The autoimmune Paleo (AIP) diet is recommended to people with all different types of autoimmune conditions, including Graves’ Disease and Hashimoto’s Thyroiditis.  And while some people thrive when following this diet, others find this to be a very challenging diet to follow.  There are a number of concerns people have when following the AIP diet, and in this blog post I am going to discuss four of the main ones.

Concern #1: The duration of the diet.  Upon having the AIP diet recommended to them, many people become concerned as to how long they will need to follow this diet for.    This isn’t meant to be a long-term diet, although how long someone needs to follow the AIP diet depends on the person. For example, the AIP diet also serves as an elimination diet, and many healthcare professionals will recommend for their patients with an autoimmune thyroid condition to follow this diet strictly for 30 days.  This is the approach I take in my practice.

After 30 days some people choose to slowly reintroduce some foods, while others continue to follow the AIP diet for a few additional months.  If after 30 days someone is thriving while following the diet then it makes sense for them to continue following it for at least a few additional months.  If someone feels worse after 30 days of following an AIP diet then it might be best for them to reintroduce foods.

It’s worth mentioning that some people aren’t necessarily thriving after 30 days, but they are feeling somewhat better, yet they find following the AIP diet to be a major struggle.  In this situation it probably is best to have the person continue with the diet, and re-evaluate after two to four weeks.  While some people will experience physical symptoms, there is a mental aspect as well.

For example, if someone started following the AIP diet with the mindset that they would need to be strict for three months, mentally this would be more challenging than planning on being strict with the diet for 30 days, and then taking it on a month-to-month basis after the 30 days had passed.  Of course everyone is different, as some people don’t find following an AIP diet to be a struggle at all (at least that’s what some patients tell me!), while others are thinking about reintroducing foods after one or two weeks.

Concern #2: Will following this diet cause nutrient deficiencies?  Some people are concerned that following an AIP diet for a prolonged period of time will lead to nutrient deficiencies.  As a reminder, this isn’t meant to be a long-term diet, but this isn’t out of concern that people will become deficient in certain nutrients.  Even though it’s a restrictive diet, the allowed foods are nutrient dense. And while some of the excluded foods are also nutrient dense, such as eggs, nuts, and seeds, you can still get all of the nutrients you need from the AIP diet.

While meat is nutrient dense, especially when it is from a good quality source, vegetables are also an excellent source of nutrients. One problem is that most people don’t eat enough vegetables per day, and another problem is that many people who eat plenty of vegetables don’t eat enough variety.  I realize that for people who don’t enjoy eating vegetables this can be challenging, but as I’ve mentioned in past articles and blog posts, you can “sneak” in some vegetables by adding them to a daily smoothie.

In addition, how you prepare your vegetables can make a huge difference with regards to taste. For example, I don’t enjoy eating plain steamed broccoli.  On the other hand, if I add garlic and olive oil to the broccoli then I find that it tastes much better.  You might prefer to add something else, and while I can’t say that I’m very creative in the kitchen, that’s what cookbooks are for.

Should you be concerned about nutrient deficiencies if you are a vegan or vegetarian?  After all, if you don’t eat meat or fish then you will rely on getting all of your nutrients from fruits and vegetables.  I spoke about this in an article entitled “Vegetarians, Vegans, and the Autoimmune Paleo Diet”.

Concern #3: The stress associated with following this diet.  Most people are dealing with chronic stress prior to making any dietary changes, but the AIP diet is perceived as a stressor by many people.  Probably the biggest concern by most people that follow the AIP diet is simply the challenge of following a restrictive diet due to the number of excluded foods.  Another concern by some people, especially many with hyperthyroidism and Graves’ Disease, is losing weight while following this diet.   I have worked with many people over the years who have lost a lot of weight due to their hyperthyroid condition, and most are concerned that following a strict AIP diet will result in even more weight loss.  I spoke about this in greater detail in a past blog post entitled “How To Maintain A Healthy Weight While Following An Autoimmune Paleo Diet”.

Of course many people have the opposite problem, as they would love to lose weight, but are having a difficult time doing so, even when following a strict AIP diet.  Although the primary goal of the AIP diet isn’t to lose weight, this can still be a stressor for many people.

Either way, the increased stress levels associated with following an AIP diet shouldn’t be overlooked.  And the reason for this is because some of the benefits of following an AIP diet can be counteracted by the person’s increased perception of stress.  Knowing that there is the possibility of reintroducing foods after 30 days can greatly help to decrease one’s stress levels, but for some people, 30 days can seem like an eternity when they can’t eat most of the foods they have regularly eaten for decades.

This is why some people need to take baby steps.  For example, it might be best for some people to first work on adding more servings of vegetables so that they won’t be as hungry when they start eliminating foods.  If someone is accustomed to eating only one or two servings of vegetables per day they can make it a goal to eat an additional daily serving of vegetables each week, so that by the time four weeks have passed they will be eating four additional servings of vegetables on a daily basis.  Some people will then be able to jump into the AIP diet at this point, while others might feel the need to exclude one or two foods each week.

The time of the year can also play a role in how stressed out someone is when following the diet.  For some people, following the AIP during the holiday season is very stressful due to the temptation of family dinners, holiday parties, etc.  Going on a vacation can also be an obstacle, as I’ve had patients who were planning to go on a vacation a few months after starting the AIP diet, and their goal was to follow the AIP diet strictly for 30 days and then to start reintroducing foods, regardless of how they felt after the 30 days.  The point here is that rushing the reintroduction process can also result in added stress on the person.  You want to try to set yourself up for success, and realize that no matter what time of the year you start this diet there will always be challenges.

Concern #4: Having decreased bowel movements.  Constipation is a concern with the AIP diet, and the reason for this is because a lot of people rely on the excluded foods for their main sources of fiber.  This includes grains, legumes, nuts and seeds.  I spoke about this in a blog post entitled “What Thyroid Sufferers Need To Know About Fiber, Resistant Starch, and Short Chain Fatty Acids (SCFA).”

In this blog post I discussed how those who follow an AIP diet will need to get their fiber from fruits and vegetables.  But the problem is that most people don’t eat enough vegetables.  In addition, some people who do eat plenty of vegetables don’t eat a sufficient number of fiber-rich vegetables.  The truth is that most people don’t know which fruits and vegetables are highest in fiber, and in the blog post I mentioned some of these, including apples, artichokes, avocados, broccoli, Brussels sprouts, dried figs, pears, plantains, and sweet potatoes.

So while there can be different factors that can cause chronic constipation, if you became constipated shortly after starting the AIP diet then you want to make sure that 1) you are eating plenty of vegetables per day, along with some fruit, and 2) most of the fruit and vegetables you eat are higher in fiber.  So for example, while it’s fine to eat some lettuce and spinach in the form of salads and smoothies, these are lower in fiber when compared to other vegetables.  As a result, if leafy greens are your primary source of vegetables then you very well might become constipated.  I personally enjoy eating salads, and I also add leafy green vegetables to my smoothies each day, but I also try to eat other vegetables that are rich in fiber.

In summary, for those who are thinking about following an AIP diet, or are currently following it, hopefully this blog post will help you to overcome some of your concerns.  If there are other concerns you have that I haven’t mentioned in this post about the AIP diet, please feel free to let me know in the comments below.

Many reading this know that I wrote a book on hyperthyroidism and Graves’ Disease in 2011, with a revised edition in 2013.  Over the years I have been asked by many people if I plan on coming out with a book that focuses on hypothyroidism and Hashimoto’s.  My goal was to have a book out on this topic in 2015, but I guess the saying “better late than never” applies here, as in early 2018 I finally plan on releasing my first book on Hashimoto’s Thyroiditis.

As for why it has taken me so long to write this book, the truth is that when I set a goal to have the book released in 2015, my goal was simply to have a book on Hashimoto’s Thyroiditis.  My practice focuses on both Graves’ Disease and Hashimoto’s, and since I already had a book on Graves’ Disease it made sense to release one on Hashimoto’s.  However, along the way I decided that I didn’t just want to write another book on Hashimoto’s, but I wanted to make it the very best book on this condition.

So with each passing year I found myself doing more and more research, and adding more and more content.  But while it’s great to have a lot of content, of course I also needed to make the book interesting and easy to understand, which is no easy task.  But finally the book is in the hands of an editor, which is why I decided to put together this blog post.

How Will This Book Be Different From Others?

There is no shortage of books on Hashimoto’s that focus on helping people get into remission, and so I’m sure you might be wondering how this book will differ from others out there?  While I’m sure there will be some overlap between my book and others, here are a few key differences:

1. I’m confident that my book will provide the most comprehensive information on the different triggers of Hashimoto’s Thyroiditis.  I know this is a bold statement, as there are a few books on Hashimoto’s that discuss many of the different causes, but if you’re interested in learning about all of the different triggers then this is the book for you.

2. I just mentioned how it will be the most comprehensive book with regards to discussing the different triggers, and I’m equally confident that it will be the most comprehensive book when it comes to helping you DETECT your specific triggers.  While it’s great to know all of the different triggers, the real key is to try to find your specific triggers, and there is an entire section dedicated to helping you with this.  You heard me right, as I didn’t just dedicate a single chapter to this, but an entire section that will show you how to find your triggers.  And while I do talk about testing, I’ll add that those who are on a budget don’t have to spend a lot of money on tests, which I also talk about in the book.

3. Overall this probably will be one of the longest books on Hashimoto’s, if not THE longest.  The reason for this is because I didn’t want to hold anything back when writing this book.  And while I realize that a longer book doesn’t always mean a better book, I’m confident that those with Hashimoto’s will find most of the information to be of value.  I don’t have an exact page count yet, and it might be a tad shorter after the editor gets through it, but most of the information will remain intact.

If the prospect of reading a very long book turns you off, I should let you know that this book is organized so that you can easily read the content you want, and skip over the content you have no interest in.  Of course you can simply visit the table of contents and choose to only read those chapters that are of interest to you.  But even within each chapter you can skip around and focus on the material that you find to be the most interesting.

I’ll talk more about the organization of the book shortly, but just as an example, the first section of the book will focus on how and why people develop Hashimoto’s, and I do think it’s important to have a good understanding of your condition when trying to restore your health.  But if for any reason you don’t want to read this then of course you can skip this entire section.

As another example, in section two (the triggers section) there will be a chapter dedicated to toxic mold, which doesn’t apply to everyone.  And so if you don’t want to read this specific chapter you can simply skip it.  Or perhaps you just want to learn about the treatment options for toxic mold, which is in section four.

So while I realize that some people will choose to read the entire book, others will pick and choose to only read the information that is of interest to them.

4. This book will be very well organized.  I just mentioned this, and while this might not seem like a big deal to you, I’ve read a lot of books on Hashimoto’s, along with other health-related books, and most of them aren’t well organized.  And there are a few reasons why a well-organized book is important.  First of all, when treating your Hashimoto’s condition naturally, you will do things in a certain order.  This usually includes first understanding your condition, then learning about the different triggers, and then you ideally will want to do things to detect the underlying cause of your condition, and finally you’ll want to take a natural treatment approach.

As a result, this book is divided into five sections, with the first section talking about how and why people develop Hashimoto’s, the second section discussing all of the different triggers, the third section showing you how to detect your triggers, the fourth section focusing on removing your triggers and correcting other imbalances, and the fifth section answering your burning questions, including how to maintain a state of wellness after getting into remission, how to overcome fatigue and brain fog, how to lose weight, etc.

Another reason why a well-organized book is important is because a good book should be used as a reference, and when referring back to the book, you want the information you’re looking for to be easy to find.  While this is the purpose of an index, which this book will also include, I think that the layout of the book alone will make it an amazing reference guide.  I should also mention that at the end of each chapter there will be a “chapter highlights” section, and some might choose to first read the chapter highlights to find out the specific topics they want to focus on.

5. There will be specific recommendations.  This of course isn’t the only book on Hashimoto’s that gives specific recommendations, and you probably know that there isn’t a one-size-fit-all treatment plan.  While this book includes some great information on diet, along with suggested doses of supplements and herbs, the book isn’t meant to replace the guidance of an experienced natural healthcare practitioner.  With that being said, I realize that some people will attempt to self-treat their condition, and while this isn’t something I recommend, anyone who is thinking about self-treating their condition should definitely read this book first.

I’ll also add that while the book gives supplement recommendations, it doesn’t promote supplements.  In other words, while I do recommend nutritional supplements and herbs to my patients, the goal of this book isn’t to sell supplements.  In fact, I also give plenty of food recommendations as well.  I even give some recommendations for those who are vegans and vegetarians.

6. There will be no recipes.  I’m sure that some people might not be happy about the lack of recipes, and while it seems that most health-related books include recipes these days, the truth is this isn’t a recipe book.  And so if you are mainly interested in recipes this book isn’t for you.  The good news is that there are plenty of other recipe books.

7. Most of the information is supported by research.  There are references to hundreds of research studies included, and so this book isn’t solely based on my clinical experience with Hashimoto’s.

When Will The Book Be Released?

I’m pretty certain that the book will be released sometime in the first quarter of 2018.  In all likelihood it won’t be released in January, and if I had to guess I’d have to say that it will be out by late February or early March.

What Format Will The Book Be In?

The book will definitely be in both printed and Kindle format.  I personally love to listen to books on Audible, and so I might create an audio version in the future, although I’m not 100% certain at this point.

As I get closer to releasing my book I will give more updates, and of course once I have finalized a release date I’ll be sending an email to let you know.

Although I think it’s a good idea to express gratitude on a daily basis, since today is Thanksgiving I figured I’d share ten things I’m thankful for:

1. My wonderful wife

2. My two beautiful daughters

3. The rest of my family

4. My excellent staff (Kate and Carson)

5. My terrific patients

6. My loyal email and Facebook subscribers

7. Continuing to maintain a state of wellness

8. Being in a profession that I absolutely love

9. Putting the finishing touches on my upcoming book on Hashimoto’s Thyroiditis!

10. Not traveling for Thanksgiving (we travel just about every year, and so it’s nice to take a break)

I’m sure there are a few other things I could have listed that I’m grateful for, but these are the ones that immediately come to mind.

Please feel free to share some of the things you’re most grateful for in the comments section below.

Have a Happy Thanksgiving!!!

Last month I released a blog post entitled “Can The Flu Shot Trigger Graves’ Disease and Hashimoto’s Thyroiditis?“.  Even though it was a very controversial post, it was also a popular one.  And the reason for this is because most people have a strong opinion about vaccines.  Of course many people are in favor of everyone receiving vaccines, while others are completely opposed to all vaccines.  A small percentage of people fall somewhere in the middle where they perhaps aren’t opposed to vaccines, but they also don’t agree with the current vaccine schedule.

Either way I figured I’d get the opinions of others who have received the flu shot, along with other vaccines.  I realize that many people who receive vaccines don’t experience negative side effects.  However, some people do, and I’d like to hear both sides of the story.

And so if you had a positive experience in the past when getting vaccines, please let me know!  And if you had a negative experience when getting the flu shot and/or other vaccines please let me know!  If you personally haven’t had a negative experience but have close friends or family members who haven’t done well with vaccines feel free to share this as well!  Thank you so much for sharing your experience with others.

With the holiday season approaching I figured it would be a good idea to discuss some “healthy eating strategies” for those who are following a strict diet.  When I dealt with Graves’ Disease many years ago I started my natural treatment protocol in the fall, and so I also had to avoid many of the foods I was accustomed to eating during Thanksgiving and the rest of the holiday season.  It admittedly was a challenge, but believe me when I say that it is worth making the sacrifice.  And it’s also important to understand that you can still have a wonderful holiday season even when eating a restricted diet.

When I talk about a “restrictive” diet I’m mainly referring to an autoimmune Paleo diet.  However, even following a standard Paleo diet is challenging for many people.  Of course this depends on the person, as if someone is following an autoimmune Paleo diet for a couple of months and then makes the transition to a standard Paleo diet, many of these people will find the standard Paleo diet easy to follow since they have a few more food choices.  On the other hand, if someone is used to eating a lot of refined foods and sugars, along with fast food, then they probably will find a standard Paleo diet to be very challenging to follow.

Is Cheating Allowed During The Holiday Season?

I know that for some people this question will seem like a silly one to ask.  But every year I get asked this question from at least a few patients.  Of course they might not use the word “cheating”, as everyone will word this question differently.  By the way, some people hate using the word “cheating” when it comes to eating foods that are not permitted on a specific diet.  And I can understand this, as most people associate the word “cheating” with being dishonest, and one of the definitions of cheating is to “act dishonestly or unfairly in order to gain an advantage”.  So perhaps it would be best not to use the word “cheating” and instead ask if “straying” from the diet is allowed.

Here are a just a few examples of how people will ask if they can stray from the diet they are following:

• Is it okay if I eat a few of the excluded foods during the holiday season?
• There will be a few holiday parties at work and I was wondering if eating a small amount of gluten or other forbidden foods will set me back?
• Can I have some gluten free pecan pie on Thanksgiving?
• Will my progress be affected if I eat a bad meal once or twice during the holidays?

Although you can make the argument that the holiday season is one of the toughest times to follow a strict diet, the truth is that throughout the year there are many occasions where you can try to justify straying from the diet.  Here is just a short list:

• Your birthday
• Other people’s birthdays
• Going on vacation
• Weekend road trips
• Summer cookouts
• Wedding anniversary
• Valentine’s Day
• Halloween party
• Other occasions (weddings, bar mitzvahs, etc.)

I realize that most people want to get well, and many people are willing to follow a strict diet, regardless of the time of year.  On the other hand, many people will postpone getting well until after the holiday season, which I think is a big mistake.  For most people the holiday season starts around Thanksgiving and ends after the New Year, and so we’re talking about delaying your quest to improve your health for 5 to 6 weeks.  Instead of doing this, just think of how good you will feel on the first day of 2018 if you spend the holiday season focusing on improving your health, and not doing things that will worsen it.

Yes, I realize that for some people this is easier said than done, but that’s why I decided to write this blog post.  For those who are striving to get into a state of remission, I want to not only encourage you to eat well during the holiday season, but I also want to give you some useful information to make it a little easier to eat well during this time.  So with that being said, here are ten action steps you can take to set yourself up for success during the holiday season:

1. Try to eat at home as much as you can.  This is the best way to ensure that you will stick to the diet, as you of course can control what you bring into your own home.  This is assuming that the rest of your family is on board.  While I realize that everyone in the household may not follow the same restrictive diet (i.e. autoimmune Paleo diet), hopefully you can at least convince them to give up the main common allergens, including gluten and dairy.

2. If traveling for the holidays, stay somewhere where you can cook your own meals.  It can be very challenging to follow a strict diet while out of town, but you can do it if you prepare ahead of time.  For example, if you are staying at a hotel, try to stay at a place where there is a kitchenette so that you have access not only to a refrigerator, but a stove as well.  And it would be great if the place you’re staying at is located within driving distance of a Whole Foods, Trader Joes, or another health food store.  Of course these days most other grocery stores sell organic and gluten free food, but you will usually have a better selection of organic food at a health food store.

If you would like to go out to eat while out of town, do some research ahead of time.  While you can start by looking up some of the local restaurants, another approach is to call a few local health food stores and ask if they have any suggestions with regards to healthier restaurants that have organic and/or gluten free options.

If you are staying with friends or family members for the holiday season, then hopefully they understand your situation and are open to you preparing your own meals, or to at least assist with the cooking.  They might even be willing to prepare some dishes that you can eat, although this is where you have to be careful, as if they aren’t health-oriented then they might unintentionally add ingredients that include some of the excluded foods.  For example, if they make a turkey for Thanksgiving, they might add seasoning that has one or more “forbidden” ingredients, such as gluten.  I realize that some people will feel too embarrassed to explain their dietary restrictions to the host, but doing so can be important in order to avoid being exposed to an ingredient that might have a negative effect on your health.

3. If invited to someone’s home for the holidays either decline, or ask if you can bring your own dish.  While you understandably might feel the need to go to a holiday party hosted by a close friend or family member, if someone who isn’t a family member or close friend invites you to a party feel free to decline.  Of course it’s up to you as to whether or not you tell them why you can’t go.  Another option is to ask the host if you can bring your own dish.  This way you will know that you will at least be able to eat one entree while at the party.

4. Never go to a holiday party hungry.  If you get invited to a holiday party and decide to go, or have one at your place of work, try not to show up to the party hungry.  I know it might seem rude to eat a meal before going to a party, or to bring some healthy snacks along.  Depending on the size of the party the host might not even notice that you’re not eating anything, and perhaps you’ll get lucky and there will be something there you can eat.  But since you won’t know this until you arrive at the party it’s best to be prepared beforehand by eating something before you leave.

5. Not eating is better than eating unhealthy foods.  If you’re in a situation where you are surrounded by unhealthy foods, don’t feel like you need to eat something.  For example, let’s pretend that you were invited the last minute to a holiday party but you didn’t have time to eat a meal beforehand, and you forgot to bring a healthy snack.  So you’re faced with a situation where you either have to eat some unhealthy foods, or you need to skip a meal.  I realize this is an unlikely scenario for most people, but if the scenario arises feel free to skip the meal!

6. Always carry some healthy snacks.  In order to prevent a situation like the one I just described, try to carry one or two snacks with you at all times.  Even if you don’t plan on being out for a long time you never know how the day will turn out.  For example, you might get stuck in a major traffic jam for a couple of hours or get a flat tire.  For some healthy snack suggestions please read a blog post I wrote entitled “9 Healthy Snacks For Graves’ Disease and Hashimoto’s Thyroiditis”.

7. If you eat out take a gluten-digesting enzyme with your meal.  Although you want to do everything you can to avoid eating any “excluded” foods, if you’re in a situation where you might be exposed to gluten or dairy then consider taking a digestive enzyme that breaks these down, as there are a few different companies that sell these.  Just keep in mind that these enzymes don’t completely degrade the proteins of gluten and dairy, and as a result it is not intended for those with Celiac disease or a non-Celiac gluten sensitivity, or those with a dairy allergy or sensitivity.

8. Try to get creative with your cooking.  One of the big problems many people have with following a restrictive diet is the lack of variety.  In other words, they eat the same foods every day, and as a result they get bored.  I honestly can’t say that I’m creative in the kitchen (quite the opposite), but this doesn’t mean that YOU can’t be creative.  Purchase a few recipe books, and if necessary do some batch cooking.  So for example, if you don’t have time to prepare meals during the week you can block out a few hours on the weekend and prepare all of your meals ahead of time for the upcoming week.

9. Mentally prepare yourself for the holiday season.  Just about everyone can follow a strict diet during the holiday season, but some people have a more challenging time doing this than others.  And while stress and other factors can play a role, many times the reason why people stray from the diet is because they aren’t mentally prepared.  I realize that this might be easier said than done, but I know that when I followed a strict diet for my Graves’ Disease condition I didn’t start this diet the day after I was diagnosed.  Although there was no question in my mind that I was going to succeed with the diet, I needed to mentally prepare myself and set a starting date.

And I do the same thing whenever I choose to follow a 21-day detoxification, which also involves following a strict diet.  While I’m sure that some people might spontaneously decide to follow a strict diet immediately, many people need to set a start date, and then mentally prepare themselves for this.  And while many people set a start date of January 1^st, you of course can choose any date you’d like, and as mentioned earlier I encourage you to start sooner than later if at all possible.

10. If you stray from the diet simply get back on track.  Regardless of the amount of preparation someone makes, they still might stray from the diet.  Although I would try to be as strict as you can, if you do happen to stray from the diet don’t get stressed out or feel guilty.  Sure, it might set you back a little, but the only thing you can do is get back on track.

So for those who are planning to follow a strict diet during the upcoming holiday season, I’m hoping that this post not only will provide you with some action steps you can take, but hopefully it will also motivate you and give you a feeling that you can succeed. Sure, I realize that following a strict diet during the holiday season isn’t easy.  But let’s face it, following a strict diet isn’t easy regardless of the time of year.  And the benefit of following a strict diet during the holiday season is that once the New Year arrives you will know that the toughest days are likely behind you.  And I didn’t even mention that after one or two months you might be able to reintroduce some other foods, which of course will make it even easier to follow.