Did you know that 1/3 of all the protein in your body is collagen?
You have probably heard of collagen before in relation to healthy skin, but there’s a lot more to it than that. Collagen plays a big role in our connective tissue strength but also in our digestion.
Vitamin can have a significant impact on collagen production – it’s actually quite powerful. Let’s focus on the connection to your skin, since it’s the easiest to understand…
The skin-deep details – how vitamin C affects your skin…
Your skin has 3 different layers: the epidermis, the dermis and the fat layer. Collagen is mostly present in the 2nd layer, the dermis, which is what gives it the elasticity and integrity.
Cultured studies of human connective tissue that have been exposed to vitamin C have been shown to have an 8 fold increase in the overall strength and quality of synthesis of collagen. That means that simply by consuming vitamin C, or being exposed to the right amount, your collagen production can increase without the synthesis of other proteins.
This is perfect for someone that wants to decrease wrinkles, improve the look of the skin, strengthen joints or improve gut health.
Why is this important?
Because it means you have a targeted approach to increasing your collagen production without increasing other protein levels. Increasing the production of other proteins can cause imbalances and other issues, so it’s ideal that vitamin C can help you avoid that.
There are 2 different components to the skin: collagen and elastin, that work together harmoniously. They are held together by something called fibroblasts, a kind of cell found throughout the dermis.
Studies are starting to show cultured fibroblasts that are exposed to high amounts of vitamin C end up having a different gene expression. They’re exposed to lipid peroxidation which produces malondiadehyde, a very specific compound that creates a different form of gene expression, causing the body to produce more collagen.
So we have a 2 fold impact on the body’s collagen synthesis process. We have the ability to produce more, and stronger collagen simply by exposing the cultured tissue to vitamin C, but we also have the ability to change how our body builds the collagen in the first place by exposing the fibroblasts to vitamin C.
Now the question is…How do you get more vitamin C?
Option #1 is rubbing it on your skin, but this can get monotonous.
Option #2 is consuming it orally. The issue with this is that it’s water soluble, meaning that what you ingest, mostly comes out in the urine.
BUT Designs For Health has come out with a very interesting form of vitamin C, with Liposomal delivery, Liposomal Vitamin C. This offers maximum absorption, which means it’s going to survive digestion, cross through the enterocytes and into the blood stream, so it can geotarget the cells. Which means, you’re going to have an oral way of boosting your collagen levels with a natural, potent supplement.
The Paleo diet is a popular and trendy diet that has been making the rounds lately. It’s also one of the most helpful healing diets for Chronic Disease! If you’re already Paleo, this article will have more information on how you can tweak this diet for best results, how to make your life easier with Paleo, and when you should move on from the Paleo diet…
If you’re thinking about going Paleo, this article will give you more info on why it works, how to do so, and how to make starting easier 🙂
The Many Triggers of Chronic Disease
Through my research and working with thousands of people having Chronic Disease, I have found that food sensitivities, nutrient depletions, intestinal permeability, an impaired stress response, an impaired ability to get rid of toxins, and infections can trigger Chronic Disease and Autoimmunity.
What do all of these triggers have in common?
All of these factors send a message to our body that the world we are living in is not a safe place and that our body should go into some type of survival mode, either conserving energy, or avoiding a dangerous food or toxin, or hiding out to prevent the spread of infection. Let me explain.
When we eat food we are sensitive to, our body gets the signal that we can’t digest and absorb key nutrients. Our body thinks we are starving or nutritionally depleted. When we eat processed foods, our body once again gets this signal. These messages to our immune system trigger that it is time to slow down our metabolism in order to conserve limited nutritional resources. And since resources appear to be scarce, it’s not a good time to be fertile, so time to shut down the libido as well! Our body is trying to survive given the world around us.
It could explain how cavemen adapted to times when food and resources were scarce. Their physiology adapted in response to the “alert” messages they were receiving from their bodies. They went into a conservation mode, and that helped them survive.
What is the best way to conserve resources? Slow metabolism, of course! That way, a person can survive with eating fewer calories. How do you slow down metabolism? One great way is to slow down thyroid function. How do we achieve slowing down thyroid function?
Why not send some inflammatory cells into the thyroid to attack it so that it doesn’t produce as much hormone? Same goes for other organs of the body.
In a way, hypothyroidism puts us in a quasi-hibernation mode when faced with nutrient-poor and reactive foods, toxins, and the like, so that we are more likely to retreat to the safety of our caves, survive on fewer calories, and conserve energy by sleeping a lot.
Chronic Disease generally makes us want to sleep and withdraw, be less fertile, and carry more weight… All of these factors are completely useless to us in modern days, however, in the olden times, these factors could increase our chances of survival when faced with significant stressors, like a famine…
So it’s reasonable to believe that our bodies developed a protective response mechanism to help us survive these difficult times. This is known as adaptive physiology.
In cave times, our ancestors didn’t have access to the agricultural advances and tools that turn grains into breads, pancakes, and flour!
They would likely hunt and gather “low hanging fruit” foods that could be eaten in their natural states or cooked in a fire.
Only in cases of famine, disease, or nutrient deficiency would our ancestors likely turn to eating items that are poorly digested by humans without significant processing, such as grains…
We still see evidence of dietary preferences changing in our modern world based on various factors. For example, the medical condition “pica,” where a person craves and eats things that have no nutritional value such as dirt, chalk, and even feces, has been connected with nutritional deficiencies — especially deficiencies in iron.
If you’ve ever observed dogs, you’ll likely know that most dogs generally avoid eating grass — they prefer using grass as a potty unless they have an upset tummy, in which case they will often eat grass to make themselves vomit.
Perhaps in some cases of Chronic Disease, our bodies still haven’t adjusted to recognizing the highly processed grains and grasses that are passed off as food today, as actual food.
Our bodies are intricate feedback systems that are constantly taking and sending messages to help us survive…
Whenever we eat grains, this can send a message to our body that we are in a state of famine and that we need to conserve resources to survive, AKA, slow down the thyroid and the metabolism!
So, if you have thyroid disease, thank your body for having this genius design that has helped your ancestors and you survive but, also, think about what may be making your body think that you are going through a time of famine, war, toxic crisis, or illness.
One of the easiest ways you can start sending safety signals to your own body is through the right diet. By eating foods that are nourishing and easy to digest, your body can register that food is abundant and that you do not need to conserve resources. In some cases, changing to the right diet can switch on your metabolism and completely switch off the autoimmune attack on the body!
But what is the right diet for people with Chronic Disease and Autoimmunity?
Unfortunately, there is no single “perfect” diet that will work well for everyone as everyone’s “safety signals” are impacted by their unique genetics and a variety of other factors.
The best diet for any given person will depend on what food sensitivities they have, as well as if they’re having issues with blood sugar, undergoing chronic stress, or dealing with infections or toxin exposures. Additionally, how your body interprets those safety signals will depend on your gut health and your ability to digest and absorb key nutrients. It is very individualized.
While there isn’t a single perfect diet, there are elements of a perfect diet that do work well for most people, and those include:
How Cavemen Survived on a Paleo Diet
The historical theory behind the health benefits of a Paleo diet is that the digestive systems of humans have not had sufficient time to adapt to today’s farming practices or to the ingredients and chemicals in modern processed foods.
In other words, our genetics have pre-programmed us for optimal health if we eat our ancestors’ food choices. So the foods allowed on a Paleo diet are based on what historians think our pre-agricultural, hunter-gatherer cavemen ancestors ate.
The theory blames the rise in chronic diseases, obesity, and allergies on the agricultural revolution which added grains and processed foods — and toxins — into our diet.
It is estimated that contemporary Western populations get as much as 70% of our daily energy intake provided by foods that were never or rarely consumed by our hunter-gatherer Paleolithic kin. These non-Paleo foods include grains, refined sugars, dairy, and highly processed fats (1).
A Paleo diet eliminates all grains and all processed foods.
After eliminating grains and processed foods, a Paleo diet replaces these with nutrient-dense foods thought to have been eaten during the Paleolithic Era: nuts and seeds, vegetables, fruit, and eggs. Meat, a caveman staple, is also allowed as is fish and other meat products (organ meats).
Depending on the particular Paleo plan you are following, dairy may also be allowed, but I do not recommend it as dairy is a highly reactive food for most people. Babies in the Paleolithic era likely were the only ones consuming dairy and that was from nursing.
Other food items of controversy on a Paleo diet include eggs and sweet potatoes. Note that many people have food sensitivities to eggs, although I include them in my own diet.
Benefits of a Paleo Diet
Our cavemen ancestors may have simply eaten the available foods around them (certainly they weren’t choosing healthy foods over unhealthy foods at their local grocery store!), but their diet was incredibly healthy, seasonally fresh, and likely sent lots of “safety signals” most of the time. Their bodies likely sent “alarm” signals only during particularly difficult seasons such as harsh winters and drought years.
The Paleo diet not only removes reactive foods but focuses on many healing foods with significant nutritional benefits providing:
The Standard American Diet (SAD) would have left the cavemen constantly sending alert signals to their bodies and they would have likely seen much greater disease than they did.
Whether you agree with the historical explanation on the effectiveness of a Paleo diet or not, (that we are genetically wired to be at our healthiest with a Paleo diet), there is really something very telling about how the Paleo diet differs from the standard american diet, and I wanted to include an interesting passage from the Institute of Functional Medicine’s Annual Conference in 2014, which focused on food and nutrition’s effects on health.
“The standard American diet (SAD) could not have been better designed to kill us; it promotes chronic disease and suppresses immune function. The SAD is 55% processed foods; 30% animal products; 11% vegetables, fruit, nuts and beans; and 4% whole grains. One-half of the 11% of vegetables consumed are ketchup and French fries. The amount of colorful vegetation consumed by Americans is less than 5% of the total diet.
Processed foods provide macronutrients with virtually no micronutrients, antioxidants, or phytochemicals. Processed grains push up insulin, but a piece of conventionally produced chicken is not nutritionally much better than a piece of white bread when you consider conventionally raised chickens’ lack of micronutrients (antioxidants and phytochemicals). In addition, products from conventionally raised animals have negative hormonal effects: The SAD’s animal products push up IGF-1, the hormone most closely linked with colon, breast, and prostate cancers, and rapid tissue aging.”
While one might disagree with the various percentages mentioned here, the conference summary is quite interesting. Much of it focuses on the merits of the Paleo diet versus Mediterranean diet versus vegetarian diet. What you’ll find is that you can argue positives and even a few possible negatives on any of these, but they are all shown to be healthier than the SAD diet which many of us eat daily (4).
The other important point here, again, is that one may be better or worse for you, or pieces of one may work better with a piece of another. You really do have to become your own best detective, always looking at your body’s clues to what is making you feel better…and what is making you feel worse.
So how do I or your doctor truly know what diet to recommend to you? Well, ideally, we would meet individually with each of you and base our advice on your individual test results, your food sensitivity testing results, and a detailed medical history that looked at your genetic profile and identified your unique issues with any parasites, infections, and toxins, etc.
But given I can’t do all of that with each of you, the next best thing that I can do is to make a recommendation to you based on existing research, working with clients, and looking at my survey of thousands of people having Chronic Disease. All of this tells me that there are significant positive results when someone removes gluten, dairy, and grains from their diet.
A Paleo diet has helped many people having Chronic Disease feel better by improving symptoms such as fatigue, joint pain, brain fog, bloating and gas. This diet has also helped people lower, or completely eradicate, their antibodies.
People do sometimes ask me about the inclusion of meat on the Paleo diet, and certainly, meat can be inflammatory, so let’s talk a bit about that.
Animal Protein Is Important for People with C
Many former vegans have reported improved symptoms of Chronic Disease following their transition to a Paleo diet. Based on this, I believe animal proteins may play an important role in building back the health of people with Chronic Disease.
Certainly, the meat needs to be “clean and lean” animal protein, not conventionally raised animals which have high levels of pro-inflammatory omega-6 fatty acids as well as antibiotics and hormones.
Additionally, while animal proteins are important for healing, eating too much of them produces an acidic environment in the body, which can hinder healing. Thus, the diet should be balanced with plenty of nutrient-rich vegetables. I suggest a ratio of about 80% vegetables and 20% animal protein. Focus on eating plenty of good fats, and reduce your intake of carbohydrates. Look for grass-fed, pasture-raised, wild-caught, and free-range options.
But while eating the right type – and percentage – of meat is good, grains and processed foods are just bad for you. High calorie and low nutrient density, they are difficult to digest and contain chemicals that affect nutrient absorption.
Why Grains Can Set Off Our Safety Signals
If you still aren’t convinced that grains and processed foods (key components of the SAD diet) trigger “alert signals” and cause intestinal permeability and other health issues, here are a few more reasons why grains are bad for us.
Blood sugar: Wheat, and even gluten free products made with grains like rice, corn, and potatoes, can wreak havoc on our blood sugar. Amylopectin A, a complex carbohydrate in grains, is highly digestible. This raises blood sugar higher than table sugar, according to Dr. William Davis, author of Wheat Belly.
Poor zinc absorption: As mentioned earlier, grains contain phytates which can interfere with the absorption of zinc from foods. One in four individuals in the general population may be zinc deficient, and most people with hypothyroidism are, in fact, zinc deficient.
Zinc deficiency has been associated with increased intestinal permeability, increased susceptibility to infections, and reduced detoxification of bacterial toxins.
Zinc is also not stored by the body so a daily intake must be consumed through foods or supplements.
Certainly removing grains and processed foods is the best way to determine if that will make you feel better, but you can also get tested.
How to Get started on a Paleo diet
Diets can be tough as the very nature of most diets is that they “take away” something you like or may even crave. You may have to stop eating your favorite food, and you have to commit to eliminating that banned food completely, as most diets won’t work if you regularly cheat. This is especially true relating to food sensitivities.
You can actually be addicted to some foods, with your body’s hormones working against your own determination! You may have a period of withdrawal when you first remove a food from your diet. For example, research suggests that gliadorphins (found in gluten) bind to our “feel good” endorphin receptors much like addictive drugs. So I often recommend that people transition from their current diet more slowly — taking baby steps and eliminating one food at a time — rather than jumping right over to the stricter Paleo menu.
Tweaking the Paleo Diet to Make It better for Chronic Disease Patients
I’ve actually tweaked the standard Paleo diet guidelines a bit based on my clients’ successes.
In addition to removing grains, legumes, and processed foods, as recommended in the traditional Paleo diet, I’ve also removed all dairy (even butter and ghee). I’ve also removed seaweeds due to their iodine content and immune-modulating potential. I’ve taken hot peppers off the “ok to eat” list as well as they can lead to leaky gut issues.
And although pea protein is controversial in the traditional Paleo diet, I include it as it’s a hypoallergenic protein that is tolerated well by most people having Chronic Disease.
Although the Paleo diet has helped many people feel better and even recover completely, the Autoimmune Paleo diet (AIP) can be even more successful for some.
The AIP diet is more restrictive, though, and I consider it an advanced intervention and would definitely not move directly to this diet if I were eating more of a standard Western diet to start with. You can read an overview of the AIP diet, including the foods it allows and restricts here.
What about Non-Food Triggers? (Other Root Causes)
Along with grains, processed foods, and other food sensitivities, you may also need to look at infections, environmental toxins, and even how you are managing stress…but getting off reactive foods almost always helps in the healing process.
Once you find your food triggers, you will still need to help your digestive system heal by adding supportive foods and nutrients. You may also need to focus on removing toxicity in your environment and supporting your body’s detoxification pathways.
Moving Forward Like a Caveman (or Woman!)
For me, as a clinician, the goal of any dietary intervention is to help your body reset, nourish itself, and reduce inflammation caused by reactive foods. It is about finding foods that make you feel better and identifying those that make you feel worse (and then avoiding the ones that make you feel worse!).
Sounds simple, but I know that it is not easy to give up favorite foods — even if they are making you sick.
Dietary protocols, such as a Paleo diet, are meant to be used as starting points, or templates, where you implement the basic plan and eventually change it up based on your needs. Some people will want to add in dairy as it may not be a trigger food for them. Others may not be able to tolerate other reactive foods (like my issue with tomatoes!).
But should you start with the Paleo diet, or should you start somewhere else?
I’ve seen that too many times people can get into a situation known as paralysis by analysis — they’re not sure if they should go gluten free, Paleo, or Autoimmune Paleo…
The truth is, all three protocols are likely going to make you feel significantly better. The sooner you start, the better, and I recommend choosing one that you are likely to stick to!
If you are on a traditional Western diet right now, your options are to use a step-up or step-down approach.
In the step-up approach, you start with the least restrictive diet and remove more foods as needed.
In the step-down approach, you start with the most restrictive diet and add back foods you tolerate.
To keep things practical, most of my clients, even those who have done the research and are sold on trying a Paleo diet, find it easier to remove gluten before anything else and transition to the more advanced protocols.
And cutting out gluten may be enough for you to feel better or even reverse your Chronic Disease.
After removing gluten, I usually recommend the removal of dairy and soy as a next step. Dairy is a highly reactive food for many people. It was a significant trigger for my acid reflux.
After those dietary changes, you can move on to a Paleo diet.
How to Make Eating Paleo Easy
There are all times we want to sit back after a long day and not worry about cooking (or cleaning!!). Luckily, there are companies out there to make it much easier to stay Paleo compliant while letting you take a day off from cooking! Here are some of my favorite resources that I turn to:
If processed foods and grains were the sole root cause for your condition, you will likely see a complete remission of Chronic Disease after you eliminate these triggers from your diet, and in some cases, function may even return to normal within 3-6 months.
If you don’t see these improvements, you will need to put your detective hat back on and dig deeper for other contributing root causes… foodwise and beyond…
To go deeper in healing with food…
Your options are to adopt the more advanced Autoimmune Paleo (AIP) diet (this is my comprehensive overview for you on how to do so!)
Or you may want to explore targeted food sensitivity testing or an elimination diet….
Elimination Diet – The Gold Standard for Food Sensitivity Testing
Without specific sensitivity testing, it is often really difficult for someone to know that a particular food is causing them problems. I didn’t know for some time that dairy and bread were causing me such significant issues.
I always recommend an elimination diet where you avoid the food in question for 3 weeks, see how you feel, and then try it again to see if you react to it.
Lab Tests for Food Sensitivity
There is a multitude of food sensitivity tests out there for many foods beyond the biggest hitters (gluten, dairy, etc.). Food sensitivities are very individualized. For me, I wasn’t just reactive to the usual suspects of gluten and dairy, but I had a reaction to pineapples and peaches! They both triggered my acid reflux.
If you can swing the expense, I recommend people get tested for food sensitivities. I’ve found that in addition to gluten sensitivity, individuals with Chronic Disease may often be reactive to multiple other proteins including grains like rice, quinoa, and corn.
(1) Kowalski LM, Bujko J. Evaluation of biological and clinical potential of Paleolithic diet. Rocz Panstw Zakl Hig. 2012:63(1):9-15.
(2) Frassetto LA, Schloetter M, Mietus-Synder M, et al. Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr. 2009 Aug;63(8):947-55. doi: 10.1038/ejcn.2009.4.
(3) A Paleolithic-type diet results in iodine deficiency: a 2 year randomized trial in postmenopausal obese women. Manousou and Associates, European Journal of Clinical Nutrition, 2017.
(4) Pizzorno L. Highlights From the Institute for Functional Medicine’s 2014 Annual Conference: Functional Perspectives on Food and Nutrition: The Ultimate Upstream Medicine. Integr Med (Encinitas).2014 Oct;13(5):38–50.
There are numerous dietary protocols that can help a person with Chronic Disease feel better. In some cases, a dietary approach can produce a complete remission of the condition!
For me, as a clinician, the goal of the approach is to help your body reset, nourish itself, and reduce inflammation caused by reactive foods — as well as to help you reconnect to an intuitive way of eating, where (eventually) you will naturally select foods that make you feel better, and avoid those that make you feel worse.
While I don’t believe in a “one size fits all” diet, I have seen versions of the Paleo type diet work wonders for many people with Chronic Disease, as it eliminates many of the foods that are most problematic — including gluten and dairy. However, some people with autoimmune conditions will need to take their diet a step further. In such cases, the Autoimmune Paleo (AIP) diet has been shown to be highly effective for many.
The Origins of the Paleo Diet
First, let’s talk about the Paleo diet, which is the diet from which the Autoimmune Paleo (AIP) diet originates. Many people, even those not diagnosed with Chronic Disease, are aware of the benefits of the Paleo diet. It has helped countless people feel better from a wide range of symptoms: fatigue, brain fog, joint pain, gas, and bloating, to name a few. In the case of Chronic Disease, the traditional Paleo diet has even helped many people lower — or completely eradicate — their symptoms and antibodies.
For those of you who have tried going Paleo but have not seen significant improvement, I want you to know there are additional steps you can take that will give you the power to take back your health!
The traditional Paleo diet is a classic elimination diet that focuses on omitting foods people are commonly sensitive to in an effort to lower inflammation.
As you may know, the Paleo diet eliminates all grains, legumes, soy, and processed foods. The focus is on replacing the foods you take out of your diet with other nutrient-dense foods, such as organic or grass-fed meats, wild-caught fish, organic vegetables and fruits, nuts, seeds, eggs from pasture-raised hens, and (depending on who you ask) dairy.
The Paleo diet is certainly a great start, but it is not always enough to address every case of Chronic Disease. Often, we need to peel back more layers of that onion! The good news is, with each new diet, supplement, or treatment that you try, you are finding out how your body responds to different external factors. Each case of Chronic Disease is unique, and many of us have additional food sensitivities that are deregulating our immune system. People with Hashimoto’s often have sensitivities to a wide range of foods — particularly to gluten, dairy and soy — which are all omitted on the traditional Paleo diet.
Anecdotally, the Paleo diet is said to have been introduced in the 1970’s with the book The Stone Age Diet by Walter Voegtlin, but it has significantly gained in popularity over the past ten years. Since then, countless resources such as cookbooks, websites, and articles have been created that include recipes ready for you to use. I’m sure many of you have seen these resources at your local bookstore, your go-to health food store, and even at Costco. It’s a very exciting time to be on a Paleo diet!
If the Traditional Paleo Diet Does Not Improve All My Symptoms, What’s Next?
Now that you understand Paleo, let’s talk about the AIP diet.
The creation of the AIP diet has been attributed to Loren Cordain, a scientist who discovered that certain foods can sometimes trigger inflammation in people with chronic disease and autoimmune disease. It was further popularized by Paleo authors such as Robb Wolf in The Paleo Solution, and Sarah Ballantyne (also known as The Paleo Mom) in her book, The Paleo Approach.
The goal of the AIP diet is to heal leaky gut by removing commonly problematic foods, thereby reducing inflammation in the body and healing autoimmune disease.
I have seen many of my clients find almost complete relief from their symptoms by implementing the AIP diet into their lifestyle changes. The symptoms that many find relief of include joint pain, muscle aches, fatigue, bloating, diarrhea, brain fog, tinnitus, skin rashes, as well as decreased food sensitivities. Even those who do not recover completely will often experience significant improvement. You have nothing to lose (except for symptoms!), and everything to gain by considering the AIP diet.
Will I Feel Better Right Away on AIP?
Please note that there is often a short transition/withdrawal period before you start feeling better on the AIP diet, especially if you are new to coming off gluten, dairy, and processed foods.
Research suggests that casomorphins (from the dairy protein casein) and gliadorphins (from gluten, a protein found in wheat) can bind our “feel good” endorphin receptors, much like the morphine found in addictive drugs can.
This has led some people to say that these foods are as addictive as heroin and other drugs (which also bind our endorphin receptors). While I think this is an exaggeration, I have seen people experience withdrawal-like symptoms, including brain fog, irritability, cravings, fatigue, and headaches, after quitting gluten, dairy, and sugar while they were adhering to the Autoimmune Paleo diet.
The good thing is, once these inflammatory foods have been eliminated, you will start to feel better. You can expect to see results within 30-90 days of implementing the AIP diet, although it may take longer. If you do not see results in 30 days, eliminate mammalian meat and use fish as your main protein source. Then, you can start to systematically reintroduce certain foods one by one. This allows you to create a diet for the long term that is tailor-made for you.
This process will allow you to be more in touch with what does — and doesn’t — work for you.
However, while the Autoimmune Paleo diet has helped many people with Chronic Disease and autoimmune conditions get better, it can be quite difficult to implement. As a pharmacist, I see this daily: many people know what they need to do to get better, but just don’t know how to get started.
If you’ve been eating the standard Western diet for most of your life, starting a dietary protocol like the AIP can be extremely intimidating. Though you may eventually end up “going AIP,” it’s okay to take baby steps and begin with going gluten free, then move on to going dairy and soy free.
I encourage you to remove one food group at a time, if that makes you feel more at ease with the transition. Committing to a 100 percent gluten-free diet is an important first step.
I know that some of you, however, love taking action and will dive right in and immediately begin your healing journey with the AIP! However, many of you will find the AIP diet difficult to adhere to at first. We all have different needs, motivations, and challenges, and I encourage you to honor your individuality and listen to your body.
The Autoimmune Paleo Diet Guidelines
At this point you’re probably wondering where to begin with the AIP diet. Let’s start by going over the lists of foods to avoid and those to focus on with the diet.
Foods to Be Avoided on the AIP Diet
When you do decide to start the AIP diet, you’ll notice that, in addition to following the Paleo diet guidelines of removing gluten/soy/dairy/grains/nightshades/legumes/processed foods, it also removes additional foods that are known to cause inflammation in many people. Here’s the full list of foods to be avoided on the AIP:
Foods to Be Included on the AIP Diet
While the AIP diet can seem a bit intimidating, if you follow a few rules and stick to the list of allowed foods, you will find that you quickly adjust to the diet, and it’ll become second nature:
Here are some meal ideas:
The Autoimmune Paleo diet is meant to be short term. As I mentioned earlier, the goal is to reduce body inflammation and allow the gut a chance to heal. These variations in diet give you the power to improve how you feel and isolate your root causes.
If, however, AIP doesn’t resolve many of your symptoms after 90 days of following it, you may have to go a step further and incorporate a rotation diet, a low-histamine diet, or low-oxalate diet.
If, after 90 days, you are still having gut issues, it may be a good time to test for parasites and other gut infections, as well as SIBO.
Food & Pantry Items to Help You Stock an AIP-friendly Kitchen
While there is no one-size-fits-all diet, the Autoimmune Paleo diet has helped many people with Chronic Disease and Autoimmune disorders. If you find you are stuck in a rut with your symptoms, trying this diet for a period of time may be the solution you need to find relief.
Starting an AIP diet may seem intimidating at first, but for many people with Chronic Disease, the benefits far outweigh the inconveniences. Once you get going and see the progress you make, you will not want to turn back!
When I was first searching for a healing plan for Chronic Disease, I learned about the important role of gut health in autoimmune disorders and chronic disease — and how replenishing it with probiotics and fermented foods can help bring gut health back into balance.
According to research, every person with a chronic disease or an autoimmune disorder has something called intestinal permeability, also known as a “leaky gut.” This made a lot of sense to me, because my clients had many of the symptoms of intestinal permeability — including bloating, stomach pains, irritable bowel syndrome (IBS), and acid reflux — as do many people with Chronic Disease.
However, not everyone with intestinal permeability will have these symptoms. Some may have no apparent gut symptoms at all.
Chronic Disease and Autoimmunity has been determined to be a three-legged stool, requiring a combination of the right genes, the right triggers, and intestinal permeability, to manifest itself.
Root Causes of Intestinal Permeability
Our gut barrier has the important job of letting nutrients into the body while keeping bacteria, viruses, parasites, and toxins out. When the gut barrier is impaired, these harmful organisms can leak into the body. We call this intestinal permeability, or “leaky gut.”
A leaky gut has gaps in the gut lining that allow irritating molecules and substances to escape from the digestive system, and enter into the bloodstream. This irritation can interrupt the immune system’s ability to regulate itself and put the body into a perpetual “attack mode” that is counterproductive to healing.
There are various reasons why a person may have intestinal permeability.
Gluten, which is the protein found in wheat products, has become a well-known cause of intestinal permeability, and many individuals with autoimmune conditions have been able to find relief in symptoms by following a gluten free diet, the Paleo diet, or another elimination diet such as the Autoimmune Paleo diet (AIP). Some people have even seen a complete remission in their autoimmune condition after removing gluten from their diet.
Other common reasons a person may experience a leaky gut include stress, food sensitivities, nutrient deficiencies, and intestinal infections.
A gut may also be more permeable due to an imbalance of probiotic (good) vs. opportunistic (bad) gut bacteria, also known as dysbiosis. E. coli and Proteus bacterial species are often referred to as “opportunistic pathogens” because they only become pathogenic when the opportunity is just right. If they are outnumbered by probiotic bacteria, they behave like good citizens of the gut and may add value. When they outnumber the probiotics, they may start to bore into the gut wall, leading to intestinal permeability.
People with autoimmunity have been found to have lower amounts of the probiotic bacteria Lactobacillus and Bifidus, and higher amounts of the opportunistic E. coli and Proteus bacteria.
I’ve seen this pattern of low levels of probiotic bacteria with high levels of opportunistic bacteria on my lab tests, as well as the tests of many clients with Chronic Disease or autoimmune disorders that have had stool testing to quantify microbial flora. (You can have your functional medicine doctor order this test for you, or you can self-order the GI-MAP or GI Effects test.)
When I first took a stool test, I was shocked to see that I had zero growth of Lactobacillus bacteria, even though I was eating yogurt on a daily basis. I didn’t realize at the time that the problem with most commercial probiotics and yogurts, is that they don’t have enough beneficial bacteria to make a difference.
I started to eat fermented foods and added high doses of probiotics… and began to feel better and better. (I had already been gluten and dairy free and had hit a “healing wall.”)
I retested myself with the same test when all of my GI symptoms were gone, and found that my probiotic bacteria were in the optimal range, and the E. coli and Proteus species were no longer dominating my gut flora.
Thus, one of the very first recommendations I make for EVERYONE with Chronic Disease or Autoimmune disorder is to be sure to get enough probiotics on board.
Probiotic Rich Foods
One of the easiest ways to introduce more beneficial bacteria to your microbiome is to eat fermented foods.
Here’s a one of my favorite recipes. I love making this coconut milk yogurt to add a dose of probiotics to my weekly diet.
Prep time: 30 minutes
Cook time: 8 to 24 hours
Coconut yogurt is a delicious way to restore balance to your gut. This creamy homemade coconut yogurt provides all of the gut-healing benefits of yogurt, without the extra sugar and other additives that can complicate your health journey. I love using this in salad dressings and smoothies, or enjoying it topped with shaved coconut, pumpkin seeds, nuts, berries or a splash of maple syrup.
14 ounces creamed coconut
½ cup water (omit if using canned coconut cream)
2 teaspoons collagen
1 tablespoon maple syrup
Dairy free yogurt starter, 2-4 high-quality probiotic capsules, ¼ cup yogurt starter, or ¼ cup yogurt from previous batch.
Probiotics have been widely researched for a variety of conditions, including irritable bowel syndrome, constipation, anxiety, depression, and even skin disorders. They can help improve digestion and nutrient extraction from the foods we eat, and can also balance the immune system. Additionally, probiotics can help with many types of gut disorders, including small intestinal bacterial overgrowth (SIBO), which is present in over 50 percent of people with Chronic Disease and Autoimmune disorder.
Types of Probiotics That I Have Used Successfully
Beneficial Yeast Probiotics
Saccharomyces boulardii (S. boulardii) is a beneficial yeast that helps to clear out dysbiosis such as the pathogenic bacteria, Candida, and some parasites (including Blastocystis hominis). It also helps to clear out H. pylori, an infection that has been implicated in ulcers and has been linked to Chronic Disease and Autoimmunity. S. boulardii does not colonize the gut wall, but instead, it causes an increase of secretory IgA, which supports our own body’s natural defense against infections and opportunistic gut bacteria.
This beneficial yeast is generally safe for SIBO, and should be used whenever you are taking a course of antibiotics (or after their use), to help re-balance the gut flora. While the label of the product recommends taking 2 capsules per day, I used higher doses, building up to 4 capsules, three times per day.
I really love this probiotic because it’s so broad-spectrum and actually assists our own gut with working better on its own. I’ve been recommending S. boulardii for many years, and some versions are stable at room temperature, while others need to be kept in the fridge. As a pharmacist, I’m always looking for ways to make taking supplements easier, so I always recommend a heat-stable version of S. boulardii from Designs for Health, so that my clients don’t forget to take it. (Remember, getting the supplement and keeping it in your home is the first step, but getting benefits from it actually requires taking it! )
Lactobacillus-Based High Dose Multi-Strain Probiotics
Most grocery stores and health food stores sell Lactobacillus-based probiotics that contain 10 billion colony forming units (CFU’s) of one probiotic strain. While this seems like a really big number, in reality, we have one trillion bacteria in our gut, and that small amount is not likely to make a difference. In fact, most probiotic supplements only contain enough probiotics to maintain an already healthy gut, not to restore gut microbe balance. I, personally, haven’t seen major benefits from using Lactobacillus probiotics — unless taken in very high doses.
Furthermore, research is showing that probiotic diversity is associated with greater health and improved gut function. I prefer probiotic blends containing Lactobacillus strains in addition to other probiotics, instead of single strain probiotics that only contain one type of Lactobacillus. Probiotic blends generally contain various strains of Lactobacillus, Bifidobacteria, and in some cases, beneficial Streptococcus bacteria. Thus, I recommend taking higher doses of multi-strain probiotics.
If you’ve never taken probiotics, you will want to start with the 10 billion CFU probiotic, but work your way up to a higher dose over time.
Rather than taking multiple pills, numerous companies have created high dose probiotic blends.
Designs for Health 50B CFU probiotic, which contains 50 billion colony forming units, is a great high dose probiotic to start with as you work your way up. (This version also has the benefit of being stable at room temperature).
Another high dose Lactobacillus-based probiotic that I have used with great success, and that has the most research behind it, is known as VSL #3, which contains 450 billion CFU of probiotics per dose. This particular probiotic has been clinically studied for ulcerative colitis and irritable bowel syndrome. The probiotic has been so successful in inducing remission, it has been labeled as a “medical food.” Please note, this is a very expensive probiotic, but you may be able to get it covered by your insurance if you have the right diagnosis.
While this used to be my go-to probiotic, in the last few years, I’ve had some negative experiences with it… Namely, a family member with new onset ulcerative colitis seemed to have a flare-up after using it. The word on the street in functional nutrition circles is that the probiotic can exacerbate inflammatory bowel conditions, which I also learned the hard way. (It was surprising, as all of the studies about this probiotic actually reported that it helped those conditions.)
Additionally, there was some recent controversy between the inventor and manufacturer of this probiotic. Allegedly, the inventor left the company, along with his proprietary recipe, and the product that the VSL-3 manufacturer has been making is different than the clinically tested product. According to the website of Visbiome, the inventor’s new company:
“Claudio De Simone, inventor of high-potency probiotic, sued pharmaceutical companies for making false advertising claims, ownership rights to the product formula and unpaid royalties.”
I have since stayed away from VSL-3 and have not yet tried Visbiome, but I also learned about a less expensive yet equally effective brand of high dose multi-strain probiotics from my brilliant nutritionist friend, called Probiomed 250 also from Designs for Health.
High dose, multi-strain probiotics can be very helpful for people with Chronic Disease and Autoimmunity in general, and especially for those who often show low levels of them on gut lab tests. However, they may be problematic for people with SIBO, which can be caused by an overgrowth of various bacteria, including Lactobacillus and Streptococcus bacteria — often found in probiotics.
Soil-based probiotics came on my radar after some colleagues reported seeing excellent results while using them with their clients. Soil-based probiotics are naturally occurring, spore-based, and have a unique mechanism of action, which allows them to directly modulate the gut microbiome.
Spore-based probiotics have shown promise in various autoimmune diseases, as well as in reducing allergies and asthma. They also have an ability to boost Lactobacillus colonies, so they can be used concurrently with Lactobacillus probiotics, as well as in place of them. Unlike the Lactobacillus probiotics, spore-based probiotics can reduce SIBO and increase gut diversity by boosting the growth of other beneficial flora.
Clients and colleagues with Chronic Disease or Autoimmune disorder have reported the following after using them for 30 to 90 days:
Tips for Using Probiotics
If you’ve never taken probiotics before, you will want to start low and go slow, as you may have increased symptoms if your gut flora changes too rapidly. For example, if your target dose is 50 billion CFU, then you may want to start off at a dose of 10 billion CFU, until your gut has adjusted. If you’ve found that you can tolerate that dose, but have not reached your gut health goals, you can work your way up to your target dose.
To boost the effect of probiotic supplements, I recommend making sure you are getting plenty of prebiotics in your diet. Prebiotics are the foods your microbiota feed on, and are necessary to ensure that the population of healthy bacteria in your gut grows and flourishes. Foods rich in prebiotics include: chicory root, Jerusalem artichoke, dandelion, garlic, leek, onion, bananas, apples, konjac root, cocoa, burdock root, flax seeds, yacon root, jicama, and asparagus.
Additionally, those with SIBO (small intestine bacterial overgrowth) will need to avoid many probiotics, especially those containing prebiotics, as they will just be adding fuel to the fire. Soil-based probiotics have been found to be effective for those with SIBO, and S. boulardii is generally safe as well.
One more thing to note when you first start taking a high-quality probiotic: the “good” bacteria will begin to colonize your gut and crowd out the “bad” bacteria that had taken up residence there. When these bad bacteria are crowded out and attacked, they may start to release toxins that build up faster than your body can get rid of them. This will cause your body to begin an immune response to clear them out, with symptoms that may include digestive discomfort, changes in bowel movements, muscle aches, headaches, and skin sensitivity. This is oftentimes referred to as a healing crisis or a Jarisch-Herxheimer reaction. While uncomfortable, this type of reaction is an indication that your probiotics are working and that you are eliminating the bad bacteria! However, this highlights the importance of starting low and going slow when you begin taking a new probiotic, so that you can minimize the unpleasant symptoms. Staying hydrated and moving your body as much as possible will also help your body clear out the toxins more rapidly.
Gut healing is a journey; you may need various interventions like removing reactive foods and infections, taking enzymes and probiotics, and balancing nutrients. In some cases, such as after a bout of food poisoning, antibiotic treatment, or a stressful life period, you may need to start the healing process from scratch. Remember, be kind to yourself — and learn to listen to your body — so that you can support and feed it properly. You are worth it!
Though the terminology often gets confused, food sensitivities are different than food allergies. Food allergies are generated by the IgE branch of the immune system, and reactions will usually show up within minutes of ingesting the reactive food. Reactions can include an itchy rash, throat or tongue swelling, shortness of breath, vomiting, lightheaded, and low blood pressure; and can often be life threatening. Shellfish and nuts are the most common foods that result in an IgE food allergy.
Food sensitivities, on the other hand, are governed by different branches of the immune system: the IgA, IgM and IgG branches. These reactions may take as long as a few hours or even a few days to manifest, and may include acid reflux, bloating, irritable bowel syndrome, palpitations, joint pain, anxiety, tingling, or headaches.
The Most Common Offenders
The most common food sensitivities found in people with Chronic Disease are gluten, dairy, soy, grains (corn, in particular), nightshades (potatoes, tomatoes, and peppers), nuts, and seeds.
Gluten is a protein found in barley, rye, and wheat. It’s a staple in the Western diet that’s found in most breads, cereals, and pastas, but can also be hidden in many other food products.
The most severe form of gluten response is seen in people with celiac disease. An estimated one percent of people (about three million worldwide) have celiac disease. Those with celiac disease must stay completely gluten free in both their diet and their lifestyle, or else they will have significant, life-affecting symptoms.
Reactions to gluten, many of which are also considered typical hypothyroid symptoms, include bloating, irritable bowel syndrome, acid reflux, stomach pains, brain fog, fatigue, hair loss, weight gain, cold intolerance, anxiety, palpitations, joint pain, carpal tunnel, allergies, and panic attacks.
My personal and clinical experience has shown that gluten sensitivity is one of the most significant triggers in Chronic Disease, and most people experience significant health improvements when they remove gluten from their diets. In fact, removing gluten can help reverse intestinal permeability (which is always a precursor to autoimmune disease) as well as reduce one’s thyroid antibody levels!
Dairy is another common reactive food in people with Chronic Disease. Lactose intolerance, which involves a lack of enzymes that prevents the proper breakdown of the milk sugar lactose, is just one type of dairy reaction — but it is not the same as dairy sensitivity, which, like gluten sensitivity, is mediated by the IgG branch of the immune system. People with Chronic Disease are more likely than others to have sensitivities to the proteins found in dairy: casein and whey.
Cow’s milk contains proteins that are different than the proteins found in human milk. A person with intestinal permeability is likely to recognize these proteins as a foreign invader and make antibodies to the proteins.
As I mentioned, these antibodies are mediated by the IgG branch of the immune system and are known as a Type IV Delayed Hypersensitivity reaction.
Many people believe that non-cow milk options may be safer. However, goat’s milk and sheep’s milk proteins are very similar to cow’s milk proteins and have about a 60-75 percent cross-reactivity rate, meaning that 60-75 percent of people who are sensitive to cow’s milk casein will also react to goat and sheep’s milk casein. Once a person becomes sensitized to the casein protein, they will react to all forms of dairy, with the possible exception of camel milk.
The most common ways people react to dairy include gut reactions (bloating, diarrhea, and acid reflux), as well as lung reactions (coughing, asthma, sinusitis, post nasal drip, and mucus) and skin reactions (eczema, rashes, or acne).
For me, dairy was a greater reactive food than gluten. Eating even tiny amounts of dairy resulted in coughing, bloating, acid reflux, joint pains, and diarrhea. I’ve been dairy free for years now, and my food reactions are all but gone. However, a small amount of dairy will still trigger a cough for me.
The third food that those with Chronic Disease may be sensitive to is soy. Many gluten free products contain soy, which can be problematic for thyroid patients. It can block the activity of the TPO enzyme and worsen the autoimmune attack on the thyroid.
A soy sensitivity will often present as gut symptoms such as abdominal pain, loose stools, nausea or vomiting, while a significant number of people will also experience mental symptoms such as headaches, dizziness, brain fog, anxiety, depression, fatigue, and insomnia.
Soy can be hard to avoid, as it’s not only found in foods such as edamame beans, soy milk, tofu, tempeh, miso, and soy sauce, but also in many processed foods and even supplements. Ingredients to look out for include soy lecithin, bean curd, hydrolyzed soy protein, soybeans, edamame, natto, okara, yuba, tamari, olean, gum arabic, carob, and hydrolyzed vegetable protein.
Food Sensitivity Testing
When we eat the foods that our body is sensitive to, on a daily basis, it is very difficult to connect the foods with the symptoms we are having. For example, people who continue to drink milk multiple times a day might be tired, have joint pain, and feel bloated on a daily basis, but won’t be able to pinpoint the symptoms to a possible dairy sensitivity.
This is because every time we eat a problematic food, the body becomes depleted in its ability to protect itself, and the reactions become more chronic, making it more difficult to identify food sensitivities.
That is why I believe testing is so important.
There are a multitude of different food sensitivity tests out there, and none of them are perfect. Some will present with false positives; others, false negatives. You may have to try more than one approach to uncover all of the foods that are causing your symptoms, but there are two types of tests that I recommend most often.
The best place to start when trying to identify your own particular food sensitivities is with an elimination diet. The first step will be to remove gluten, dairy, soy, and other foods that you suspect you may be reactive to. These may include fruits and vegetables you’ve been eating all the time. Avoid these foods completely for at least two weeks. During this time, make note of your symptoms. Which have improved? Which still remain?
After you have spent a period of weeks without the suspected food irritants, try slowly adding them back in one at a time, waiting several days between each food to notice if any of your symptoms return. Many people will notice an immediate reaction when they reintroduce a food they are sensitive to. If you experience this, take this as a very strong clue that you should avoid that food!
If, after removing gluten, dairy, soy and other foods you suspected were problematic, you are still experiencing symptoms of food reactivity, it might be time to dig a little deeper.
Some food sensitivities can be harder than others to pinpoint, and some people may need to see the numbers on paper before they are able to accept that they will need to give up a food they love in order to feel better. In those cases, I recommend food sensitivity testing through a lab. While most conventional medical professionals and insurance companies consider food sensitivity tests to be “experimental”, I can testify that as I “experimented” with removing the foods the tests found to be reactive for me, I felt dramatically better!
How Do I Eat This Way?
While it can be quite liberating to figure out which foods are problematic for you, and eliminating them can make you feel so much better than you have in years, you may find yourself asking, “How can I continue to eat this way, especially when the foods I am so sensitive to are so prevalent in our modern diets?”
Cook Your Meals at Home
When you’re avoiding certain foods, particularly foods like wheat and dairy that are so prevalent in our culture, the best strategy is to cook most of your meals at home. At least until you’ve mastered your diet and know where you can order specially prepared meals with safe ingredients in your area, it’s best to avoid eating out as much as possible.
If you feel like you may be missing out on social gatherings, try hosting a family dinner at home and incorporate some delicious new recipes. That way, you can control what food you are eating while still enjoying time with friends and family. If you’re heading to a gathering at someone else’s home or at a restaurant, try eating beforehand, or pack a bagged lunch and explain that you are on a special diet for a time. Most people will understand and be gracious about your health needs.
The good news is that there are so many delicious recipes that can inspire you to create some delicious home-cooked meals, while still avoiding the foods that cause reactions for you.
If you really don’t have time to cook, or just don’t like spending a lot of time in the kitchen, there are even some Paleo-friendly food services that allow you to customize your meal plans to your own food sensitivities. Paleo On the Go offers regular Paleo, ketogenic, and Autoimmune Paleo options, while Trifecta offers customizable Paleo and vegan options.
Adopt a Paleo-style Diet
Though being on a Paleo diet isn’t required for healing from Chronic Disease, and everyone’s diet is going to look a little bit different to suit their individual needs, I have found a Paleo-style diet to be helpful to a lot of people with thyroid issues. First, the Paleo diet eliminates the most common food sensitivities in Chronic Disease: gluten, soy, and oftentimes, dairy. Second, it places an emphasis on quality protein, fruits and vegetables — all of which are healing foods.
There are so many resources to be found on eating a Paleo-style diet, which makes it easy to incorporate into your daily life. For more information on what eating Paleo looks like, you can take a look at this article on Paleo diets, or this article that dives deeper into the Autoimmune Paleo diet.
Focus on Healing Foods
It can be easy to focus on the foods that you have to give up when you uncover your food sensitivities. I know first hand how hard it can be to give up some of your favorite foods. But, I’ve found it helps to place your focus on adding in nourishing foods that help your body to heal. When the food you are eating makes you feel great, it is much easier to give up the foods that made you feel so terrible!
Some of the foods I always recommend for people with Chronic Disease include green smoothies, bone broth, grass fed meats, fermented foods, gelatin, hot lemon water, beets, cruciferous vegetables, cilantro, fiber, green juices, berries, and turmeric. All of these foods have amazing healing qualities, and when you feel better, you will be encouraged to keep eating in a way that nurtures your body and keeps your Chronic Disease symptoms at bay.
Can I Ever Eat Those Foods Again?
The concern that most people have when they start to eliminate foods from their diet is that they will never again be able to enjoy the foods that they love. Some of us will even avoid doing any type of food sensitivity testing because we’d rather be ignorant to the news that we can no longer eat our beloved grilled cheese sandwiches and ice cream cones!
The good news is that, after a period of elimination and gut healing, there are many foods that you will be able to add back into your diet. Depending on how many foods you are sensitive to and how damaged your gut is when you begin eliminating foods, the amount of time you’ll need to wait before reintroducing those foods will vary. Everyone starts from a different place, and your own timeline may be different than the next person’s.
The turning point for me was when I began to incorporate nutrients, digestive enzymes and more healing foods like bone broth, green juices and green smoothies into my diet. I began to feel and look better, and began to tolerate more foods. Continuing to nourish my body, while treating gut infections and toxins, allowed me to eventually incorporate more and more foods back into my diet, and I’ve now been able to reintroduce most foods I was once sensitive to!
Before reintroducing foods to your diet, I suggest eliminating that food completely for a period of 3-6 months. One study from the Journal of Laboratory and Clinical Medicine looked at the half-lives of IgG antibodies in patients with immunodeficiencies and found that the total half life of IgG antibodies was 25.8 days. A half life refers to the amount of time required for a substance to be reduced to one-half of its previous level. Therefore, we can infer that it will take a period of several months for the antibodies to be fully eliminated from your body.
You will also want to make sure that your gut is healed by incorporating nourishing foods and addressing any gut infections that you may have. When you feel that your symptoms have abated, and you are ready to reintroduce some previously reactive foods, be sure to go slowly, introducing one food at a time to see how you feel.
What About Gluten and Dairy?
Though my body has healed to the point where I can tolerate all other foods I had previously eliminated, I still follow a gluten and dairy free diet.
In general, I believe that most people with Chronic Disease should stay gluten free. Though there are some people that seem to be able to add gluten back into their diets without incident, the majority of people will experience adverse reactions and seem to fare better on a gluten free diet.
Similarly, dairy seems to be problematic for most people with Chronic Disease, and I generally recommend that they continue to eliminate all dairy products from their diets. If you feel you’ve healed to a point where your gut can handle it, you can try adding in a small amount of dairy and note how you feel.
Again, each person is different and there is no “one-size-fits-all” diet that will heal everyone. You will need to experiment with what foods do and don’t work for you, and tailor your own diet to a way of eating that makes you feel great.
When my clients hear this information about food sensitivities, some are excited because they finally have a starting point from which to approach feeling better. Others feel overwhelmed, especially if they are dealing with debilitating fatigue, and wonder how they’re going to find the energy to incorporate a new diet into their lives. I’m here to tell you that the changes you make to your diet become easy to manage with a little time and practice, and the relief of symptoms you may experience will be more than worth it!
If you are feeling overwhelmed, I encourage you to take it slow. Try removing one food sensitivity at a time and give yourself time to adjust to the change. We are all different, with different sensitivities. What works for one person, may not work for the next. Stick with it and let your diet evolve with you — you are bound to find a way of eating that works for your lifestyle and makes you feel good.
Those of us with Chronic Disease often blame our thyroid for the many signs and symptoms we experience. Hair loss? Thyroid! Weight gain? THYROID! Fatigue? It’s gotta be the thyroid!
Treating hypothyroidism without treating the adrenals is one of the biggest reasons people continue to feel exhausted despite receiving treatment with thyroid hormones. Patients may initially report feeling more energetic after starting thyroid hormones, but this is usually followed by feeling worse and worse until they are right back to where they were before they started the thyroid medications. At this point, they will likely go back to their physicians to check blood work and will be told that everything is normal.
Many symptoms of hypothyroidism overlap with symptoms of under-active adrenals. However, physicians don’t routinely check adrenal function in those with Chronic Disease.
Symptoms of poor adrenal function may include the following:
The Adrenals at a Glance
The adrenal glands release hormones such as cortisol and adrenaline. These “stress hormones” impact many important functions throughout the body. They help establish your stress tolerance, tame inflammation, regulate blood sugar and body fat, control potassium and sodium levels (impacting blood sugar), and influence sex drive and anti-aging… among other things.
You may have heard that the stress hormone cortisol is “bad”. This is misleading — while high levels of cortisol are problematic, what could be equally or more problematic is having low levels of cortisol, especially when it comes to having an autoimmune disease and fatigue.
Cortisol is a hormone that is required for life — we could not live without it, and it is an important anti-inflammatory hormone. In fact, it gets released whenever we have inflammation to cool things down.
I have found that the majority of people with Chronic Disease have low levels of cortisol.
Testing for Adrenal Issues
In addition to looking at your symptoms (above), you can determine if you have adrenal dysfunction by utilizing the assessments below.
The Irritability Test
Irritability and overwhelm are two cardinal signs of adrenal dysfunction. My best test for determining adrenal issues is being snappy or short-tempered, feeling overwhelmed, or finding other people annoying. For example, I can always tell that my adrenals are overwhelmed when my mom calls to say hello, and I feel like this is too much of a demand!
Blood Pressure Test
People with adrenal fatigue often have low blood pressure and/or a drop in blood pressure after standing up from a lying down or sitting position (orthostatic hypotension). If your blood pressure is below 120/80 mmHg, this may mean that your adrenals are under-active, or that you are dehydrated. Symptoms may include dizziness or lightheaded when standing up from a sitting/lying down position.
People with low adrenal function may often have difficulty with contracting their pupils. Usually our pupils dilate (enlarge) in the dark, and contract (get smaller) in the light. Symptoms of adrenal dysfunction may include light sensitivity, difficulty seeing in bright lights, having to wear sunglasses on most days, or as I like to call it, feeling like a vampire in daylight!
If you are keeping track of your first morning temperatures, low and unstable morning temperatures may be suggestive of adrenal insufficiency. In contrast, pure hypothyroidism usually results in temperatures that are low, but rather stable, on a daily basis.
The “Whole Bag of Chips” Test
Have you ever eaten (or wanted to eat) an entire bag of chips in one sitting? You’re not alone! Salt cravings are a cardinal sign of adrenal issues. With adrenal issues, we may find ourselves with intense cravings for salty foods like crackers, chips, pretzels and olives.
Adrenal saliva tests provide a way to test our current adrenal function. These tests are generally only available from functional medicine and integrative health care professionals.
Normally functioning adrenals are supposed to put out the most cortisol in the morning, and the levels of cortisol should decline during the day until very little cortisol is secreted at bedtime. A cortisol kick in the morning helps us to get out of bed bright-eyed and bushy-tailed, ready to face the day. Low cortisol secretion at bedtime helps us relax and sleep.
Some people with adrenal dysfunction have the opposite pattern — they can’t get up in the morning and drag their feet until the early afternoon, feel slightly human for a few hours between 2pm and 8pm, then get a second wind at bedtime. These people often have a flipped cortisol rhythm, where their adrenals put out very little cortisol in the morning and too much in the evening, causing them to be alert and sleepy at the wrong times.
Other people may have abnormally low cortisol readings all day, everyday. These poor souls wake up tired and the fatigue lasts all day — I have been there, and it’s not fun. This low cortisol causes inflammation to go unchecked in the body, prevents healing, and causes the person to be sluggish for most of the day.
I recommend the Adrenal Complete Profile test from Ulta Lab. I have found it to be the most accurate for adrenal testing. However, the lab recently redefined their reference ranges, resulting in labs I would have previously classified as dysfunctional to be misread as normal by the untrained eye. If you’re going to go down the road of adrenal saliva testing, I recommend working with a practitioner trained in interpreting these labs, preferably one who has been interpreting them for at least 4-5 years.
What Causes Adrenal Fatigue?
In most cases of adrenal fatigue, the problems generally originate in a communication breakdown that occurs within the hypothalamic-pituitary-adrenal axis, otherwise known as the HPA axis. The HPA axis describes the interactive feedback loop that takes place between these three endocrine glands.
The hypothalamus is like the CEO of our body’s production of hormones. It scans messages from our environment and other endocrine glands, as well as checks the body’s overall hormonal status before passing on the order for more hormones to the pituitary gland. The pituitary gland then acts as a project manager and will pull together individual workers (like the thyroid gland, the adrenal gland, and the gonads) to do their jobs. The pituitary will also make sure the workers have adequate resources to do their jobs by managing growth (and repair), and electrolyte/water balance.
The HPA axis works in response to two types of stress: immediate stress and chronic stress. Let’s see how the responses to each type differ.
In cases of immediate stress, the hypothalamus senses stress and sets off a hormone cascade that leads to the activation of our fight or flight response. As part of this response, the adrenals pump out extra hormones and our bodies go from the state of relaxing, digesting and healing, to a survival state.
Your body’s energy is shifted from activities not essential to survival like growing beautiful hair, metabolizing nutrients into energy, making hormones, and digesting and repairing itself to instead focusing its resources to meet the great, stress-induced demand for cortisol and adrenaline.
Then, once you’ve escaped from the threatening bear or gotten out of the way of the oncoming car, the demand for emergency levels of hormones settles down and the focus once again turns to parasympathetic response, focused on body maintenance and upkeep.
In cases of chronic stress, the never-ending presence of stressful, yet non-life-threatening situations, can lead to the constant activation of the stress response.
To help meet the demand for cortisol, your body will decrease the production of other hormones normally produced by the adrenals such as progesterone, DHEA, and testosterone.
Eventually, with enough chronic stress, the HPA axis becomes overwhelmed and desensitized to the usual feedback loop and stops sending messages to the adrenals to produce more hormones or less hormones, no matter what’s happening. Additionally, a person may run out of nutrients that are required for proper adrenal function.
One of the most common causes of adrenal fatigue is stress, which creates an intense demand for stress hormones such as cortisol and adrenaline. There are four main types of stress to consider:
Mental Stress: Feelings such as grief, guilt, fear, anxiety, excitement and embarrassment can be classified as stress. This stress is based on our perception, not on the nature of the individual stress. For example, public speaking may cause plenty of mental stress for someone with social anxiety, but another person who enjoys speaking in front of others may perceive the experience as pleasurable. Situations that are new, unpredictable, and threaten the ego, or that involve feeling a loss of control, are perceived as stressful.
Glycemic Dysregulation: Researchers in Poland have found that up to 50 percent of patients with Hashimoto’s have an impaired tolerance to carbohydrates. This means that after consuming carbohydrate-rich foods, their blood sugar levels would spike up very high, causing a great amount of insulin release. The role of insulin is to clear blood sugar out of our bloodstream and store it in our cells, so a large insulin release is followed by a rapid drop of blood sugar (hypoglycemia). Symptoms of hypoglycemia are very unpleasant and may include irritability, fainting, lightheadedness or tremors. Hypoglycemia necessitates the release of cortisol to help maintain the glucose supply to the brain and counteracts insulin, causing insulin resistance. (This is also linked to the Type 2 Diabetes epidemic).
Inflammation: Chronic inflammation may occur from joint pain, obesity, toxic burden, inflammation in the GI tract from irritable bowel disorders, pathogens, or food sensitivities. These conditions will signal cortisol for its anti-inflammatory effect.
Recovering From Adrenal Fatigue
There are six main pillars of my Adrenal Recovery Protocol:
Sleep is the reset button for the adrenals. When we sleep, our body releases human growth hormone and repairs itself. Make sure to get at least 7 hours of sleep each night and go to sleep before 10pm. If you can pull it off, I actually recommend getting 10-12 hours of sleep per night for 1 month in my adrenal-focused recovery protocols.
Balancing Blood Sugar
Stabilizing your blood sugar through diet is a crucial step in overcoming adrenal fatigue and thyroid conditions. Balancing your blood sugar can create noticeable improvements in how you feel each day.
Aim first and foremost to eat more fats and proteins, and less sugary and starchy carbs. When consuming carbohydrate-rich foods, your blood sugar goes up too high, too quickly, causing symptoms such as nervousness, lightheaded, anxiety, and fatigue. These swings in blood sugar can weaken your adrenals and cause a spike in your thyroid antibodies.
The most important strategy for combating adrenal fatigue does not involve dieting, supplements, medications, or testing. This strategy, however, is often the hardest to implement.
That strategy is… stress reduction.
Reducing my stress was probably the hardest lifestyle change for me to implement. I only had two settings, “GO” and “SLEEP.” I did not know how to relax, smell the roses, turn-off, or unwind.
So, I came up with this list of strategies to make myself more relaxed and shift my body into a state of relaxing, digesting, and healing. I hope some of my strategies will resonate with you. But, many of you will want to come up with your own list. Many of these items may be really difficult to implement, especially for those of us with responsibilities like jobs, children, or elderly relatives who need our care. However, somehow, you HAVE to schedule time for yourself.
We often expect our doctors to heal us, but the healing comes from within just the same. No one else will do it for you. Put it in your planner if you must.
Some strategies to reduce stress include:
Food sensitivities are a common source of inflammation. Gluten, dairy and soy are the most common reactive foods in Chronic Disease, and eliminating them will eliminate inflammation in your body. Elimination diets and food sensitivity testing may help you determine additional foods that may need to be removed from your diet.
Chronic infections are also a common source of inflammation in the body. Common infections include H. pylori, Blastocystis hominis and Candida, but there are numerous potential infections that can be root causes as well.
The salt cravings and feelings of dehydration that occur with adrenal fatigue are our body’s way of letting us know that we need more salt. Rather than reaching for processed foods or thyroid toxic iodized salt, including a good-quality sea salt in your diet may help if you feel a bit dizzy getting up in the morning or after a hot bath, or have other symptoms of adrenal fatigue. I like to recommend buying a pink or grey sea salt and making yourself a salty drink each morning and sipping it throughout the day. Homemade bone broths with plenty of sea salt are also a great and tasty way to rehydrate.
While supplements often need to be individualized for people depending on their level of adrenal dysfunction (which needs to be determined via testing), I have found that most people with Chronic Disease feel better when they utilize the ABC’s of adrenal supplements.
The ABC’s are: Adrenal Adaptogens, B Vitamins, and Vitamin C.
Adaptogenic herbs are any natural herb products that supplement the body’s ability to deal with stressors. In order to be considered an adaptogen, an herb must possess several qualities. First, the herb must be nontoxic to the patient at normal doses. Secondly, the herb should help the entire body to cope with stress. Finally, the herb should help the body to return to “normal” regardless of how stress is currently affecting the person’s functioning. In other words, an adaptogenic herb needs to be able to both tone down overactive systems and boost underactive systems in the body. Adaptogens are thought to normalize the hypothalamic-pituitary-adrenal (HPA) axis.
Adaptogenic herbs include: Ashwagandha, astragalus reishi mushroom, dang shen, eleuthero, ginseng, jiaogulan, licorice, maca, schizandra, spikenard, and suma. These are examples of herbs that may increase the body’s ability to resist stress, and have been helpful in relieving adrenal dysfunction when used in combination with vitamins and minerals.
B’s and C’s
Vitamin C and B Vitamins become depleted during high cortisol production. Pantothenic acid and biotin deficiency in particular have been linked to decreased adrenal function in animals and humans.
While some may wish to obtain these supplements from natural whole food sources, due to gut issues, people with Chronic Disease usually have an impaired ability to extract vitamins and minerals from food.
In comes Designs for Health Adrenal Complex. Designs for Health created the supplement Adrenal Complex to use a combination of the ABC’s I recommend for balancing adrenals: Adaptogens, B Vitamins and Vitamin C.
Alternative ABC Blend
HPA Adapt –This blend of adaptogenic herbs, vitamins, minerals, and amino acids is designed to support the adrenals and provide a powerful defense from the mental and physical factors associated with occasional stress. The formula synergistically supports mental relaxation while counteracting the metabolic effects of occasional stress as well.
In some cases, you may benefit from additional B vitamins and Vitamin C to support your adrenals.
Standalone B Vitamins
B Supreme – B vitamins play an important role in cell metabolism, thyroid function, and adrenal function. They become depleted in stressful situations that often precede the development of autoimmunity. Four especially important B vitamins are pantothenic acid (B5), thiamine or benfotiamine (B1), biotin (B7), and cobalamin (B12). This exceptional combination of B vitamins, including Vitamins B1, B2, B3, B5, B6, B12, biotin, and folate (as Calcium Folinate) should be helpful for most people with low energy levels. B vitamins are water-soluble vitamins and do not build up in the body, so the risk for toxicity is almost nonexistent.
Other Supportive Nutrients
Magnesium Citrate – As magnesium is depleted by stress and is often difficult to obtain from foods, most people will benefit from long-term supplementation. It is also excellent for promoting relaxation.
Vitamin C – Vitamin C is an essential vitamin for supporting adrenal function. I recommend doses of 500 mg to 3,000 mg per day, as tolerated.
While many cases of adrenal dysfunction are caused by current stress and modifying those stressors can help with overcoming adrenal dysfunction, in some cases, additional interventions may be needed to address past traumatic stress, as well as chronically altered release of adrenal hormones.
Traumatic stress may lead to a chronic pattern of adrenal hormone dysfunction. Various types of traumas and abuse have been tied to autoimmune conditions and thyroid hormone abnormalities. Many of my clients have experienced significant traumas such as the loss of a loved one and/or being in an abusive relationship before the onset of Chronic Disease. Some of us have also experienced childhood trauma, which can set the tone for altered hormone patterns in adulthood.
Resolving traumatic stress usually requires a targeted therapy (I prefer neurofeedback and EMDR).
A variety of hormones and adrenal-supporting substances may be used based on your adrenal testing or cortisol saliva test results and adrenal insufficiency stage.
Although most of these hormones are available over the counter at health food stores, they are certainly not benign and should be used under the supervision of a trained professional with extreme caution. Not everyone will need all of these supplements.
Your practitioner may utilize pregnenolone, DHEA, 7-Keto, adrenal glandulars and in some cases, the medication hydrocortisone to rebalance your adrenals.
Clinical depression, or major depression, is a mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.
Most people are unaware of how frequently depression occurs with Chronic Disease. A study in 2004 found an association between the presence of a mood disorder, and the presence of anti-TPO antibodies. It has also been observed that a slight reduction in thyroid hormone secretion (such as that found in subclinical hypothyroidism) may affect mood as well. Thus, it’s possible that the depression you are feeling is related to your thyroid.
About one in 10 U.S. adults are affected by depression, which can impact their mood, thoughts, physical health, and behavior. Depression affects more women than men, and the symptoms and severity of depression can vary from person to person.
The most common type of mood disorder reported in people with thyroid antibodies is obsessive compulsive disorder (OCD). OCD is also more common in pharmacists and Type A’s, so I am intimately familiar with it. 🙂
The amazing thing that I’ve learned with functional medicine is that many of the same root causes, triggers, and strategies that help Chronic Disease, can also help depression. In fact, 81 percent of the participants in my Chronic Disease Self-Management Program reported an improvement or resolution of depression!
While there are many different root causes, strategies, and solutions for depression, I want to focus on a few low hanging fruit that can help a person with depression, whether used in conjunction with antidepressants, or on their own.
These include common nutrient deficiencies, dietary changes, lifestyle changes, and supplements that have been shown to boost mood.
I have found that many people with Chronic Disease who are experiencing depression are reacting to a food that they are sensitive to. Some of the most common food sensitivities that can lead to symptoms of depression are gluten, dairy, grains, soy, nuts and seeds. Sometimes, eliminating these foods from the diet can bring enormous relief to a person’s mood and mental state. In fact, 60 percent of the people with Chronic Diseases who I surveyed, reported symptoms of improved mood by eliminating gluten, 59 percent by going grain free, and 45 percent by giving up dairy. I recommend starting with an elimination diet to begin to uncover the foods that are problematic for you.
Additionally, balancing blood sugar levels is one of the most important components in reducing anxiety for people with Chronic Disease, and can have an impact on symptoms of depression as well. When insulin levels swing from high to low, it’s like being on an emotional roller-coaster that can cause some of the extreme emotions that are characteristic of mood disorders. Of the people with Chronic Disease that I surveyed, 61 percent reported improved mood with a low glycemic index diet, while 65 percent experienced improvement on a sugar free diet.
Nutrients for Depression
Addressing nutrient depletions can be a game changer when it comes to relieving depression. Often times, a deficiency in a key nutrient results in many of the symptoms associated with depression, and supplementing with a quality supplement can make all the difference in improving mood.
Nutrient depletions that are often seen in people experiencing symptoms of depression include:
Treating hypothyroidism without treating the adrenals is one of the biggest reasons people continue to feel exhausted despite receiving treatment with thyroid hormones, and it can lead to symptoms of depression.
The adrenal glands release hormones, such as cortisol and adrenaline, that impact many important functions throughout the body: among them, stress tolerance and mood.
In cases of chronic stress, the never-ending presence of stressful, yet non-life-threatening situations, can lead to the constant activation of the stress response. To help meet the demand for cortisol, your body will decrease the production of other hormones normally produced by the adrenals, such as progesterone, DHEA, and testosterone.
Eventually, with enough chronic stress, your body becomes overwhelmed and desensitized to the usual feedback loop, and stops sending messages to the adrenals to produce more hormones or less hormones, no matter what’s happening. We call this adrenal fatigue.
If you think stress could be at the root of your depression, you may want to look into supporting your adrenals. As a starting point, I recommend the ABC’s — Adaptogens, B Vitamins and Vitamin C.
Adaptogenic herbs support the body’s ability to deal with stressors and are thought to work by normalizing the hypothalamic-pituitary-adrenal (HPA) axis. Some herbs, such as Ashwagandha, can help normalize thyroid hormone levels, as well as support the body’s stress response. Of the readers I surveyed, 77 percent said they’re mood improved when they took adaptogenic herbs. Stay tuned for an upcoming article on using adaptogens for Hashimoto’s!
The B vitamins and vitamin C become depleted during high cortisol production. Pantothenic acid (B5) and biotin deficiency, in particular, have been linked to decreased adrenal function in animals and humans. Meanwhile, vitamin C helps to regulate cortisol and prevent blood pressure from spiking in response to stressful situations.
If your TSH is elevated or suppressed, you may need to initiate or adjust thyroid hormones. The ideal TSH for most people is between 0.5-2 μIU/mL. Levels that are too high or too low indicate an imbalance of thyroid hormone levels and have been associated with various symptoms, including depression and anxiety.
Taking a T3 containing medication, in particular, has been shown to reduce symptoms of depression. You may want to read my articles on understanding your thyroid labs and taking thyroid medications for more information on how adjusting thyroid medication dosages can help optimize your thyroid hormone levels and elevate your mood.
There are many types of therapies, exercise, and activities aimed at reducing depression — the important thing is finding one that will work for you. This may take some experimentation, but a few of my favorite forms of mental health therapy include:
Please note that, if you are currently taking prescription anti-depressants, it is important not to stop taking your medications without the oversight of your physician or therapist.
Going back to my lucid dream… I did things differently this time during that doctor’s appointment. I stopped him mid-sentence and said, “No, Doctor, I don’t need antidepressants. I came in because of my physical symptoms.” I may have thrown a swear word or two in there somewhere. And it was liberating!
Now that I’m a rebel with a cause — a Root Cause Rebel — my voice is getting stronger, and my pathological politeness is getting weaker with each and every day.
So if you’ve ever been told that it’s all in your head, or that you need antidepressants, or that you should just settle for the status quo, say it with me, my fellow Root Cause Rebel: “No, Doctor, I don’t need antidepressants!”
Selenium, iron, Vitamin A, Vitamin E, the B vitamins, potassium, iodine, and zinc are all required for proper thyroid function as well as being essential for optimal immune system, gut, liver and adrenal function.
Most people who are diagnosed with chronic disease will also present with low levels of selenium, Vitamin E, and glutathione, as well as zinc and ferritin (the iron storage protein).
Why Do People with Chronic Disease Have so Many Nutrient Depletions?
One of the reasons so many of us suffer from nutrient depletions is due to the way that conventional farming methods and food processing are robbing our food supply of good nutrients. In conventional farming methods, the same vegetables are grown on the same soil year after, depleting the soil of nutrients. Vegetables are also harvested before they are ripe and have had a chance to pull all of the nutrients from the soil they were planted in. These conventionally grown vegetables are far less nutritious than organic varieties. I always recommend that people eat organic vegetables, fruit, and meat whenever they possibly can to gain the most nutrition from their food.
Poor digestion can be another root cause of nutrient depletion for many people with chronic disease. A person who is deficient in digestive enzymes will not be able to properly extract nutrients from their foods. They could eat large amounts of steak day after day, but if they don’t have enough stomach acid on board, they’re not going to be able to get enough iron out of that steak. Altered gut flora, or dysbiosis, will also prevent the extraction of nutrients from food.
Some of the most common medications prescribed to people with chronic disease are notorious for depleting the body of nutrients. These include acid blockers, synthetic estrogen, progesterone (such as the birth control pill) as well as antibiotics.
Many of the diets that people with chronic disease follow to help relieve their symptoms can actually be a root cause for nutrient depletions. Going gluten-free or Paleo can have a substantial, positive effect on people with chronic diseases, but it can also eliminate some essential vitamins from the diet, including the B vitamins, that will need to be supplemented.
Vegan, vegetarian, and low-fat diets will, likewise, put us at risk for deficiencies, including Vitamin A, Vitamin B3, Vitamin B9, Vitamin B12, Vitamin D, calcium, chromium, copper, iodine, iron, magnesium, manganese, zinc and omega-3’s.
Additionally, hypothyroidism, in itself, will lead to poor extraction of minerals and vitamins from our food sources. Thyroid hormones determine our metabolism throughout the entire body, including the digestive tract. Lack of sufficient thyroid hormones makes nutrient extraction more difficult and less efficient, and can lead to nutrient deficiencies.
Risk Factors for B12 Deficiency
Vitamin B12 is an essential water-soluble vitamin that is commonly found in animal proteins such as fish, shellfish, meat, eggs, and dairy products. B12 is required for protein synthesis, cell reproduction, and normal growth.
The risk for Vitamin B12 deficiency is higher with increased age. It has also been found to be more prevalent in males and in people of Caucasian and Latin American descent. It results from insufficient intake, malabsorption from food, and other medical conditions that may prevent absorption.
In the case of people with thyroid disorders, a B12 deficiency is often a result of damage to the digestive tract that prevents the absorption of vital nutrients.
B12 is released for absorption with the help of hydrochloric acid (stomach acid) and protease, an enzyme in the stomach. Low levels of hydrochloric acid, commonly found in those with chronic disease, put people at risk for B12 deficiency. The consumption of bread and cereals fortified with folic acid (synthetic folate) may mask this deficiency on standard lab tests.
Because Vitamin B12 is only found in animal proteins and not in plant foods, those that have been following a vegetarian or vegan diet are at an especially high risk for developing a B12 deficiency. Taking a Vitamin B12 supplement is essential for vegans, and may be helpful for those with low stomach acid until the condition is corrected.
If you have a thyroid disorder, there is a very good chance that you are not absorbing B12, even if you eat a diet rich in animal proteins. Along with removing problematic foods and supplementing with Betaine with Pepsin to restore healthy gut function, adding in a B12 supplement may go a long way to restoring your energy, cognitive function and overall sense of well-being.
Most people with thyroid conditions and adrenal fatigue will also have low stomach acid (hydrochloric acid or HCl), which is necessary to break down protein. This is known as “achlorhydria”. This lack of adequate digestive enzymes leads to a depletion of amino acids, iron, zinc and other nutrients obtained from protein. Symptoms include gas, heartburn, bloating, and heaviness in the stomach after eating a protein-rich meal.
Achlorhydria and the inability for the digestive tract to break down and absorb many important nutrients can result in severe deficiencies for many people who have hypothyroidism.
Chronic Disease often co-occurs with other autoimmune conditions. One of these conditions is specifically tied to B12 deficiency and is known as pernicious anemia. In pernicious anemia, the immune system attacks intrinsic factor, a protein in our stomach that is required for B12 absorption. (Please note, pernicious anemia, Hashimoto’s and Graves’ can all be caused by Helicobacter pylori, and treating the H Pylori can lead to a remission of all three of the conditions.)
Another risk factor for B12 deficiency is small intestinal bacterial overgrowth, commonly known as SIBO, which may be present in up to 50% of people with chronic disease.
Do You Have Low Levels of B12?
Lab tests for measuring B12 levels are available but do not always tell the whole story. Established “low” ranges are too low, and researchers have found that “normal-low” B12 levels have been associated with neurological symptoms such as difficulty balancing, memory lapses, depression, mania, fatigue, and even psychosis!
Normal serum Vitamin B12 levels range between 200-900 pg/mL, with concentrations less than 200 pg/mL usually resulting in deficiency. B12 deficiency may result in gastrointestinal lesions, and neurological damage, as well as symptoms such as depression, memory loss, weakness, personality and mood changes, and impaired cognitive performance. Impaired digestion and inflammation are also symptoms of a B12 deficiency.
An elevation of B12 in your serum can be tied to the MTHFR gene variation. When the body is unable to properly use B12, it will show up as elevated on the test. As B12 is a water soluble vitamin, any amount that is not used by the body will simply be eliminated.
To find out if you have low levels of B12, you can ask your health care provider for the B12 (or cobalamin) test. This test can be ordered individually or added to a blood panel. Your levels may be low, even if all other screening tests for iron and anemia come out within the reference range.
Alternately, you can self-order the B12 test via Ulta Lab Tests. When you receive your test results, it’s important to note that optimal B12 levels should be between 700-900 pg/ml. Most labs will not flag B12 levels unless they are under 200 pg/ml.
How to Take B12
Options for B12 replacement include tablets, sublingual (under the tongue) liquids, and injections. I prefer the sublingual route as there may be advantages for those with absorption issues, and it is more convenient than injections.
Sublingual doses of 5 mg (5000 mcg) of B12 daily for ten days, then 5 mg once per week for four weeks, then 5 mg monthly, have been found to be effective in restoring B12 levels in those with a deficiency.
Liposomal B Supreme comes in a convenient liquid form that can be administered sublingually for optimal absorption. The active form of B12 in this formulation is highly bio-available and has been shown to support neurological function, nerve cell health, healthy cognitive and nerve function, as well as memory and emotional well-being.
Vitamin B12 is also an important co-factor for energy production and plays a role in immune system health and healthy homocysteine metabolism. Homocysteine is a naturally occurring amino acid found in blood plasma. High levels of homocysteine in the blood are believed to increase the chance of heart disease, stroke, Alzheimer’s disease, and osteoporosis. For this reason, I highly recommend optimizing your B12 levels today!
I wish you well on your journey to health!