Overcoming Thyroid Hair Loss and When to Reintroduce Gluten With Dietitian Nataliia Sanzo

Introduction and Natalia's Hashimoto's Story 0:00

Hello, everybody. Welcome to the thyroid pharmacist healing conversations podcast. I'm your host, Dr. Isabella Wentz. And today, I am so excited to have a fellow Hashimoto's expert and warrior joining me. We have dietician, Natalia Sanso, joining us. Hello Natalya, it's so great to Thank you so much, Dr. Wentz, for having me. I'm such a fan of your work. And, you know, I remember grabbing your book when I was diagnosed with Hashimoto's and thinking to myself, oh, my God, this is it. This person knows exactly what I am going through.

As like you said, Hashimota warrior myself. So to me, You were the first person in my journey. So I think the world of you and I, just like a million of listeners and viewers, appreciate your input into the World of Nutrition, Hashimoto's Medicine. Thank you for having me. It's an honor. Well, thank you so much for your kind words. I so, so appreciate that. And it's an honor and a pleasure to be a part of your healing journey and so incredible to see you taking your own diagnosis and now helping other people with Hashimoto's as well.

So it is an I think one frustrated person decides like, I just need to speak out and share this with the world. And then that message can reach somebody who helps themselves and then goes on to help so many more other people. So thank you for doing the work that you're doing. Yes, of course. Honestly, I was never really interested in thyroid disease during my clinical rotations at Vanderbilt University. I did it here in Nashville, Tennessee. And I concentrated on the community outreach, weight loss.I worked for four years at the rehab center at Vandervild doing tube feedings, working with traumatic brain traumatic brain injury, spinal cord injury and all that stuff.

And I loved it. I love being there in clinical settings. But then when I was diagnosed with Hashimoto's in 2016, I realized I wasn't in the wrong field. Like, what was I doing forcing weight loss on patients that were, you know, bed bound in a hospital, laying there, not wanting to see you like you're there. They couldn't run away from you. So I hated that idea of treatment when the people didn't want to. So my diagnosis kind of guided me in this Hashimoto's world. And when I started looking for solutions to treat myself, because when i went to the doctor, the doctors said, oh, don't worry.

It's treated very easy. Just take this pill for the rest of your life. You'll be fine." Of course, I was appalled by that answer. Not having a family history of Hashimoto's, none of my family members knew what Hashimoto's meant. And I said, why did I develop this? I'm the first generation in the United States and I am the 1st one having Hashimoto's. So that was a puzzle and such a science nerd for me was like, I will figure this out. I quit my full-time job at Vanderbilt. That was kind of a risk.

to get on this journey of discovery and that journey led me to opening up a private practice here in Franklin, Tennessee, and seeing first long distance but via telehealth, patients via Zoom and tele-health. Now I have so many in-person clients that I love. So now I definitely know that i'm in the right place because I found answers for my Hashimoto's and I live a very busy and happy and vibrant life and i want that for everyone that come in contact with me that struggle with Hashimotos. I love that.

I'm going to tell everybody joining a little bit about you, just a quick bio. So you are a licensed registered dietitian, Nashville thyroid expert and certified health and wellness coach, specializing in autoimmune thyroid disorders. And you also have expertise in digestive disorders, food sensitivities, gut health, and hormone imbalance. You're passionate about helping clients live well with autoimmune disease, transforming their health through nutrition as the foundation of whole body treatment plans.

As a dietitian and Hashimoto's warrior yourself, you've been treating people with Hashimoto's since 2015. through your website, All Purpose Nutrition, you share your expertise in thyroid disorders and educate readers on how Hashimoto's affects gut, brain, liver, pancreas, skin adrenals, and hormones. You live in Nashville, Tennessee, where you maintain a private practice, all purpose nutrition. And something super, super cool that I learned from your Instagram and we were just chatting about is that you're also a pilot.

Why Gut Health Matters in Hashimoto's 5:36

I am, I'm a commercially rated pilot. I can fly pretty much any midsize jet. I realized that my brain actually works in mechanics. I thought I was very language-oriented, science- oriented. Never thought of myself as a commercial pilot, but when I met my husband who was a pilot it just led me to fall in love with aviation and I'm going to say something. I think aviation school, which took me two years, was harder than my medical school that I completed at Vanderbilt. Because we're like, you know, I don't know.

Women are not just mechanically oriented. We don' know what's under the hood of our car or the engine aeroplane. So like I had to pivot a little bit and but I always like every time when I was learning aviation, or I actually applied that to anything in my life. Every time I learned something hard, I'm thinking to myself, ''I'm preventing Alzheimer's, like I am just training my brain, creating new neurotransmitters, new connections.'' That's the only thing that keeps me going, not to like, oh, let me fly the plane.

No, you know what? Let me exercise my brains. I love that. What a beautiful mindset to have. And I have a six-year-old and I try to teach him now these days when he says, this is hard. I, and he's like, I can't do this. This is too hard, mommy. My thought process is like you can do hard things. You can do hard things. You could try this. I wanted to highlight that because I feel like you are just such an inspiration for what you can with Hashimoto's. A lot of times people have the diagnosis and they feel very disempowered by it where it's something that prevents them from following their dreams and really living their lives to the fullest.

And so I love, love love that you were able to become a pilot. Like how cool is that? It's cool. It is challenging. it's stressful. You're on the road a lot and we know everybody who's been diagnosed with Hashimoto's you kind of you close yourself in this bubble and you're afraid of going out and exposing yourself to toxins or food that is not on your diet, all the restrictions. You can no longer enjoy things that you used to, alcohol, whatever. Even flying can flare up Hashimoto's. Sleepless nights, not only sleepless night, but time change and all that stuff.

So I am a prime example that if you're managing your Hashimoto's right with the correct tools, you can do anything and achieve anything in your life. So hopefully today's conversation will help listeners or if somebody's watching this live. I really hope that we can put our heads together and help the community as much as we. Can I love that? I'm so excited to have you on. We're going to be focusing on gut health, hair loss, the right supplements and really building that resilience. Uh, we're also going be talking about how some people might not need to how to hack that, right?

So super, super excited. One of the first things I wanted to ask about is gut health and the Hashimoto's connection. We know that every person with an autoimmune condition like Hashimoto's has something going on with their gut. And you and I both love to utilize stool tests. And I feel like every practitioner maybe uses them a bit differently. So I would love for you to share more about gut health and then the key markers that you look on stool test. Absolutely. I feel like, you know, with Hashimoto's, we know it's not just a thyroid disease, right?

It's an immune system dysfunction. And we that about 70% of our immune systems resides in our gut. That means gut health plays a foundational role in managing Hashimoto's symptoms and slowing the disease progression. Because Hashimatos is not going anywhere for most of us. but we want to slow down the progression of the disease. So if your gut isn't healthy, your thyroid will not function optimally. There are a few reasons why gut health is important. The first reason is that your good health, is like a gatekeeper of your immune system.

The gut lining acts like a barrier preventing harmful bacteria, toxins, and undigested food particles from entering the bloodstream. And if this barrier becomes compromised, aka our leaky gut, the immune system goes into override, increasing inflammation and potentially worsening autoimmune thyroid attack. So chronic gut inflammation can trigger or even exacerbate Hashimoto's making symptoms very, very hard to control. The second reason why gut health is so important is that gut inflammation worsens the actual thyroid function, our gland.

Inflammation in the gut increases cytokines activity. Cytokine are the proteins that help transport signals from cell to cell. When that activity is triggered, it can disrupt thyroid hormone production, conversion, and absorption. All of that is just from cytokine, from that activity. Inflammation in the gut conditions like IBS, SIBO, I know we see a lot, you and I see lot of people with Ibs, Sibo, Candida, H. pylori, gut dysbiosis. That creates an ongoing stress response, which raises our cortisol and we talk about cortisol in adrenals all the time.

and that cortisol, a hormone that inhibits thyroid function. And finally, I think another important reason is that gut is critical for Hashimoto's because it plays a major role in nutrient absorption. And as a registered dietitian, I concentrate majority of my time on how do we increase nutrient absorption in the gut and improve gut health. Because Hashimoto's is often linked to nutrient deficiencies, right? Even if people eat a nutrient-dense diet, it's not what you eat is what your absorb. For example, there are some key nutrients required for thyroid health that depend on gut function.

That's our selenium. Everybody knows about selanium, selinium can reduce thyroid inflammation and it aids in T4 to T3 conversion. Of course, our zinc, iodine, iron, RB vitamins, magnesium, vitamin D, we know that There was one of the strongest studies that came out long time ago showed that everyone who was diagnosed with Hashimoto's had low levels of vitamin D. So you have to always think about it like first test your vitamin d and how do we bring those levels up to optimal levels. So, that's the importance of the gut health.

And actually, the last thing is that your thyroid hormone, most people don't know that about 20% of T4, which is inactive thyroid hormones, is converted into T3 in your gut. So if your got is not healthy, you're not converting that hormone. You can be taking a mega dose of thyroid medication, but if you got it's not health, not converted thyroid hormon, then it's very hard to manage Hashimoto's symptoms. We can write a book about just the symptoms, the digestive symptoms like bloating, gas, abdominal discomfort, constipation, diarrhea, possibly in the same day.

nutrient deficiency related symptoms, our fatigue, brain fog, poor focus, and man, I can relate to every symptom. And I think the signs and symptoms there's probably like a hundred of them and they're so non-specific. That's why it's so hard to diagnose Hashimoto's because they are just, we're all over the place and we think, oh, half of it is in our head and it not. So, Majority, like I said, majority of what I do is trying to heal our gut and support Hashimoto's through nutrient strategies like supplements, support, lifestyle changes.

And one of the most important nutrient strategy is that I talk to my patients all the time is is the diet, because we want to decrease this full body systemic inflammation. And how do you do that? By eating anti-inflammatory whole foods diet. Our colorful vegetables, lean protein, healthy fats, right? We know, we know all of that. We need to increase fermented foods or not only, you know some people start needs to start eating fermented food, but a lot of people need Our sauerkraut, kimchi, even coconut yogurt if you're doing dairy free.

Coconut yogurt is a great way to boost the beneficial gut bacteria. Prebiotic fiber is another one. It's our flax seeds, green bananas. I know they're not tasty, but you can hide them in a smoothie. So it's okay, you know, our garlic, onions, and that's to feed the good bacteria because prebiotic fiber is the food for our good Bacteria. And then, of course, to heal your gut, You need to consider an elimination diet. Because we talk about, a lot of people, if you If you've been diagnosed with Hashimoto's, you know, um, You've heard that everybody needs to follow.

It's like a general recommendations that. Everybody needs. To follow a gluten, dairy free diet, sometimes soy free, not free nightshades free. There is everything. And it's a very restrictive world out there, but I'm here as a first personal example. and second, working with for the last. eight years working only with clients who have Hashimoto's, so I'm a very specialized dietitian. I don't work with people just for weight loss or teenagers or pregnancy. success rate was people reintroducing gluten, dairy, soy, if they ever eliminated that.

And that all comes from healing your gut. That's first, right? We know that we need to heal that gut lining to prevent all the irritants, maybe gluten, may be dairy and all that stuff,

Food Sensitivities, Elimination Diets, and Reintroduction 17:24

going through those tight junctions into your bloodstream eventually and causing this full body systemic inflammation. So we know we need to heal that gut. But second, It's also, and this is a big part of Hashimoto's, is that fear of, you see a few studies, there are only a handful of studies maybe two or three that came out said that a gluten-free diet decreased TPO antibodies. And this is a very powerful statement. And a lot of people, when they go gluten-free, they're afraid to introduce gluten back into your diet because of that one study.

But we got to be more critical and cynical. about the studies that are maybe poorly done, or maybe they didn't report other things. For example, the study that reported that on the gluten-free diet decreased TPO antibody, they also increased foods that were high in selenium and vitamin D. One of the best ways to lower your TPU antibodies is by taking selenium like 200 mcg per day plus vitamin D and even inositol. There is a big great study with inocitol so did did selanium and vitamin d lower tpo antibody or did gluten lower TPO antibodies?

So You have to take that into account and then that barrier to be open-minded and trying things out, it's very scary. It's scary to introduce something bad because you remember how miserable you felt when you were following the normal diet. So, That's such great insights and so much to unpack here. First, you mentioned the fermented foods. I'm a big proponent of adding fermented food as well. This can be a really, really big game changer for people with Hashimoto's and thyroid disease. And I love that you talked about nutrient deficiencies.

I think this is such a powerful place to start for a lot of people. So much fantastic research with selenium and myoinositol and vitamin D in lowering thyroid antibodies. Speaking to some of the food sensitivities, I know in the beginning of my healing journey, it's like I felt so much better gluten-free and dairy- free where people were like, isn't this hard for you? And I was like no, It's actually really easy because I feel so bad when I'm on the foods. Or if you had asked me 10 years ago, i would say I am going to be off of these foods forever, right?

And my experience about 88% of people feel better gluten free, and about 80% and people Feel better dairy free 80 or so percent in my Experience feels so that are soy free. And then I was a new mom in 2018 and I started working with some like lactation consultants and taking lactations supplements and all of a sudden, like I just had this shift in my body, I used to just find dairy very like disgusting, just grossed me out this smell of cheese, the smell milk would kind of gross me, and this was at the same time when dairy was causing me like bloating, irritable bowel syndrome, so on and so forth.

And then within like a two to three day period, dairy started like being appealing to me again, after taking alfalfa and carnitine to support lactation. So, so interesting. I repeated my food sensitivity testing and I was no longer dairy sensitive. Like I had done this food, sensitivity tests from all the tests, like every year, just keeping up with things. And every sensitive to like everything you know even butter would cause me like carpal tunnel and symptoms and all of a sudden all those things were clear and so i became no longer dairy sensitive and i um can have dairy now i don't like stinky cheese i dont think i ever did i do not think I ever will but you can eat cottage cheese and I could eat a lot of different types of dairy And I think it's something that I would love to share with more people that sometimes, yes, you might need to go on an elimination diet.

If you have celiac disease, this might be like a forever elimination with gluten. It will be forever, unfortunately. There's no way around it. You don't outgrow it, You Don't heal your gut by... You have to be gluten-free for the rest of your life if you had celia. Oh, I was going to say, unless we find new research and I think you're sharing some exciting things that you are finding with your work with clients on how to get rid of food sensitivities when you don't have celiac disease and that's so exciting.

Exactly. And I'm so excited, like you said, for the new research and it needs to be researched more so we don't use our personal experience to treat thousands of people. It's still I share my experience and I always tell my clients you can take it or leave it, but we always work on mindset. Like, what are your blocks? What did you, you know, forget everything you learned 10 years ago because there's a new research or we have proven that that research was not done properly and they lied. You know it was like.

Don't want to name. There is a big guy, you know, there's a guy on Instagram. He's very millions of followers. And he says there is this study that Hashimoto's, everyone with Hashimoto's are sensitive, have lactose intolerance. So, we need to eliminate dairy. So the first part of his sentence is correct. Most people with Hashimoto's are lactose intolerant. The second part, of the sentence, so we have to remove dairy, why? Lactose is just a sugar, a milk sugar in the milk. You can still enjoy lacto-free dairy products.

And so you don't have to eliminate the whole group. So the conclusion of his statement or the research study was incorrect. And I know a million of people probably dropped dairy for that reason. You can still enjoy that lactose free cottage cheese that is incredible for you. All the fermented food. Now they have lacto free milk if you're into it. I'm personally probably like 80 percent dairy free. Not for my thyroid, it has nothing to do with thyroid. And another thing is that there's not a really good study that says that dairy directly affects your thyroid gland.

So you gotta think about that. Again, I'm like 80% dairy free, only for skin. I have a very oily skin and it just seems it flares up my skin if I eat a lot of dairy, but I will never say no to a key lime pie or cheesecake or something on the menu that is full dairy. But most of it, like for my coffee, I add either oat milk or almond milk and all that stuff. Again, it has nothing to do with Hashimoto's. I had this conversation with my clients all the time. The goal is to reintroduce all the foods back, the goal to bring joy back into your life.

Especially when you don't have a medical reason to avoid gluten, if you do not have celiac or non-celiac gluten sensitivity, there is no medical reasons to have gluten. Now, If it makes you feel good, stay on it. But again, are you feeling good? Because when you went gluten-free, you eliminated the doughnuts and Starbucks and all the stuff you were eating and lost weight. And yes, eliminated a lot of inflammatory foods and additives and colors, all that stuff. So which one is making you feel better?

The just elimination of processed food or elimination gluten? So you have to explore that side of the world. Another last thing I'll say about the gluten diet is that there is a very small study, there are a couple of them, with a handful of women that show that a gluten-free diet decreased TPO antibodies. I said that maybe it's selenium with vitamin D. My TPU antibodies went down when I stopped gluten and dairy- free diet. Amazing, yes, because when I got diagnosed, of course, I was gluten-free, dairy- free, and I did it for a year and a half, but I like tired, stressed out, exhausted following these rules.

And then the more I looked into the research and used common sense and interpreted blogs and somebody else's conclusion, I realized that like, okay, this is not a way to live. And so I went back to my normal eating and I lost weight. Well, like a few pounds. My TPO antibodies decreased, my inflammatory markers decreased. I think that's because I removed the stress from constant planning, constant worrying about, or not going out with my friends because I'm afraid of what that five ounces of wine will do to me.

I think to it was one of the biggest shifts and I mean, NTPO antibodies went down on a normal diet. So there's never a one fits all approach. I love that. And yes, stress is such a powerful trigger or even reacting to foods. Whenever we're stressed, our digestive enzymes stop working properly. For some people, if the restrictive diet is so stressful, then that can be a really, really big trigger. And I think, you know, to your point, we have to consider—I think there are people that may be specialized in diet, and they try to use diet for everything, right?

But when you actually look at diet as one potential intervention, then there's medications as another intervention. Then there's nutrient deficiencies as an intervention, working on your stress response as other intervention and then also looking at like your gut health. That's going to be another interventions. So a lot of times you might start off with a elimination diet and you're off of these foods But that doesn't mean you need to be on it forever. I know I've worked with people that had autoimmune paleo diet that they have been on for years, and they're great to introduce foods back in.

And we're working with them. Let's look at what's going on with your stool test, right? and we would find that there's like a protozoa and that's causing so much inflammation in your digestive tract no matter what you're eating you are inflamed and have a food reaction and so I love that we're sharing about that because it's not always it's hard to get that across in like a 30-second clip on social media of what you need to do with Hashimoto's. It's going to be different depending on what your symptoms are, when you're diagnosed, where you are in your journey, what And so you take on a really,

Stool Testing and Targeted Gut Support 29:36

really comprehensive approach. And I know that you're a fan of stool testing as am I. I would love for you to share more about that. You offer stool tests with your clients, and I'd love to know what are some of the gut imbalances that look out for and how do you help them restore that balance? Do you use just food and nutrition? Perhaps use some other kind of things? So I think the stool test is one of the best investments, and you're literally looking inside your gut health without troubleshooting.

We test, we get results, if we know the problem, then we'll know how to fix it. So the most common problems I see with my clients is gut dysbiosis. Of course, that's imbalance of gut bacteria. That can lead to inflammation and poor nutrient absorption. So just that simple, it's like everybody has got dysbiosis. I don't think I've ever seen a clean stool test. So yes, inflammation, poor nutrient absorption, then pathogenic bacteria, parasites, candida overgrows. That's again, my top priority. And that may contribute to autoimmunity.

It can actually trigger Hashimoto's. in some people. Of course, I always look for, well, first, every test I order, it's not optional. It comes with zonulin marker, and that's the marker of intestinal permeability, aka leaky gut. So I don't let my patients choose what they want in this tool test. This is because I want to see your zionulin levels. That shows the high zonula levels, shows a compromised gut lining that can trigger immune dysfunction as well. Of course, we look at the good and bad bacterias.

I zoom in on the bacterials that make butyrate, like our acrimensia, and we know that butyrate is a key ingredient for our gut integrity and reducing inflammation. Of course, H. pylori probably present in like 99% of my clients. And man, it's a nasty one. That bacteria, some people have it chronically and they always say, oh yeah, my doctor did the stool test, but they never addressed it because it wasn't high enough or the virulence factor wasn't strong enough, but they don't realize what that H.

pylori is doing to your gut lining over time. H pyrori, we know it burrows itself, like it hides itself in your stomach lining and it causes this full body systemic inflammation and triggers must cells that release histamine. That's why so many people have histamine intolerance nowadays because they have H. pylori that is not treated. And over the years, yes, it's going to grow into Food sensitivities, of course, there's actually one study that showed that H. pylori actually leads to food sensitivites and eradicating H pyrori will clear that food sensitivity.

So it's not the food that you react into, it is what your gut bacteria, what you cells, how they react to that So dairy is not inherently bad. Gluten is just like, how is your body reacting to it? So looking at all of these markers, and I always come up with a care plan for each and every one of my clients, we go into this comprehensive approach its diets, supplements, lifestyle, everything that's under the sun, we include in this like step-by-step guide. And that is increasing fiber in prebiotics.

I only say that as a general recommendations because if somebody has SIBO or IBS, I will not be adding a ton of fiber or telling them to eat fermented foods because it's only going to exacerbate their bloating and stomach aches. So it's very, very personal, but overall, just in general, it is adding probiotics. And I know, I am like all about, as a dietitian, food needs to come first. Food is our first line of defense. But supplements make our life so much easier. Especially at the beginning of treatment, get a head start, because if somebody's been dealing with a problem for a long time, do we have two or three weeks to wait for, you know, by the time you add fermentive foods, it'll take a while for your body to react.

But as soon as you ad probiotics, a mega dose of butyrate supplements, or to improve you know, your stomach acid, like add digestive enzyme with HCl in it. You see that difference like within 12 hours, 12, 24 hours. And I know you have such a great line of supplements that are very easy, you go to and because you already you've lived through it, know exactly what we all need, what our body requires. So it's very helpful. So when it comes to, again, supplements, digestive enzyme, L-glutamine is my go-to as well.

I love it. It's like, yes, you can drink bone broth and stuff, but sometimes, like I'm on the road all the time. So I unfortunately rely on supplements a little bit too much because I can bring bone bros with me. Bone broth with you on every like little baggies, right? Oh my God, I should make a video of it, What Hashimoto person or a person was diagnosed with Hashimotos, what do you do when you fly a 12-hour flight? What do I do? I should bring all my stuff with it. Of course, again, sunbutyrate, turmeric, and omega-3.

Those are my go-to supplements when addressing all those markers like red flags on GI maps tool test. I love that. I'm a big fan of butyrate and betaine was the big game changer. Betaine with pepsin on my healing journey, I went from being fatigued and exhausted to waking up the following morning with like bright-eyed and bushy-tailed. And I was like, oh my goodness, this was actually one of the reasons why I decided to write my book because I like this just changing my diet was a game-changer, but then discovering nutritional supplements and digestive enzymes, it was like gave me so much more of my life back.

And like you said, and you wake up feeling better right away. It's just as such. it's a good jumpstart. I don't think we all should be taking you know, 20 supplements every day, but sometimes when we create this like H. pylori protocol, if you're not getting on antibiotic therapy, um, If your virulence factor, H pilari viral, less viral lens factor is low enough, you can get rid of H Pyloria naturally, But that protocol is pretty heavily geared towards the supplements because there's no amount of turmeric you Can eat or sprinkle on your salad to to dumb down the active infection, we've got to take a mega dose of that turmeric or omega-3 or whatever we're taking.

So I am a big proponent of supplements, but the right supplements. For the right person, I've been seeing a lot of emerging resistance to H. pylori. I used to use like DGL and mastic gum, and these were some of my go-tos for H pyrori, but a lotta people have been coming up positive despite utilizing those. Do you have any special protocols or things that you like to utilize with H Pyloria? Again, it's not something that'll just go away on its own or with diet, right? It will never go away on its own, it will just get stronger and build resistance.

So the longer you have it, I think, like I've seen clients that had a H. pylori for two years without treating, so that's going to be a challenge to eradicate. It'll take more than four weeks. I supplements that I've been using. It's called Corptus Chinesis. You can buy it on Amazon for like $10.00. One of the main ingredients there is berberin, but it's very concentrated. So it is a natural supplement from the root. Berberine, the study shows that it has one of ingredients that can eradicate H.

pylori. I always add that one, especially to my chronic H pyrori patients. Thank you so much for that. Sometimes the most disgusting things are the more effective, aren't they? Yes. Yes, I agree. But also with diet.

Blood Sugar, Liver, and Gallbladder Support 39:24

Pills are not magical. If you don't add those flaxseeds and artichokes and onions and green bananas to your diet, apple cider vinegar, digestive bitters, zinc to increase your stomach acid, nothing's going to happen. So definitely it's a comprehensive approach and it is so complex. Sometimes we lose track of like, okay, what are we doing? Because there's so much going on. That's why my first initial consultation takes one hour with each client, because there is just so many things going. I love that.

I think that gut health is so underappreciated and I love that you really focus on that with your clients. You also focus some additional things. What are some really overlooked factors in lifestyle and dietary factors that make a huge difference? Everybody knows about thyroid medication. We have to take it. We have to take it, right? So that's number one, it makes the biggest influence. It keeps you alive. Of course, everybody talks about gut health and we can spend another three hours talking about just gut-health.

But I think what people don't concentrate on is blood-sugaring balances and insulin resistance. Because most people don't realize that unstable blood sugar and insulin resistance can worsen Hashimoto's symptoms, even if you don' have diabetes. And it matters because high insulin and blood-sugar spikes increases inflammation and autoimmunity. It can trigger fatigue, mood swings, and brain fog. So when people think that they need to either up their medication or decrease because of increased brain fog or fatigue you know one way or the other.

Are we not looking at blood sugar? What are we doing with our? Got to check fasting insulin, fasting blood sugars, hemoglobin A1c on maybe not quarterly, but at least once a year to keep a finger on our pulse thing. Another thing that chronically high insulin disrupts T3 conversion leading to low energy and slow metabolism. Even if most people take levothyroxine, which is a synthetic T4 only medication, you can talk about it. But we all need to convert it to T3. That conversion, of course, happens in the gut and most of it happens on the liver.

If you have high insulin levels, that conversion will not happen. Even, if you think that you're following a healthy diet and your liver is great, The conversion will not be there. You'll have low energy, slow metabolism, mood swings, brain fogs. So the easiest way to address that is to eat protein and healthy fats with every meal to stabilize that blood sugar. We need to try to avoid high carb, especially processed simple carbohydrates and high sugar meals. that spike insulin. We need to, of course, increase or add resistant training.

And walking after meals, I think that was the game changer for me because I feel like I live by the book. I eat right, exercise, normal weight, but my blood sugar was rising in my hemoglobin A1c, which is a marker of diabetes. This is how we see if the person is pre-diabetic or not, my numbers were climbing. I started walking after every meal, I was just taking my dog for a walk, only 10 minutes of gentle exercise, and it started dropping my blood sugar post meals. It helped me a lot. For me, that was like my magic bullet.

I didn't change anything else because my diet was already normal. We need to concentrate on that. The last thing that is overlooked, I think, by most doctors and nobody really talks about is our liver and gallbladder function in thyroid hormone conversion. And I already mentioned that liver converts with like 60% of T4, two active, two-three, and the gold bladder is critical for fat digestion and detoxing that excess hormone. If these are not working well, your thyroid will not function. People don't even probably know where their gold letter is or what it does.

We all like detox in liver, but we detox liver with harsher supplements or protocols. So, liver is our best detox organs, right? And the poor bile flow from the gallbladder, it reduces fat soluble vitamins like our A, D, E, and K, which impact thyroid function. So again, we need to support liver and, you know, there's a lot of talk about the cruciferous vegetables, in the world. Supporting your liver with cruciferous vegetables is one of the best ways. That's our broccoli, brussels sprouts, cauliflower.

We mentioned digestive bitters or ox bile supplements, that's a great one to support gallbladder function. Of course, our water, green tea, dandelion tea whatever you want to take just to get fluids through your system to flush out toxins. And another thing that I love and I mentioned it a couple of times during this conversation is turmeric, which is one of the best foods to cleanse your liver because it aids in the liver. It aids liver in producing bile, Which helps break down fats and toxins to get it out of our system.

So I think those are the two ones that we need to talk more and address more. I love that. For me, I was very, very surprised. And then I started utilizing gallbladder support and my seasonal allergies went away. It's just really, really incredible when you take a comprehensive plan and you really dial in your body. I know I'm a big proponent of not just when you have a thyroid condition, some people basically take like a little lens and they're like, okay, I've just gonna look at this part of your and we're gonna give you thyroid hormone.

And there's like supplements that are like thyroid support supplements, but it's an autoimmune condition with Hashimoto's. It's a whole body condition and there are different parts of the system that you need to support to truly feel your best and to thrive. Yes, and it takes a village. Everyone needs an endocrinologist to get the prescription, second set of eye. But it also, everybody needs a dietician. Everybody needs pharmacy expert. You're doing an incredible job addressing it from all sides.

It's a complex issue. I mean, we're talking about an autoimmune disease. understand how people without any medical background or any research background can treat, it's an autoimmune disease. It's so complex. Like I said, I don't understand all parts of it. I just rely heavily on research and do my best to bring the best research out in the light and present it in 30 second video on Instagram. But it is so hard. I agree with you. One of the things that's a super, super frustrating symptom for a lot of people is hair loss.

Hair Loss Causes and Recovery Strategies 47:48

I know this is one of your areas that you love to focus on. Can you tell us a little bit more about the causes that see and what you like to utilize? Absolutely. So hair loss, you know, it's personal. It's frustrating. Its emotionally draining symptom of Hashimoto's. When I was diagnosed, actually the reason I diagnosed myself with Hashimoto's, I found that something was wrong with me because doctors could not. But since I already was working at Vanderbilt, i got my own blood work done and I pretty much found my Hashimaotos.

I went to get blood work done is because my hair, I was pulling clots of hair out. I sitting after shower, crying in the bathroom because it felt like I lost at least 50% of my hairs, which recovered most of it. But before it was so full and lush and it has nothing to do with age. It's only 10 years apart. Like it should not have Hashimoto's hair loss is very distinct. I know exactly where people are coming from when they come to me or just searching for quick fixes for hair lost because this is our security blanket, especially for us girls.

Everybody wants shiny hair and stuff. So I actually had a whole podcast for two years. with Kimberly Vaughn, she owns two hair loss clinics here in Nashville. We have like 100 episodes on connection between Hashimoto's and hair-loss. That's how complex and complicated that topic is. But I'm going to try to give highlights what I see in my clients. The problems that arise, it's that low T3 levels. It doesn't matter what your diet is, how well you're eating, managing your stress. If your active thyroid hormone T3 is low, basically what T 3 does, it stimulates hair follicles to grow.

So if that hormone is slow, your hair will not grow, maybe you'll stop shedding from all other stuff that you are doing to it. but it will not grow. And there are ways to improve your T3 conversion is, we talked about gut, that's the conversion site, your liver. Third way, it's more pharmacy related, pharmacology, is taking a T-3 only medication. or taking like a natural, dedicated thyroid that has T3 hormone in it. So again, there's like many ways to improve it, the second reason for hair loss is of course nutrient deficiencies, iron, zinc, selenium, B12, biotin.

All of them play a huge role in how fast your hair grows, how it's falling out, is it brittle, shiny. Every doctor tests for iron, nobody tests it for ferritin. You can have low ferritin levels, which is a storage form of iron, but normal iron levels. And when I told that to my doctor, he said he's never heard that before. But then he looked at my blood work and I'm always anemic. This is the problem with people with Hashimoto's and especially menstruating women. We lose a lot of Iron and we don't absorb Iron well.

we Don't eat enough red meat and all that stuff. to get iron. So, but low ferritin is one of the main reasons for hair loss. And research shows that anything above 70 nanogram per milliliters of ferretin, that's basically people who have ferrettin levels above seventy don't have hair lost. That was a great study. For me, if somebody coming to me with hair loss with ferritin levels at 35, I'm like, we're going to bring you up to 70 and then we'll see. I like to have a number to reach for and that's why we have optimal thyroid levels because It's something we need a goal to strive for.

Of course, like I said, nutrient deficiencies. Chronic gut infections, not only leaky gut, low stomach acid. Low stomach acids causes poor nutrient absorption. our SIBO, small intestinal bacterial overgrowth, it impairs digestion and absorption. All that stuff like chronic gut infections are nasty by itself, but they also prevent nutrient absorption, so that's another reason to treat, to get a stool test done, these red flags to improve your hair loss. See how we got to hair-loss through stool tests?

What? That's how complicated it is. You have to be a detective to figure all this stuff out. I don't even need to talk about high cortisol, right? How hair loss or high stress level causes hair lost because chronic stress raises cortisol and cortisol slows the hair growth and increases shedding. of full body systemic inflammation, all that stuff. And finally, our female sex hormones, estrogen, testosterone, DHT, always check. You can't just know what they are. What I started doing once a year, I gift myself a comprehensive blood work.

January 1st, you don't have to have an MD for it. I know Dr. Wentz, or is it patient-oriented blood work that you can order yourself online? Just get all the bloodwork done, comprehensive. Test all of the hormones, test T3, free T-3. You know, tests reverse T 3, your TPO antibodies. Do it for yourself, like a gift. And that's why I started doing it like, well, eight years ago when I was diagnosed and I think it's the best The best thing you can do for your health and in turn improve hair health.

And if somebody wants to listen, you know, I have a hair related podcast episode, like I said, 60, still posted on my page. If somebody want to dive in and listen to it, there's so much information. Amazing. I'm going to have to link that for the show notes because I know everybody is excited to listen to those and dive deep into hair loss. For me as like a Leo, I could deal with all the symptoms I was having, but the hair lost was just like, this is something that I really, really need to handle.

Um, and I love your perspective about gifting yourself these things. Just like what a gift it is to have amazing health and amazing hair too, right? And I feel like we really need to think of ourselves as an investment and that way that you can really, really thrive versus, I guess, For me, when I was first diagnosed, it was more about asking for somebody to heal me and do these things for me. And now it's more of, I'm empowered and I can reach out for help and assistance. And I, you know, I don't just rely on like this doctor says no and closes the door in my face.

Like I'm gonna look for other people to help me get the labs that I need or the treatments that, um, feel like I needed to advocate for. So really, really appreciate that perspective. I have really really loved having you on and I feel we need to come back, have another episode where we deep dive into another topic with you. One of the questions I would love to ask for you is, how do you add in gluten back into your diet? Do you have any best practices for that? And what about it increasing antibodies?

Can you share a little bit more about that, maybe some of their research on antibodies. Absolutely. So as far as research, like I said, there's only two studies that show that a gluten-free diet decreases TPO antibodies, but it didn't decrease in every one. So there is one caveat. Which side are you falling on? do an elimination diet for at least four weeks because half life or not half-life of gluten, but gluten stays in your system up to four-weeks. So, you have to be completely gluten-free for more than four week and then start introducing slowly.

Start introducing gluten slowly, don't eat a bowl of pasta, right away and say, oh, I had a reaction. I actually had. A client who said I. Had a. Reaction to a bowl of pasta with carbonara sauce or something. It was like a dairy related sauce. So I don't eat like sauces, so I can't remember what it was. But I asked her, did you react to the sauce that was dairy because she was lactose intolerant or did she react gluten and when she ate just pasta, just with olive oil and red pepper and stuff, she had zero reaction.

What are you introducing? First, start slow with introducing gluten. Second, don't add, it has to be like clean gluten, just pasta, no sauce. Well, I think those are two main things of introducing. And I always say, whatever you want to hear, you'll find. So if you Google, How bad is gluten or negative effect of gluten on thyroid or Hashimoto's? You will find thousands of articles. But if you reframe your question and you ask it differently, just be open-minded and that can apply to anything in your life.

Ask your question differently. What are the benefits of eating whole grains, your gluten, for overall health, including thyroid? And you will find thousands of articles about that. So change your perspective, change, you know, Just get out of your box and everything you've been learning and try it out. I'll never tell you like, no, gluten is okay for you. You're going to have to figure it figure out for yourself. But I guide my clients through it. We do an elimination diet and we do a tactical step by step, bringing it back one thing at a time.

Yeah, I think that makes so much sense. I know a lot of times people just do an elimination diet and they perhaps don't add things in at the right pace.

Gluten Reintroduction, Research, and Resources 59:12

Personally I was like, oh, i've been off of gluten, dairy, soy and tomatoes and then my first food I introduced was pizza and of course I felt terrible. It was a huge deep dish Chicago style pizza. And then you're like okay, well what is it again? And you kind of have that fear of of introducing, so doing that introduction slowly and one food at a time and figuring that out and perhaps, you know, really working on all of the other things that we talked about. And always like whoever's watching and listening, for your own sake, test your TPO antibodies, get the blood, know you can just test Tpo antibodies.

Test it. start getting gluten back into your diet and see maybe you just like me, maybe your TPO antibodies will go down, it will give you a great reassurance that maybe gluten is okay for you. I don't have a celiac markers, I do not have non-celiac gluten sensitivity. Like I mentioned, my TPO antibodies went down after I went back on normal diet. So maybe you're just like me, we're all in this spectrum. Don't be afraid to test it out. I love that. I loved that empowering take. You also have a free guide for us.

Can you tell us a little bit more about that and where people can get that? I'll link it in the show notes. Yes, I do have a free guide. And now, so this free guy, it's discussing five stages of Hashimoto's and how to address it from like medical nutrition therapy perspective, because I'm a clinical registered dietitian. So my guide is geared towards nutrition, supplements, lifestyle approaches. I created that guide because So many of my clients and followers are all at different stages. Somebody was just diagnosed and messaging me like, what is Hashimoto's?

And somebody has already been dealing with it for 10 years and can teach me something, you know, because we all know our body well. So I created this guide to kind of give you a jump start, a head start. Like here's if you just diagnosed, here is what to do. One, two, three, four, five. And it's again a nutrition supplements lifestyle. Very minimal, very generalized. Again, please don't take that guide as a medical advice, but it is there for you. It will be Dr. Wenz. You said you'll link it in the show notes.

But if somebody wants to go on my Instagram and just comment five stages, just two words, Five stages under any of my post. it will automatically send you that guide. That's perfect. Thank you so much for sharing that with us. And where can people learn more about your work? I hate to say that, but I think Instagram is my best business card at this point because it's very accessible. You can see everything I do, you can where I stand on nutrition research and all that stuff. Instagram, I thing, is one of the fun ways to find me.

Of course, they have a website where a list the services I provide, prices, payment plans, everything is laid out there clearly. So you can book on my website, you book a free discovery call, I offer a 15-minute call because I never want to force anybody into this relationship, like I want make sure we connect. I wanna make I'm the right person for you because if I am not the person right for I refer people to other dietitians. that either concentrate on other stuff or another doctor. I have a huge referral network at this point.

We've been doing it for eight years. So I want to make sure we're right fit for each other and we have this connection because I think it's very personalized. Instagram, website, allpurposenutrition.com. Thank you, thank you so much, Natalia, for being here. This has been such an incredible conversation. It's been so fun connecting with you. And I hope everybody listening, I have been healing on your healing journey. Until next time.