiting. They haven’t waged their attack yet, but they’re there.  This is an excellent time to get on a proper dose of thyroid meds (if needed, as not everyone will need them) and remove gluten and dairy 100% from your diet.  For some, this is all they have to do and are on the road to remission.  Lucky!

Two, that you keep an eye on the number to see that it comes down over time.  Personally, I don’t test antibodies every time I do thyroid labs as I don’t see the point.  Antibody counts fluctuate all the time, and again, the number is not that important.  I’ve seen too many people get upset over the fact that their antibody counts went up a few points in 4-6 weeks.

Also important to keep in mind that if you have changed your diet recently (going gluten/dairy free or starting the AIP) that antibody counts may actually *rise* in the next 3-4 months.

I maybe once a year to see the general trend.  If those numbers keep going up-up-up, then something is going on.  If dietary and lifestyle interventions don’t help, then it’s time to dig deeper, looking for infections, heavy metal toxicity, mold or chemical issues, other AI disorders (like Lyme disease), etc.

Thyroid Hormone Conversion Issues.

A last word on thyroid meds:  Sometimes a Free T4 lab may be perfect yet the Free T3 lab is low.  Most of T4 is converted into useable T3 in the body, and some folks find they do not convert well. If you have T4 to T3 conversion issues, you may want to try other medications. See this post for more info on T4-T3 conversion.

If you have iron or cortisol issues, your body may be having a hard time utilizing those hormones.  Speak with your doctor about having a full iron panel and cortisol test done to see if there are things going on that may be affecting how your thyroid meds are working.

For information on when to take thyroid meds before blood work and also what to avoid to ensure best lab test results, see my post on when to take thyroid meds when having blood work done.

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Ready for change? Learn more about working with me one-on-one.

Artificial Sweeteners – Are They Any Better Than Sugar?

Artificial Sweeteners – Are They Any Better Than Sugar?

Do you have that friend (or “friend”… ahem) who always orders a Diet Coke instead of the real deal?  Perhaps they think they are doing their body a favor by avoiding real sugar and opting for artificial sweeteners.  Not that “The Real Thing” is that […]

8 Things to Help With Fatigue

8 Things to Help With Fatigue

Fatigue is a huge issue from which many of us suffer.  We’re talking beyond busy lives and being tired (aka not getting enough sleep at night).  This is mind-numbing fatigue.  Where you simply can’t move. Muscles don’t respond, your brain doesn’t respond. Like our little […]

Why Levothyroxine or Synthroid May Not Be Working For You

Why Levothyroxine or Synthroid May Not Be Working For You

So many of us with thyroid conditions are put on synthetic meds like Levothyroxine or Synthroid.  These meds contain synthetic versions of the thyroid hormone T4.

However, many of us are “poor converters”. This means that our bodies have trouble converting T4 into the useable T3. This is a quick and easy explanation from Dr. Datis Kharrazian (if you haven’t read his book “Why Do I Still Have Thyroid Symptoms If My Lab Tests Are Normal”, I highly recommend a read, it’s well written and easy to understand):

 
“About 94 percent of the hormone made in the thyroid gland is T4. The remaining 6 percent is triiodothyronine (T3), named for its three molecules of iodine.
 
“These thyroid hormones hitch a ride through the bloodstream on thyroid-binding proteins, during which they are referred to as “bound.” When they are dropped off at the cells for active duty, they are called “free” hormones. 
 
“T4 must be converted to T3 before the body can use it. Most of this conversion happens in the liver, but also take place in cells of the heart, muscle, gut, and nerves.
 

“In the end, only about 60 percent of T4 is converted into usable T3. Twenty percent becomes reverse T3 (rT3), an inactive form the body cannot use. Levels of rT3 can become too high in times of major trauma, surgery, or severe chronic illness. Another 20 percent of T4 can be converted to T3 by healthy gut bacteria in the digestive tract.”

You can read the full post from Dr K here.

 
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So, if you are a “poor converter”, your body may not be able to make that T4 to T3 conversion.

Levothyroxine is a T4-only med. Do you see where this is going? If you’re not converting well, your labs may consistently show low Free T3 in your body.  And that Free T3 is what’s needed by the cells in your body for energy, gut motility (the opposite of constipation), body temperature (are you always cold?), mood, skin and hair issues… you know the laundry list of symptoms, so I’ll stop there!

Here are some things to consider if you are a poor converter:

  • I was always in touch with my doctor about my labs and how we could tweak and improve them.  This sometimes meant raising my meds, lowering them, or trying another med.  If your doctor is not willing to discuss this with you, find another doctor if you can.  This is your health, not your doctor’s.  Find a doctor who will listen.
  • Sometimes adding in T3 (liothyronine, one brand is Cytomel) or switching to Natural Desiccated Thyroid (NDT) which has both T4 and T3 hormones (Amour, WP, Naturethroid, etc) is the key to giving the body what it needs.  But again, not everyone does well on NDT.  One must be mindful of fillers in all meds and any sensitivities one has.  For me, I also had to get my iron and cortisol in good shape before NDT worked, as both can affect how thyroid hormones work in the body. More on that in a future post.
  • As you heal your gut (see above about the gut converting T4 to T3 – if the gut is not healthy, guess what may not happen? T4 to T3 conversion!) – which we do by removing gluten, dairy, and other inflammatory foods – and your detox pathways heal and open (liver is mentioned as another place where much of the T4 to T3 conversion happens), your body may regain the ability to convert. So stay on top of those labs and symptoms in your journal.

Moral of the story:  If you suspect you are a “poor converter”, get that Free T3 lab as well as Reverse T3 to get the best picture of what’s going on in your body, and work with your doctor to find a solution that works for YOU.

See my post Thyroid Labs to Get for recommended thyroid labs.

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Ready for change? Learn more about working with me one-on-one.

Is your levothyroxine or Synthroid not working for you? This explains why that T4 thyroid med may not be working for you. autoimmunenutritioncoach.com
ADHD and Gluten

ADHD and Gluten

I have a few friends who have kids with ADHD, so this study piqued my interested.  The study explores the correlation between zonulin and ADHD. Zonulin is a protein found in our guts that helps regulate “drawbridges” and “trap doors” found in the gut lining. […]

What is Functional Medicine?

What is Functional Medicine?

Functional medicine – what is it? What is a functional medicine practitioner, or functional MD? What is a functional medicine health coach? Good questions all! Functional medicine, in general, looks at the whole body, instead of just a part at a time.  Everything is connected, […]

What is AIP?

What is AIP?

What is AIP? AIP is the AutoImmune Protocol (sometimes called AutoImmune Paleo).  The most important thing to remember about the AIP is that it is NOT a diet – it is a PROTOCOL that includes dietary interventions.

Aside from diet, the protocol addresses lifestyle, sleep, and emotional health. If these things are not addressed, the diet part may not be enough to help you heal!  Sorry to be the bearer of bad news, but, if you work 60 hours a week and only sleep for 5-6 hours a night, that’s probably not helping your health.

And then there’s stress. Sometimes we can’t avoid it (your mean boss, rambunctious kids, rush hour traffic, a parent who is now living with you, health issues, etc.). However, balancing that stress and how we deal with it is key.  Self-care in the form of meditation, exercise, and saying no when possible can all help with stress levels.  Easier said than done, I know.  I’ll be writing more about stress in future posts.

So, the diet part of AIP goes like this:  You eliminate potentially inflammatory foods for a while (30 days minimum, but 90 days is better). Then you systematically and carefully add back in foods one at a time to see what you react to, if anything.

This process can take a while, sometimes years, so patience is key!  If you have been sick a long time, you probably won’t heal overnight.

I did about 2.5 months of strict AIP before I added back in eggs.  I have since reintroduced a few other things here and there (tomatoes, certain nuts, seeds, ghee, white rice among other things).  Almost 4 years later I still feel my best when I’m strict with the diet part, but I can now have a cup of coffee, some tea, chocolate, a tiny bit of dairy now and then without “feeling it”.  I’ve learned that reactions are cumulative for me, so I don’t push it with these non-compliant foods.

After AIP most of us have to dig deeper.  For me, this was addressing heavy metal issues (I had a quite a few mercury amalgams and I was in NYC during 9/11).  Everyone will veer off in different directions, but AIP should be the first step for all of us.

Check out this post for more details on how to start the AIP.

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Ready for change? Learn more about working with me one-on-one.

A brief answer to that perennial question, What Is AIP. AutoimmuneNutritionCoach.com
Thyroid Health: Should I take my thyroid meds before labs?

Thyroid Health: Should I take my thyroid meds before labs?

It’s best to not take any thyroid meds prior to your labs, as T3 spikes rather quickly in the blood and may give you a false high reading in your labs – and your doctor may want to decrease your meds, which may not be […]