Hashimoto’s Thyroiditis Lifestyle Interventions for Finding and Treating the COMPANION GUIDE Izabella Wentz, PharmD, FASCP with Marta Nowosadzka, MD CONTENTS Introduction Page 1 1: T esting Page 4 2: Diets Page 10 3: Recommended Supplements Page 25 4: Resources Page 32 Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide INTRODUCTION Back to Table of Contents Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide 1 SO NOW YOU’VE READ THE BOOK? WHERE SHOULD YOU START? I’ll tell you my approach, and how I came to figure out what was working for me. Please note, the information presented below does not replace the recommendation of your physician, pharmacist, individual test results, best practices and is meant for educational purposes only. 1. First, if you can afford it, get some testing done. a. The recommended tests are listed at the end of this guide. b. If you do not have a physician that will order the tests for you, see the list of di- rect to consumer lab tests in the resource guide. c. The tests, as well as the quizzes in the book will direct you where to go as far as infections and imbalances go. 2. The next step would be to start reducing your inflammation by removing things that are toxic. a. Refer to the Intolerances Chapter on how to do an elimination diet. Generally, the worse off your gut, the more restrictive elimination diet will be needed. b. Basic elimination diets include grains like rice, potatoes, etc, and eliminate glu- ten, dairy, eggs, soy … Some people have reported eliminating their TPO Antibod- ies after removing gluten, dairy or all of these foods. Three months is generally long enough to know if this is all you need. If that doesn’t work, you can progress to the advanced elimination diet. c. Advanced elimination diets should kick off with an elemental diet or a modified elemental diet to reduce intestinal inflammation and remove small intestinal bacterial overgrowth. d. If you have a history of GI problems you should start with the more advanced elemental diet. Having an abnormal tongue is an indication of poor GI function. e. Please see the recipes for an elemental diet. f. You can then start adding foods in and testing for reactions. 3. After you have finished the elimination diet, start fermented foods and probiotics. You may get die-off reactions! If they are too severe, cut back on the dose or start Anatabine- Anatabine detoxifies LPS, the toxin released by bacterial die-off. 4. Once you have completed the elimination/reintroduction diet, your next step should be to detoxify. Alkalizing the body is an important strategy for detoxification. Please see the detoxification recipes on page 14. 5. Next, while you work on your gut, also work to remove triggers and toxins like excess iodine, fluoride, and chlorine, based on the Five Rs discussed in the book. 6. Healing foods and healing supplements should be incorporated. Back to Table of Contents Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide 2 7. Find out everything you can about autoimmunity and Hashimoto’s. Your root cause may not be the same as mine. I provide a list of recommended reading in the re- sources section. 8. Still have questions? Contact me at [email protected] or find me on Facebook. HOW DO YOU KNOW A CHANGE IS AN IMPROVEMENT? I use the P-D-S-A approach: Plan-Do-Study-Act Plan: First I plan out what one small change I am going to make, for how long, and how I will measure the results I get. I note down my baseline TPO antibodies and my ratings on symptoms (see Thyroid Journal on page 6). Do: I then actually make the change. No hesitations, no cheating. I don’t take up any- thing new, I stick to the plan. Study: After I carry out the plan, I repeat my TPO antibodies (up to one time per month) and redo my symptoms rating in the Thyroid Journal. Act: Based on my results, I decide if I should Adopt, Adapt or Abandon the intervention. If it makes me feel better, I adopt it and write it down in the “Makes me Feel Better” col- umn (see worksheet). I abandon the intervention if I feel worse on it, and I note it down in the “Makes me Feel Worse” column. If the intervention needs some tweaking (change in dose, removing one more thing, etc.), I will Adapt it and repeat the test. Back to Table of Contents Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide 3 1 TESTING Back to Table of Contents Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide 4 TESTS AT A GLANCE THYROID FUNCTION TESTS ADRENAL FUNCTION … TSH … Adrenal Saliva Profile … TPO Antibodies … Adrenal Antibodies … Thyroglobulin Antibodies … Fasting Blood Glucose … Free T4 … Free T3 GUT FUNCTION … Reverse T3 … Symptoms Questionnaire … Elimination Diet DEPLETIONS … IGA Food Intolerance Screen … Alkaline Phosphatase … Hydrogen Breath Test … B12 … Stool Test … CBC with Differential … ALCAT … B12 … IGG Food Sensitivity Panel … Ferritin … Spectracell Mineral Testing TRIGGERS … Mineral Hair Analysis … Triggers Assessment … Iodine Intake Assessment IMMUNE FUNCTION … Iodine Urine Test … CD4+/CD8+ Ratio … Th1/TH2 Stimulant Challenge TOXINS … Liver Function Tests INFECTION … Mineral Hair Analysis … Antibodies to viruses, bacteria, parasites … Assessment … Stool Test Back to Table of Contents Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide 5 MY THYROID JOURNAL Date: Thyroid Medications: Brand: Dose: Other Medications/Supplements: MY NUMBERS Test Test Test Date Comments Name Results TSH TPO Free T3 Free T4 Basal Temperature (Day 1-10) Blood Sugar (Fasting) Blood Pressure Pulse Weight Cortisol Alkaline Phosphatase Vitamin D Ferritin Stool Test Back to Table of Contents Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide 6 SUBJECTIVE TRACKING MY NOTES AND SYMPTOM SCALE OBSERVATIONS 1 = LOW, 10 = HIGH. N/A = NOT APPLICABLE Drowsiness: 1-10: or N/A … Hair Loss: 1-10: or N/A …  Cold Intolerance: 1-10: or N/A … Inability to Lose Weight: 1-10: or N/A … Sadness: 1-10: or N/A … Mental Fog: 1-10: or N/A … Forgetfulness: 1-10: or N/A … Joint Pain: 1-10: or N/A … Acne: 1-10: or N/A … Acid Reflux: 1-10: or N/A … Stomach Pain: 1-10: or N/A … Morning Fatigue: 1-10: or N/A … Irritability: 1-10: or N/A … Palpitations: 1-10: or N/A … Night Sweats: 1-10: or N/A … Emotional Lability: 1-10: or N/A … Weight Loss: 1-10: or N/A … Nervousness: 1-10: or N/A … Anxiety: 1-10: or N/A … Feeling Hot: 1-10: or N/A … Trouble Sleeping: 1-10: or N/A … Back to Table of Contents Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide 7 MY CURRENT INTERVENTIONS … Selenium 200mcg … Fermented Coconut Yogurt … Biotin/ … Betaine/Pepsin … Glutamine/ … Digestive Enzymes … B12/ … Licorice … Low GI Diet … FODMAPs/Low Residue … Th1/Th2 Stimulants … Green Smoothie … Gluten Free … Acupuncture … Dairy Free … Paleo Diet … Soy Free … Homemade Broth … Fermented Foods … Gelatin … Acupuncture … Grain Free … Probiotics … Egg Free … Adaptogens … Tomato Free … Zinc 30mg … Iodine Restriction … Vitamin A Rich Juices … Stopping Estrogens … Antibiotic … Parasite Cleanse … Body Ecology … Liver Cleanse … Sugar Free … Curcuminin … Vitamin D3 … … Omega 3 FA … … … MY NOTES AND OBSERVATIONS MY NEXT INTERVENTION Back to Table of Contents Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause Companion Guide 8