managing thyroid disease

I was asked to write a post about my own experience with thyroid disease, since I often mention it here as something that influences my own lifestyle choices. But before I explain my own experiences and thoughts on it, I want to state two things for the record.

This is only my experience and shouldn’t be construed as advice or a judgment on someone else’s experience or the way he/she chooses to handle his/her own disease. I’m not your doctor and I’m not a licensed expert of any kind (unless you count book expert since I have a master’s degree in literature).

I do not believe that all diseases can be cured or even necessarily affected by lifestyle changes. I am not anti-medication and will always encourage people to seek actual medical advice from a legitimate, licensed professional. (And I’m NOT talking about Dr. Oz here, okay?)

About five years ago, at a routine physical with my then-PCP, I mentioned that I’d had great difficulty losing weight even though I was watching what I was eating and exercising, and that I also was experiencing severe hot flashes/night sweats and having major difficulty sleeping. I was fatigued all the time as well (falling asleep on the couch at 6 p.m. kind of fatigued). He told me that “some women just have a hard time losing weight no matter what they do” and that there wasn’t an explanation for these symptoms, but that he’d order routine blood work anyway.

Lo and behold, I had hypothyroidism. He put me on generic thyroid hormone replacement (levothyroxine) and called it a day. So I started taking it and saw no relief, which led me to my first endocrinologist.

I am now seeing my fourth endocrinologist (who is fantastic and someone I plan on seeing until either one of us isn’t in the area anymore). That will give you an indication of how difficult it’s been for me to find real relief and support.

Throughout the few years that I was seeing other endocrinologists, I was misdiagnosed as being pre-diabetic (and took Metformin unnecessarily for almost a year, which was a total nightmare) and was also given different dosages of three different meds – generic levothyroxine, Synthroid brand levothyroxine, and Armour (synthetic porcine (pig) thyroid that includes T3). I was also made to feel like my symptoms made no sense, and therefore shouldn’t exist. I was also forced into the clinical “normal” range for my TSH (level of thyroid stimulating hormone produced by the pituitary gland) regardless of whether or not that was my body’s normal and told to just deal with the symptoms.

During that time when I was receiving no support whatsoever from the medical professionals I was seeing, I started to do my own research on behavioral/lifestyle modifications that might give me some relief. I realized that I had to take my health into my own hands and wanted to feel like I was doing everything that was within my own control to get relief. It was around that same time that I started to learn more about our industrial food system and its impact on health. Things started to make sense, and I decided to make changes in my diet.

I started small by eliminating soda and then moved to artificial sweeteners all together. I began to phase out unhealthy processed foods and then eventually moved to any hyper-processed foods, even if they were supposedly “healthy.”

Why? Because having a disease that creates chaos in my body’s levels of its own hormones and chemicals means I don’t need to add to that chaos by ingesting chemicals, many of them with unknown properties. To me, that’s common sense.

Did my symptoms disappear? No. But they were lessened, and I also noticed a dramatic shift in my energy levels, no longer being dependent on caffeine and stimulants in food for energy. When I felt good, I felt really good.

Later, I took a nutrition and fitness combination class called Project Jumpstart and I began to exercise. Exercise was something I had never incorporated into my life in any meaningful way, partially because I was so utterly exhausted. (This is a big way that hypothyroidism contributes to weight gain – it doesn’t necessarily make you gain weight, but it makes your metabolism so slow that you don’t have any energy to work out.) I started with a little bit at a time, and almost two years later, I’m about to run my first half marathon and I’m in the best shape of my life. Exercise has great energy benefits as well, and I notice my body feeling sluggish when I get out of my routine.

I also take the brand name thyroid replacement hormone, Synthroid. I take the brand because it’s recommended for people who need to have the exact same fillers with each dosage. When you take a generic pill, the fillers and dyes are different for each company that makes it and you don’t know what your pharmacy will be carrying from month to month. So for consistency’s sake, I take the brand. I have seen much better results with the Synthroid than Armour or the generic levothyroxine.

Essential to this entire thing is my new endocrinologist, who supports me keeping my TSH at a level where I have less symptoms. She also supports my own lifestyle changes with food and exercise, and helps me with other solutions for some of my symptoms, which she believed were triggered originally by my thyroid when the TSH was really high, but then continued even when the TSH came down (trouble sleeping and gastrointestinal difficulties).

In particular, she recommended a sleep therapy workbook that has really re-trained my brain to know how to sleep and rest properly, and I continue to use it to control my insomnia. It’s essential to find a doctor that listens to you and your needs, trusts that what you tell them about your symtpoms and your body is true, and wants to commit to helping you feel well, even if it means they spend 30 more minutes with you. 

My plan of attack for thyroid disease now consists of the following:

– Seeing my endocrinologist regularly and getting regular bloodwork to keep a close eye on my TSH
– Eliminating processed foods and hormones in meats as much as possible
– Reducing exposure to chemicals in household products that have been clinically shown to be endocrine disruptors
– Guarding my sleep and following the behavioral modifications to keep the insomnia under control

I hope that gives some insight as to how I manage my own disease. Leave any questions in the comments – it’s always good to share experiences!

Book Review: Salt Sugar Fat by Michael Moss

Salt Sugar Fat: How the Food Giants Hooked Us by Michael Moss is probably the best food book I’ve read this year, and definitely ranks up there with the best food journalism that’s available today. For anyone who has ever craved an Oreo cookie or loved Lunchables as a kid and now is skeptical about the health of processed foods, this book is for you. (Also, if you recognize any of the letters on the book cover from the packaging of foods you eat or have eaten in the past, you should read this book. Very clever graphic design.)

I went into this book thinking that the writing would be great, since Michael Moss is a Pulitzer Prize winning writer. (Spoiler alert – it was.) I also thought I’d enjoy it because I am passionate about people being educated on what’s in their food. And I definitely did. But I didn’t expect to learn so much that was new – and also to realize how much of my life I spent not just as a marketer’s target customer, but as their pawn in the relentless pursuit of profit over any other priority.

The book is divided into three sections, each discussing one of the pillars of processed foods. Moss goes back to the beginnings of processed foods and investigates how the foods developed over time. Many large food producers today started out as small, family-owned companies, with the owners committed to using natural or real ingredients. Even large companies were afraid at first to sell products with chemicals in them because they were afraid of the public’s reaction. The book discusses how we got from that point to where we are today, with Americans eating way too much of all three building blocks of processed foods.

I found the discussions about our tastes and the science behind that to be fascinating. Babies are not drawn to salt – in fact, they are repulsed by it. We are all born with an innate like for sweet and a dislike for excess salt. Studies have shown that exposure over time to sodium in processed foods for babies leads to the development of a taste for and eventual craving for salt that otherwise would not have been there. Also, if you reduce your salt intake for just a few months, your taste for salt will reset and you will likely not enjoy the level of saltiness in your food that you once did. 

There are so many details in this book that are worth knowing that I couldn’t possibly list them all here (and it would deprive you of a great reading experience), but perhaps the greatest lesson I took from this book was to be very aware of the power of marketing and to never take products at face value. Processed food manufacturers (including the ones that make processed “health” foods) have a vested interest in making you come back for more. Bet you can’t eat just one isn’t just a marketing slogan – it’s a call to action for them. 

They manipulate the content of foods to make them craveable and addictive, lighting up the same parts of the brain that are receptive to drugs. And then market them as something positive that plays on our desire for happiness, convenience or health. Every marketing or health claim is designed to play off one of those needs. Want a cereal that has less added sugar? Jack up the sodium and/or fat and then put “less sugar” as a marketing label on the box. Want a low-fat frozen lunch? Jack up the sodium to more than twice the daily recommended amount to make up for the lack of flavor. 

People want to feel like they are making good choices for their families, and that’s admirable. But marketers and food manufacturers know that, so they use that desire to their advantage. Moss details companies who were sued for misleading health claims that helped sales to skyrocket but were empty of any truth or real benefit to the consumer. After reading this book, you feel like the processed/industrial food world has played you for a fool.

The good news is that educating yourself about the content of your food and what labels and package claims really mean can help you stop playing into their hands. This book is a great place to start if you’ve been thinking about moving your diet away from processed foods. (By diet I mean the foods that you eat, not diet in the “weight loss plan” sense.) 
Also, I should note that I don’t believe that eating one Oreo cookie with chemicals in it is going to doom you to bad health. But for me? I feel better in general when I avoid processed foods, and I know that I have never in my life eaten just one Oreo. And I also feel better knowing that my money goes to farms or food producers that are making their best efforts to produce healthy food, or non-healthy food that’s transparent about what it is. I don’t want to give my money to companies that know that what they produce makes people unable to stop eating and to prey on their weaknesses. Corporations are not people (regardless of how the government likes to classify or treat them) and their motivation is profit, not our well-being. And that’s what I try to keep in mind when I shop.

i used to be a diet coke junkie

I’ve written before about why I won’t consume sports drinks, even during long races. And it’s pretty obvious to anyone that I’m not a fan or a consumer of processed foods in general. But this wasn’t always the case. If you opened the cupboard door in my first apartment 8 years ago, you would see a vastly different array of products than in my pantry today. Boxed meals and processed snack foods, not much resembling a “whole food” at all. But what really stuck out, in my tiny galley kitchen, was the stack of Diet Coke cases against the wall. 

I actually didn’t drink a lot of pop growing up (and I obviously grew up where we called it pop and not soda). I didn’t even like cola until I was a teenager. And when I started working at McDonalds and the only thing that was free was pop, I began to drink a lot of regular Coke. That only lasted for about a week, as I quickly overloaded on the sugar and decided to give the diet version a try. And from that day, for the next 10 years, I was addicted to Diet Coke.

When I say addicted, I’m not exaggerating. I drank the equivalent of 6-8 cans of Diet Coke a day, either at work from the fountain or in cans in my dorm room or later, apartment. I quickly became addicted to the caffeine, especially because I also took up a coffee habit in college. By graduate school, working and going to school at the same time, I was drinking 40 ounces of coffee and more than 72 ounces of Diet Coke every day. If I was thirsty, I drank Diet Coke. I rarely drank water. 

When I’d randomly go on diets after gaining bits of weight here and there, Diet Coke was a staple. Zero calories! It was one thing I never had to “give up” and there were times I honestly craved feeling an icy cold can in my hand and hearing the click of the open tab and the bubbles. You know those commercials where someone opens a can of soda and a ton of fun starts? That’s almost how I looked at it, as embarrassing as that is. I couldn’t wait for the burn of the first cold sip. 

Also during the time I was a heavy consumer of Diet Coke, I suffered from pretty severe migraines. I thought it was the stress of college, graduate school, work, etc. and I saw a neurologist regularly and was on special migraine medication. Never once did the doctor ask me about my eating or drinking habits. So I medicated rebound headaches which I attributed only to caffeine withdrawal, and I kept on glugging. 

After we watched Food, Inc., Mark and I started changing our eating habits. We started sourcing meat, dairy and produce differently. We cooked more and more and we cut out processed foods and investigated nutrition labels closely before we made purchases. Except for Diet Coke. I just couldn’t give that up. It was one thing I really wasn’t willing to part with, justifying my consumption because it was calorie-free. 

It might have been the studies linking diet soda and depression. Or the fact that aspartame, the sweetener in Diet Coke, has been linked to cancer and premature birth. It might have been the fact that we were spending a lot of money every week on Diet Coke (generic would not do). But one day, I just decided to stop. I replaced some of the caffeine with tea or coffee in the mornings, but not all. I started drinking water.

And I haven’t suffered from a severe migraine since. After noticing a distinct rise in my energy levels and also a decrease of cravings for sweet foods, I cut out all artificial sweeteners entirely. I now look back and can’t believe that a beverage had such a hold over my body (and my wallet). I was a marketer’s dream come true and I played right into their hands, falling for all of their lies hook line and sinker.

It didn’t help me lose weight. In fact, I’ve lost more weight since I gave up soda and artificial sweeteners than I ever did when I was addicted to Diet Coke. It gave me headaches and gave me cavities. (Thank goodness I didn’t get to this point. Warning – it’s disgusting.) And I was consuming something with questionable health risks. Was drinking Diet Coke now worth developing cancer later? Of course if I’m someday diagnosed with cancer, I won’t necessarily know what caused it. But I can at least have the peace of knowing I eliminated a known risk factor. 

If you are a regular consumer of diet soda (or really any soda), I’d challenge you to give it up, even for just a few weeks. I would venture to guess you’ll notice a change in how your body feels (and you’ll save yourself some money too). 

this race brought to you by sugary chemical water?

Since taking up running in early 2012, I’ve participated in my share of races and adventure/obstacle races. Every race I’ve done, from the small community 5Ks to large races that draw thousands of participants, has had some sort of electrolyte-enhanced sports drink available post-race. I’ve never been tempted by sports drinks because of the taste. My mind associates them with sickness, since I would drink them during bouts of stomach flu when I was a child.

This weekend, Mark and I participated in Mud on the Mountain, a 7.7 mile, 26 obstacle race at Seven Springs Mountain Resort in the Laurel Highlands.  Gatorade was one of the sponsors, with its logo on the start and finish line banners. 

These photos aren’t the greatest quality. It was foggy, raining, and I was about to run up a mountain.

But who owns Gatorade? Pepsi.

What’s a race without giant bottles of soda? Should have made one of the obstacles carrying these up the mountain.

Along the course there were hydration stations with Gatorade (in Gatorade cups) as well as water. The Gatorade logo was everywhere. 

I also participated in the Pittsburgh Marathon the previous week, running on a relay team. Gatorade was also a sponsor of that race, and the hydration stations gave a choice of lemon-lime Gatorade or water. 

So what’s in Gatorade? The first thing I notice when I look at the nutrition label is that the traditional bottle is actually 2.5 servings. Most people drink the 20 ounces in the bottle, as opposed to pouring 8 ounce servings. For the lemon-lime flavor, which was the flavor available at the marathon as well as Mud on the Mountain, if you drink a serving, you get 14 grams of sugar. If you drink a bottle, you get 34 grams of sugar. 

Turns out you also get a lot more. Here is the list of ingredients, according to the company website: WATER, SUCROSE, DEXTROSE, CITRIC ACID, NATURAL FLAVOR, SALT, SODIUM CITRATE, MONOPOTASSIUM PHOSPHATE, GUM ARABIC, GLYCEROL ESTER OF ROSIN, YELLOW 5.

Water, that’s good. Sucrose and dextrose are sugars. Sucrose is table sugar. Dextrose is similar to sucrose, but has a higher glycemic load, which means it can give you a boost of energy, but the crash afterwards is higher, so it is usually tempered with sucrose. Citric acid is a preservative and also gives some flavor (along with the listed unknown “natural” flavors). Salt provides flavor and also sodium (an electrolyte). Sodium citrate is a salt of citric acid and provides some flavoring. Monopotassium Phosphate provides another electrolyte (potassium) and also acts as an emulsifier and pH buffer. Gum arabic is a stabilizer, an additive that has replaced brominated vegetable oil in drinks recently, since Gatorade changed its formula in response to a petition. And finally, Yellow #5 (tartrazine) which is a synthetic food dye derived from petroleum. Yes, petroleum. Tartrazine/yellow #5 is required to be listed on labels even when used in small amounts due to health concerns about allergies or intolerance. 

And that’s what’s in lemon-lime Gatorade. I don’t know about you, but I’m not super interested in a petro-chemical, synthetic sugar water in the name of health and fitness. It’s basically glorified soda. 

But what about athletes? Don’t we need electrolytes? Electrolytes are minerals (like calcium, chloride, magnesium, phosphorous, potassium and sodium), and they affect the amount of water in your body, your muscle function, and other important processes. You lose electrolytes when you sweat. You must replace them by drinking fluids. 

The American College of Sports Medicine recommends sports drinks to replenish these electrolytes. That’s no big surprise, considering they have financial ties to Gatorade (British Journal of Sports Medicine). We’ve recently seen a lot of hoopla about nutritionists and health professionals teaming up with and having their meetings sponsored by large food companies, and the sports drink industry is no exception.

The fact remains that for most people, water is all you need to stay hydrated and balanced because you need to work out for 3 hours or so before you need to replenish electrolytes. Research is sketchy that sports drinks improve performance and much of what exists is industry-funded. People were running marathons and excelling in athletic competitions long before Gatorade existed. 

If you are doing high-intensity exercise and you really sweat or feel like you need to replenish, go for electrolyte-enhanced water. It’s water with the appropriate minerals added back in after distillation, but none of the other garbage. I drink this type of water sometimes during intense workouts and seem to feel less light-headed afterwards, though I acknowledge that it could be the placebo effect. (I don’t like the taste of our tap water, which usually has a small amount of electrolytes naturally.) Get your carbs from a healthy diet and you won’t need the sugar water boost of Gatorade.

I am appreciative that races and events like this encourage people to be fit and active. I love participating in them and love the motivation they give me to keep at my fitness goals. And I do understand the need for these events to have sponsors, since they cannot generate enough revenue to produce them on registration fees alone. But in a dream world, the events wouldn’t have to promote sugary, chemical-laden junk, either. 

On Saturday, I ran (okay, hiked) up this mountain:

And three hours later slid down this (yes, that is snow and ice in May):

And crossed the finish line without being dehydrated. Muddy, wet and disgusting with my bib number hanging on by a thread? Yes. But I was Gatorade free and pretty proud of it, too.

Book Review: Twinkie, Deconstructed by Steve Ettlinger

Ever since I got my first taste of food journalism with Michael Pollan’s The Omnivore’s Dilemma, I’ve been an avid reader in the genre. I’ve always felt like the more knowledge I have about my food, the more I understand the world and how it works. So I’ve decided to share my thoughts on the food books I’m reading. (To be fair, I’m not actually reading these books so much as listening to them – I use my substantial commute to fit in my non-fiction reading.)  


I stumbled on Steve Ettlinger’s Twinkie, Deconstructed when I was searching for a book on Amazon, and it was listed as a similar book. Its subtitle is My Journey to Discover How the Ingredients Found in Processed Foods Are Grown, Mined (Yes, Mined), and Manipulated into What America Eats, and it is exactly that. For detail nerds like myself, the book provides a wealth of information on the origin of each of the individual ingredients of a Twinkie. Since many of these ingredients are the quintessential building blocks of processed foods, they are things that are not unique to Twinkies, and also not entirely unique to our own pantries. For example, baking powder is technically a processed food, as is white flour. 

However, this book will also tell you where polysorbate 60, high fructose corn syrup, sodium stearoyl lactylate, and partially hydrogenated soybean oil come from. (The book begins with a conversation that the author had with his children about where the ingredients in an ice cream bar came from. He ended up choosing Twinkies to investigate, since they are a classic American snack food and also are the subject of a great mythos, with rumors about their abilities to survive a nuclear holocaust alive and well.)

At first I thought, why do I care where these ingredients come from? If they aren’t pronounceable and I don’t already know what they are, I don’t want to eat them. But the more I listened/read, the more I realized that it IS important for me to understand the ingredients that I choose to avoid in my diet, if for no other reason than to explain to people why I’m not comfortable ingesting them.

If anything, this book made me yearn for more transparent information about where our food comes from. Even Ettlinger admits that the FDA guidelines are not as clear as the Chicago Manual of Style. Why not? We do we not demand more of our government that is charged with protecting our food supply? This is the argument that’s at the heart of the GMO labeling debate, though that’s another topic for another time.

Ettlinger asks the question, if chemicals are found in nature, when does a chemical become a food? Why are some chemicals found in nature classified as “unnatural” when they occur in nature, in some form? That’s a good question too. Shouldn’t we just admit that all food is made of chemicals and just get on with it? Even an apple is made up of chemicals, at its root.

Somehow I’m not buying that argument, though. The entire world is made up of chemicals – so are our bodies. But that doesn’t mean everything should be ingested. The book suggests that these ingredients have been vetted for safety, since the government classifies them as “generally recognized as safe.” Generally recognized isn’t a category that I’m going to put my faith in, when the only people that have to recognize the ingredient as safe are the ones who are being paid by companies who stand to make a large profit from this recognition.

Also, just because these ingredients have been around for 50 years doesn’t mean they are “safe.” Sure, eating a Twinkie may not cause you instantaneous distress or illness. But what about long term effects? Why can’t science explain why our society just keeps getting sicker and sicker? Why can’t they explain why there are little girls developing breasts at age 6 and why autism is so much more prevalent than it was even 20 years ago? Why is it “paranoid” of me to be skeptical of eating a snack cake that doesn’t really even fit the standard definition of cake?

Ettlinger’s reporting of the details of the component parts of Twinkies is certainly impressive, especially in an industry known for secrecy. But I didn’t really see the book as a compelling argument for why one should eat a Twinkie at all. At the end of the book, he describes the experience of eating a Twinkie, obviously from the perspective of someone enraptured by its taste, texture and nostalgia as opposed to someone like me, whose gag reflex is activated by the chemical, fake taste of Twinkies and the like.

But I couldn’t help but wish that after all his investigations and the knowledge of what’s IN those finger-sized spongy treats, he would have ended up a skeptic too.

Full disclosure: I will admit that when Hostess announced its bankruptcy plans last year and the Great Twinkie Rush of 2012 was on, I had Mark pick up a Snowball for me, since I had never tried one and feared I was missing out. (I think I watched The Mirror Has Two Faces too many times.) One bite and I knew exactly why I don’t eat them. Gross. I think I had to scrape my tongue.