Pregnant with Hashimoto’s

I’m back after a long break from blogging! I had to step away from the thyroid world for a bit to preserve my own sanity. I started to feel like I knew too much; you know, the more you know the more you suffer. Before I go on, let me just preface this by saying that I LOVE all the advocacy sites out there to help people like us. I am so glad I had a place to connect with others and get direction and ideas as to how to advocate for myself and optimize my treatment. This information was invaluable. The problem was that I became stable and healthy and continuous reading of other people’s symptoms, symptoms I hadn’t experienced, links to other diseases, etc… was starting to take me away from the present moment and fueled my fear and anxiety that bad things were awaiting me. I recall someone asking on a popular thyroid site, “Where are all the people that are doing well?” I can tell you where they are; out living their lives and free from fear of the next bad thing.

So that’s what I did; I unplugged and started living my life. I still answered people’s personal emails and use my knowledge in my therapy practice to encourage client’s presenting with depression and anxious symptoms to go back to their physician’s and ask to have a complete thyroid panel. I educate my colleagues on how thyroid dysfunction can mimic mental illness. I encourage all of my friends of childbearing age to have their thyroid’s checked prior to becoming pregnant. When I was experiencing the hyperthyroid symptoms of postpartum thyroiditis 2 years ago, and had just received my diagnosis of Hashimoto’s, I searched for a way that something good could come out of it. I’ve found the good; I feel so blessed that I have been able to help others and that I can continue to do so.

This is what brings me back to blogging; I’m 8 months pregnant with baby number 2 right now. My first endocrinologist, the one that told me I would likely never lose the tremendous amount of weight I gained from the pregnancy with my son, also mentioned that I may have a hard time becoming pregnant again. Like many things she told me, this too turned out to be not true. Of course, I was terrified about how hashi’s would affect by unborn baby. I didn’t have to go back to the internet to scour the information; I already had read it.

I can’t control a lot with this disease; I can just take care of myself to the best that I know how and leave the rest up to God. So far things are going so well! With the collaboration of my OB and Endocrinologist, I’ve been able to keep m y thyroid levels optimal. I have also been able to continue working out (far less and more modified at this point in pregnancy, but still able)! I’ve had no complications, baby is healthy, and I’m on track for a healthy weight gain (23 pounds at 32 weeks). So I’ve been thinking about the direction I want to take with my blogging…maybe It’ll be about ME. All of me: A mother, a lover of cooking healthy foods, and fitness addict. Oh yeah, and I just also happen to have hashimoto’s as well. You see, I am (and so are you!) so much more than a medical condition.

32 weeksbow

The Plan that Worked for ME!

Let me begin by telling you that I’m not claiming to have all the answers, and I can’t say that just because this worked for me, it’ll work for you. Every BODY is different. Even those of us with the same diagnosis of Hashimoto’s are different. I was diagnosed accurately pretty early on so treatment started earlier than some of you that went years suffering or that had been misdiagnosed. This is not a phase or a diet, this is a lifestyle change. I have spent the past year researching and tweaking my lifestyle so I can feel the best possible, and because there were so many sad stories out there, I wanted to find something that worked for me and share in the hopes to inspire another fellow thyroid sufferer to find what works for them.

I get a lot of emails asking me what in particular I eat or don’t eat, and I decided to write it out. I want to be VERY CLEAR that I am not a dietician, nutritionist, or a doctor. So PLEASE check with your doctor or do your own due diligence before starting any new program. I believe in treating this illness with a combination of thyroid meds (whichever combo works best for you) and through diet and lifestyle.

Step 1.

Grab a calendar. Go to the date 1 year from now and circle it. This is your healthversary date. You need to give this a solid year before you give up. I’ll say more after you complete step 2.

Step 2.

scale

Throw out or have someone hide your scale. Seriously. So many People start a workout regimen and expect fast results. Unfortunately, when results aren’t immediate, they get discouraged and give up. I have a friend that joined a boot camp program at her gym and gained weight in the first month. This has also happened to me. There are several reasons why, but in short, the scale isn’t accurately reflecting what is going on. Provided you are eating well, when you begin an exercise routine and start shredding previously sedentary muscles, your muscles hold onto more water as they repair, thus making the numbers on the scale bigger. Plus, ever heard the old adage muscle weighs more than fat? Let your body get used to such fluctuations, and instead go by how you FEEL instead of a number on the scale. At this point, you may be thinking, “Well you weighed yourself, you know what you lost”. Sometimes it was those darn doctors that made me get on the scale, but otherwise I tried to do quarterly weigh ins to track progress from one regimen to another. This brings me back to step one. If you give this a go, you are not allowed to re-evaluate until the 1 year mark. My point, Rome wasn’t built overnight and neither was your body. Be patient and allow yourself some time to see desired changes. Regardless of weight loss, remember, you are doing this to better your health.

Step 3.

shortvuts

Exercise. This is a must! We have sluggish metabolisms and the best way to kick ‘em into high gear is by engaging in some sort of physical activity. A lot of research for thyroid patients tout weight training combined with HIIT (high intensity interval training) as effective modes to weight loss. I personally did a bunch of things; I trained for and ran a half marathon, did 60 days of Insanity, 90 days of P90x, and now do a mix of HIIT/cycling/running/weights. This sounds intense, I know. I actually am one of those people who enjoy working out! I find this is a great stress reliever and satisfies my competitive spirit. I currently work out 6 days a week for around 30-60 minutes depending on the activity. My advice is to find something you enjoy or can at least tolerate. I like the structure of programs; there is a beginning and an end, and I like to mix things up. If you hate it, you will not continue to do it!

If you have any physical limitations, find a way to work around them. Google is your friend. Money is not an obstacle here either people. You don’t need to go to a gym. A Jillian Michael’s DVD is $10 and youtube offers free HIIT workouts or go to dailyhiit.com. Bodybuilding.com offers many free workouts as well. If 30-60 minutes sounds too intense, start with 10-15 minutes and work your way up.

Step 4.

cheap and easy

Diet. This is the tricky one. When I got diagnosed with this disease and started searching around a lot of stuff on the internet came up about paleo, low-carb, and gluten free. I made a lifestyle change I knew I could live with. For me, Paleo was tough because I LOVE my oatmeal. I read a lot about gluten, including the book Wheat Belly, and decided I could make this change permanent. I also eliminated cruciferous vegetables in the beginning (due to having a goiter), and reintroduced in the cooked form and in moderation once my goiter disappeared. I wrote more in detail about goitrogens here https://hashimomblogs.wordpress.com/2013/02/08/spicy-shrimp/. I also avoid soy, and limit my dairy. Truth be told, I’m fairly certain I’m sensitive to dairy, but I struggle with saying I can NEVER have cheese or yogurt again. I know how my body reacts, so I do my best to eat sparingly. Some people also limit or avoid nightshades (tomatoes, eggplant, peppers). I personally don’t feel like I react negatively, so I do not limit. I recommend keeping a food journal to track how you react to certain foods. I use myfitnesspal; it’s free, easy to use, and provides a wealth of information.

A word of caution when using any calorie counting or food logging application. When people go on “diets” they immediately think “eat less, workout more”. Myfitnesspal will tell you that if you are looking to lose weight and are a female that you should limit to 1200. I’ve NEVER cut my calories so low. The long reason is another blog post, but the short answer is because we NEED food for FUEL. After coming off a pregnancy, I needed to re-understand portions, so I initially weighed and measured my food and put myself at a NET calorie goal of 1400 when I had 65 pounds to lose. Net meaning if I burned 500 calories working out, I would aim for 1900 calories. 1900 – 500 calories burned in exercise = 1400. There are plenty of calculators online to give you an estimate of your TDEE (total daily energy expenditure). At my weight now my calorie “goal” for maintenance is to net 2040 calories a day! Now I just go by my hunger; some days I’m sure I’m over, some days under. It tends to even out.

I prescribe to a whole foods way of eating, popularly referred to as “clean” eating.

Clean Eating “Principles”:

1. Choose whole, natural foods and seek to eliminate or minimize processed foods.

Processed foods are anything in a box, bag, can, or package, and although there are always a few exceptions to the rule (like a bag of fresh green beans), the majority of your foods should be fresh.

2. Choose unrefined over refined foods.

While it may not be possible all the times, you can up your intake of whole grains like brown rice and quinoa. Beans and legumes are also important. Clean sugars include honey, maple syrup, and dehydrated sugar cane juice.

3. Include some protein, carbohydrate and fat at every meal.

Most of us typically do well with carbohydrates and fat, but we often lack protein, especially in the early part of the day, like at breakfast and lunch. Protein is an important muscle-builder, and it can also help curb your appetite. When eaten throughout the day, it keeps us feeling full longer. Be aware of the kinds of meals you put together and space out your protein.

4. Watch out for fat, salt, and sugar.

This is easier than you think, particularly if you’ve cut out processed foods, which are responsible for most of our excess calories and high levels of fat, sugar, and salt. Clean foods are usually naturally low in all of these ingredients.

5. Eat five to six small meals throughout the day.

This usually pans out into three main meals and two or three hefty snacks. Eating this way prevents you from skipping meals and overeating. It also keeps your blood sugar levels steady so energy doesn’t lag.

6. Don’t drink your calories.

High calorie drinks like specialty coffees and soft drinks, on average, tack on an extra 400 to 500 calories a day. Choose water first, or my personal favorite, unsweetened tea (any flavor). Other clean drinks: low-fat or skim milk and 100 percent fruit juice diluted with sparkling water.

A SAMPLE Meal Day:

A quick search for “clean” recipes will bring up several resources; every recipe I’ve posted is considered “clean” as well.

Breakfast: Old Fashioned Oatmeal (Gluten Free) made with coconut milk and cinnamon; 4 egg whites and 1 egg topped with salsa. Coffee. Homemade coffee creamer.

Morning snack (after my workout): Protein shake made with almond milk, chocolate protein powder (raw warrior), and frozen berries

Lunch: 2-3 Turkey muffins (http://www.bodybuilding.com/fun/video-jamie-eason-turkey-meatloaf-muffins.htm) and vegetable or salad; sweet potato

Afternoon snack: Almonds, Organic Greek yogurt (plain) with kiwi or blueberries

Dinner: Lean meat (Tilapia, turkey, chicken) and vegetable

NOTE: I food prep on Sundays; this is a tremendous time saver; it takes me about 2 hours to prep easily accessible food for my family of 3 that lasts until Thursday.

Step 5:

Keep stress as low as possible. Meditate. Sleep at least 8 hours.

This is A LOT in one post. I’d be happy to elaborate or answer any questions!

In Support of Mandatory Thyroid Testing in Pregnancy

As we are nearing the first birthday of my son, I have spent some time in reflection on the journey that we have undergone over the last few years to get to this place.

Unknowingly, the beginning of my thyroid journey started with the back to back losses of two pregnancies. Every time I became pregnant, I literally gained 8-10 pounds in a matter of a week. After each miscarriage, I would lose a few of the pounds, but had a difficult time losing the rest despite my extremely active lifestyle and good diet. I went in to my general practitioner to specifically have my thyroid checked and it came back “in range”.

After the second miscarriage and my OB telling me it was just “bad luck”, I switched to an infertility clinic in an effort to prevent miscarriage number 3. I wasn’t sure my heart could handle another disappointment. The specialty clinic performed several tests including a check of my TSH levels. The numbers came back at 2.94, which I now know are not optimal for a succesful pregnancy, but at the time she said they were “in range” so I listened. My antibodies were never checked despite my family history of thyroid disease.

When we conceived what would (luckily) become our son, I was asked to come in immediately upon testing positive for pregnancy. More blood was drawn, and my progesterone levels came back dangerously low. I was supplemented immediately, and offered a regimen of baby aspirin and prednisone. Prednisone is a steroid and is classified as a Category C drug. My OB stated there was a theory that when taken in the first trimester, the prednisone could prevent a woman’s body from attacking the baby. There was no evidence that this was what was happening to me, but I decided it was worth a try as I had little confidence in my body’s ability to support a pregnancy. The risks of taking prednisone weighed heavily on me; low birth weight, premature delivery and cleft palate. However, I was desperate for something to work.

And work it did. Or maybe it was my pleading prayers to God. Perhaps a bit of both. My son was born just shy of 40 weeks gestation at 8 pounds 2 ounces and has perfect lips! However, any informed individual living with a thyroid disease could read the above 3 paragraphs and pick out immediately the warning signs that I was suffering from an undiagnosed thyroid disease. Rapid weight gain, miscarriages, low progesterone, strong family history, and although my TSH was “in range”, the American Thyroid Association recommends TSH levels in the first trimester be between .1-2.5. With a TSH at almost 3, I was suffering from overt hypothyroidism during my pregnancy and went untreated.

As mentioned in earlier posts, I wasn’t diagnosed until after my son was born…when my thyroid went completely haywire (thyroid storm) and the symptoms had me feeling like I belonged in the hospital or a mental institute! I can’t say I’m upset at the trajectory of my story, but more disappointed in the knowledge that this is likely happening to many more women. I’m a firm believer that things happen for a reason. If I had doctors that were more diligent and informed I wouldn’t have the son I have today. I also believe that God doesn’t allow anything so bad to happen to prevent any good from coming from it.

I wish for a day where early screening is mandatory as it is just a simple blood test. Currently this is a controversial subject as the experts are mixed about the cost effectiveness of screening all pregnant women. Meanwhile there is evidence that women with even mild thyroid dysfunction have double the risk of miscarriage and seven times greater risk of stillbirth.

This has become my new mission. I hope that through advocacy and spreading knowledge that someone gets their happily ever after before having to learn the hard way. So now, while other women are passing on tips to deal with morning sickness, I’m advocating for them to get their thyroid checked.

Me and my lil love 🙂

nolan and mom

Getting Healthy by Becoming Sick

I remember when I first made my diet changes; NO gluten, NO processed foods, organic foods, limited sugar (I’d like to say none, but I need my few glasses of wine a week; a girl’s got her limits!). I GRIEVED and cried pretty much nonstop for 5 days. Yes. I cried. Over food. Sounds ridiculous to me now. In our culture, food equals celebration. We meet friends for happy hour, have cake at birthdays, and barbeque on 4th of July. I thought of all that I would miss out on, and it made me sad.

After I ended my little pity party, I had to start looking not at what I would miss out on, but what I could gain. Health. Feeling good. Do I want a piece of pizza or do I want to feel good enough to play sports with my son? That thought sealed the deal.

It’s amazing how your taste buds change when you eat whole, nutrient rich foods. It’s really true that you start to crave such foods. Food is fuel, not comfort. If I need comfort, that’s what I have so many good friends for! Is my diet “perfect”? No. I indulge occasionally on a little ice cream or dark chocolate, but it really isn’t that frequent.

People often ask me how I stay committed to this way of life. Buying organic IS more expensive. Making foods from scratch DOES take more time. I’ve learned how to shop smart for organics. I buy organic meat in bulk from Costco, and they also offer large bags of frozen organic produce that saves a ton of money when you compare it to what you would have paid for it fresh. We also eat out a lot less, which helps me justify the increase in our grocery bill. I cook several meals on Sunday to provide us with most of the week’s meals.

The hardest part of my new lifestyle is going to dinner at other people’s homes. With my family, it’s easy. My mom is Gluten free, and she makes sure I can eat what she’s serving. In other cases, I’ve asked the host (depending on the relationship) what he or she is serving to see in advance if I can make it work, and if not, I bring a dish to share that I know I can eat. It’s worked pretty seamlessly so far.

At the beginning of this all, I talked to one of my best friends who told me, “This will eventually become your new normal”. How right she was. It’s kind of ironic that I’ve become the healthiest I’ve ever been by getting sick.

Hashi-what? My Japanese Restaurant Disease

My life, to this point anyways, can best be described as pre-Nolan and post-Nolan. In my pre-Nolan life, I would not be writing this blog. Certainly not about Hashimotos, but probably not any blog. Not because it was a boring life. It was semi-charmed; kinda vanilla. Nolan, by the way, is my 6 month old son.

Pretty cute huh?

Post-Nolan life was “supposed” to be just like it sounds. Insert bouncing baby boy into loving marriage, adjust to new life as a mom, etcetera. But shortly after he was born, I was not feeling well. The beyond the usual postpartum bluesy not feeling well. My hands began to shake. I was exhausted but when I had the opportunity to sleep, I could not. My heart was racing and I felt on the verge of a panic attack every waking moment of the day. I started getting hot flashes and was ALWAYS hot and sweating. Finally, I took my temperature thinking I had a fever. My body temperature was 93.8 degrees. Clearly, not normal.

So I did what most people would do. I googled it. And that’s when I saw it…thyroid disease can cause lowered body temperature. This wasn’t exactly a surprise as both my mother and grandmother had thyroid diseases. I had mine checked every year to watch it, but still thought it’d skip me because I was healthy. Pre-Nolan, I was a runner and a cyclist. I ate healthier than most of America, or so I thought.

I took my hunch right to the doctor the next day. She skipped right over the postpartum depression questions and went right into bloodwork. I received a call that afternoon that my “levels” were off and an immediate referral to an endocrinologist.

Within days my husband and I found ourselves sitting in an endocrinologist’s office and hearing the words “You have hashimoto’s”. Hashi-what? Sounds like the name of a Japanese Restaurant. She went on to explain that my current symptoms were a result of a hyperthyroid state, but that the usual trajectory would result in a hypothyroid state. Translation, my metabolism would slow way down. This autoimmnune disorder was attacking my thyroid gland and would ultimately render it useless. I would eventully be on a medication taken daily for the rest of my life. Telling this to a woman that gained a bit too much during pregnany, and still had a good chunk of weight to lose was a bit traumatizing I have to admit.

So back to google I went (bad idea), and what I found is the reason I decided to start this blog in the first place. Now here is where I need to be careful. I’m not discounting that the side effects of this disease are real and felt by many; including myself. What I felt discouraged about was the lack of positive stories to tell. I felt hopeless and sad reading the endless personal stories of copious weight gain, struggles with weight loss, depression, fatigue, hair falling out, exercise intolerance, infertility, etc… What I needed to hear is how one can LIVE WELL with this disease.

I’ve read nearly everything I can get my hands on. Based on the information I’ve read, I’ve made the following lifestyle changes:

  • I’ve cut out gluten and adopted a “clean” eating lifestyle
  • I work out  days 6 days per week 45-90 minuted per time depending on the type of exercise (this wasn’t that big of a change from pre-pregnancy)
  • I take a high potency daily multivitamin and fish oil supplements

I also should add that about 4 weeks after I was diagnosed, I switched into hypothyroidism. I began taking Levothyroxine, and just had my dosage increased. So far, I feel lucky. I was diagnosed early and was able to avoid a lot of the ugly side effects. I’ve lost 52 0f the 65 pounds I gained in pregnancy, and just completed a half marathon. So far, I feel pretty good.