Thyroid Antibodies: Why Test?

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Thyroid antibody lab tests are tests often overlooked by physicians when checking for thyroid disease. This is unfortunate because when caught early, the amount and length of time the thyroid is being attacked could be decreased. If you are interested in learning more about thyroid health, click here for my last post. Hang with me here and we will talk about why thyroid antibody tests are important and if you should have yours checked.

What are Antibodies?

An antibody is a protein made by plasma cells in response to an antigen, or a substance the body thinks is a “bad guy”. Each antibody can bind to only 1 antigen in order for the immune system to attack and destroy that antigen. So, obviously, thyroid antibodies set up an attack on the thyroid gland, each one in a different way.

Anti-thyroperoxidase (TPO) antibodies are the most common and are associated with Hashimoto’s Thyroiditis along with anti-thyroglobulin (Anti-Tg) antibodies. Thyroid Stimulating Hormone (TSH) Receptor (TSHR-Ab) antibodies are associated with Graves’ Disease.

Did you know that thyroid antibodies can be present before other thyroid hormones are out of “normal” range?  

So, if I ask you if you’ve had your thyroid labs check and you are like, “yep, my doctor says my thyroid is good”, it is usually only a TSH level that is checked. This lab test can only give us a small picture of what is going on with the thyroid or maybe not tell us anything at all. Antibodies can be present for years before we see a change in the TSH level. This is super frustrating because if antibodies are present, they can slowly destroy the thyroid over time. This will eventually cause the thyroid to not be able to produce hormone efficiently, then causing the change in TSH.

Thyroid antibodies can produce symptoms even when there is no hypothyroidism detected. Symptoms can include fatigue, anxiety, depression, weight gain, general poor feeling and potential for miscarriage. So no, you are not crazy when you tell your doctor you think there is something else going on even though your labs don’t show it.

Thyroid antibodies with a normal TSH can be an early warning sign of Hashimoto’s Thyroiditis, an autoimmune disease. It is estimated that 90% or more of those with hypothyroidism have Hashimoto’s disease. But, not all of those with Hashimoto’s will have elevated antibodies and will need a thyroid ultrasound if symptoms persist. I am one of the few with hypothyroidism and not Hashimoto’s. If there are antibodies present and an elevated TSH, Hashimoto’s is likely in the later stages.

Why are doctors not testing antibodies?

After reading the information above, you may be asking this same question. Right? Many general medicine practitioners don’t think that an autoimmune disease can be treated and reversed. Therefore, there is no need to know if antibodies are present because it doesn’t change their treatment plan. The root cause doesn’t really matter. They will treat the thyroid if the labs show that it makes sense. Or, if they are aware of autoimmunity, they want to suppress the immune system causing more problems and side effects.  

If I have antibodies will I always have antibodies?

There is no cure for autoimmune disease. Once autoimmunity is present, there is always a potential for your immune system to attack your own cells causing problems. There is, however, a way to support the immune system, reverse or decrease autoimmunity and prevent further attack on the body. Nutrition and lifestyle play a large role in supporting the immune system and this topic deserves multiple blog posts! And, just so you know, I care about the root cause and it does matter!

Antibody levels will change in response to underlying causes, like stress, food sensitivities and infections. It is important to also look at the big picture of how you are feeling. If you have antibodies, it is great to have them checked occasionally with your other labs because it can tell you if your interventions are working or if you are maybe having a flare up and need to try something different.

Who should have thyroid antibodies tested?

If your doctor is already doing blood work to check your thyroid health, I recommend asking for a full thyroid panel, which will include antibody tests. It is great to get these labs done and see the full picture from the start. If this isn’t being done, here are some reasons you may want to ask for thyroid antibody tests:  

  • You have another autoimmune disease like celiac disease, multiple sclerosis, Sjogren’s, etc. Once you have an autoimmune disease, you are 3x more likely to develop another one.

  • You have classic symptoms of a thyroid issue but your TSH continues to come back in the “normal” range.

  • You have a close family member with an autoimmune disease, especially Hashimoto’s or Graves’ disease.

  • You’ve been diagnosed with hypothyroidism or hyperthyroidism but have not had antibody tests done.

Antibodies can be an important piece of information when we are looking at thyroid health and thyroid diseases. They do matter and they can be decreased with immune system support. Antibodies can be present long before the thyroid is showing signs of attack and decreased function. As always, be aware of symptoms and be diligent in finding a doctor who will listen to you.

In health,

Lin

Thyroid Awareness Month: What You Should Know

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January is Thyroid Awareness Month so I wanted to bring a little more awareness to this growing group of diseases and overall thyroid health throughout this month. Have you ever heard of thyroid disease? Do you know what your thyroid is and what it does? Did you know that Hashimoto’s Thyroiditis is one of the most prevalent autoimmune diseases? In this post I’ll talk more about the thyroid gland, thyroid diseases, thyroid testing and and why it is all important.

I wish I had known way more about thyroid health much sooner than when I was diagnosed with hypothyroidism. The more I’ve learned and read about hypothyroidism, the more I’m convinced it started after my pregnancy, which was 8 years prior to my diagnosis. I dealt with postpartum depression as well as some other bouts of depression, anxiety, stubborn weight that doesn’t come off easily, thinning and dry hair, and mood issues. I still deal with some of these occasionally but it’s so much better than it was. You can read more about my story in this post. Determination to figure out how to feel better is what drove me toward integrative and functional nutrition, especially working with others with thyroid disease.

According to The American Thyroid Association, more than 12% of the American population will develop a thyroid condition at some time in their life. That is about 1 out of every 8 Americans, with women being 5 to 8 times more likely to develop thyroid disease. But, they say that up to 60% of those with thyroid disease are unaware of their condition. That is a very large percentage! Undiagnosed thyroid disease can lead to many health problems including cardiovascular disease, osteoporosis and infertility. That is why thyroid awareness is so important!

What is the Thyroid Gland?

The thyroid is a butterfly-shaped gland in the middle of the neck that produces hormones. It plays a major role in metabolism and growth and development. It controls our body temperature, how efficiently our body burns energy, and our menstrual cycles just to name a few. Basically, thyroid hormones affect every cell and organ in the body.

The thyroid gland produces thyroid hormones T3 (triiodothyronine) and T4 (thyroxine or tetraiodothyronine). The body needs more T3, the active form, but produces more T4, which must be converted into T3. There is a potential of underlying causes not allowing proper conversion of T4 to T3, which can cause hypothyroid symptoms.

Then there is thyroid stimulating hormone, or TSH, which is produced by the pituitary gland. Its job is to signal the thyroid to release hormones, which will depend on the amount of hormones already circulating in the blood. It all needs to work together properly for optimal thyroid function.

What is Thyroid Disease?

There are different types of thyroid diseases where too little or too much thyroid hormone is produced. There are also autoimmune thyroid diseases that attack the thyroid gland. I’ll briefly discuss hypothyroidism, hyperthyroidism, Hashimoto’s Thyroiditis and Graves’ Disease.

Hypothyroidism is where the thyroid gland does not produce enough thyroid hormone, or is underactive. It is much more common than hyperthyroidism. Symptoms of hypothyroidism include weight gain, sensitivity to cold, fatigue, brain fog, anxiety, depression, constipation, dry and brittle fingernails, loss or thinning of hair, irregular menstrual cycles, edema and puffiness, joint aches, and trouble sleeping. I suffer(ed) from many of these symptoms and didn’t realize they were all related.

Hyperthyroidism is an overactive thyroid or where the thyroid produces too much hormone. Symptoms include unexplained weight loss, rapid heart rate, excess sweating, irritability, and shaky hands.

Hashimoto’s thyroiditis is an autoimmune disease, meaning the immune system attacks its own healthy cells. With Hashimoto’s, the immune system attacks the thyroid gland and produces antibodies against the thyroid eventually causing the thyroid to not produce hormone properly. It is estimated that around 90% of those with hypothyroidism have Hashimoto’s.

Graves’ Disease is also an autoimmune disease, where the immune system attacks the thyroid gland. The antibodies produced in Graves’ Disease cause the thyroid gland to grow and produce too much thyroid hormone. It can also cause problems with the eyes, called Graves’ Ophthalmopathy.

What Tests Detect Thyroid Disease?

TSH (thyroid stimulating hormone) - This is the most common thyroid test run when checking for thyroid function. The lab range is controversial. Most functional medicine doctors looking for a lower number than conventional medicine ranges for optimal symptom improvement.

Free T3 - the amount of T3 hormone circulating in the bloodstream

Free T4 - the amount of T3 hormone circulating in the bloodstream

Reverse T3 - produced from T4 but blocks the action of free T3 so it can not be used.

The following antibody tests are used to diagnose autoimmune thyroid disease.

TPOAb - thyroid peroxidase antibody

TgAb - thyroglobulin antibody

A full thyroid panel should include all of these tests. The reverse T3 may be an add-on test and not included in the panel.

Takeaways

With as many as 60% of Americans unaware that they have a thyroid disease, it is important to be aware of symptoms and to have a regular screening done by your physician. Many women present to their doctor with symptoms of a thyroid disorder but are referred to other specialists or are treated for their individual symptoms rather than looking at the thyroid. If you are like me, you don’t even realize that the thyroid can be to blame.

If you aren’t sure if your doctor is checking any thyroid labs when you do blood work, ask. If you aren’t sure if your doctor is running all of the appropriate thyroid labs, ask. If your doctor is dismissing your symptoms or prescribing medications for your individual symptoms, find a second opinion and someone who will listen. Know your body, know your symptoms and take control of your health.

Comment below on anything you’d like to know more about with thyroid health. Want to learn more about what I do? Schedule a free call here.

In health,

Lin

Almond Flour Banana Bread Muffins

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Muffins! Banana bread muffins that are gluten-free, made with almond flour, so perfectly moist and melt in your mouth! They are like little love muffins. I added a little candied pecan on top for some extra yum. I was originally working on a banana bread recipe (which you could totally do with this), but I love muffins and so here you have it.

Muffins are just so easy. You take one, break it in half, spread all the butter or peanut butter in the middle and you are set. Maybe grab one for breakfast on your way out the door or pack one in your lunch for a little sweet treat. Or, you eat them in one bite if you are like my husband.

I have been baking and cooking with almond flour for over a year now and I love all of the different things I can do with it. I have been looking for almond flour recipes and using it to create my own recipes because a lot of my clients can have almond flour. It is only 1 ingredient compared to a gluten-free 1:1 flour, which contains at least 5 ingredients. I have used it for cookies, muffins, breads, pizza crust and pot pie.

Almond flour is made of finely ground blanched almonds. It is lower in carbohydrates than wheat flour, coconut flour or other gluten-free flours and is a good option if you are grain-free. It is a good source of vitamin E, manganese, iron, magnesium, potassium and calcium.

These almond flour banana bread muffins are lightly sweet with, of course, the bananas as well as a little applesauce and maple syrup. I love the cinnamon flavor in them and I think you will too.

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Recipe

Almond Flour Banana Bread Muffins

Gluten-free, grain-free and lightly sweetened.

Makes: 12 muffins

Ingredients:
  • 1/2 cup pecans
  • 3 eggs
  • 3 ripe mashed bananas
  • 1/8 cup natural applesauce
  • 2 Tbsp pure maple syrup (1T for candied pecans and 1T for muffins)
  • 1 tsp vanilla
  • 2 1/4 cups almond flour
  • 1/4 cup coconut flour
  • 2 ½ tsp cinnamon (1t for candied pecans and 1 1/2t for muffins)
  • 1 tsp baking soda
  • 1/2 tsp sea salt

Instructions:
  1. Preheat oven to 350 degrees.
  2. Line muffin tin with muffin liners.
  3. For candied pecans(optional): toast pecans in pan over medium heat for about 5 minutes, stirring to prevent burning. Add 1 Tbsp maple syrup and 1 tsp cinnamon and stir to mix. Remove from heat. When cool, chop into smaller pieces.
  4. Whisk eggs in medium bowl. Add mashed bananas, applesauce, the other Tbsp maple syrup and vanilla. Mix well.
  5. Mix dry ingredients in mixing bowl. Add wet ingredients and mix until incorporated.
  6. Fill muffin cups until almost full. Top with chopped candied pecans.
  7. Bake at 350 for 20 minutes or until toothpick comes out clean.
  8. Allow to cool before removing from muffin liners.
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There are a few possible substitutions that would work in this recipe. If you don’t have coconut flour, you can leave it out. I’ve made it without but it will be a little more “mushy”. You could use honey in place of maple syrup. You could leave the applesauce out if apples bother you. Don’t like cinnamon? Leave it out. Maybe add walnuts or chocolate chips before baking? I always like to give you some options.

However you decide to make them, I hope you enjoy these muffins! As always, let me know what you think when you make them. What is your favorite gluten-free flour to use when baking?


Inflammation: What You Need to Know and How to Reduce It

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Inflammation is a word that gets thrown around a lot in the nutrition world. Maybe you’ve heard of inflammatory diseases or an anti-inflammatory diet? I was pretty unaware of inflammation until it affected me. I first found out about my inflammation about a year ago after tests run by a functional medicine clinic. I started going there because of some problems I was having that I couldn’t figure out. My inflammatory marker, CRP, was high and I was also having insulin resistance, which goes hand-in-hand with inflammation. I was completely shocked that I was dealing with insulin resistance but it was starting to make much more sense. There were things happening in my body causing problems that I didn’t know about. That’s just my story but it also may sound a lot like your story.  

So, what exactly is inflammation and how does it work in our body? There is a lot of information when it comes to inflammation and it can be very sciency! Is that even a word? Yep, pretty sure it is. Let’s break this information down to help make sense of it. And, just the juicy tidbits instead of all the blah, blah, blah stuff. I personally like the blah, blah, blah stuff but I’m a geek.

What is Inflammation?

Inflammation is the body’s natural immune response to a stimulus, usually to protect itself from harm. Inflammation can be good and bad, also known as acute and chronic. Acute inflammation happens when we get a cut and our body sends out the defenses to heal the wound. This is good and is shorter in duration. We need inflammation to survive. Chronic inflammation happens when our immune system is consistently in the “on” switch causing a release of chemicals that cause damage leading to disease. This is bad and long term. Chronic inflammation is responsible for pain and tissue destruction in disease.

What Causes Inflammation?

In working to figure out how to calm chronic inflammation to heal, we must understand the causes of inflammation. According to integrative and functional Dr. Mark Hyman, the list of causes isn’t very long. His list of causes of inflammation:

  • Poor diet: mostly sugar, refined flours, processed foods and inflammatory fats such as trans fats.

  • Lack of exercise

  • Stress

  • Hidden or chronic infections with viruses, bacteria, yeasts or parasites

  • Hidden allergens from food or environment

  • Toxins such as mercury and pesticides

  • Mold toxins and allergens

 I would also add to this list:

  • Excessive exercise

  • Gut dysbiosis or imbalance of good and bad bacteria (often caused by diet and medications)

  • Negative thoughts and emotions

Inflammation is very individual and it can be hidden to some. It can present in different ways, even in people with the same disease. The key is for health practitioners to work with an individual to find their specific inflammatory triggers by digging into their health history and testing to get more specific information. Testing can be very helpful when we talk about food allergies or sensitivities, toxins and chronic infections. There are also a few tests that can determine inflammation in the body with C-reactive protein (CRP) being most common. This is the test I had run. Mine was 1.2 with optimal (according to my practitioner) being <0.3 so it wasn’t terrible but wasn’t awesome. If you suspect inflammation, ask your doctor for this test with your next set of labs.

What Diseases are Correlated with Chronic Inflammation

Inflammation is at the root of many common and chronic conditions. It can slowly cause problems with many systems in our body. We usually don’t know about the inflammation until major issues and symptoms show up. If it is a chronic disease, you can bet there is underlying systemic inflammation that needs to be dealt with. Here is a small list of inflammatory diseases:

  •   Metabolic disorders

    • Type 2 Diabetes, sleep apnea, heart disease, fatty liver disease

  • Cancers

  • Neurological Disorders

    • Alzheimer’s Disease, Parkinson’s Disease, ALS

  • Autoimmune diseases

  • Bone, muscular and skeletal disorders

    • Osteoporosis, osteoarthritis

  • GI disorders

    • IBS, IBD, Chron’s, Colitis (microscopic and ulcerative)

  • Mental disorders

    • Depression, anxiety, ADD/ADHD, Autism spectrum disorders

Symptoms of inflammation include

  • Brain fog

  • Swelling

  • Headaches and migraines

  • Insulin resistance

  • Fatigue

How Can You Reduce Inflammation?

There are a number of strategies that can help to reduce inflammation in the body. Let’s talk about the heavy hitters that can give you a big bang for your efforts.

1. Eat real food. Yes, I said it. Eat real, high-quality food, lots of colors, lots of flavors and things you can pronounce. Anti-inflammatory diets can be helpful in reducing inflammation as the name would suggest. See your dietitian (or me =) ) for guidance starting an anti-inflammatory diet.

2. Decrease inflammatory fats and oils and increase anti-inflammatory fats and fatty foods. This could go with #1 but I like it on it’s own. Inflammatory oils are often found in processed packaged foods like chips, crackers, frozen meals, and shelf-stable peanut butter. Get my free guide to healthy fats here.

3. Exercise, but not too much. Studies have shown that exercise can protect against chronic diseases. Over-exercising can cause more stress on the body leading to increased inflammation.

4. Control blood sugar levels. Decrease or eliminate sugar and processed carbohydrates, eat at regular intervals and include protein and healthy fat with meals and snacks.

5. Address food sensitivities. This can reduce inflammation quickly. An elimination diet can help with finding food sensitivities but you can have a sensitivity to even the healthiest foods you eat. See my post on the MRT food sensitivity test and the LEAP program for more information.

6. Address nutrient deficiencies. Talk to your physician or dietitian about testing for nutrient deficiencies, and more than just vitamin D and B12. If this isn’t an option, a high-quality multivitamin and mineral supplement is never a bad idea to fill in the gaps. I also like a high-quality vitamin D with vitamin K-2 supplement for most of us.

7. Relax, de-stress and get adequate sleep. Is this a joke? No, no it’s not. Lack of sleep increases stress. Stress, as mentioned above, can cause inflammation. Find your favorite ways to relax. Maybe yoga, meditation, bubble baths, music, more time with friends, a vacation. Allow yourself this time. Get on a better sleep routine and aim for 8 hours a night. Read my post on the importance of sleep.

8. Minimize toxic burden. Decrease exposure to plastics, pesticides, oxidative fats, pollutants, and harsh chemicals. What goes on your body and on/in your food is important also.

I hope this gives you some good, useful information. I am definitely not saying that everyone is dealing with chronic inflammation that is causing problems. I am saying that if you have a chronic condition or generally don’t feel well, taking some action to reduce inflammation can make a big difference. I would also take away that your lifestyle now can play a role in your health later down the road. I know it is a lot of information to digest so feel free to leave me your questions. You can also schedule a free 15 minute discovery call with me if you would like to learn more about working with a registered dietitian.

Lin

Thai Peanut Spaghetti Squash Bowl

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Finally, I have another meal for you guys and this is a good one! It is easy to put together and is full of nutrients and big on flavor. The hardest part of this recipe is cutting the spaghetti squash. It’s like its own little arm workout in your kitchen. Then, you can get everything else ready while the spaghetti squash is cooking and you’ll be ready to roll when it’s done. Easy peasy, lime squeazy.

Please tell me you love Thai peanut flavor as much as I do. I’ve been using it with salads, on pizza and now with this Thai peanut spaghetti squash bowl. I love a good Thai peanut sauce and finally wrote it all down into a recipe for you. It may not be totally authentic, but it’s really good and doesn’t involve ingredients you will never use again. Like fish sauce. Have you ever smelled that stuff? Don’t do it. You’re welcome.

I tried spaghetti squash for the first time just a few years ago. To be honest, I’ve never been much of a squash eater…of any kind. It wasn’t something I had as a kid and definitely wasn’t something I was familiar with cooking. It’s a little intimidating, right? A big heavy, hard core squash with no cooking instructions. Nope, I’ll pass. But I’ve embraced the intimidation and now, gimme all the spaghetti squash recipes!

Spaghetti squash has become much more popular due to the increase in fad diets out there as well as people needing more gluten-free and grain-free meal options. It is versatile and contains a good amount of nutrients. It is a low-calorie veggie with fiber, vitamin A, vitamin C as well as folate, niacin and pyridoxine (vit. B6). It is also lower in carbohydrates than pasta at 10 grams per cup compared to 42 grams.

We really enjoy using spaghetti squash as a gluten-free substitute for pasta. It’s so good with meatballs and marinara sauce or a cashew cream sauce. I especially love spaghetti squash with veggies, chicken and Thai peanut sauce! This dish is so flavorful and makes great leftovers. It is also easy to change up for diet or food preferences by switching up the veggies, using almond butter in place of peanut butter or changing out the chicken for a different protein. Options, so many options!

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Thai Peanut Spaghetti Squash Bowl

Easy and flavorful gluten-free, grain-free meal.

Makes: 3-4 servings

Ingredients:
  • 1 small-medium spaghetti squash, sliced lengthwise
  • 1 lb chicken breasts or thighs chopped into small chunks
  • 1 Tbsp sesame oil or extra virgin olive oil
  • 1 bell pepper, sliced into thin strips
  • 1-2 cups carrots, shredded or sliced into matchsticks
  • handful chopped green onions
  • handful roughly chopped cilantro
  • chopped peanuts or cashews to garnish
  • Thai Peanut Sauce
  • 1/4 cup natural creamy peanut butter
  • 3 Tbsp Coconut Aminos
  • 1 Tbsp rice wine vinegar
  • 1 tsp sesame oil
  • 1 tsp fresh grated ginger
  • 1 tsp minced garlic
  • squeeze of lime juice or from ½ lime
  • 3 tbsp canned coconut milk
  • 1 ½ tsp sriracha, or more to taste
  • Instructions:
    1. Carefully slice spaghetti squash lengthwise. Place squash, cut side down, on foil lined baking sheet. Bake at 425 degrees for 30-40 minutes depending on size of squash.
    2. Prepare sauce by whisking ingredients together in small bowl. If sauce is too thick, gradually add more coconut milk or water to thin. Set aside.
    3. Heat sesame oil in saute pan over medium heat. Add diced chicken and saute until cooked through. Set chicken aside in bowl.
    4. Add carrots and peppers to pan and cook to desired tenderness. Add chicken to pan with veggies to keep warm
    5. Spaghetti squash is done when fork tender. Allow to cool. Use fork to pull into spaghetti like strands.
    6. Assemble your bowl with spaghetti squash, chicken and veggies and desired toppings like cilantro, green onion and chopped peanuts. Drizzle with peanut sauce.
    7. Enjoy!

I hope you enjoy this healthy, flavorful Thai peanut spaghetti squash bowl and can use it as a guide to get creative with different vegetables, proteins and toppings. Or, make it like it is and you can’t go wrong.

Lin