What you can do this World Mental Health Day

What you can do this World Mental Health Day

It’s World Mental Health Day.

Mental health is all-encompassing. It is not limited to a small population – it impacts each of us. While the severity of that impact varies, we all have a responsibility to take mental health seriously. I’ve experienced the healing and empowerment that comes with taking ownership of my mental health, and on this World Mental Health Day I want to help others do the same.

According to the Mental Health Foundation, one in six adults experiences symptoms of a common mental health problem, such as anxiety or depression, every week. One in five adults has considered taking their own life at some point. Nearly half of adults believe they have had a diagnosable mental health problem in their lifetime; only a third have received a diagnosis.

Mental health does not occur in a vacuum: demographic inequalities are rampant. Women between the ages of 16 and 24 are three times as likely to experience a common mental health problem as their male counterparts, and women have higher rates of self-harm, bipolar disorder, and post-traumatic stress disorder. In the UK, white individuals are more likely to receive treatment while people of color have particularly low treatment rates. Low income populations are more likely to have requested but not received any mental health treatment.

Despite the progress we’ve made, roughly one-third of all people with a mental health problems suffer in silence and have not sought professional help.

Mental health carries a stigma.

And that stigma may be the greatest barrier to mental health care for all individuals. The word stigma is derived from the Latin word stigmata – meaning “mark made on skin by burning with hot iron”. This was traditionally reserved for criminals and exiles, and in the 17th century, the term was defined as “the mark of shame”.

Stigma creates a phenomenon called “social distancing”, or the social isolation of those labeled as mentally ill. Stereotypes, negative attitudes, and lack of public health resources and education perpetuate stigma and social distancing, leading to further isolation, worsening mental illness, and fewer individuals seeking the help they need. It is easy to internalize this stigma and carry the burden of shame, hopelessness, and diminishing self-worth. Stigma may prompt suffering individuals to avoid seeking help in an attempt to suppress the feelings and “problem” – often worsening symptoms and one’s overall mental and physical well-being.

The stigma goes both ways. According to the CDC’s Attitudes Towards Mental Illness report, stigma can result in a lower prioritization of public resources and poorer quality of care. Stigma and embarrassment are the top reasons why people with mental illness do not seek or follow-through with treatment. In addition, mental health conditions are typically omitted in health care screenings.

Mental health is inextricably linked to physical health. Mental health problems are one of the main causes of overall disease burden worldwide. In 2013, depression was the second leading cause of years lived with disability, causing over 40 million years of disability in 20-29 year-olds.

Mental health is not just a healthcare issue.

According to the World Health Organization and the World Economic Forum, mental illness racked up a global cost of $2.5 trillion in 2010, making it the greatest economic burden of any health issue in the world. It is projected to cost $6 trillion by 2030. Despite these costs, of the 450 million individuals suffering from mental illness worldwide, 60 percent do not receive any form of care, and 90 percent of the individuals in developing countries receive no form of care.

But there is something we can do about it.

Stigma is preventable.

In fact, it is one of the few things in healthcare that we can 100 percent eradicate. In reducing stigma, we also reduce suffering, disability, global economic burden, and a leading cause of death in the United States.

But how do we do it?

Talk about it. Brené Brown, PhD, a self-described “shame researcher”, says “Shame depends on me buying into the belief that I’m alone… Shame cannot survive being spoken. It cannot survive empathy.” By talking about and sharing our experiences we remove isolation and close the social distance, reminding others that they were never alone.

Education and advocacy. In sharing our stories, we also provide an opportunity to educate and advocate on issues of mental health. If you hear someone say something inappropriate, shameful, or supporting stigma, kindly call them in – start a conversation out of curiosity and kindness and acknowledge how that makes you feel and how it perpetuates stigma.

Watch our language. Words such as “crazy”, “psycho”, and “retarded” fuel stigma and fears associated with mental illness. Language matters. By refraining to use mental health conditions as adjectives we also refrain from feeding the shame and stigma surrounded those conditions.

Show compassion. Close the distance. Choose kindness over fear. Listen to what others have to say and meet them where they are. As Brown says, “The two most powerful words when we’re in struggle: ‘me too.’”

Choose empowerment. Meet yourself where you are. Take responsibility for your experiences, recognizing that no one lives this life but you. There is power to owning our own narratives, and by owning yours you can limit stigma and shame’s hold on you.

Be open about treatment. It’s easy to share that you have a primary care check-up or appointment. It’s not so easy to share when you’re seeing a therapist or psychiatrist. While owning our narratives and only sharing what’s comfortable, we can also be brave and share our mental health treatment process and normalize mental health care. In normalizing mental health care, we normalize mental illness, too.

Limit self-stigma. Be persistent. You are worth fighting for. Take action for your own treatment and well-being. Ask for help when you need it. Dedicate yourself to your entire self – not just your physical health, but mental health as well.

And when in doubt, know you are always worth seeking help. There is no such thing as “sick enough”. You are worth fighting for.

Here are some mental health resources if you’re not sure where to get started:

National Suicide Prevention Lifeline – 1-800-273-8255

National Domestic Violence Hotline – 1-800-799-7233

Anxiety and Depression Association of America – 240-485-1001

National Eating Disorders Association – 1-800-931-2237

National Alliance on Mental Illness – 1-800-950-6264

The National Alliance on Mental Illness (NAMI) has the following recommendations for getting started seeking treatment:

  • If it’s an emergency in which you or someone you know is suicidal, you should immediately call the National Suicide Prevention Lifeline at 1-800-273-8255, call 911 or go to a hospital emergency room.
  • If you can wait a few days, make an appointment with your primary healthcare provider or pediatrician if you think your condition is mild to moderate.
  • If your symptoms are moderate to severe, make an appointment with a specialized doctor such as a psychiatrist. You may need to contact your community mental health center or primary health care provider for a referral.
  • If you or your child is in school or at college, contact the school and ask about their support services.
  • Seek out support groups in your community and educate yourself about your symptoms and diagnosis. Social support and knowledge can be valuable tools for coping.

 

Note: I am not a mental health expert, nor is this article intended to give you medical advice. It is intended to help you find community, summon the courage to speak up, and find essential resources. If you feel you need professional support right now, please consult one of the resources listed above. 

What’s AIP again? An autoimmune healing update

What’s AIP again? An autoimmune healing update

I ditched the autoimmune protocol.

Excitedly making all the fruit crumbles in my post AIP phase.

It happened gradually and yet quite suddenly. One day I was on board, the next I was not. I didn’t reintroduce everything in a day. I was (somewhat) systematic in my reintroductions; I didn’t want three-plus months of strictly following the elimination phase to go to waste. But I also wasn’t entirely scientific in my approach. I added things one at a time, waited to add legumes as I know they can be fickle for me, and what do you know, I felt better and better with each reintroduction.

When I started the autoimmune protocol (AIP), I was very invested. I bought books, consumed podcasts, and religiously followed every #AIP Instagram influencer I could find. I’m glad I took this all-in approach, otherwise, completing the elimination phase may not have been possible. I stuck with it, gave it my all, and emerged on the other side somewhat unscathed.

The first 4-6 weeks on the protocol went well. Symptoms improved, I believed in the process, and I was sure I was on the path toward healing. Some symptoms remained, however, and the real healing didn’t start until two things happened:

  1. I started thyroid hormone supplementation.
  2. I actually, legitimately rested.

The key component here was rest. Real rest. Not an extra rest day here or there, but sit-on-the-couch, do nothing rest. This is when things really turned around.

Less pounding, more downward dog-ing.

One of my physicians recommended I take some time off. I resisted. And in that resistance, I found softness. Ease. I recognized my history of exercise addiction, disordered eating, and restriction. I noticed my fear and insecurity, the wisps of my identity wrapped around my running shoes. This was an opportunity to push myself, address my fears, and honor my body. I circumnavigated my ego and stopped running. I was terrified.

I took some time with no structured exercise. I still moved: I did yoga, went on walks, rock climbed with friends – but nothing was prescribed. Each day was a blank slate. It nourished my soul – and my adrenal glands.

During those two months, I did some blood work with my doctor and discovered that since starting AIP, my inflammatory markers worsened, while my thyroid levels stayed roughly the same. Some GI symptoms were reemerging, despite continuing to abide by AIP, and my energy levels weren’t up to par. My doctor recommended I ditch the prescribed diet and focus on eating intuitively instead.

“It’s up to you,” she said. “But if I were you, I’d at least add some variety into your diet.”

I reintroduced black pepper that night. A few days later, I ate some white rice. The next day, a bell pepper. It was scandalous.

Many factors could have contributed to the change in blood levels: stress from AIP, a sudden shift in brain chemicals from ditching regular, intense physical activity, the stress of choosing a grad school and flying across the country multiple times… many things could have influenced this shift. After stressing over the change in blood levels – and at the recommendation of many health care providers – I’ve chosen to place my focus on my day-to-day symptoms (or lack thereof!) instead of the numbers.

I continued reintroducing foods in what I’ll call an aggressively systematic manner. I felt better and better with each reintroduction. My energy increased, my skin improved, I was sleeping through the night, and my GI system found a state of normalcy and regularity I have never known (it’s a miracle!). And, after nearly four months of an absent menstrual cycle, my period returned. Things were in working order again – and all it took were some tomatoes and white rice.

The upward trajectory continued as I reincorporated more movement into my days and weeks. I started running again, gently and slowly, honoring my lost fitness and gained perspective. I relished the activity’s simplicity, even with sore legs and tired lungs. My heart was full.  

Let's Adventure
Dormant dreams (of mountain adventures with friends) are coming alive again.

The elimination phase of the autoimmune protocol provided a physical, emotional, and mental recalibration. It helped me widen my lens and gain a greater understanding of my relationship with food, movement, and my body. It stripped me raw and was triggering in many ways, but it also helped me rebuild. A few steps back, a few steps forward.

I no longer subscribe to AIP. I no longer subscribe to any dietary regimen (except gluten-free, because autoimmune disease). I am working to better understand intuitive eating and its many principles and takeaways (this podcast series is a great start!). I know what makes me feel good and what doesn’t – sometimes that’s ice cream, other times it’s a salad. I can feel my body inch toward homeostasis – toward its home base, a place of health, nourishment, and vibrancy. If AIP has taught me anything it is that my body knows exactly what it needs at any given moment, and it is up to me to listen.

Listening to my body is akin to running up mountains – it requires grit, grace, patience, and humility. I am feeling like myself again: Fueled, energized, and dreaming up big, audacious goals that excite, inspire, and scare me. This feels right. This feels like home.

The Autoimmune Protocol: Reintroductions

The Autoimmune Protocol: Reintroductions

It’s day 65 on the Autoimmune Protocol (AIP), and this week, I reintroduced black pepper.

It’s been a long road to these reintroductions.

I was nervous. I tried to reintroduce black pepper about a month ago, and had a rough flare that week. Looking back, I wouldn’t say it was the pepper’s fault – I had just returned from my first weekend of travel on AIP, was ramping up my running after a 50K, and was juggling some major life decisions. The environment was not conducive to food reintroductions; however, I was antsy.

First meal with black pepper! Featuring my cacti.

After recovering from that flare, making some additional lifestyle changes, and getting through two weeks of cross country travel, I’m feeling ready for these reintros. There are fewer variables, fewer symptoms, and I’ve been strictly following AIP for two months. I’ve seen incredible improvement in my symptoms. I’m ready. It’s time.

Last weekend, I dug my pepper mill out of my off-limits AIP cabinet, cranked it out for two days, and then waited. It was a major success. Welcome back, black pepper. I’ve missed you.

The world is my oyster with this additional spice. Rotisserie chickens are no longer off the table on a busy weeknight. Every brand of jerky is mine for the taking. Half of my freezer is no longer off limits (the pre-AIP days included pepper with every meal). This… this is glorious.

Reintroductions on AIP are an exciting time.

Today, I’m reintroducing paprika to my diet (largely because, with black pepper and paprika, I can go to CAVA, a Mediterranean Chipotle-style restaurant I have missed dearly).

There is a science to reintroductions; however, I am not directly abiding by that science. I’m using it as a template. In fact, I think the entire Autoimmune Protocol should be considered a template. Throughout this process, I am learning a lot about my body. I’m discovering just how fragile my digestive system is and intimately exploring my relationship with food, the act of eating, and my appearance. The last 65 days have not been easy, by any stretch of the imagination. There have been tears, tantrums, utter defeat, and behaviors resembling that of a four year-old while handling raw liver.

AIP is a template. It is just one season of my healing journey.

It’s important to note that this protocol is just that: a protocol. It is not a diet. It includes an elimination phase and a reintroduction phase. The goal is not to live in the elimination phase forever. The goal is to make the time and space for your body to heal by removing certain foods, and then slowly, methodically and with an open mind, reintroduce those foods and expand your diet. I am seeking health and healing, not a set weight or clothing size. And I firmly believe that a wide variety of foods is necessary both for our physical and mental health. We cannot live in the elimination phase forever. Nor should we.

With that, let’s talk reintroductions.

Sarah Ballantine, the medical biophysicist who created the Autoimmune Protocol, outlines the reintroduction phase well in her book The Paleo Approach. I’ll be combining her methodology with the suggestions and protocol provided by my physician and dietician-nutritionist.

When reintroducing foods, it’s important to maintain a journal of symptoms, especially as some food reactions may seem completely unrelated to the food consumed.

Reactions may include:
  • Symptoms of your disease returning or worsening
  • GI symptoms: bloating, gas, stomachache, changes in bowel movements, etc.
  • Reduced energy or fatigue
  • Food cravings for sugar or fat
  • Pica (cravings for minerals from nonfood items, such as clay, chalk, or sand)
  • Trouble sleeping
  • Headaches
  • Dizziness or lightheadedness
  • Increased mucus production (runny nose, postnasal drip, etc.)
  • Coughing or increased need to clear your throat
  • Itchy eyes or mouth
  • Sneezing
  • Aches and pains
  • Changes in skin (rashes, acne, dry skin, dry hair or nails)
  • Mood changes (mood swings, feeling depressed, anxious, less able to handle stress)

Even just one of these symptoms may indicate a food sensitivity (yes, even mood swings!). Symptoms may occur an hour after the food was consumed all the way up to a couple of days after the fact. You want to limit the variables when reintroducing foods, so do your best to keep your lifestyle the same. If you’re sick, facing a looming deadline at work, or suddenly decide to train for a half-marathon, it isn’t time to reintroduce foods. Remember that any number of factors can cause the above reactions, so do your best to limit the lifestyle factors that may complicate your reintroduction process.

When you’re ready to reintroduce foods (huzzah!), Dr. Ballantine suggests the following protocol:
  1. Select one food to challenge, be prepared to eat it two to three times in one day, and then avoid it for a few days.
  2. First, eat a tiny nibble of the food (a half teaspoon or less). Wait fifteen minutes. Then, eat a tiny bite of the food (one teaspoon). Wait fifteen minutes.
  3. If you have any symptoms, stop! It’s not time for this food quite yet. If you don’t have symptoms, eat a slightly bigger bite (1.5 teaspoons). Carry on with your day.
  4. After two to three hours, monitor yourself for symptoms.
  5. Now, eat a normal-size portion of the food – either by itself or as part of a meal.
  6. Don’t eat the food again for 3-7 days, depending on your sensitivity. Don’t reintroduce any other foods during this time. Monitor yourself for symptoms.
  7. If you have no symptoms over three to seven days, you’re in the clear! Nom away.

For me, I’m going to follow a slightly looser reintroduction methodology, especially as I work my way through the spices.

My reintroduction protocol is more like this:
  1. Select one food to challenge, be prepared to eat it over the course of one to two days, and then avoid it for three to four days.
  2. Eat a meal’s worth of that food/spice – ideally, cook with the spice for a meal and enjoy it.
  3. Monitor yourself for symptoms in the hours following that meal.
  4. If no symptoms occur, eat another meal with that food (in this case spice) either the same day or the following day.
  5. Don’t eat the food again for three to four days. Don’t reintroduce any other foods during this time. Monitor yourself for symptoms.
  6. If no symptoms occur, you may reincorporate that spice/food into your regular diet (boomshakalaka).

When reintroducing foods, it can be hard to decide what to reintroduce first. Some say to reintroduce what you miss the most first. Others, what would add more ease and convenience to your life. Ballantine suggests a set order of reintroductions based on what is most likely to cause a reaction. For me, I’m combining these tactics and creating my own system based on my symptoms and triggers.

Here is Ballantine’s suggested order of reintroductions, as outlined in The Paleo Approach:

Stage 1:

  • Egg yolks
  • Legumes with edible pods (green beans, sugar snap peas, peas, etc.)
  • Fruit- and berry-based spices
  • Seed-based spices
  • Seed and nut oils (sesame seed oil, walnut oil, etc.)
  • Ghee from grass-fed dairy

Stage 2:

  • Seeds (including whole, ground, and butters, like tahini)
  • Nuts (including whole, ground, and butters like almond butter), except cashews and pistachios
  • Cocoa or chocolate
  • Egg whites
  • Grass-fed butter
  • Alcohol in small quantities

Stage 3:

  • Cashews and pistachios
  • Eggplant
  • Sweet peppers
  • Paprika
  • Coffee
  • Grass-fed raw cream
  • Fermented grass-fed dairy (yogurt, kefir)

Stage 4:

  • Other dairy products (grass-fed whole milk and cheese)
  • Chili peppers
  • Tomatoes
  • Potatoes
  • Other nightshades and nightshade spices
  • Alcohol in larger quantities
  • White rice
  • Traditionally prepared legumes (soaked and fermented)
  • Traditionally prepared gluten-free grains (ideally, soaked and fermented)
  • Foods you have a history of a severe reaction to
  • Foods you are allergic to
Since I started this protocol, one thing has become very clear: my lifestyle is my main trigger.

Despite spending 60 days on the protocol, I have caused flares, GI distress, and surges in symptoms solely through my physical activity, stress management techniques, and (lack of) sleep. For me, managing my illness is more so about managing my stress and shifting my mindset and lifestyle than it is about what I eat. I am not downgrading the importance of AIP and eating a nutrient-dense diet – these have been huge in my healing process – however, I know, for me, my lifestyle is the biggest factor in my healing journey. Not my diet. With that said, my process for reintroductions will differ from someone suffering from a different autoimmune disease with different symptoms and triggers.

My Reintroductions Plan

Gang’s all here.

I am going to reintroduce all spices (including the seed-and fruit-based spices and nightshades), followed by eggs and tomatoes and sweet peppers. Nightshades are typically associated with pain, which I have never experienced as a symptom, so we (me and my treatment team) are going to approach these foods first. I am going to avoid all nuts, dairy, and legumes a while longer, as these have caused major GI issues for me in the past.

Rather than create a comprehensive four-stage reintroduction phase, I am taking it one food at a time, and continuing to work to improve my stress management techniques and lifestyle choices.

Want to learn more about the Autoimmune Protocol? Check out my introduction posts and explore the leaders of the AIP community: Sarah Ballantine at thepaleomom.com and Autoimmune Wellness, which provides a wealth of information curated by the powerful duo Angie Alt and Mickey Trescott.

Are you on the Autoimmune Protocol? How are you approaching your reintroductions?

I have a chronic illness, and I am grieving.

I have a chronic illness, and I am grieving.

A friend recently shared her journey through grief in accepting her autoimmune diagnosis and chronic illness. She inspired me to do the same, because I am grieving. In gaining this diagnosis, I lost my health. I lost the life I am accustomed to living. I lost who I am, but then again, maybe I didn’t. 

More mountains, less fatigue, please.

In my last update, I shared my latest adventure: a 50K on the autoimmune protocol. I felt good, invincible even. The week after the race, remnants of my old, energetic self broke through the fog and fatigue. Vacuuming my apartment didn’t exhaust me. I was able to stay focused on a task for more than 30 minutes. My mood stabilized. I felt good.

And then I didn’t.

Symptoms returned.

Getting out of bed became a chore. Food prepping was more exhausting than a long run. Running felt forced and sluggish. My mood resembled an EKG, jolting from joyous to irritable to sullen. My thoughts were scattered and my mind encased in a dense mesh. I had plans. I had ideas. I wanted to get to work. And yet, simply preparing myself dinner felt insurmountable. I slurred my speech (one of my stranger autoimmune symptoms) and lost any sense of balance. My anxiety returned, accompanied by a sense of isolation and deprivation. The life I used to live – an energetic, predictable, fast-paced life – once again slipped through my fingers.

I was in the midst of a flare.

Many things could have contributed to this flare: Returning to my regular training load, racing a 50K, traveling for a conference, reintroducing black pepper, starting thyroid hormone supplementation.  A lot was happening, and I expected my body to keep up. I thought I’d been doing everything right. I took time off post race! I’d been on the autoimmune protocol for 30 days! I was doing acupuncture! And meditation! Surely, I should be healed by now.

Unfortunately, chronic illness does not operate on my timetable.

I cringe at those words, chronic illness. It feels like an overreaction. A plea for attention. Something only a hypochondriac would say. It oozes with high-maintenance and inflexibility. Cool girls don’t have chronic illness. Ultramarathoners don’t have chronic illness. Twenty-something women who eat organic vegetables and use paraben-free shampoo don’t have chronic illness.

And yet, I do. I have a chronic illness. I have an autoimmune disease. My body is destroying itself, forcing me to recalibrate my lifestyle, goals, and choices. My life will never be the same, and I am grieving.

When the weather matches your mental haze.
First, I was in denial.

I received this diagnosis last fall, but it took months for me to acknowledge its severity. I lived in denial, blaming everything but my health for its own decline. After years of being denied this diagnosis, of being told I simply run too much, eat too little, have a “sluggish but normal” thyroid, am too perfectionistic, have too high of expectations, burn the candle at one too many ends, I grew to believe these assumptions. Maybe my expectations were too high. Maybe I was running too much. Maybe this is my fault. Maybe it is all my head. Maybe it is normal to feel this way.

And then I grew angry.

Because it isn’t normal to feel this way. It isn’t normal for a young, active woman to struggle to get out of bed. It isn’t normal to end up in the ER in anaphylactic shock from something you’ve eaten all your life. It isn’t normal to take days if not weeks to recover from a single workout.  

And to feel normal? Hours of doctor’s appointments, countless vials of bloods, an intense dietary protocol bringing me nose to nose with my eating disorder. Weeks of new seemingly unrelated symptoms, things I kept to myself for fear of seeming over-reactive or melodramatic. Sadness. Isolation. Hopelessness. There is no cure for autoimmune disease. There are no easy treatments or ways to address its root cause. Once you develop one, it becomes much, much easier to develop another. You are left, flailing, dozens of supplements in one hand, fingers crossed in the other, waiting for the next unexpected symptom or autoimmune disease to hit.

I’m angry with the many doctors and specialists who provided a misdiagnosis, handed me prescription medications without digging deeper, shrugged off my complaints, or declared every ailment an outcome of “running too much.” I’m angry with society for encouraging me to compare myself with others, to run bigger miles, weigh fewer pounds, collect more accolades, sleep less and do more. I’m angry with the #fitspo movement and feeling inundated with alluring diets, fads, and “self-care” movements that resemble religion.

And, I’m angry with myself. Angry for falling into these traps. For allowing stress and anxiety and perfectionism to consume me until I am left ragged and bare. Vacant and overwhelmed. Always wanting more.

Initially, my denial and anger were intertwined.

While I know I didn’t do this to myself, I do believe my past behaviors and lifestyle contributed to triggering my autoimmune genetics. You can’t develop an autoimmune disease unless you have the genetic predisposition for it; environmental triggers (combined with intestinal permeability) can turn that genetic expression on. I believe my environment turned it on. There are studies linking my particular illness, Hashimoto’s thyroiditis, with food restriction and eating disorders, likely because restriction can wreak havoc on your gut health, adrenals, and hormones. After receiving my diagnosis, I sought control. I sought answers. I wanted someone to blame. So I blamed myself. I have a history of disordered eating and addiction to exercise. I restricted calories for years. I exercised obsessively. I didn’t take care of myself. I caused my Hashimoto’s.

While identifying the root cause of my autoimmune disease isn’t this simple, I found solace in having just one direction to point my finger, especially when that direction was toward myself. I channeled my frustrations, anger, and grief inward, prompting a vicious cycle of self-loathing, criticism, and doubt. It was exhausting.

I am still tired.

I am tired of being tired. Tired of the exhaustion and fatigue. The apathy and instability. The isolation and depression. The sense of deprivation and anxiety. I am tired of feeling unsettled, uprooted, and unsure of myself. But within these flares, within these question, I am finding one answer – my health is sacred. This body is mine, and it is up to me to take care of it. I have an autoimmune disease, and while I can’t control that fact, I can control what I do about it. 

I am learning. I am grieving. And, finally, I am accepting.

I have an autoimmune disease.

I eat organic vegetables, use paraben-free shampoo, run ultramarathons, and have a chronic illness. I’m recalibrating. Each day is an opportunity to shift my expectations, tune in to my body, and practice patience. During this initial phase of healing, my priorities are evolving. My goals aren’t finish lines, heavy training weeks, or big writing projects. They’re smaller: going for a walk, prepping meals for the week, practicing patience and self-forgiveness. I’m moving slower, both physically and mentally. I’m saying no and honoring my limitations. I’m creating space – space to heal, space to grow, and space for this new aspect of my world.

This is my new reality. It is no longer just me. It is me and my autoimmune disease: me and my Hashimoto’s Thyroiditis. Life is changing – it always does – and I’m changing with it.

Doing what I do best: keep moving forward (albeit at a slightly slower pace).

The Autoimmune Protocol

The Autoimmune Protocol

Let’s talk food. Specifically, let’s talk Autoimmune Protocol food.

 

An Autoimmune Disease Diagnosis

I recently shared my Hashimoto’s Thyroiditis diagnosis, and what I’m doing about it. My first line of defense was supplements to combat my body’s inflammation. Next, while I determine my route for thyroid hormone supplementation, I’m working to heal my gut and immune system through an elimination diet called the Autoimmune Protocol.

The Autoimmune Protocol

The Autoimmune Protocol, or AIP, is a refined version of the Paleo diet that focuses on nutrient density and places stricter requirements on what foods you should and should not eat, at least temporarily. Medical biophysicist Sarah Ballantyne created this protocol and dedicates her career to understanding autoimmune disease and promoting healing through diet and lifestyle changes.

Under AIP, foods can be broken down into two groups: those that promote health and those that undermine it. Some foods are pretty self-explanatory: most vegetables, seafood, and grass-fed organ meats are health-promoting, while gluten-containing grains, peanuts, and soy products are health-undermining. Other foods are a little tougher to categorize, such as nightshades, eggs, nuts, and seeds.

The theory behind the Autoimmune Protocol is twofold: by removing all foods that may contribute to inflammation and gut irritation, you promote healing and immune system regulation through nourishing, nutrient-dense foods. Autoimmune diseases are typically linked to four main contributors: nutrient deficiencies and imbalances, poor gut health, hormone imbalances, and an immune system gone rogue. The Autoimmune Protocol removes all foods that may contribute to these triggers and gives your body a reprieve of sorts. Once your symptoms subside, whatever that looks like for you, you can reintroduce foods one at a time and see what, if any, trigger your symptoms.

What to Eat – and What Not to Eat

The Autoimmune Protocol uses the general Paleo diet as a template and builds upon it, excluding all foods that may activate the immune system or irritate the gut. These foods include:

  • Grains
  • Legumes
  • Dairy
  • Refined and processed sugars and oils
  • Eggs
  • Nuts
  • Seeds, including cocoa, coffee, and seed-based spices (Boohiss)
  • Nightshades: white potatoes (but not sweet potatoes!), tomatoes, eggplant, sweet and hot peppers, cayenne, red pepper, tomatillos, goji berries, and spices derived from peppers, such as paprika
  • Alcohol
  • NSAIDS (sorry, Advil)
  • Non-nutritive sweeteners (i.e. stevia)
  • Emulsifiers, thickeners, and other food additives, such as carrageenan in some almond milks and guar gum in some coconut milk products

So what can you eat?

  • All the vegetables! (minus the nightshades): it’s recommended to eat 8-14 cups of veggies per day
  • Fruit, but only 1-3 servings a day to limit fructose intake (unless you’re running an ultramarathon, then you eat all the dried blueberries)
  • Quality meats: grass-fed, pasture-raised, and wild meat as much as possible
  • Organ meat and offal (I’m still a little afraid of this one)
  • Herbs and spices
  • Good, yummy fats: avocado, grass-fed animal fats, fatty fish, olive, avocado, coconut, and palm oils
  • Probiotic/fermented foods
  • Glycine-rich foods: such as collagen peptides, bone broth, and that pesky organ meat
  • Natural sugars, such as maple syrup (thank goodness), honey, and blackstrap molasses (but in limited quantities)

Autoimmune Protocol and Eating Disorder Recovery

This is a little daunting, especially for someone who has a history of disordered behaviors around food. I learned about AIP months ago, when I was first diagnosed with Hashi’s, but I pushed it aside. It sounded too hard and too restrictive, and I was finally to a place where I could go out to eat without dragging guilt, shame, and fear with me. I’ve been gluten-free for seven years (years of GI distress led to a gluten-intolerance diagnosis long ago), but removing everything else (or so I thought) was too much. My eating disorder recovery process was too raw and vulnerable.

But the Autoimmune Protocol planted itself in the back of my mind. In the last month, AIP kept me awake at night, tossing and turning with indecision. I wanted to try it, to give it a fair shot and address some GI issues I’d been having (particularly around tomatoes, bell peppers, chickpeas, and lentils – see a trend?), but I was scared. Terrified. What if this triggered more restriction? What if this awakened a part of me – the disordered, restrictive, controlling part – that I try to keep at bay on a daily basis?

But, what if it didn’t? What if, like the 1,200 scientific studies denote, the Autoimmune Protocol does promote healing and alleviate my symptoms? What if I can address the root cause of my autoimmune disease and put it into remission? What if eating disorder recovery and autoimmune disease healing are not mutually exclusive?

So, I started the protocol. I hid all of my gluten-free flours and pastas, my lentils and grains, even the chocolate and hard ciders in the hardest-to-reach pantry in my kitchen. My many jars of nut butters and seeds are in a bag in the corner of my fridge. I brought all of my random candies and jars of peanut butter to community food table at work. I donated my tomatoes and peppers to friends. I started the Autoimmune Protocol.

Autoimmune Protocol: A Process 

It took three days to not accidentally eat something I wasn’t supposed to (sorry pea milk and Vega protein powder). On day 3, I threw a fit over a plate of uneaten kimchi (it had chili in it). On day 4, I almost cried over (a lack of) pancakes. On day 5 I realized it’d been four days since I had crippling fatigue or extreme mood swings. On day 6 I craved meat and avocado for breakfast and broke through a weeks-long plateau at the climbing gym. It wasn’t until day 7 that I thought I could maybe have a shot at doing this – and then on day 8 I nearly gave up, again.

It has been work. I rarely cooked meat before this (save for eggs), and making sure I have enough food to fuel my adventures and training is no easy feat, with or without the Autoimmune Protocol. While I am learning how to not overcook every animal product I touch, I’ve also had some major culinary successes, including a Valentine’s Day dinner of mint lamb burgers and sweet potato fries, and crowd-pleasing guacamole and plantain chips at my first AIP-era social outing.

I’m figuring out how to meal plan while allowing myself to continue honing my ability to decipher what my body craves and eat intuitively, an important skill to practice in my eating disorder recovery. I’m turning to podcasts and websites and books on healing and the Autoimmune Protocol, including my current favorite Mickey Trescott’s book The Autoimmune Paleo Cookbook and Trescott and Angie Alt’s book The Autoimmune Wellness Handbook.

Tracking the Elimination Phase

I’m committing to at least 30 days in the elimination phase of the Autoimmune Protocol and am keeping a journal of daily symptoms and notes on things such as training, energy levels, my menstrual cycle, and anxiety. I am also setting daily and weekly goals as I embark on my healing. AIP isn’t just about what you eat, it’s also about lifestyle, including adequate rest, addressing adrenal fatigue, and stress management.

In just a few days on the protocol, I am already discovering what foods leave me feeling good (avocado, squash, all sautéed greens) and those that leave me feeling not so great (more than one serving of broccoli, yams, and dates). I’m learning.

I’m also unpacking my emotional ties and relationship with food and eating – and how I can heal and mend this as well as my gut and immune system. Food has so much emotional weight and power – and I’ve found that in this process of resetting my diet, even temporarily, I am also resetting my relationship with food, mealtimes, and the act of eating. Under the Autoimmune Protocol, food is nourishment. It is not a source of guilt or shame, nor is it even a source of a tummy ache (usually). It is an opportunity to provide my body with what it needs, and only that. That is pretty powerful.

This week is my second full week on the Protocol, and my first with an actual plan. This is also the week I race a 50K, on an AIP compliant diet. We’ll see how this goes.

This week’s goals in healing and nourishing:

  1. Prepare more than enough food for my race Saturday, including dried blueberries, maple syrup, roasted sweet potatoes (not the orange kind!), and some post-race bone broth.
  2. Set a bedtime alarm of 9 pm and only hit snooze once (even if Lindsey Vonn is skiing).
  3. Pack real lunches for work each day. And accept that no, I cannot make this up on the fly like I used to.
  4. Find out of the box sources of grass-fed, pasture-raised meat within my budget.

Let’s raise our mugs of bone broth to healing.

When the immune system goes rogue: Hashimoto’s Thyroiditis

When the immune system goes rogue: Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis and Autoimmune Disease

I was covered in mud. Splatters of grime, red clay, and wet dirt speckled well past my running skirt. My shoes, once a deep purple, were a dark brown and squished over the singletrack. My breath was somewhere between labored and controlled, muffled by the steady rain and wind. Arms pumping, legs flying over the rolling terrain, I felt swift. Efficient. Determined. I was alone, running new trails and moving with a power I’d forgotten I have.

In the early miles of this run, I nervously avoided the puddles, toeing my way around the edges of the trail. Now, I barreled through, no longer avoiding the mess, no longer skimping on the opportunity to play.

Puddles, deep mud, and the occasional fallen tree were no match for my stride. My emotions and thoughts fueled every step, creating a cohesive thread of emotional response, mental calculation, and physical movement. This thread pulled me through phases of confusion and grief, anger and frustration, and finally, as I stomped through ankle deep mud, acceptance.

I was recently diagnosed with Hashimoto’s Thyroiditis, an autoimmune disease where the immune system attacks the thyroid. The diagnosis wasn’t necessarily a shock, however, the emotional weight of an autoimmune disease was. This diagnosis is the ankle deep mud. It is the puddle I tiptoed around, in fear of getting my shoes wet. It is unavoidable, unpredictable, and now splattered well past my knees. But I’m done avoiding the mud – I’m done pretending I don’t have an autoimmune disease. I want to heal, I want to play, I want to jump in some puddles.

So, let’s start talking about it. About autoimmune disease, Hashimoto’s, and my path toward healing.

Hashi-whato’s?

Hashimoto’s Thyroiditis is an autoimmune disease where the immune system attacks the thyroid, leading to chronic inflammation and impairing the thyroid’s ability to do its (very important) job. Hashi’s is the leading cause of hypothyroidism in the US – a condition where the thyroid doesn’t make enough thyroid hormones to meet your body’s needs. Researchers aren’t entirely sure why some individuals develop autoimmune disorders such as Hashi’s and others do not. The likely cause is a combination of genetics, environmental triggers and toxins, and intestinal permeability (aka, “leaky gut”).[i] There are also studies linking this particular autoimmune disease with eating disorders.

Over 50 million Americans suffer from autoimmune disease, and of that 50 million, 75 percent are women. Once you develop one autoimmune disease, it becomes much, much easier to develop another. There are more than 80 types of autoimmune diseases, and many have very broad, all-encompassing symptoms, making diagnosis difficult.

In the case of Hashi’s, getting a definitive diagnosis can take years. In my case, it did.

What about this thyroid?

The thyroid is important. This little butterfly shaped organ nestled in the lower front of your neck controls the body’s most basic functions. Its main job is hormone production – thyroid hormones are multifaceted worker bees with too many accolades for a single page resume. They control the way your body uses energy and regulate breathing, heart rate, the central and peripheral nervous systems, body weight, metabolic rate, muscle strength, menstrual cycle, body temperature, and cholesterol levels, among other things. Every cell in your body is impacted by your thyroid hormones.[ii] When you have too much or too little of these hormones, your entire body is out of balance, and you can experience a slew of symptoms, including:

  • Fatigue and sluggishness
  • Trouble tolerating cold
  • Muscle aches, tenderness and stiffness
  • Joint pain and stiffness
  • Muscle weakness
  • Constipation
  • Pale, dry skin
  • Dry, thinning hair
  • Irregular menstrual cycles
  • Trouble getting (and staying) pregnant
  • Excessive or prolonged menstrual bleeding (menorrhagia)
  • Brittle nails
  • Hair loss
  • Acne
  • Trouble sleeping
  • Unexplained weight gain
  • Unexplained weight loss
  • Memory lapses and brain fog
  • Depression
  • Anxiety
  • Vertigo
  • Irritability, mood swings, and mood disorders
  • Nervousness
  • And, apathy, feeling emotionally numb

I am no stranger to these symptoms. I’ve been told to “keep an eye” on my thyroid hormone levels since high school – while also enduring an eating disorder, amenorrhea, and running many, many miles in an attempt to find solace in it all. After years of visiting physicians, nutritionists, gynecologists, acupuncturists, naturopaths, and my fair share of therapists, I finally have an answer (and I finally found a medical provider willing to dig a little deeper). I have Hashimoto’s Thyroiditis (with a side of sub-clinical hypothyroidism). I have an autoimmune disease. I thought I was healthy – and yet, I am not.

What comes with a diagnosis?

I am still settling into the diagnosis. Still working my way through nearly weekly diagnostic tests and doctor’s appointments. Still reading study after study on treatment options. Still learning. Still discovering. Still wondering, how did this happen? Why me?

While I could list the symptoms and share the years of daily struggles and anxieties I can now attribute to this disease, I want to talk about how I am feeling right now, and what I am doing about it.

I am relieved, scared, ashamed, and angry.

I am frustrated, tired, humbled, and overwhelmed.

When I first received this diagnosis, I pretended it didn’t exist. I shoved it under the rug with the fears and anxieties it prompted and assumed everything would be fine. My symptoms worsened, but every time I thought about the diagnosis, I felt sick to my stomach. I didn’t want to deal with it. I didn’t want to face my reality. So I didn’t.

And then things started piecing themselves together.

Symptoms worsened. Energy levels plummeted. I developed a sudden allergy and wound up in the hospital in anaphylactic shock. I shook with full-body chills throughout the winter. My situational anxiety and depression became not so situational. I developed severe cystic acne for the first time. The more I learn about the thyroid and Hashi’s, the more I realize just how much this disease controls my daily life.

Facing reality (and treatment)

Treatment began with a slew of supplements to combat the inflammation. I worked to incorporate more protein into my diet, ate more gut-healing foods, and got over my fear of kimchi. I researched treatment options, committed to routine blood work, and memorized the carpet’s pattern in my physician’s waiting room.

Despite these holistic attempts to combat inflammation, my thyroid hormone levels are still too low, and my thyroid antibodies (the sign of inflammation) are still too high. My symptoms remain, spontaneously shutting my entire system down with fatigue and unexplainable exhaustion. I’m now to the point of needing to supplement my body’s thyroid hormones – and am navigating my options on this front.

I’m committed to holistic medicine and addressing the root cause of this autoimmune disease, rather than solely placing a Band-Aid to mitigate my symptoms. That being said, at this point alleviating my symptoms is one of my top priorities. I am desperate for healing.

Phase One: Diagnosis

So, we’re at phase one: Diagnosis. And in this phase, I’ve struggled. I’ve grieved over the loss of the health I thought I had. Over my lost energy and fire. Over the years of tireless work and struggle to recover emotionally, mentally, and physically from an eating disorder, only to immediately have another struggle placed before me. I yelled, screamed, and kicked at the universe, demanding to know why. And then, I accepted my reality. I ran through the mud.

I am choosing to navigate my healing on my terms, to use this opportunity to learn more about my body and hear its subtle signs and signals. I’m excited to discover what nourishes me, and how I can provide my body the rest, fuel, and (potentially) hormone supplementation it needs.

My first stop? Food. Specifically, the autoimmune protocol. More on that to come.

 


[i] The Hashimoto’s Protocol, by Izabella Wentz 

[ii] The Hashimoto’s Protocol, by Izabella Wentz