Nataliia Sanzo RD, LDN: 0:00

Hi everyone, Welcome to Hashimoto's Nutrition Rx. If you're dealing with Hashimoto's and also struggling with painful or irregular periods, you're not alone, and this episode is going to connect the dots in a way you've probably never heard before. I'm joined by functional practitioner, Meg Langston to unpack how iron deficiency or iron dysregulation, chronic gut infection like H pylori and unresolved inflammation can directly affect your menstrual cycle and worsen your thyroid-related symptoms. Meg welcome.

Meg Langston, FNTP, RWP, RCPC: 0:37

Thanks so much for having me.

Nataliia Sanzo RD, LDN: 0:39

Yes, I'm so excited about our conversation. But before we dive into this conversation, I would like to introduce you to those listeners who don't know who you are. So Meg Langston is a functional nutritional therapist. Her passion for using lifestyle and nutrition to support healthy hormones and normal digestion was burst out of her personal battle with overcoming irregular cycles, learning why diet and hustle culture hinders your health and what powerful tool every woman's menstrual cycle is. She and her team specialize in helping women address the root cause of hormones and digestion and believe you should and can feel good all months long. Meg runs a virtual private practice with the team of practitioners dedicated to supporting busy women, get answers, feel empowered and bring back the joy in health. Meg, I love that your journey into this space started with your own experience of irregular cycles and learning to work with and not against your body. It's incredible. So can you take us back to that time and share what really sparked the shift from struggle to healing and what are some of the early lessons that changed how you help women?

Meg Langston, FNTP, RWP, RCPC: 2:03

Yeah, I make this joke far too frequently, but I do think that women potentially may be more superior, given the fact that we do have a menstrual cycle. I'm just going to put it out there because we do have this powerful tool where we can truly tells us like, hey, what's going on, how are we doing, how resilient is our body to stress. And this knowledge, this body literacy, this cycle literacy really came, like you had said, from my own story and throughout the years I was a competitive athlete and once I stopped playing soccer, I tried to figure out okay, what does health look like to me if it's not eating pasta before a big soccer tournament? And at the time this is back in 2007, we didn't have Instagram, facebook was just becoming a thing, and so I looked to magazines and I looked at different books of what was health and really how I defined health was really by aesthetics. There was nobody really talking about your period should come and go. Everything was defined by oh, in order to be healthy, I have to look a certain way, and so that spun into disordered eating habits and all these different things and through the years of really trying to pursue health but actually creating almost like eating disorders and just inappropriate relationship within my health.

Meg Langston, FNTP, RWP, RCPC: 3:23

My cycle was just completely non-existent and I developed things like a lot of anxiety and I would just tell myself I'm just a worrisome person. It's just who I am. I would bloat really bad if I just went out to a restaurant and participated in life, and it wasn't until I really started to learn about my cycle that I actually then started to learn about functional health and I actually then started to learn about functional health and holistic health. And I went through the whole thing of going to a conventional doctor and they're like you're an athlete, cause at this time I was doing marathons and triathlons and whatnot and they're like of course your period's going, that's totally normal and I'm like this book is saying it's not like this, but this is taking charge of your fertility. Do you know that book?

Nataliia Sanzo RD, LDN: 4:04

No, I don't know.

Meg Langston, FNTP, RWP, RCPC: 4:05

Oh, it's such a great book and every woman needs to read it. And so I was like this book is saying it's not it's and actually my temperature is really low, which is indicating low thyroid. Can we test that? Everything was normal. Then I went to a functional doctor and the functional doctor was really great at being like yes, you do have something subclinical hypothyroid, so I never had a hajimotos. You should be having a period every month. These are abnormal.

Meg Langston, FNTP, RWP, RCPC: 4:31

I just fell into a lot of the same patterns with the functional doctor, where it was very much like test and supplement and I never really felt fully healed, and it wasn't until I then started to just fall in love with the science. I want to know everything, tell me how the body works. I want to know every detail and I realized there's actually a huge missing puzzle piece between lifestyle and nutrition that everyone talks about. It's actually just not implemented in the practice.

Meg Langston, FNTP, RWP, RCPC: 4:54

And years later went back to school, decided to open up my own practice that was very focused on women's cycle we help women with Hashimoto's, we help women with digestive issues, we help women with acne, infertility, all of the things and it's very driven by functional testing, but also psycholiteracy and then heavy focus on not just testing it in the protocol, but also how are you feeling yourself? Are you eating enough and are you going at a pace of life that doesn't serve you well? How do we implement truly a holistic healing method? And so that's where I am now. That's how I got into everything, and throughout the journey I have learned so much, and one of the biggest things that I've learned is that the more you know, the more you don't, so you can't stop learning.

Nataliia Sanzo RD, LDN: 5:36

Exactly, I spent five years in medical school studying human body and psychology and physiology and all that stuff, and every single day there is a new study should come out, not necessarily about Hashimoto's, but about skin, new supplements, new gut microbiome microbes that they found hair loss because we address all these problems from multiple perspectives. Right, we can't just treat thyroid or just low iron, and we'll talk about periods and all that stuff, but also hair loss. If we have iron dysregulation, there is hair loss. So you have to be very versatile in that space and I think the best practitioners, the way we develop, is because we struggled at some point with all of these problems we're talking about and we couldn't find a solution. So we create this solution.

Nataliia Sanzo RD, LDN: 6:28

Yeah, I love having you here, because all this hair and dysregulation and heavy periods and hair loss is such a huge but often overlooked piece of the puzzle for women, especially with Hashimoto's, when they're dealing with like painful and irregular periods, fatigue, hair loss or just that deep sense that something is off, even when their thyroid lab looks normal, right. So let's set the foundation. Why do people often have this iron dysregulation or deficiency and how does it show up in Hashimoto's? Because I think a lot of our audience hear low iron and immediately think anemia or fatigue. But there are so many settler signs that we might be missing, especially in the early stages.

Meg Langston, FNTP, RWP, RCPC: 7:17

Yes, yes, and actually I would say it is so common, especially people with autoimmunity, to have this iron dysregulation, whether or not their bloods are showing like low ferritin or low iron saturation. And here's why. So I come from what's called like a root cause protocol background, which is very much like we're looking at the full iron panel. So a lot of people in this community likely know oh, you have to get a full thyroid panel. Are you getting a full thyroid panel? Are you getting a full thyroid panel? Similarly, you have to get a full thyroid panel. Are you getting a full thyroid panel? Are you getting a full thyroid panel? Similarly, you have to get a full iron panel. If we're just doing ferritin, if we're just doing TIBC, iron saturation, you know that's not a full iron panel. In order to get a full iron panel, we have to look at everything that moves iron appropriately in the body. So I often talk about iron dysregulation again, especially when it comes to Hashimoto's and autoimmune condition, and that's because iron can accumulate within the tissues very easily, and here's how so many of us have grown up eating iron fortified foods. Whether we know it or not, it's in your pastas, it's in your cereals, it's in your birth control, it's in your antibiotics, it's in your prenatals, it's in your multivitamins. There is iron everywhere in our diet and what we're not necessarily getting is the actual cofactors that move iron appropriately. And without those cofactors that move iron in and out of the cells, then it actually accumulates within the tissues. So let me give you a scenario. We're going to go into a little bit of a nightclub and so we're in the nightclub, and how that should work is that we should have iron going in and out of the cells, in the cell, out of the cell, in the cell, out of the cell, and then we have the bouncers. The bouncers are opening up the door, letting iron leave the door. So they're opening up the club. You're leaving the club. So these are the bouncers, and these bouncers are run by copper yeah, they're run by copper. And then we have the managers, and these managers are run by retinol, vitamin A. So there's vitamin A, baricarotene, but we're talking about vitamin A, retinol, and so you have your vitamin A, the managers, you have your copper, letting iron go in and out of the cell, and then you have the iron that goes into the club and should be leaving the club.

Meg Langston, FNTP, RWP, RCPC: 9:27

So, as I mentioned, it's very easy to get a lot of iron into the club. Iron goes into the club often. Again, if we ever took antibiotics, it's in there. If we ever have pasta or flour. Or again, if you look at your prenatal, if you look at your adrenal supplement any supplement it's very common to get iron in there. And so we see a couple different scenarios. Either people do not have enough of the bouncers, so they don't have enough copper, and so that copper runs different enzymes Ferroxidase is one of them, ceruloplasm is another one of these and these are different enzymes that again shuttle iron in and out throughout the body.

Meg Langston, FNTP, RWP, RCPC: 10:06

So either they don't have enough staff so we're not seeing enough copper or they have a lot of staff copper toxicity where they have a lot of staff members but they don't necessarily have managers and somebody can not have managers and just no staff. In general you don't have any retinol, you don't have any copper. That's also very common, especially when we go into the AIP diets and we're taking out dairy and we're taking out a lot of these foods because we're not sure how to really eat and you're not used to eating like organ meats. So you're not getting that retinol, you're not getting that copper Maybe you're even allergic to shellfish, so you're not getting that copper.

Meg Langston, FNTP, RWP, RCPC: 10:40

So your foods become limited, so your staff members become limited and what happens is if we don't have enough of these staff, iron is going to keep accumulating within the nightclub, it's going to keep accumulating within the body and it's not going to go anywhere. And iron gets actually stuck in a couple of different places throughout the body so the macrophages, so the immune system. It's going to impact Anytime you're impacting the immune system. That's obviously going to impact and trigger autoimmunity. It's going to impact the liver Anytime that we have any type of stagnant in the liver. We're not able to clear estrogen, we're not able to clear endotoxins and whatnot. This is a huge reason why many people with thyroid issues have very heavy bleeding clotting periods, because the iron will accumulate within the liver and then you can't clear the excess estrogen the way that you should be. It can get stuck in the GI. It feeds these parasites and these pathogens in the body. Any type of damaged tissue. Iron will accumulate there and this is why if somebody is showing up low iron, I want to run a full iron panel.

Meg Langston, FNTP, RWP, RCPC: 11:45

I want to look what's your retinol look like. What's your vitamin A serum? So your retinol. What is your ceruloplasm? That enzyme that's bioavailable, that helps move iron in and out of the cell. What does your copper look like? And then different things like magnesium, rbc. All of these things are help us have a good indication of why, necessarily, you may be. Actually it's very hard to be low, not that you couldn't be anemic, it's just very hard to, especially when these people are constantly anemic. You're like if you're eating meat, if you've been taking iron effusions and whatnot, then it's hard to be that low of iron. What else is going on? That's not that it's not moving iron.

Meg Langston, FNTP, RWP, RCPC: 12:24

So often you'll hear me say either iron overload or iron dysregulation and again and its impact on immunity. So it will cause oxidative stress, so rust in the body. It accumulates within inflamed tissues which can again directly cause inflammation and impact Hashimoto's. It disrupts the immune system by impacting something called C-cells, which has very much everything to do with autoimmunity and flare-ups, liver and gut function, which we talked about, feeding again these pathogens in the GI, which again is going to increase, cause of autoimmunity and inflammation in the body and then causes inability to absorb and utilize nutrients. It is a huge thing that anytime somebody comes with us with hajimotos, we are directly looking at first like a mineral status, like we just do a hair tissue mineral analysis. But often we will go to bloods too if there's unresolved things, because we may have to look at how much.

Meg Langston, FNTP, RWP, RCPC: 13:20

What are your liver enzymes look like? Do we want to really focus a little bit heavier on the liver to get in your liver as vitamins are broken down? So I always remember it this way all day, elephant's kite. And so I'm like, okay, are you having a hard time breaking down these? All day, elephant kite, these fat soluble vitamins, and then and again those that vitamin A is going to tell the copper hey, copper, go do your job. Go open up the cells, go bouncer, go open up the door. Without the managers, no one's going to do their job. They're just going to sit down and chat.

Nataliia Sanzo RD, LDN: 13:52

I love this story about the nightclub. I'm sure we in our early or late 30s can relate a long time ago. But I love this analogy and I love that you explained everything in very simple terms, because this is a complex topic and I do appreciate that you're simplifying this. But just for everybody who's listening and watching, it's not as easy. You've been in the practice for what you said seven years. I've been doing it for eight years and it's still a freaking puzzle that we have to put together and you have to work as a team with other practitioners to figure all this out.

Nataliia Sanzo RD, LDN: 14:32

Because even though you mentioned your iron, that shows up on your blood work may be normal and that's usually the case, but staggering statistics shows that about 43% of people with Hashimoto's have this iron dysregulation with normal blood work. And I always pay attention to all these minerals and metals because iron is needed for what? Thyroid hormone synthesis, especially for the TPO enzymes. So low iron or iron dysregulation, you making less T4 and less T3. And it doesn't matter what stage of Hashimoto's you're in. Also, the ferritin you mentioned, the storage form of iron is strongly associated with hair thinning. So anything that's below 50, which is normal in conventional medicine. For me it's a red flag, and especially if somebody says, hey, I have hair thinning.

Nataliia Sanzo RD, LDN: 15:28

Iron also plays a critical role and you mentioned that in our production of neurotransmitters like dopamine, serotonin, norepinephrine, and that's strongly connected with what our mood swings, anxiety, poor concentration. So even when somebody comes to me with Hashimoto and saying, oh, I have this Hashimoto's related symptoms like mood swings and anxiety and poor concentration, I'm like, oh, let's think maybe about something else. And that's where the blood work and hair analysis comes into play when we're fine tuning things with normal labs. So I love that you brought it up. Now here's where I think the conversation gets really interesting. A lot of my clients have gut infections show up on their GI map, especially like H pylori, and I know you've talked about this connection before. So what is the relationship between H pylori infection and impaired gut like iron absorption?

Meg Langston, FNTP, RWP, RCPC: 16:25

Yeah, so I would say a couple different things. The unique thing about H pylori is that the body itself is kind of like a corkscrew, so it corkscrews into the intestinal walls, very much, buries itself and this is why when you go to a conventional doctor and they do, or a GI specialist and they test for H pylori, it may not come up and but we know that it is very much connected. I actually don't know the percentage you may know of people with H hajimotos have a high percentage of H pylori because it does a couple of different things where it will lower stomach acid and anytime we have low stomach acid it will allow for pathogens to overgrow. So if you think about, you're eating your food and you need this stomach acid to crumble up the food so that you can easily digest it, it can be absorbed, it can be utilized throughout the body. If you don't have enough stomach acid because you have an H pylori infection, then what will happen is it corkscrews in the intestine, it's hidden and then it's continuing to lower stomach acid and then you have these big food chunks coming down, breaking through a leaky gut and then allowing for these overgrowths to happen.

Meg Langston, FNTP, RWP, RCPC: 17:31

And again, anytime we have these overgrowths that will happen. This will increase inflammation and again allow for nutrient depletion. And then anytime there's any type of high inflammation and high gut, leaky gut, permeability, then it will again impact autoimmune and then those TPO antibodies. And I think mineral depletion is a big thing is if you are not able to actually get enough of your conversions T4 to T3, maybe you actually are getting enough retinol in your diet but you're not able to absorb and utilize it. We need enough retinol to convert T4 to T3. So it will increase the inflammation and oxidative stress, so rust in the body which will impact the TPO antibodies and then again mineral depletion and vitamin depletion. The body will not have the correct nutrients to do its proper functions, like again, support pituitary function or support conversions of the thyroid.

Nataliia Sanzo RD, LDN: 18:26

But yeah, yeah, absolutely Like you mentioned H pylori. It lowers stomach acid and I think that's one of the key factors why we experience impaired absorption not just iron, but other vitamins like B12, magnesium, calcium and zinc, all of which are crucial for thyroid function and hormone balance. So it's such an important piece of puzzle that you and I address One of the. You said oh, I don't know what the real percentage.

Nataliia Sanzo RD, LDN: 18:59

Studies show that over 50% of people with Hashimoto's have H pylori. Wow, and I know there is a study was done and it was one meta-analysis which has a very strong backbone and it was 2010. They found that H pylori positive people are three times more likely to have iron deficiency anemia. So we know there is a strong relationship between H pylori and low iron levels or this dysregulation. Another thing I wanted to say that clients that choose to do GI maps stool test my clients about 80% of them have H pylori. So I don't know where that statistic about 50% of people have H pylori. Every client that chooses a GI maps stool test, most of them have H pylori. So I think that number is actually higher.

Meg Langston, FNTP, RWP, RCPC: 19:54

I would agree. I was actually surprised to hear that it was 50% because it's so easily passed from saliva. This is where I'd be curious to see if it was done in a breath test or something at a GI special. A GI map is just so much more comprehensive and sensitive specifically to H pylori, so that would be interesting to look into. If anyone decides to do that either way, it doesn't matter because, like you said, clinically you see it where if you're having Hashimoto's, because of the impact of the gut microbiome and leaky gut and how it increases inflammation, it unfortunately has a negative impact on your gut and this is why, personally, I'm not necessarily a fan of always going to AIP diets and everything and it's only because the more restriction, the more taking away.

Meg Langston, FNTP, RWP, RCPC: 20:38

I don't think always benefits. I think sometimes it's also very stressful. Most of us are just trying to get through our day. I saw the funniest reel the other day where it was like nobody told me as an adult that I would have to worry about what I'm going to cook for dinner for the rest of my life and I was like I hear that especially with kids. It's like the emotional burden of having to come up with dinner. But all that to say is that's why I would rather do a stool analysis. I would rather look at the minerals, because if we take away food sometimes, that's not the root of the issue. Root cause is always going to be what's going on in the gut microbiome, what's going on mineral status wise, what stress look like all those things yeah.

Nataliia Sanzo RD, LDN: 21:14

Absolutely. And now I want to touch on the planning meals and dinner, especially for the rest of your life. That's why I still do as a registered dietitian for the last eight years. I still create personalized meal plans and some people like, oh my God, I can't believe meal plans are still around.

Meg Langston, FNTP, RWP, RCPC: 21:31

It is another thing to think about.

Nataliia Sanzo RD, LDN: 21:34

Exactly so. Some people not everyone likes a meal plan, but it's one of the services I offer, and some people just love following an easy, step-by-step guidance. They know exactly what they're going to eat seven days from now. Now, the other thing I want to mention is that iron supplement. While we're talking about H pylori, that iron supplements often actually worsen gut symptoms like constipation, nausea and even SIBO. If you already have H pylori, that is not treated right. Because we talked about what H pylori does in the stomach. Now let's touch on some red flags that show up on either blood work or stool test. Were there some signs or lab markers that might hint at iron or ferritin imbalance in someone with Hashimoto's or just someone who's experiencing all the symptoms we're talking about? And I should say, especially when those symptoms are showing up as menstrual issues, mood swings or lingering fatigue? What do you look for on blood work or stool test?

Meg Langston, FNTP, RWP, RCPC: 22:38

Yeah. So I don't start with bloods typically. So I'll look at a GI map and I'll look at a mineral test first. So hair tissue mineral analysis and I will only go to bloods if I feel like I need to see a little bit more. So typically what I'm looking at in a hair tissue mineral analysis is do they have what's called a calcium shell? So is their calcium really high? Is their boron really low? Is their cobalt really high, if their cobalt's really high? So those patterns before I'm looking for a stress response. And then I want to know okay, you do have a stress response, where is that stress coming from? Something like a high cobalt.

Meg Langston, FNTP, RWP, RCPC: 23:10

It's going to be a good indication of liver congestion. Again, all day elephant's kite, if they have any type of liver congestion in the bile is where we break down fat soluble vitamins. If you don't have those managers, then you're going to have a hard time telling your staff what to do. Vitamin A literally pushes copper into the cells to be utilized. It becomes something called bioavailable copper, called ceruloplasm. I'm looking for the liver congestion. You do actually see low iron, low copper, on a mineral test and I would say that again, just because it shows a low iron doesn't indicate that you actually are low iron. We want to see is there any accumulation elsewhere? And I would say more often than not, especially just because this, unfortunately, is very expensive, the tests. So I try not to go to the bloods but if we have to, I am looking at again. I'm looking at AST, alt. I'm looking at liver enzymes. Is there any type of liver congestion? I'm running vitamin A serum, so retinol sometimes they'll say retinol, sometimes it'll say vitamin A serum. It's the same thing and I like that to be around 65, not higher, because we don't want to get obviously vitamin A toxicity but lower. You really don't want to get obviously vitamin A toxicity but lower. You really don't have enough staph and then ceruloplasm, again, that's that bioavailable copper that runs those enzymes, copper in general.

Meg Langston, FNTP, RWP, RCPC: 24:25

I want to see magnesium, rbc. I want to see zinc. If we actually have a ton of zinc in our HTMA, that could be lost. It means that we don't have enough. We want to look at do we have anything going on in the GI or is it too high? Because you're supplementing it, which also can blow up copper. That's why we never just blindly supplement, because if you have too much zinc it's going to make copper work antagonistically against it. So again, I am looking at ferritin, I am looking at TIBC, I am looking at iron saturation. So all of these different markers are giving me a good indication. But also, if somebody has high monocytes and acinophils on their blood chem, I'm thinking parasites. And if they have parasites, I'm thinking, okay, so GI map maybe says it or maybe doesn't, but blood chem does what feeds parasites? Oh, iron, okay, so there is iron accumulation. So if there's iron accumulation, what's going on?

Nataliia Sanzo RD, LDN: 25:10

Yes, and thank you for sharing that, because I think it's very important to know how much. Yes, and thank you for sharing that, because I think it's very important to know how much goes into either diagnosing somebody with iron dysregulation or finding a parasite. We always look at the full picture and things that are not seems unrelated. We're putting it all together in a puzzle and for people that you know not feel overwhelmed, we want to leave people with some directions, right. So what are some safe and effective ways to address iron dysregulation from a functional medicine standpoint, including food-based strategies, maybe supplement timing and dosing tips?

Meg Langston, FNTP, RWP, RCPC: 25:50

Yeah, yeah, like you said, the encouragement is that, oh wow, there's actually always a reason that my body's talking back. If you get with the encouragement is that oh wow, there's actually always a reason that my body's talking back. If you get with the right practitioner, it's actually it should be encouragement. Oh, my body is so wise, it's always going to talk back in symptoms and I can be my own advocate and say I need to keep looking. So when I talk sometimes I know it can be so like, but no, it's just actually it's amazing how, how amazing our body is that they're just going to keep fighting for us and saying, hey, please keep looking more into this. But, with that said, I feel like the more I've been a practitioner, the more I am so heavily focused on nutrition and lifestyle, especially in addressing like imbalances and when it comes to supplement timing and dosage. It's very difficult to give without knowing your specific needs and there really is so much that we can do in order to positively impact our body by just focusing on nutrition and lifestyle. So I'll put these two together and try to make it as quick as I can. But the thing I would say about the lifestyle that's really important is that if our body is in a space where it's fight or flight, it's like I wake up and I'm so stressed and I'm looking at the news and I'm looking at my phone and my kids are screaming and I'm not eating and I'm getting one last thing done and I'm eating in my car and then I go to work all day or I'm in the house all day and then I come home and it's prepping for dinner and we're living in this like just very reactive state. It's very much fight or flight. We're burning through these key minerals that help our body function optimally. So the first thing I'm going to say is look at your lifestyle. What are things that we can change? How can we make sure that we're fueling ourselves well? Can we wake up, eat within the first 30 minutes of waking? If you're on, obviously, thyroid medication, that may be a little bit delayed, but can we make sure we're fueling ourselves well? Can we take a second to do nervous system reset? And I'm not like out of practice. My husband's a firefighter, I have two kids, I run two businesses. He runs a business. We're crazy, but there are actual practical things that you can do that in the midst of a really full life that actually stop your nervous system, that actually put you at a fight or flight. And for me, that's actually just sitting outside. I don't sit outside for hours at a time I wish I could, but I sit outside for hours at a time I wish I could. But I sit outside, I really look out, I put everything away, I enjoy my kids, I take deep breaths, we play in the rain. There's no such thing as bad weather, only bad clothes. So there's different things that you can do to do nervous system reset, you to understand that it's so much matters about these lifestyle choices that we make how we're eating, how we're fueling ourselves, how we're taking nervous system reset, and that stress alone, when we're not burning through these minerals, is healing in itself. That is free.

Meg Langston, FNTP, RWP, RCPC: 28:26

And then the second thing I would say is that we just need to eat a variety of foods. We do not need to make anything complicated. When I tell you I have a full life, I have a full life and I know most people do, I do not make anything complicated with my foods. It is always we're having a sheet pan, we're having a slow cook, we're having tacos, we're having like some type of meatloaf. Now what I do is I look back and I say, okay, last week we had beef, we had chicken, we had cod, so this week we're going to do ancestral blend, so we're going to get some like organ meats in there. We're going to do shrimp, we'll do like a good grass fed chicken, we'll do a grass fed beef, and so we'll switch it up. So we keep it very simple.

Meg Langston, FNTP, RWP, RCPC: 29:04

So there are different things that that you can do to increase your copper and your retinol status. But if you keep your meals similar but you switch up your protein and your vegetables, what you're going to do is actually get more vitamin A, you're going to get more B vitamins, you're going to get more copper. It's going to do this give and take without the like stressor of having to come up with different meals. That is how I practically suggest getting in the right vitamins and minerals. But things like dairy products are going to have high quality retinol. Things like cod liver are going to have high quality retinol. Things like cod liver are going to have retinol. Things like or cod, rather things like organ meats are going to have retinol and B vitamins and magnesium that all help move iron. Things like copper so shellfish, bee pollen, again, organ meats all of those things are going to be high and rich in these vitamins and minerals that move iron appropriately.

Nataliia Sanzo RD, LDN: 29:57

So you mentioned, of course you covered, copper, zinc, vitamin A, all that stuff. Now, when it comes to iron, if people want to improve because with heavy menstrual cycle we do lose a lot of iron and people everyone I have not met someone with Hashimoto's with normal iron and ferritin we're all deficient, we're all anemic and of course, to figure out why, then we test all other minerals, right. But I always say to correct all these levels doesn't matter what vitamin or mineral we talk about, it starts with food first. When possible, of course, red meat if people can tolerate grass-fed, pasture-raised oysters, lentils, Lentils or any kind of beans. There are incredible sources of these nutrients and a lot of people eliminate them because they follow either AIP diet or they read somewhere that beans are not good for whatever. Autoimmunity and I'm like beans are one of the best. If you're like on deserted island, beans will keep you alive because they have so many nutrients and they have what fiber.

Meg Langston, FNTP, RWP, RCPC: 31:05

And it grabbed the estrogen. And estrogen I know we didn't talk about this but, like an excess of estrogen is going to have a negative impact on your immune system. It's going to increase inflammation on the body. So when people have these heavy periods, heavy clotting, again you want to look to the why. Is it the liver? Is it also derived from the GI? But this estrogen dominance is also going to play a large role in increasing inflammation, increasing again the autoimmune to flare up into the Hashimoto's flare. And that's where again, like you said, the beans, the fiber, carrots, and that's another that I think is a really simple thing, the getting outside, slowing down eating enough fiber intake.

Nataliia Sanzo RD, LDN: 31:47

It's like we don't eat enough fiber either. Nobody counts fiber. If we do a new client that comes to me, we do like a food frequency questionnaire just to see where they are with their food intake. They eat on average 10 to 15 grams of fiber, as opposed to 45 and 50. My goal with somebody with Hashimoto's is to eat around like 40, 45 grams of fiber because that improves every marker that we talked about.

Nataliia Sanzo RD, LDN: 32:11

Of course, when it comes to food, I always say avoid calcium-rich foods or supplements within two hours of iron intake or supplementation, because calcium competes for the absorption. So a lot of people know that. When it comes to supplements, I always say don't ever supplement iron without getting full blood work done that we talked about. I had a client who came to me post-fact but before she signed up with me. She's like and he came to me post fact but before she signed up with me. She's like oh, I did iron infusion, she's like I just felt fatigue and of course she had extreme hair loss.

Nataliia Sanzo RD, LDN: 32:45

Iron, like you said, deposits everywhere and it's exacerbates Hashimoto's related symptoms. So I used to work at Vanderbilt as a clinical dietician. We did iron infusions for somebody who were going through cancer therapy, or when somebody was airlifted to the hospital. That's the only time you do iron infusion, so I'm going to leave it at that, because I think it's such an important point to make. With all these IV clinics popping up every mile here in Nashville, we literally have it on every corner. So, guys, please don't do any kind of drastic supplementations like this Think about food.

Nataliia Sanzo RD, LDN: 33:23

Pair your foods with vitamin C and maybe like stomach acid support, digestive bitters, maybe HCL if appropriate, if you have low digestive enzymes, and I want to say always, we have to treat the root cause, like H pylori or low stomach acid, first, otherwise absorption stays impaired. Yeah, nothing is changing Right. Lastly, I want to kind of wrap up how important is to consistently monitor iron markers in women with Hashimoto's or not, especially if they have chronic gut infection like H pylori. What are we looking at? Do we need to test every month, every six months? What do you guys do in your practice?

Meg Langston, FNTP, RWP, RCPC: 34:06

Yeah. So I would say that I don't have people chronically like testing their antibodies I'm sorry, not their antibodies, their iron markers unless their antibodies are just like flaring up again. I would say that the initial testing obviously is important to figure out where you're low in. If your antibodies are going high again, then I would retest. But I would say that, for the most part at least, what we're teaching is more so of hey, we've addressed this.

Meg Langston, FNTP, RWP, RCPC: 34:34

We looked at the full picture. You are specifically low in copper and we had some gut infections, so you weren't absorbing and utilizing this. So now, moving forward, I want you to just work on your lifestyle. I want you to continue to get out of that fight or flight Cause again. Anytime we're in fight or flight, it's going to allow for the low stomach acid. It's going to allow for those infections and gut dysbiosis to overgrow pathogens bad guys and then from there, just like, focus on eating variety of foods, take the stress out of having to make health so complicated.

Meg Langston, FNTP, RWP, RCPC: 35:00

But of course, I would say the very blanket advice if there are people that are really struggling, I genuinely go by okay, you're really struggling with these symptoms again, we've already talked through the foundational things. You are doing pretty good at that. What else could be going on? And typically it's a mom changed her kid's diaper and I know this is a little gross and they got a parasite, and so there's some gut stuff going on that we have to readdress. But I think when you take the approach of the foundational push, there's not much that you have to retest.

Meg Langston, FNTP, RWP, RCPC: 35:27

Often, unless it's like a mineral test is not diagnostic. You're always retesting. You're always under stress. Right, we built our dream home and that was really fun, but it was stressful. Our lights got delayed or something like that. There's always just different ebbs and flows of life, so minerals can quickly be depleted.

Meg Langston, FNTP, RWP, RCPC: 35:41

If nobody is perfect not us and so, even though we have good intention and we understand, sometimes life gets hard and you're like you know what? My blood sugar has been all over the place and that's keeping me in a fight or flight state, so I really need to go back to X, y, z. So anyway, I'm getting all over the place. But all that to say is I would say, unless there's a reason to, we don't really just go and retest. And I would still caution you if you are in that spot to make sure you're addressing what I would call the foundations Again. Are you eating enough? Are you going outside? Do you have a good bedtime routine? All these things that are very controllable have a large influence on your health and sometimes it's not as talked about because it's not as sexy, but it's crucial and you can avoid a lot of the in-depth stuff sometimes when we've already built that resiliency 100%.

Nataliia Sanzo RD, LDN: 36:23

I agree with you on all of the points you mentioned. Now, the only thing like if somebody does a GI map stool test with me, the only thing we retest in about six to eight weeks it's H pylori, because we're actively addressing that. Everything else, like my GI map stool, includes zonulin, because all of my peeps was Hashimoto's. That's not an option for my stool test. I want to see the zonulin level. All of that, or gut dysbiosis, whatever we're testing. People say, oh, should I retest the GI map stool test, the comprehensive one, with you? And I'm like no, because you're going to know if the approaches that we're implementing are working or not. Are we decreasing food sensitivities? Can we reintroduce food safely? So as we work through it, you see if it's working or not. H pylori is the only one because it can be dormant. So if it was active, were we treating it? I still want to retest to see has it been eradicated completely or is there still lingering some colonies that will still cause symptoms for some people who are very sensitive too.

Meg Langston, FNTP, RWP, RCPC: 37:29

So I would say this is the only time, and if your spouse has it, it can easily be passed, which I don't know what y'all do, but we always do a pilo guard or something too, if the spouse has it. It's hard, though, because if your kids do too, and you're passing it back. Retesting H pylori is definitely something that's always a good idea, because, again, it can be present but still be causing issues, and anytime you use what's called a biofilm disruptor I know you know that, but it can expose it when it was dormant and then actually go higher, and so's a great one to retest.

Nataliia Sanzo RD, LDN: 37:53

Amazing, yes, there are a few questions, people are asking about nutrition connection with gut health, and I think that's all we talked about is gut health. Somebody asked if I have H pylori and I eradicate H pylori, will I lose weight?

Meg Langston, FNTP, RWP, RCPC: 38:13

I would say, when you talk about aesthetics and weight and whatnot, and especially when it's a thyroid, my personal opinion would be that there's a lot to so so much love like no potentially right. Yes, if you take out stressors, then it's easier to achieve aesthetic goals and weight loss and cause your metabolic system's working. And metabolic meaning thyroid is working the way that it should be. But also it does matter. Are you overeating and fat? Are we over? Like your macronutrients do matter. You do have to eat with somewhat of a deficit, but you can't be in a deficit for too long because there's something called metabolic adaption. So I think, when it comes to weight loss, not to make it overly complicated, but sometimes it's not as simple as oh my gosh. Yes, you get rid of it, girl, your metabolic system is going to go because you want to look at the person as a whole.

Meg Langston, FNTP, RWP, RCPC: 38:57

Have you been dieting your whole life? Because if you've been dieting your whole life, then no, you got to make sure you're feeling your body well enough to go into a caloric deficit. Are you working out? Are you strength training? How much cardio are you doing? You know what's emotional stress. So that would be my answer. You may have a more simple one.

Nataliia Sanzo RD, LDN: 39:21

There is no simple answer when it comes to any kind of question about weight loss, but I will say, just based on all the clients that I've ever worked with that addressed H pylori, the side effect is some weight loss, depending on what their goal is right, because when you treat H pylori you improve markers like fatigue, markers like CRP, the inflammation. Your energy goes up and as a side effect, when you improve your energy, you are more likely to get off the couch and go exercise. So treating H pylori will not cause weight loss. But because you're addressing, you're more aware of how your body reacts, you feel better, you may be exercising more and, like with me, when we do the GI maps tool test and we give all these recommendations of how to improve your dietary intake, I usually give a meal plan to my clients that last a week or two just to give them an idea how to incorporate everything that we talked about for an hour into their lifestyle. So people are more aware of their food choices. Maybe supplements, maybe we cut back on certain supplements. So I'd say it's just a nice side effect, but it's definitely not a guarantee.

Nataliia Sanzo RD, LDN: 40:33

Now, just to have fun, meg, I didn't tell you this, but I have a surprise. Let's do it. I like to do like a rapid fire questions, okay, to wake everybody up and to maybe learn a little bit about you, okay. So there are like questions, it's a yes or no, you don't have to get into explanations. So something like what is one food you always recommend for healthy period? One food Carrots Carrots. Is it because of vitamin A?

Meg Langston, FNTP, RWP, RCPC: 41:03

No, it is because it binds to excess estrogen and so the unique fiber of carrots will bind to it and it helps you poop. So it binds to the estrogen and poops out. So if somebody has heavy periods, I would say carrot Cooked or raw.

Nataliia Sanzo RD, LDN: 41:17

Raw periods. I would say carrot Cooked or raw Raw. Oh, good point, I'm taking notes.

Meg Langston, FNTP, RWP, RCPC: 41:21

Yeah, your go-to meal when you're short on time but want to support all of your hormones. What do you love to eat? One of my favorite things right now is it's called a Mississippi chuck roast, and I'll take like a good chuck roast and I'll take some peppers and I'll put it in there, and then we'll do that on the side of the mashed potato or cooked potato. I don't know if that's quick, though, but we do slow cooks when we're super busy.

Nataliia Sanzo RD, LDN: 41:44

I think I love slow cooking because you leave for work, you turn on your slow cooker, you come back and the dinner is done.

Meg Langston, FNTP, RWP, RCPC: 41:51

I've never felt more successful than when I come home from a busy day and dinner is ready because I've done a self-talk. I'm like am I great or what? Yeah, you're amazing, you're a superwoman, you're like I know.

Nataliia Sanzo RD, LDN: 42:11

Okay, let's talk about supplements. Overrated or underrated. Which one do you think deserves more attention? You have to pick one supplement, though. If somebody says there's one supplement I need to take, what would that be?

Meg Langston, FNTP, RWP, RCPC: 42:19

Can it be a drink? Sure, I would say wine. Yeah, I would say potassium because I want to say magnesium, but magnesium, if you are super low in sodium and potassium, you're actually going to feel worse taking magnesium. So I would say, focusing on potassium, like in not necessarily supplement, I would say more so like coconut water or just watching your potassium intake, would be good as supplement. It's so hard for me because it could be not the right fit for you. So I would say watching that potassium in the day because then if you do have enough potassium, you're good to go. And even if it's high on a HTMA, it's usually a loss in general and it has everything to do with glucose and thyroid and stress and all the things.

Nataliia Sanzo RD, LDN: 43:01

So eat one banana a day, get some kiwi.

Meg Langston, FNTP, RWP, RCPC: 43:04

Kiwi is so high in potassium.

Nataliia Sanzo RD, LDN: 43:06

Yes, I love yellow kiwi because you can eat it with the skin, on which most of the vitamins and minerals are in the skin. So you can eat it with the skin and skin almost tastes like a peach texture. Yeah, peach or pear is a little dancer Delicious.

Meg Langston, FNTP, RWP, RCPC: 43:22

So you're saying there's a green kiwi and a yellow. I've only ever, yes, a golden. I've only bought in green my entire life. I am newly finding this out right now. I never knew there was a yellow kiwi.

Nataliia Sanzo RD, LDN: 43:33

It's actually called golden. Yeah, it's golden kiwi. Golden kiwi yeah, it's golden Kiwi. Yeah, so I buy it in Publix. I think you can buy it on Amazon. It's better, it has more nutrients than the green Kiwi. Oh, I didn't know that. Yes, I love it. Speaking, you mentioned the drinks potassium, coffee and an empty stomach. Yay or nay?

Meg Langston, FNTP, RWP, RCPC: 43:52

for a whole month. Never you eat your breakfast and then you have your cup of coffee Never you eat your breakfast and then you have your cup of coffee.

Nataliia Sanzo RD, LDN: 44:02

Never, ever, I can't believe. I invited you to my podcast because I drank two double shots espresso on an empty stomach five hours before I have my breakfast. No, I drank espresso, yes, and my hormones are like, beautifully balanced.

Meg Langston, FNTP, RWP, RCPC: 44:14

I don't. Yeah, I will say my philosophy is very much tied with Dr Catherine Dalton, where I'm very much of like. Women have to eat within the first 30 minutes of waking and if they have thyroid it's at 45 minutes of waking and it's very much tied towards the balance of having especially starch and because I think caffeine can increase after such a long period of fast. Hopefully you're sleeping around nine hours, seven to nine hours, then the increase. Yeah, Good for you. That's great for me and my clients. I think they would know I'd be like I do it.

Nataliia Sanzo RD, LDN: 44:47

But listen, it just shows how different we all are and I would never say, oh no, don't do that, because I do it and I feel amazing. And research shows that people, the coffee drinkers, especially chronic coffee drinkers I only do two espressos in the morning. Now they're very strong, right, they're real espresso. We have a real espresso machine at home. Chronic coffee drinkers actually, your body adapts to caffeine, so if you have an espresso, it may shoot your cortisol to abnormal levels, make you a little jittery, may gives you anxiety to abnormal levels, make you a little jittery, gives you anxiety. For me, the double dose of what you would drink does nothing because my body's already adapted. I don't know. Just a little side note. Yeah, that's a good one.

Nataliia Sanzo RD, LDN: 45:28

Last question One wellness trend you secretly love, even though it's like a little weird.

Meg Langston, FNTP, RWP, RCPC: 45:37

I would say secretly glove, probably sunlight, like looking at the sun. That's not cool or unique, but just because it's obviously supports thyroid, it increases immunity, lowers inflammation. I think sunlight is one of the most important things that we can do and I would say underrated.

Nataliia Sanzo RD, LDN: 45:55

I love it, love it. So when neighbors see you standing outside and just staring at the sun, pretty weird, there she goes again that nut yeah.

Nataliia Sanzo RD, LDN: 46:05

Awesome. Now for Meg, for people who stuck around, I think we need to give them a little 50% off of your Fix your Period. Your group coaching program? Yes, and I know that discount code is FIX50. Yes, can you tell us a little bit about your group coaching program, and I know that discount code is fix 50. Can you tell us a little bit about your group coaching program? What does it entail? How?

Meg Langston, FNTP, RWP, RCPC: 46:24

do they sign up? Yeah, so fix your period is a group program that it's all designed for women Actually, everybody in the world. I only work with us clients and Canadian clients but fix your period you can no matter where. We've had people from Ireland, we've had people from Iran, we've actually had people all over. It is all designed towards supporting your periods.

Meg Langston, FNTP, RWP, RCPC: 46:42

If you have no libido, if you have painful periods, if you have breakouts, if you have spotting you're not ovulating all of these things. The entire group program is designed to get you from one point to another. We offer HTMA testing in there and you join. You can join a community page where myself and my practitioner are answering your questions every single day. We hop on live calls, we have guest speakers, so it's an amazing community and we've had amazing results.

Meg Langston, FNTP, RWP, RCPC: 47:09

Some of my favorite is there's a woman that had constipation for five years and she, within eight weeks of the program, started to poop every single day, which is important, right. We got to clear that estrogen and then another one that was wrote a long letter about how she had such low libido. It was really impacting her marriage for 12 years. It was a big stress point, got her libido back and she was like it has impacted her marriage in such a positive way, and, of course, we can never guarantee these things, but we've had a lot of babies, a lot of people that were struggling to get pregnant and once we work on our hormones obviously that baby making machine you're ready to go. I think it's a special program. I'm really proud of it and yeah, yeah, I'm so excited to offer it to your community.

Nataliia Sanzo RD, LDN: 47:49

Yeah, I love it. So I'm gonna leave a link to that program to make it easier for everybody, under the show notes on YouTube, facebook, instagram when it's on live. You also have a podcast Beyond Her Symptoms. I'm going to link that as well so people can listen, sign up and distress, or when they go for a walk, they can listen to your voice, to your soothing, calm yeah, meg, you've been such a fun person to talk to and your wealth of knowledge. Thank you so much for sharing your expertise. I know my community will benefit from all the tips you gave us. There were practical tips. I love that. You simplified everything. I learned a thing or two, so thank you so much for your time, and maybe we should do another episode concentrating on some other aspect of health.

Meg Langston, FNTP, RWP, RCPC: 48:39

Yeah, let's do it. Thank you so much for having me.

Nataliia Sanzo RD, LDN: 48:42

Thank you, and we'll talk soon.