A Fresh Take On Hypothyroidism
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The Three Rs To Boost Thyroid-Related Energy Levels
This is Dr. Izabella Wentz. She’s a doctor of pharmacology, and after her own diagnosis with Hashimoto’s thyroiditis, she has taken it up as her personal goal to educate others on managing hypothyroidism.
Dr. Wentz is also trained in functional medicine through The Institute for Functional Medicine, Kalish Functional Medicine, and the American Academy of Anti-Aging Medicine. She is a Fellow of the American Society of Consultant Pharmacists, and holds certifications in Medication Therapy Management as well as Advanced Diabetes Care through the American Pharmacists Association. In 2013, she received the Excellence in Innovation Award from the Illinois Pharmacists Association.
Dr. Wentz’s mission
Dr. Wentz was disenchanted by the general medical response to hypothyroidism in three main ways. She tells us:
- Thyroid patients are not diagnosed appropriately.
- For this, she criticises over-reliance on TSH tests that aren’t a reliable marker of thyroid function, especially if you have Hashimoto’s.
- Patients should be better optimized on their medications.
- For this, she criticizes many prescribed drugs that are actually pro-drugs*, that don’t get converted adequately if you have an underactive thyroid.
- Lifestyle interventions are often ignored by mainstream medicine.
- Medicines are great; they truly are. But medicating without adjusting lifestyle can be like painting over the cracks in a crumbling building.
*a “pro-drug” is what it’s called when the drug we take is not the actual drug the body needs, but is a precursor that will get converted to that actual drug we need, inside our body—usually by the liver, but not always. An example in this case is T4, which by definition is a pro-drug and won’t always get correctly converted to the T3 that a thyroid patient needs.
Well that does indeed sound worthy of criticism. But what does she advise instead?
First, she recommends a different diagnostic tool
Instead of (or at least, in addition to) TSH tests, she advises to ask for TPO tests (thyroid peroxidase), and a test for Tg antibodies (thyroglobulin). She says these are elevated for many years before a change in TSH is seen.
Next, identify the root cause and triggers
These can differ from person to person, but in countries that add iodine to salt, that’s often a big factor. And while gluten may or may not be a factor, there’s a strong correlation between celiac disease and Hashimoto’s disease, so it is worth checking too. Same goes for lactose.
By “checking”, here we mean testing eliminating it and seeing whether it makes a difference to energy levels—this can be slow, though, so give it time! It is best to do this under the guidance of a specialist if you can, of course.
Next, get to work on repairing your insides.
Remember we said “this can be slow”? It’s because your insides won’t necessarily bounce back immediately from whatever they’ve been suffering from for what’s likely many years. But, better late than never, and the time will pass anyway, so might as well get going on it.
For this, she recommends a gut-healthy diet with specific dietary interventions for hypothyroidism. Rather than repeat ourselves unduly here, we’ll link to a couple of previous articles of ours, as her recommendations match these:
She also recommends regular blood testing to see if you need supplementary TSH, TPO antibodies, and T3 and T4 hormones—as well as vitamin B12.
Short version
After diagnosis, she recommends the three Rs:
- Remove the causes and triggers of your hypothyroidism, so far as possible
- Repair the damage caused to your body, especially your gut
- Replace the thyroid hormones and related things in which your body has become deficient
Learn more
If you’d like to learn more about this, she offers a resource page, with resources ranging from on-screen information, to books you can get, to links to hook you up with blood tests if you need them, as well as recommended supplements to consider.
She also has a blog, which has an interesting relevant article added weekly.
Enjoy, and take care of yourself!
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The Immune System Recovery Plan – by Dr. Susan Blum
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The subtitle of the book is “A Doctor’s 4-Step Program to Treat Autoimmune Disease”, so we’ll not keep the four steps a secret; they are:
- Using food as medicine
- Understanding the stress connection
- Healing your gut and digestive system
- Optimizing liver function
Each of these sections gives a primer in the relevant science, worksheets for personalizing your own plan to your own situation, condition, and goals, and of course lots of practical advice.
This is important and perhaps the book’s greatest strength, since there are dozens of possible autoimmune conditions, and getting a professional diagnosis is often a long, arduous process. So while this book can’t necessarily speed that up, what it can do is give you a good head-start on managing your symptoms based on things that are most likely to help, and certainly, there will be no harm trying.
While it’s not primarily a recipe book, there are also recipes targeting each part of the whole, as well as an extensive herb and supplement guide, before getting into lots of additional resources.
Bottom line: if you are, or suspect you are, suffering from an autoimmune condition, the information in this book can make your life a lot easier.
Click here to check out The Immune System Recovery Plan, and help yours to help you!
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Tasty Versatile Rice
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In the nearish future, we’re going to do some incredible rice dishes, but first we need to make sure we’re all on the same page about cooking rice, so here’s a simple recipe first, to get technique down and work in some essentials. We’ll be using wholegrain basmati rice, because it has a low glycemic index, lowest likelihood of heavy metal contamination (a problem for some kinds of rice), and it’s one of the easiest rices to cook well.
You will need
- 1 cup wholegrain basmati rice (it may also be called “brown basmati rice“; this is the same)
- 1 1/2 cups vegetable stock (ideally you have made this yourself from vegetable offcuts that you saved in the freezer, then it will be healthiest and lowest in sodium; failing that, low-sodium vegetable stock cubes can be purchased at most large supermarkets. and then made up at home with hot water)
- 1 tbsp extra virgin olive oil
- 1 tbsp chia seeds
- 1 tbsp black pepper, coarse ground
- 1 tsp turmeric powder (this small quantity will not change the flavor, but it has important health benefits, and also makes the rice a pleasant golden color)
- 1 tsp garlic powder
- 1 tsp yeast extract (this gently improves the savory flavor and also adds vitamin B12)
- Optional small quantity of green herbs for garnish. Cilantro is good (unless you have the soap gene); parsley never fails.
This is the ingredients list for a super-basic rice that will go with anything rice will go with; another day we can talk more extensive mixes of herbs and spice blends for different kinds of dishes (and different health benefits!), but for now, let’s get going!
Method
(we suggest you read everything at least once before doing anything)
1) Wash the rice thoroughly. We recommend using a made-for-purpose rice-washing bowl (like this one, for example), but failing that, simply rinse it thoroughly with cold water using a bowl and a sieve. You will probably need to rinse it 4–5 times, but with practice, it will only take a few seconds per rinse, and the water will be coming up clear.
2) Warm the pan. It doesn’t matter for the moment whether you’re using an electronic rice cooker, a stovetop pressure cooker, electronic pressure cooker, or just a sturdy pan with a heavy lid available, aside from that if it’s something non-stovetop, you now want it to be on low to warm up already.
3) Separately in a saucepan, bring your stock to a simmer
4) Put the tbsp of olive oil into the pan (even if you’re confident the rice won’t stick; this isn’t entirely about that) and turn up the heat (if it’s a very simple rice cooker, most at least have a warm/cook differentiation; if so, turn it to “cook”). You don’t want the oil to get to the point of smoking, so, to test the temperature as it heats, flick a single drop of water from your fingertip (you did wash your hands first, right? We haven’t been including that step, but please do wash your hands before doing kitchen things) into the pan. If it sizzles, the pan is hot enough now for the next step.
5) Put the rice into the pan. That’s right, with no extra liquid yet; we’re going to toast it for a moment. Stir it a little, for no more than a minute; keep it moving; don’t let it burn! If you try this several times and fail, it could be that you need a better pan. Treat yourself to one when you get the opportunity; until then, skip the toasting part if necessary.
6) Add the chia seeds and spices, followed by the stock, followed by the yeast extract. Why did we do the stock before the yeast extract? It’s because hot liquid will get all the yeast extract off the teaspoon 🙂
7) Put the lid on/down (per what kind of pan or rice cooker you are using), and turn up the heat (if it is a variable heat source) until a tiny bit of steam starts making its way out. When it does, turn it down to a simmer, and let the rice cook. Don’t stir it, don’t jiggle it; trust the process. If you stir or jiggle it, the rice will cook unevenly and, paradoxically, probably stick.
8) Do keep an eye on it, because when steam stops coming out, it is done, and needs taking off the heat immediately. If using an automatic rice cooker, you can be less attentive if you like, because it will monitor this for you.
Note: if you are using a simple pan with a non-fastening lid (any other kind of rice cooking setup is better), more steam will escape than the other methods, and it’s possible that it might run out of steam (literally) before the rice is finished. If the steam stops and you find the rice isn’t done, add a splash of water as necessary (the rice doesn’t need to be submerged, it just needs to have liquid; the steam is part of the cooking process), and make a note of how much you had to add (so that next time you can just add it at the start), and put it back on the heat until it is done.
9) Having taken it off the heat, let it sit for 5 minutes (with the lid still on) before doing any fluffing-up. Then you can fluff-up and serve, adding the garnish if you want one.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Should You Go Light Or Heavy On Carbs?
- Chia: The Tiniest Seeds With The Most Value
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Why Curcumin (Turmeric) Is Worth Its Weight In Gold
- The Many Health Benefits Of Garlic
Take care!
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Ghanaian Red Bean & Sweet Potato Groundnut Stew
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This is a dish popular in principle throughout West Africa. We say “in principle” because that’s a big place, and there is a lot of regional variation. The archetypal peanut stew is from Senegal (as maafe) or Mali (as tigadèguèna), but for its more balanced nutritional profile we’ve chosen one from Ghana—and since there are regional variations within Ghana too, we should specify that this one is from the south.
If you are allergic to nuts, you can substitute a seed butter (or tahini) for the nut butter, and omit the nuts—this will work in culinary terms and be fine healthwise, but we can’t claim it would be the same dish, having lost its defining ingredient. If your allergy is solely to peanuts, then substituting with any oily nut would work. So, not almonds for example, but cashews or even walnuts would be fine.
You will need
- 1½ lbs sweet potatoes, peeled and cut into ½” cubes
- 2 cups low-sodium vegetable stock
- 2 cans kidney beans, drained, cooked, and rinsed (or 2 cups same; cooked, drained, and rinsed)
- 1 can chopped tomatoes
- ½ cup unsalted dry-roasted peanuts
- 1 onion, chopped
- 1 red bell pepper, deseeded and chopped
- ¼ bulb garlic, finely chopped
- 2 heaped tbsp unsalted peanut butter, minimal (ideally: no) additives
- 2 tsp white miso paste
- 2 tsp grated fresh ginger
- 1 tsp ground cumin
- 1 tsp cayenne pepper
- 1 tsp black pepper
- ½ tsp MSG or 1 tsp low-sodium salt
- ½ tsp coarsely ground nigella seeds
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a sauté pan, or other pan suitable for both frying and fitting the entire stew in. Fry the onions until softened, turn the heat down low, and add the garlic, ginger, red bell pepper, cumin, cayenne, black pepper, and MSG/salt.
2) Add ¼ cup of the vegetable stock, and the sweet potato, and turn the heat back up, on high for about 30 seconds to get it to temperature, and then take it down to a simmer.
3) Stir in the miso paste and chopped tomatoes.
4) Add most of the rest of the vegetable stock, keeping ¼ cup aside. Simmer for about 20 minutes.
5) Stir in the kidney beans, and simmer for about 30 minutes more—the sweet potato should be soft now; if it isn’t, let it simmer a while longer until it is.
6) Combine the peanut butter with the remaining ¼ cup vegetable stock, and blend until smooth. Stir it into the stew.
7) If the stew is looking more like a soup than a stew, take out 1 cup and blend this 1 cup to a purée, adding it back in.
8) Add half the peanuts unto the stew. Taste, and adjust the seasonings if necessary.
9) Crush the remaining peanuts using a pestle and mortar; not too much though; you want them broken into bits, not pulverised.
10) Garnish with the crushed nuts and nigella seeds, and serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat More (Of This) For Lower Blood Pressure
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we used 4/5 today!
Take care!
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‘Sleep tourism’ promises the trip of your dreams. Beyond the hype plus 5 tips for a holiday at home
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Imagine arriving at your hotel after a long flight and being greeted by your own personal sleep butler. They present you with a pillow menu and invite you to a sleep meditation session later that day.
You unpack in a room kitted with an AI-powered smart bed, blackout shades, blue light-blocking glasses and weighted blankets.
Holidays are traditionally for activities or sightseeing – eating Parisian pastry under the Eiffel tower, ice skating at New York City’s Rockefeller Centre, lying by the pool in Bali or sipping limoncello in Sicily. But “sleep tourism” offers vacations for the sole purpose of getting good sleep.
The emerging trend extends out of the global wellness tourism industry – reportedly worth more than US$800 billion globally (A$1.2 trillion) and expected to boom.
Luxurious sleep retreats and sleep suites at hotels are popping up all over the world for tourists to get some much-needed rest, relaxation and recovery. But do you really need to leave home for some shuteye?
RossHelen/Shutterstock Not getting enough
The rise of sleep tourism may be a sign of just how chronically sleep deprived we all are.
In Australia more than one-third of adults are not achieving the recommended 7–9 hours of sleep per night, and the estimated cost of this inadequate sleep is A$45 billion each year.
Inadequate sleep is linked to long-term health problems including poor mental health, heart disease, metabolic disease and deaths from any cause.
Can a fancy hotel give you a better sleep?
Many of the sleep services available in the sleep tourism industry aim to optimise the bedroom for sleep. This is a core component of sleep hygiene – a series of healthy sleep practices that facilitate good sleep including sleeping in a comfortable bedroom with a good mattress and pillow, sleeping in a quiet environment and relaxing before bed.
The more people follow sleep hygiene practices, the better their sleep quality and quantity.
When we are staying in a hotel we are also likely away from any stressors we encounter in everyday life (such as work pressure or caring responsibilities). And we’re away from potential nighttime disruptions to sleep we might experience at home (the construction work next door, restless pets, unsettled children). So regardless of the sleep features hotels offer, it is likely we will experience improved sleep when we are away.
Being away from home also means being away from domestic disruptions. Makistock/Shutterstock What the science says about catching up on sleep
In the short-term, we can catch up on sleep. This can happen, for example, after a short night of sleep when our brain accumulates “sleep pressure”. This term describes how strong the biological drive for sleep is. More sleep pressure makes it easier to sleep the next night and to sleep for longer.
But while a longer sleep the next night can relieve the sleep pressure, it does not reverse the effects of the short sleep on our brain and body. Every night’s sleep is important for our body to recover and for our brain to process the events of that day. Spending a holiday “catching up” on sleep could help you feel more rested, but it is not a substitute for prioritising regular healthy sleep at home.
All good things, including holidays, must come to an end. Unfortunately the perks of sleep tourism may end too.
Our bodies do not like variability in the time of day that we sleep. The most common example of this is called “social jet lag”, where weekday sleep (getting up early to get to work or school) is vastly different to weekend sleep (late nights and sleep ins). This can result in a sleepy, grouchy start to the week on Monday. Sleep tourism may be similar, if you do not come back home with the intention to prioritise sleep.
So we should be mindful that as well as sleeping well on holiday, it is important to optimise conditions at home to get consistent, adequate sleep every night.
Good sleep hygiene doesn’t require a passport. Maridav/Shutterstock 5 tips for having a sleep holiday at home
An AI-powered mattress and a sleep butler at home might be the dream. But these features are not the only way we can optimise our sleep environment and give ourselves the best chance to get a good night’s sleep. Here are five ideas to start the night right:
1. avoid bright artificial light in the evening (such as bright overhead lights, phones, laptops)
2. make your bed as comfortable as possible with fresh pillows and a supportive mattress
3. use black-out window coverings and maintain a cool room temperature for the ideal sleeping environment
4. establish an evening wind-down routine, such as a warm shower and reading a book before bed or even a “sleepy girl mocktail”
5. use consistency as the key to a good sleep routine. Aim for a similar bedtime and wake time – even on weekends.
Charlotte Gupta, Senior postdoctoral research fellow, Appleton Institute, HealthWise research group, CQUniversity Australia and Dean J. Miller, Adjunct Research Fellow, Appleton Institute of Behavioural Science, CQUniversity Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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I Contain Multitudes – by Ed Yong
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A little while back we reviewed a book (Planet of Viruses) about the role of viruses in our lives, beyond the obvious. Today’s book gives the same treatment to microbes in general—mostly bacteria.
We all know about pathogens, and we all know about gut microbiota and that some (hopefully the majority) there are good for our health. This book covers those things too, but also much more.
Pulitzer Prize-winning science writer Ed Yong takes a big picture view (albeit, of some very small things) and looks at the many ways microbes keep us alive, directly or indirectly. From the microbes that convert certain proteins in breast milk into a form that babies can digest (yes, this means we produce nutrients in breast milk that have been evolved solely to feed that bacterium), to those without which agriculture would simply not work, we’re brought to realize how much our continued existence is contingent on our trillions of tiny friends.
The style throughout is easy-reading pop-science, very accessible. There’s also plenty in terms of practical take-away value, when it comes to adjusting our modern lives to better optimize the benefits we get from microbes—inside and out.
Bottom line: if you’d like to learn about the role of microbes in our life beyond “these ones are pathogens” and “these ones help our digestion”, this is the book for you.
Click here to check out I Contain Multitudes, and learn more about yours and those around you!
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Grains: Bread Of Life, Or Cereal Killer?
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Going Against The Grain?
In Wednesday’s newsletter, we asked you for your health-related opinion of grains (aside from any gluten-specific concerns), and got the above-depicted, below-described, set of responses:
- About 69% said “They are an important cornerstone of a healthy balanced diet”
- About 22% said “They can be enjoyed in moderation, but watch out”
- About 8% said “They are terrible health-drainers that will kill us”
So, what does the science say?
They are terrible health-drainers that will kill us: True or False?
True or False depending on the manner of their consumption!
There is a big difference between the average pizza base and a bowl of oats, for instance. Or rather, there are a lot of differences, but what’s most critical here?
The key is: refined and ultraprocessed grains are so inferior to whole grains as to be actively negative for health in most cases for most people most of the time.
But! It’s not because processing is ontologically evil (in reality: some processed foods are healthy, and some unprocessed foods are poisonous). although it is a very good general rule of thumb.
So, we need to understand the “why” behind the “key” that we just gave above, and that’s mostly about the resultant glycemic index and associated metrics (glycemic load, insulin index, etc).
In the case of refined and ultraprocessed grains, our body gains sugar faster than it can process it, and stores it wherever and however it can, like someone who has just realised that they will be entertaining a houseguest in 10 minutes and must tidy up super-rapidly by hiding things wherever they’ll fit.
And when the body tries to do this with sugar from refined grains, the result is very bad for multiple organs (most notably the liver, but the pancreas takes quite a hit too) which in turn causes damage elsewhere in the body, not to mention that we now have urgently-produced fat stored in unfortunate places like our liver and abdominal cavity when it should have gone to subcutaneous fat stores instead.
In contrast, whole grains come with fiber that slows down the absorption of the sugars, such that the body can deal with them in an ideal fashion, which usually means:
- using them immediately, or
- storing them as muscle glycogen, or
- storing them as subcutaneous fat
👆 that’s an oversimplification, but we only have so much room here.
For more on this, see:
Glycemic Index vs Glycemic Load vs Insulin Index
And for why this matters, see:
Which Sugars Are Healthier, And Which Are Just The Same?
And for fixing it, see:
They can be enjoyed in moderation, but watch out: True or False?
Technically True but functionally False:
- Technically true: “in moderation” is doing a lot of heavy lifting here. One person’s “moderation” may be another person’s “abstemiousness” or “gluttony”.
- Functionally false: while of course extreme consumption of pretty much anything is going to be bad, unless you are Cereals Georg eating 10,000 cereals each day and being a statistical outlier, the issue is not the quantity so much as the quality.
Quality, we discussed above—and that is, as we say, paramount. As for quantity however, you might want to know a baseline for “getting enough”, so…
They are an important cornerstone of a healthy balanced diet: True or False?
True! This one’s quite straightforward.
3 servings (each being 90g, or about ½ cup) of whole grains per day is associated with a 22% reduction in risk of heart disease, 5% reduction in all-cause mortality, and a lot of benefits across a lot of disease risks:
❝This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes.
These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.❞
~ Dr. Dagfinn Aune et al.
We’d like to give a lot more sources for the same findings, as well as papers for all the individual claims, but frankly, there are so many that there isn’t room. Suffice it to say, this is neither controversial nor uncertain; these benefits are well-established.
Here’s a very informative pop-science article, that also covers some of the things we discussed earlier (it shows what happens during refinement of grains) before getting on to recommendations and more citations for claims than we can fit here:
Harvard School Of Public Health | Whole Grains
“That’s all great, but what if I am concerned about gluten?”
There certainly are reasons you might be, be it because of a sensitivity, allergy, or just because perhaps you’d like to know more.
Let’s first mention: not all grains contain gluten, so it’s perfectly possible to enjoy naturally gluten-free grains (such as oats and rice) as well as gluten-free pseudocereals, which are not actually grains but do the same job in culinary and nutritional terms (such as quinoa and buckwheat, despite the latter’s name).
Finally, if you’d like to know more about gluten’s health considerations, then check out our previous mythbusting special:
Enjoy!
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