SPEAKER_00: 0:00

Welcome back to the Hashimotors Nutrition RX podcast. Today's episode is one you absolutely don't want to miss because we're diving deep into one of the biggest struggles women with Hashimoto's face: why weight loss feels so hard when you're doing everything right. And this conversation is extra special because it's not just a theory or research, it's real life experience. You're about to hear from two registered dietitians with over 20 years of combined experience who both live with Hashimoto's and truly understand what it's like to battle fatigue, stubborn weight gain, and this unpredictable metabolism. Because together we're breaking down what's actually happening inside the body when weight loss stalls, mistakes we see when women are doing their everyday, daily life. When it comes to healing your metabolism, balancing hormones, and finally seeing progress again. So if you ever felt like your body isn't listening to you, or you've tried every diet, detox, or exercise plan out there, grab a tea, settle in, and listen closely. This is your permission slip to stop fighting your body and start working with it. Alicia, I'm so excited to have you here.

SPEAKER_01: 1:18

Welcome to the show. Thank you so much, Natalia. I'm really excited for our conversation today.

SPEAKER_00: 1:24

I love having another registered dietitian on my Path podcast because I feel like we're always on the same wavelengths. And because we're here to serve our community, I'm just so excited for this conversation. And guys, we have so many great topics prepared for you. But before we get into the juicy part of our conversation, I want to introduce Alicia formally. Alicia Nicely is a registered dietitian and integrative functional practitioner with over 10 years of experience and specialize in hypothyroidism condition. Being a Hashimoto's warrior herself, Alicia understands what it's like to both live with and effectively manage this common yet complex condition. Alicia's approach is comprehensive and holistic in nature, utilizing and emphasizing the immense positive impact that lifestyle and nutritional changes have for managing endocrine and autoimmune conditions. Being a part of and serving this community is a true passion for Alicia, making her work both enjoyable and extremely rewarding. Did I miss anything? No, I think that's great. Yeah. You got it all. Fantastic. Before we uh get to our questions, can you share with us what inspired you to become a dietitian and focus on thyroid health?

SPEAKER_01: 2:56

Yeah, absolutely. So I actually originally went to college to be a marine biologist. So I didn't even have it on my radar to become a dietitian. And I started off with a science major and in biology. And about a year in of my studies, I learned that the college I was going to had a pretty well-renowned dietetics program. And as soon as I heard that that was an option, I immediately switched my major the next day because there was such a draw to wanting to become an expert in nutrition and health and human biology. And this was long before I even knew that I had a thyroid condition myself. So this was just more about the interest of wanting to serve people, be in the health industry, be a professional in this way. And I was just super excited to learn. So I knew that would be a good career path for me because it made me feel excited. I was very excited about it to pursue it. And it wasn't until a couple of years into my career. So many years after college, and I was working as a clinical dietitian in the hospital setting, inpatient population, that I figured out that was not maybe the course for me long term. I wanted to be working with my patients more long term in an outpatient setting and really helped them establish habits and educate them and support them. So I switched to outpatient and I found a wellness center in my hometown. I was hired as a staff dietitian, and I really loved learning more about it, really opened my mind to more of a functional, holistic approach. I trained under a naturopath. I learned so much during that time. And it was actually during my time working there that I learned I had Hashimoto's and hypothyroidism. And that's a whole other thing, I can go into that too. But it came as quite a shock and it really turned my world upside down. I was not expecting the diagnosis, but it is a blessing in disguise. That's the way I choose to look at it because I had to get my own health right first and understand what it took to do that. And then it also really opened my eyes to the immense gap in care for thyroid patients across the board for women specifically with thyroid disease and autoimmunity. How, because I became a patient that day. I became a patient and I went through the process of being referred to an endocrinologist and being dismissed or told specifically that diet would not matter, my dietary changes wouldn't matter, that I didn't need to change anything about my lifestyle, that there was nothing I needed to do or could do to improve my symptoms. I simply needed to take thyroid medication. And that immediately felt wrong to me. It didn't seem like a great answer or a complete answer. So that very much pushed me down the path to I need to understand what autoimmunity is and all of the things that I can possibly explore to improve my health and protect my health long term. And that just blossomed into my career and specialty as I worked on my own health and then started specifically and exclusively working with women with thyroid disease and thyroid patients.

SPEAKER_00: 6:04

Thank you for sharing your story. It sounds just, I'm sure a lot of people can relate, but it also sounds like my personal story. I was actually diagnosed right after graduation. So I don't know if it was waiting for it for it to guide me to the right. Yeah. Yeah. But I also see it like that. It's maybe not a blessing, but I'm blessed that I can live through it and continue to live through it. And I can just like you guide my clients through the same journey. And I understand where they're coming from. So I think living with Hashimoto's makes us better practitioners. Oh, 100%. Yes. There's always positive in everything, even autoimmune disease. Yeah, I couldn't agree more. So let's jump straight to the first question that everyone is struggling with. Why does weight loss feel impossible for so many of us with Hashimoto's, even when we're doing everything right?

SPEAKER_01: 7:09

Yeah, such a great question. Something I really like to bring attention to and educate on. And I'm really big about giving context for Hashimoto's because it is more complex and doctors don't always provide any education surrounding what could be going on. So what the way I like to look at it is we have to think about how did we get to this place? Why is the immune system overactive? Why is there a lot of inflammation? And this can guide you to looking more at lifestyle nutrition. And when we take that into consideration, we can look at the areas that are either led to the development of the autoimmunity or worsening it. And it's not just one thing, it's not just about calories and exercise. We have to take into consideration environmental stressors, emotional stress stressors, your daily habits, not to mention the symptoms that the condition that Hashimoto's and hypothyroidism produce themselves that make it very difficult to even improve your habits. So whether you're dealing with inflammation and pain and fatigue and brain fog, it's already hard enough to make healthy changes and stick with them. But then when you feel really bad, oh my, it's 10 times harder, right? Because I know it that's I've been in that place where we're told, okay, to lose weight, do more cardio or do this HIIT program training, this very intense, make sure you're really strict on your diet. I've done all of those things. I've tried all of the different types of dieting. And boy, did my body rebel because that was not what my body needed at the time to be healthy. I view fat loss and healthy weight loss as a positive outcome for making the right changes for your body in the right order. So going back to the whole context piece, I was completely ignoring the context of the state my body was in when my Hashimoto's was in its in its worst or at its worst. I was neglecting my stress. I was didn't really realize that I was living in mold and exposed to mold for years. I didn't understand that I had been chronically under-eating for years, and my training was more of a stressor than it was a helpful part of my health journey. So all of these things, we when we really hyper focus on weight loss as the outcome, I think we can become blind or ignore, not be aware of why is the weight loss not working? And maybe shifting our focus more to establishing a strong foundation and health first will allow for your body to lose weight more easily and will allow for things to operate as they should internally.

SPEAKER_00: 9:46

100% context always matters. But before I kind of give my five cents to why I think I have theories, why does it feel like it's impossible to lose weight? I want to say something to your note. You said doctors don't provide nutrition education. And now we're in this era of shifting towards more functional medicine. And now there is a talk that doctors will have more nutrition courses or classes. And at first I got excited about it. I was like, oh my God, they're gonna know a little bit more about nutrition, especially for Hashimoto's autoimmune disease. But then I think the whole dietetic field realized we don't need doctors speak about nutrition. They need to refer their clients to the registered dietitians. So I switched gears. Now I don't want doctors to have more nutrition courses, I want them to concentrate on saving our lives from the medical perspective and let us take care of our clients from medical nutrition therapy perspective. So I just wanted to say something because that's something that is actively brewing on the internet. And I hope the policies don't change. The only thing I do want to change is that referral system. We need to have a stronger referral system from our physicians to our practice.

SPEAKER_01: 11:14

Yeah, I agree. And the other thing I'll just add to that is say doctors do get more nutrition training and are more aware about that. My follow-up question would be is do they have the time to sit down and coach and educate? That takes a lot of time, and that is part of our that's built in usually to a dietitian's job, is the time necessary to educate and support and guide over time, not just in a 15 missit, 15-minute appointment. So that has to be considered. And I don't think the current medical system is set up for that.

SPEAKER_00: 11:46

And I was just like you, I worked as the outpatient registered dietitian at one of the biggest hospitals here in Nashville, Venerable University. And believe it or not, I only had seven to 15 minutes with the client. And of course, that was hard to make any kind of positive change on somebody's mindset or dietary changes or lifestyle habits that they've had for the last 20 years, it's very hard to influence somebody. So I love that we're both in private practice where we don't have to follow any kind of like insurance style guidelines. We can spend an hour or two hours with the patient, whatever they need. That's why it's called a personalized nutrition. So I love that part of medical nutrition therapy right now, that you can be your own boss and you don't have to answer to nutrition companies.

SPEAKER_01: 12:36

Yeah, yeah, exactly. I think that freedom is necessary.

SPEAKER_00: 12:40

Yeah. But going back to why weight loss feels impossible, I think so many of my clients come to me feeling like they have failed their bodies when in reality their metabolism is just trying to protect them. When inflammation is high or their conversion from T4 to T3 is impaired, no amount of dieting will move that needle until the root causes are addressed. And then with my ladies, and I'm sure you and I experience that, chronic dieting and muscle loss that leads to slower metabolism, right? The less muscles you have, the less calories you burn, your resting metabolic rate decreases. And of course, then when we look at chronic gut infections like H. pylori, E. coli, all that stuff, some of them decrease stomach acid. And then the nutrients are not broken down completely, they're not broken down properly. And I always say it's not what you eat, it's what you absorb. So if your nutrients are not broken down properly, you're not absorbing all of that. So you have low vitamin D, low iron levels. Just those two have a huge impact on your energy. So there is your fatigue, you don't feel like going exercises. No matter what your practitioner, a doctor, or dietitian say, Oh, we need to do gentle exercise. If those nutrient deficiencies are not addressed from medical nutrition perspective, like you said, no amount of goodwill or willpower. Move that needle in the right direction.

SPEAKER_01: 14:23

Yeah, absolutely. Yeah, I was just gonna say that's something that I know we're gonna dive into deeper with body composition. And my whole philosophy is setting the stage for fat loss. And there's a lot of work that needs to be done for most of the patients I work with, most of the clients, where we have to get them out of that chronic dieting cycle. We have to help them restore robust metabolic health, we have to correct nutrient deficiencies, we have to work on the health. This all takes time. And there is no quick, sustainable fat loss trick. It really is about honoring your biology. And that's where a lot of education comes in. On my point, if I can just get my clients to buy into that and trust me, I will liberate them from this low calorie, sluggish, low thyroid function nightmare that so many women get trapped in and they're really not sure how to dig themselves out in a way that is healthy or sustainable. So, yeah, setting the stage for fat loss is so crucial if you want to improve your health over time and feel good and look good and be lean and strong and energized. So I could not agree more. That's exactly how I approach weight loss with Hashimoto's.

SPEAKER_00: 15:35

You said chronic dieting. That this kind of leads me perfectly into the next question because a lot of what we're talking about comes down to behavioral and belief system that women are taught about weight loss, right? So, what are the some of the biggest mistakes women making when trying to lose weight with Hashimoto's hypothyroidism?

SPEAKER_01: 15:57

Yeah, yeah, there's definitely quite a few. The first one is maybe not understanding nutrition, right? Unfortunately, we're not everyone, most people are not educated on nutrition. They may know how to read a label or count calories or avoid processed foods, but that is not the same as understanding nutrition. So, and understanding your body's personalized needs. That's a whole other piece to it, right? So it a lot of times what I see, and this is a very common mistake, is someone, a woman, they don't know how much they're eating, but then they know that to lose weight, they need to eat less. So then they just cut from where they are. So maybe they're eating 1400 calories, 1500 calories. They're like, I want to lose weight, so let me like cut out carbs or let me really cut back overall in my calories. So that drops them down to a thousand, eleven hundred on average. And that might work initially a little bit, the body may respond, but I guarantee you're gonna hit a plateau. And where do you go from there? You know, you're moving into starvation territory where you're not gonna get enough micronutrients, like you were talking about, important cofactors and nutrients needed to just function properly. And it's only going to downregulate thyroid function and make you feel worse because this is a protective mechanism built in. Our thyroid function will downregulate to protect us if we are not eating enough energy and getting enough nutrients from our diet. That's how we survive famines or low, low food intake. Our body doesn't know that we're doing it intentionally versus it's a situation we have to survive through. So that's a huge one, is just not understanding where you're at and not understanding your body is probably not in a position to drop fat when we start. We have to lay the foundation, like I said before. The other one is confusing just cutting out foods with improving your nutrition. So, what I mean by that is many times I have people tell me on social media or when it were speaking one-to-one that I've cut out gluten and I'm dairy-free, and I don't eat sugar, and that can all be well and good and maybe needed. But then I look at what's left of their diet, and it's there's not a lot of nutrients, not enough calories, not their macronutrients aren't balanced very well. So if they didn't really improve their diet, they just maybe removed a few triggers and they're not understanding why they're not feeling better. So, nutrient density and balancing your meals and all of these things are part of optimizing your nutrition and personalizing it to you. So, this is where dietitians are needed to provide this education on nutrition. It's not as it's not always as simple as just cut calories and that will improve your health, right? Those are not one and the same every time. So those are some really big mistakes I see that are very common and it's not to blame anyone. A lot of times they're not intentional. People just they want that result, they want to feel better, they just don't know how to get there in a healthy way.

SPEAKER_00: 18:51

I love that you brought up nutrition education because I think when people think that, oh, I know how to read the nutrition label, I know how many calories are in a slice of bread or how many carbs, they think that they understand nutrition. But the truth is that we registered dietitians spend at least five years of basic education about human body and how it interacts with micronutrients, my macronutrients, it's chemistry, it's physiology, it's all of that stuff. And a lot of dietitians are now required to have a master's degree. In addition, so you're looking at about seven years of education about nutrition. So there's a lot more to it than cutting out carbs and following cutting, knowing that you need to eat less than or to be in a deficit of 500 calories to lose a pound of whatever of fat per week and stuff like that. So a lot of good points. I also see a lot of women undereating and over-exercising, thinking that more restrictions equals faster results. In reality, it is usually slowing down their metabolism, their thyroid, spiking cortisol and keeping them stuck in that metabolic trap, just like you said. They don't understand why it's not working. And part of that, I think a part of that vicious cycle comes from not knowing how to manage blood sugar and energy throughout the day. So, what are some of the blood sugar hacks that work really well for Hashimoto's clients who struggle with cravings or like afternoon crashes?

SPEAKER_01: 20:31

Yeah, that's a great question. And yeah, there can be a lot of symptoms alone that stem just from not learning to manage your blood sugar. And I made a lot of these mistakes when I was a dietitian, and I should have known better looking back, but not eating enough overall, smaller meals that aren't balanced, and you hear this a lot, balanced with having a protein present, having fiber present, having the complex carb, having fats present. But even just doing that, making sure you're not eating maybe just a carb source or a quickly digested carb source by itself, especially if you are a metabolically sensitive person, like your blood sugar is not that stable, your metabolic health isn't that flexible or robust yet. That can be something that that just that change of pairing your macronutrients together and eating a substantial meal can make you feel so much better overall with your energy, the stability of your energy, your mood, your appetite, all of that. Another one that I really is gentle movement after meals, like a quick walk, especially if there are more carbohydrates involved, which is fine. We need carbohydrates, they're great. But I recommend to my clients after dinner, if you can, just go on an after dinner walk. And that also supports digestion, but it helps to stabilize glucose and it improves insulin sensitivity and it does optimize that. And you will feel better. I can almost guarantee it when you practice that habit. So movement and those are like the biggest ones. They're low-hanging fruit, they're simple. Most people can do that. It doesn't cost you anything, it's just these small habit shifts that you can practice day after day.

SPEAKER_00: 22:07

Absolutely, because stabilizing blood sugar is foundational. I always tell my clients that if your energy dips, mood swings, or cravings are unpredictable, that means that your metabolism doesn't feel safe enough to burn fat efficiently. And so something as simple as like adding protein and fiber to every meal, or even like you mentioned, walking after meals can change everything. So I completely agree. Those two things are the main things for me as well. Now I'm gonna go in with a follow-up question. Yeah. What do you think about the CGMs, continuous glucose monitor devices for someone who does not have a diabetes?

SPEAKER_01: 22:50

Oh, very good question. And I forgot to add one more, and I can't forget this one. Skipping breakfast or having a very light breakfast that is like a piece of toast, some oatmeal, or having coffee and waiting to eat a couple hours. That's a huge one because your first meal of the day can really set the tone for blood sugar stability for the next 24 hours, even having protein, fat, and fiber for breakfast within an hour or so of waking is a great way to hack or optimize blood sugar balance for the rest of the day. So I couldn't forget that one because that's a big one I also see. That's pretty common. But yeah, CGMs for people who are not diabetic, I think it can be interesting to learn that data in real time because there is the fact that I may respond differently to the same carbohydrate than you would, type of thing. I may respond differently to sweet potatoes. Maybe it spites my blood sugar a little bit more than you. Yeah, that's true. If it's helping you create awareness and maybe learn how to balance your meals better and then see that in real time and compare that. If that's someone, if that lends to your personality, you like objective data to view and help you make changes. Sure, if you want to invest the money and do that, I'm not against it. But at the same time, there is a natural blood sugar increase after meals, and I don't want people to become obsessive over it and make sure that be in this mindset that I can never have my blood sugar spike and that is bad, that is bad. It's no, it's actually natural and needed. Really, there's like a two-hour window after eating where you want to just make sure that your blood sugar starts to come down under a certain range, usually like 180, I believe. But I don't want people to become obsessive, and I think sometimes that can happen with people who are very focused on their health, that they can tip over into that obsessive, and then that can also be really stressful. And then there's more stress around eating, which I want to eliminate or reduce as much as possible because eating should be more of a natural, enjoyable, healthy habit, not something that is causing you stress because your blood sugar went up, which again is supposed to happen and it's normal.

SPEAKER_00: 25:02

I actually have quite a few clients who are using CGM to track their blood sugar. They don't have type one or type two diabetes. And I actually were one just to understand my clients that have diabetes, for example, or the ones that just simply wants to use CGM, what they're going through. Because for me to educate them on this, I needed to understand how the chart look when you eat an oatmeal that was peanut butter, and of course, you have blood sugar spikes, and everybody's, oh my God, I'll know I should not have oatmeal. And that's where education comes into play. So I'm glad that I wore it. And I saw that blood sugar spikes all the time from almost anything, it doesn't mean that it's bad. So I always have to be cautious with my clients, and I do not only physical assessment, but also where are they mentally? Do they have any predisposition to disordered eating? Now I'm not talking about eating disorder, full-blown eating disorder. But if somebody comes to me saying, Oh, I eat clean, and by clean, there's nothing but a dry toast and water, and everything is soy-free, gluten-free, corn-free, all that stuff. And in their mind, this is clean eating. This is a pattern for disordered eating. So I always advise a client like that not to get CGM, but to get back to basics and learn what's nourishing, what will give you instead of sugar spike energy. Let's rephrase some things. So we're in the same area, the same stand with you. It's not for everyone. Some people love and benefit from looking at the objective data and learning it and moving forward without it. Like you they wear it for months, but that's it. You should not be wearing it for years and years to come. So I think it can be a fun tool, but it's not for everyone. Yes. And speaking of quick fixes, though, there's one trend or actually movement, I want to say, that takes over almost every conversation lately. What are your thoughts on a Zempic and GLP1 medication for women with Hashimoto specifically? Do they actually work or could they make things worse long term?

SPEAKER_01: 27:30

Very good question. I can say they work. I work with clients who are on GLP1 agonists specifically lately. It's been trazepatide. They do work, but there's a huge caveat to that. And again, it's really understanding that the foundational pieces still need to be present. You know, this is not a quick fix. And obviously, there's also been a lot of backlash for these medications or these peptides when they're used and abused and misused type of thing. They're the dose is really high, it's inappropriate, it's too quick. Anytime you do a very rapid weight loss time frame and you are not strength training and you are not eating enough protein and you're not doing everything in your toolbox to preserve lean muscle mass, it does tip over into that less beneficial than it is going to be helpful category because losing muscle mass is a losing game. We need muscle tissue, and this is the organ of longevity, I've heard it put, which I really like that. Also for your bone health, too, that kind of falls into that category. You can lose bone density as well, especially as women, depending on where you're at and your hormonal season of life. But there's two sides to this coin when used appropriately, microdosing, and depending on the client, depending on their blood work, depending on their history, it can be an excellent tool. And I have worked with clients and I've helped them make sure that we're doing it the right way, the safe way, we're coming off it in a healthy way, but they are lifting weights, they are hitting their protein targets, they are keeping eye on digestive health, all of these things. And that's also usually after we've tried all of the things and they are still maybe stuck or needing a little extra support. And I also think it's interesting that they're obviously it's helping with the glucose and insulin and that metabolic piece, but also there's been research to show for a variety of autoimmune conditions it helping with the inflammatory aspect a little bit. There's other peptide therapies that target that more, or the immune system, of course. So that's also interesting. I'm not saying it's for everyone. I've had clients try it and they cannot tolerate it at all, even at a microdosing level. But yeah, it can absolutely be overdone and, like I said, misused and abused in high doses and causes really rapid fat loss, but also muscle loss, so weight loss in general. And then if those habits aren't instilled or that foundation isn't laid, when you stop taking the GLP1, and it's almost guaranteed that like any Any type of crash diet style or approach, you are going to regain that weight and your body composition will likely be worse, even at a lower weight, because of the shift in the muscle loss. And that's a dangerous place to be, and something I would avoid at all costs. If you are someone who could benefit and is interested in trying a GLP one, just please partner with a savvy practitioner or whomever who can guide you on it appropriately so you can avoid the negative consequences that can potentially come. So that's that is my current stance. I'm not for or against it.

SPEAKER_00: 30:37

You had all the great points. I almost have nothing to add because this is exactly what I think. I do want to say that there is a right and a wrong way to do peptide therapy. All the horror story that we hear about people getting into ERs with they call it dead stomach, paralyzed stomach, or this chronic constipation or severe dehydration, it's because they're abusing the medication. They're not working with an MD and RD to hit everything from a comprehensive perspective and get comprehensive support. So all of the bad side effects we actually hear in the news come from people that misuse the medication and do not work with a medical doctor or a registered dietitian. Because I have so many clients who are doing very well on these microdosing, both trisepatite and semaglutide. A lot of them, like you mentioned, don't tolerate the last client I had. She took trusepatite. She said the side effects that she had from the smallest dose were unbearable. So she stopped. But that's one, maybe one in ten. But if what my point is, if done correctly, I think it can decrease inflammation, improve hemoglobin A1C, because a lot of people with Hashimoto's have insulin resistance. So if we've tried already everything, maybe that's a good little micro-dosing. But also microdosing means different things. There are there are no protocols of how to microdose, it has to be personalized. So if somebody's thinking about it, I say, like you said, find a savvy practitioner and work with the team if you want to try this. Okay, so that's our peptide talk. Yeah, let's talk about uh another little trend that's making a comeback, intermittent fasting. And you already mentioned the breakfast is one of the most important meals of the day, but you can still fast and eat your breakfast as soon as you wake up. So, what is your stand on intermittent fasting? If you would recommend, is it 12 hours? Is it 16? Is it 24 hours stand?

SPEAKER_01: 32:58

Yeah, so I do sometimes use this as a tool. Granted, the foundational pieces are there. It's this isn't just a quick fix by any means. But for some clients, I think it can be really helpful, especially when we're trying to shift habits and we're looking to optimize things like digestion and sleep and insulin sensitivity. So, for example, yes, I think most people do very well or better when they eat a substantial breakfast and it's well balanced and they're setting the tone. If anything, I would encourage having an earlier dinner because stopping your last meal two to three hours before sleep allows for deeper, better sleep. It doesn't impede on melatonin production and it's not all of digestion, it's a lot of work and a lot of blood flow, and that can compromise your sleep quality, which is something we absolutely don't want to do either. So for me, I have felt really good having an earlier dinner and it and I sleep better. And then also for some people too, when it comes down to food choices and cravings, usually we maybe don't make the best food choices late into the evening, the snacking, the more like sweets or more processed foods. So this can be a nice way to curb that habit. Not saying you can't have certain foods for fun and have that, but in the evening, late at night, when you are not moving very much and we are watching shows and having lots of like blue light filtered, like it's just not metabolically aligned. It's not really aligned with our circadian rhythm either to eat late into the evening. So that's where it can be really helpful. 12 to 14 hours max for women is where I say, which a lot of people, without even realizing it, do fast for 12 hours if they have their dinner at 6 p.m. and then they have breakfast at 6 or 7 a.m. You know, that there's 12 hours right there. Some people maybe benefit from a little bit longer of a fast if their meals are balanced and they're getting enough calories and all of that. And again, depending on our specific goals, is it insulin sensitivity? Is it breaking habits? Like what are we working with here? What are we working on? We can implement that and start easy and then maybe make it a little more advanced if needed, and if it makes sense for the person. But yeah, again, it's a tool. And when it's used in the right context, it can be really helpful for some people.

SPEAKER_00: 35:13

Absolutely. People ask me on Instagram all the time, do you recommend intermittent fasting for someone with Hashimoto's? And it's such a loaded question. And I always ask, or I want to ask, because I can't engage with every comment like this or with every question. I want to ask, what are you doing it for? What are your goals? Because if your goal is to, I don't know, manage blood sugar, this is not the first tool that I would recommend for you. Are you inclined to disordered eating? This is the not definitely not the tool I would recommend for you. Are you trying to decrease inflammation? Are you trying to let your body rest and your bowel rest and get into autophagy, right? When your body naturally cleans out dead cells, including cells in your intestinal tract, in your small intestines, large intestines. So it all depends on your goal. Some people, including me, benefit from intermittent fasting. I've been fasting for probably five years. I do 16,8, meaning that I fast for 16 hours, sometimes longer, and it makes me feel amazing. But I don't have any blood sugar dysregulation, I don't have cortisol dysregulation. And intermittent fasting by itself, it will not cause the stress. If you're predisposed to it, if you have everything going on with you wrong, and then you're like, oh, let me add intermittent fasting to it, of course it's gonna backfire. You probably started with imbalanced blood sugar. So yeah, intermittent fasting, I think it's a great tool if you s initiate it right and at the right time and with the guidance of somebody who understands the metabolic processes that your body goes through the whole circadian rhythm. I actually have I still make meal plans. I know it's maybe outdated, but some people love the structure. And some of my meal plans not only are based on intermittent fasting schedule to make sure that you get all your nutrition because it's harder to eat all of your calories with an eight-hour period. And the thing is, people start uh intermittent fasting to lose weight. I haven't lost a pound in last three years doing intermittent fasting for 16 hours every day. So this is not the tool per se to lose weight unless this is your goal. So see how like I'm always tracking back what is your goal? Let's go from there, let's design your plan based on your goals. So don't just take a tool, a peptide, an intermittent fasting, a detox, and use it towards a goal that is not clearly defined. I think intermittent fasting is great for some people, for others, it can be uh can completely wreck chaos on their whole hormones. And and since we're talking about the stress response, let's move into something that a lot of people are talking about all the time detox for weight loss trend. Like detox, uh teas, extreme detox juices, five-day slim down are everywhere online. What are the risks of these trends for someone with a sluggish thyroid? And can you lose weight doing those things?

SPEAKER_01: 38:46

Yeah, it's it's crazy that it won't just die and go away. It's that it's still hanging on. And I I understand the appeal of a quick fix, right? People want results now. And again, more education on like results take time when you want them to last. And the thing with these quick detoxes or flushes or whatever, it's not detoxing anything, most likely. You may lose a lot of water weight because that's natural to restrict carbs or you don't eat for a period of time or you're on a liquid diet, you will likely feel worse. Again, unless this is medically supervised and appropriate for your health, don't follow something generic or something that an influencer is promoting because they're already lean and it looks like that's how they got there, but it's not. It's very deceptive marketing. Yeah, for thyroid health, your biology is hardwired and it's very adaptive and it's going to respond to what it's perceiving as oh, we are not getting the nutrients we need. Let's slow things down. So, likely at the end of that, you're going to be in a worse position than you were to start off. So, yeah, I don't ever recommend that. There are other real effective ways to support drainage pathways, detox pathways, bile health, liver health. Absolutely, that is a real thing. I do believe that our detox pathways do get overburdened or compromised physiologically because thyroid hormones are underactive, or there's inflammation, or there's nutrient deficiencies, whatever may be going on. Yes, but there's a difference between supporting it long term by shifting your nutrition and the way you live. For example, cutting out alcohol is a great way to support your liver and in detox pathways, versus I'm gonna do drink whatever, follow whatever because they said it will help me detox and lose a bunch of weight. There's realistically, there's you can't lose so much weight in a few days, anyways. True fat loss, which I think is what people want. They don't want just weight. So, yeah, again, more education about helping people achieve what they want, but also setting those realistic parameters of how to get there in a healthy way and not a way that's gonna leave them worse off and more frustrated at the end of it.

SPEAKER_00: 40:58

When somebody online says that these detox tea or five-day cleanse will help you get rid of toxins and help you lose weight, does not understand the chemistry and physiology of the body and how we truly detox toxins and where they detoxing from. So when you guys hear the claims like this, know that person chances are does not have a medical background, any kind of even basic education. So let's stay away. Detoxing is important, but not the way social media present it. I always say the body detoxes through not only nourishment, our protein, fiber, but also through supporting the liver, supporting your kidney, because that's where you pee out all that stuff. Your gut, and of course, that's pooping. That's your detox. One of the main major detox pathways is your pooping every day. And of course, chronic constipation with Hashimoto's that's a big one because the longer the stool sits in your colon and small intestines, those toxins actually get reabsorbed back in your in your system. So detoxing through pooping, and of course, skin barrier, sweating is one of the best ways to detox. So I think both we both teach women that sustainable detoxification comes from giving your body more in the right way, not less.

SPEAKER_01: 42:28

Absolutely. And if it sounds too good to be true and it sounds too easy, it probably is. That rule stands the test of time more often than not. So I always keep that, or I tell my clients that like if it sounds too good to be true, just ignore it and move on. Yes.

SPEAKER_00: 42:43

If it sounds too sexy, too appealing, too good to be true, it's they're trying to sell you something. Yeah, yes, yes, because eating more protein and fiber is not sexy. Talking about food all day and how to detox through your colon and stuff is not sexy, but that's what we do because it works. It works. Now we've already talked about low-carb diet, keto. What is your stand on that? And if somebody is following a low carbohydrate diet, what's the minimum amount of carbs do you see or people with Hashimoto's should have?

SPEAKER_01: 43:17

Yeah, the same thing with the same theme we've been talking about today is it really is so dependent on the person. I do believe there are medical conditions and situations where a ketogenic diet can be therapeutic. It has to be appropriate. And that's almost never the clientele I work with, if I'm honest. But yeah, absolutely. There are conditions where it's highly beneficial. And they're learning more and more, too, about even just the brain health and TBIs and seizures, absolute stroke victims, that type of thing. And but when it comes to supporting thyroid hormones and optimizing that and being able to live, I always like to also understand like your lifestyle. What do you want your diet to look like in 10 years? Can you follow the same thing? And what's going to help you function well, feel recovered, support, and also allow for a social life, flexibility, traditions, holidays. That's so important too. It's not just about fueling your body, it's also about living your life and be able to be consistent and also enjoyable. So, yes, everyone does have a different carb tolerance. And I do think that's flexible too. You can work on that through building muscle and improving insulin sensitivity, and that can be done over time. So, ideally, like we are eating a wider variety of carbohydrates and improving your metabolic health over time. So you can easily utilize glucose and from your carbohydrates without it causing symptoms, right? And that energy utilization can be efficient and smooth, and you can also utilize fats for energy. That is great metabolic flexibility that I want people to achieve over time. Yeah, some people, if there's a lot of insulin resistance and they're struggling with carbohydrates and symptoms, we may scale back for a time frame. And it's so individual. Like I, for the most part, most of my clients, I want them eating well above 100 grams of carbs a day. Sometimes it's 200 grams, depending on how active they are. I've worked with athletes too or personal trainers. Like they are doing some heavy-duty movements all the time where they're training a lot. So the demand is there and they can utilize it very well. Yeah, time and place. If someone has something like SIBA or Candida overgrowth, yeah, therapeutically we may scale back for a time frame to help the gut rebalance. It just is so depends. But yeah, I'm not the first person I know there are some people out there and practitioners who do advocate for keto for Hashimoto's. Can it work for some? Yeah, clearly it does. But then my follow-up question is this something that you feel like you want to or need to follow forever for many years? Again, I think that's even a smaller percentage. And then for other people, it's if the answer is no, maybe it's a more of a short-term experiment or even just a reset. But it just so depends on where someone's at mentally. Ketogenic diet is not easy to follow. It does take practice, it does take troubleshooting for sure, and guidance ideally by a dietitian. But yeah, that's kind of the answer.

SPEAKER_00: 46:17

I'm kind of in the same stand with you there. When somebody comes to me and they're just they want to do this low carb diet, I meet my clients where they are. I'll say, okay, let's design a keto or low carb diet, but in a healthy way. There is always a better way to do a diet. So it doesn't matter. If you want to be vegan, more power to you. But let me help you make it balance and to prevent nutrient deficiency, to keep your energy, to keep your period, and especially with fertility, with Hashimoto's and infertility, and that's another topic. We can talk about that for another hour. But with low carb diet, I always say at least 120 grams, and that's a ballpark number. We don't know the exact number, even clinically speaking, but the ballpark 120 grams of carbohydrates net. So goal for my clients usually the meal plan is design 160, for example, grams of carbohydrates. 40 of those grams of carbohydrates is our fiber. So we take total number of carbs minus fiber, and there is your net carbs. So I always say, what is your goal? It's net carbs and 120 grams of carbs, that's a low carb diet. The people think that low carb diet means 50 grams. No, like it's at around 100, that's already a low carb diet. So you have to be careful not to dip too deep with that. Yeah. Now we're running out of time, but I do want to ask you the question: the social media influencers are like promoting things like parasite cleanses and colon hydrotherapy for weight loss. What are your thoughts on these extreme methods?

SPEAKER_01: 48:09

Yeah, for weight loss, no. That's my short answer. Sure, yeah, parasites are real and they can be pathogenic and they can be a problem. But that again is so needed to be personalized and dealt with on a one-to-one basis. But as far as weight loss, can it cause other health issues? Yes. But it's appealing because it's a quick fix and it's a silver bullet. Oh, it's just this one thing I need to do, and all of my health problems will melt away and I will be fixed. That's the mentality and that's the appeal. And that's why it works and becomes so popular, is telling people whether simplifying it down to I just have one problem I need to address. And therefore, that will allow me to lose weight again when in reality it's really hard to take an honest look at your life, at your nutrition, at your habits and change them. That's way harder than doing a parasite cleanse. So I get that, I get why, but no, I don't ever use any of those things. And I help many women with Hashimoto's lose weight and keep it off. Yep, that's my take.

unknown: 49:12

Yes.

SPEAKER_00: 49:13

I agree 100%. And was this colon hydrotherapy when people literally wash out everything from large intestines, your microbiome, and we know Hashimoto's is an autoimmune disease. Your immune system is overreactive, attacking your thyroid. And over what 70% of your immune system lives in your gut. So when you do hydrocholon therapy and wash out all that stuff, you're washing out your immune system, literally. And one of my clients said, No, but that's okay. After that, they gave me a little shot of I think it's chlorophyll or something. I can't remember what she said, but it's like a bunch of green grass in there or something. And she said, and they told me that it replenishes my microbiome. And not a lot of people know, but it takes up to six months to rebuild your microbiome after something traumatic like this, hydrocholine therapy or antibiotic, those two are in the same therapy. You're washing out, you're killing off your immune system, your microbiome. So you stop overreacting. So every time you do stuff like this, you take harsh supplements, even for parasite cleansers. They kill off your good bugs as well. So not a lot of people know that. So will you so be ready to take up to six months to rebuild your immune system? And don't expect your Hashimoto's to magically uh get better while you're killing off all the stuff that is actually responsible for improving Hashimoto's related symptoms. So I'm against it. First, they're unnecessary, and most importantly, they're dangerous. Okay, so I think we're clear on that. Now, if someone is listening right now and feels stuck, exhausted, and gaining weight, what would you tell that person? What is their next step? And are there any resources you offer your clients right now or somebody that's following you?

SPEAKER_01: 51:15

Yeah, if you're stuck and you're going in circles and not making progress, and my biggest advice is hire a coach, hire a dietitian, hire someone to help you because if they're a great coach and a dietitian or practitioner, they're gonna know where your hangup is. And also, a lot of times, if you've never had the chance to dive deeper about your health and get the proper testing done, or have someone analyze and help you look into your habits and see where you can improve, it will save you so much time and stress and frustration to have a clear path forward. So when you do actually make changes, your effort will yield some sort of progress versus staying exactly where you are, or even backtracking sometimes, or doing things that you know you don't realize are heart hurting your health or harming your progress. So that's a big one. Also knowing that it's it is possible, like there is there should always be some level of hope there. Like hopefully you're working with someone too who is instilling hope and showing you that no matter where you're at in your Hashimoto's journey, no matter how bad it is, there is always hope to restore your health. Like the body wants to be, the body wants to heal, it just needs the right support. The body doesn't like being sick either. So that's an encouraging message I like to share too, because sometimes it can feel that way. It can feel like your body is working against you, it can feel like your body is broken, and being stuck in that mindset sometimes also holds you back from making forward progress and healing. And I take on one-to-one clients, I'm doing that right now, so that's something I really enjoy doing because we go deeper into your health, we look for underlying causes that are preventing you from healing, making progress. So that's something I really enjoy. I like to get much deeper than you will with your doctor and provide the support that you've likely been seeking. And then I have courses and I have free guides. And if you visit my Instagram page, a lot of it's linked there. And of course, my page too is on social media's all free education to hopefully help you understand Hashimoto's better and how it's affecting your health, but also solutions that you can start implementing right away.

SPEAKER_00: 53:28

Amazing. I love your social media platform, it's such a beautiful community. You have a lot of engaging comments. So I see that the people are interacting, they're not just showing up to learn from you, they're interacting with each other, which I think that's why we're here in this space on social media to see this, to see the community growing. It's not about number of followers. Who cares? It's to see this community talking, learning from each other because we're still learn. When somebody signs up with us, they don't come for uh old school education, because now education is free on Google and this chat GPT is blowing up. They don't come for us for that education, they come for our experience as a clinician, put that piece of puzzle together to find a missing piece, to find what are they hung up on, because we use clinical correlation to address all of this. We implement, we're actually the only professionals who are licensed to use medical nutrition therapy as a treatment for chronic disease. And Hashimoto's is a chronic disease. So I think that's why we don't have to sell our services. People come to us and they know exactly what to ask for. So I really appreciate what you do on social media. And thank you, Alicia. Thank you so much for dedicating a whole hour to us. I know you have the little kiddos at home, and you're such a busy professional and businesswoman. So thank you so much for your time. And I really hope this conversation brought clarity to whoever's listening or watching, and most importantly, maybe actionable steps they can start taking today to improve their health. And thank you so much for providing all the resources, guys. I will link them all in the show notes when this podcast goes live. And of course, right now it's already live on YouTube, so you can go and listen to it again. So, Alicia, thank you so much for your time.

SPEAKER_01: 55:34

Thank you so much. This was such a pleasure, and yeah, I hope it reaches the right ears and helps someone today so they can start improving their health. Absolutely, no doubt about it.

SPEAKER_00: 55:44

Thank you guys, and we'll talk to you in the next episode.