Hashimoto’s and me……. Part 1
I have been planning to write about Hashimoto’s Hypothyroidism for quite some time, but somehow I haven’t been able to pick the right moment or feel the time was right. This year has seen big changes for me and I have consciously been trying to rebalance my life. The last few weeks has really pushed me into feeling the time is right to write. In my youth, I thought I was invincible, I tried to be everything to everyone, I empathised and sympathized with others on their poor health or misfortunes and tried to rebuild or improve them, but never in a million years thought that ill health could happen to me. My lack of truly listening to my body over many years caught me out, and with a family history of auto-immune disorders I regret now this stubborn inner me. However, as I live with a chronic auto-immune condition I feel that if anything positive has come out of it, is that it has really allowed me to understand my patients at a level deeper than ever imaginable before. Hashimoto’s thyroiditis, for those unfamiliar with this condition, is in which the body’s own immune cells attack and destroy the thyroid gland. There can be up to 300 different symptoms and so there can be many of these symptoms that cross over into other illnesses. It can be slow progressing for some and so blood test may not detect it in the early stages making lives unpleasant with symptoms and no answers. Hypothyroidism is the most common outcome for a Hashimoto’s sufferer and medication is used to help treat this condition end of story. That is what I was taught when learning about the Thyroid at Uni and during my hospital career. Take a tablet and all will be fine, next…. NOW I KNOW THAT SADLY THIS IS NOT ALWAYS THE CASE…. My Story is a common classic: I had not been to the GP in years, I had no time and no reason to see him, I had strangely and uncharacteristically booked to get my Vitamin D checked mainly due my Dietetic curiosity with the media hype. Don’t get me wrong I had felt rubbish for years but put that down to long hours running my business, caring for 3 small kids, getting older and was involved weekly in caring for my disabled mother. My husband, a fabulous man, was hardly around with his job. I was a “no time for me person” to whom I used to say if I met someone like this: If you don’t look after your health you will have “plenty of time in the future”, as you won’t be able to work! A total Hypocrite I know. I just did not see it for myself or maybe I chose to ignore it. I remember when my blood panel came back I was shocked and if honest relieved. I was not surprised that something showed up and that all my symptoms that I tried to ignore or had secretly stressed about were valid. In addition to a Hashimoto’s diagnosis I had a very low Vitamin D level and suboptimal levels of B12. My diagnosis was in Dec 2012 and I thought that was it, all fixed. I was commenced on Levothyroxine and I slowly built up the dose as guided by my GP and I sat back and waited to get better. Did I feel better? Psychologically maybe a little as I started to take more interest in myself and others around me had to also consider my health. However this feeling did not last long; 4 weeks later and I was worse and so the GP increased the tablets and so the story went on until my bloods were in NORMAL range but I was feeling worse than ever. My GP made an urgent appointment for me with an Endocrinologist who assessed me and said “go take a holiday”. OMG I didn’t see that coming. I was hoping to be taken seriously but clearly I was not ill on the small panel of thyroid blood tests taken and so it had to be in my head….any of you who have been there will know the score. From that moment onwards, as best I could, I did my research. I was so unwell I did not see how I could make it to my next birthday: I was 1 month away. Some major symptoms: severe headache like a vice, walking in concrete, mixing up words, brain fog, exhaustion not able to get out of the car to lift my kids or shop, back pain, chest pain, lots of sighing, brittle nails and hair, skin on chin irritated, sensitive teeth and gums, low moods, insomnia, tearful, constipation, freezing cold, heart palpitations….my adrenal glands were struggling too. I bought a medical thyroid book book which was a great starting point and I commenced the recommendations. I know you would think that as a Dietitian I would be an expert in nutrition, which I am! but the subject of auto-immune and supplements was lacking in my knowledge and so all news was new and I ate it all up. (With these new skills I now successfully treat patients today) Anyway; I took a summer holiday with my family but sadly as a shadow of my former self in vitality, stamina and energy. Sitting at 40c I was cold and wrapped up, but the headaches were gone and that was one step in the right direction. I came home from my holiday and began to fix myself further. I joined the Health Unlocked forum which again has been instrumental in my recovery. I requested further blood tests and from this I commenced a medication which had a combination of T4 and active T3. This along with the daily regimen of supplements made a noticeable difference and some of the significant symptoms began to settle. At the same time I made a difficult but important decision that I
5:2 Fasting diet – my thoughts and experience after completing it…
Hi I am Clare writing as part of the 121 Dietitian team. Below is my own assessment of Michael Mosley’s fasting diet. Why I did 5:2 fasting diet I’m soon to graduate as a Dietitian and I have a keen interest in weight management and awareness of food content. When I heard about this diet, I knew that I would be asked about it and decided the best way to be able to give my view/understand what people were dealing with, would be to try it out myself. “Dietitians should take into account what people actually do rather than what we would like them to do” – Dr Krista Varady Note: I didn’t do the fast diet with the aim to lose weight; simply to see how it would feel and the effect it would have on my health and lifestyle. In the UK, nearly 2 in 3 adults, and 1 in 2 children, are overweight or obese. (2012) Having a BMI above 25kg/m2 puts you at higher risk of many other diet-related diseases including Type 2 Diabetes, Heart Disease and Cancer. this is something to be taken seriously and probably one of the biggest reasons for our world’s growing obsession with diets. * To work out your BMI: divide your weight (kg) by your height squared (m)2 e.g. if you are 57kg and 1.62m, it would be 57/2.62 = 21.8kg/m2 Dieting is no new thing; a quick search in google brings up some odd historical diets ranging from the self explanatory ‘chew and spit diet’ to eating tapeworm eggs… So what about this 5:2 fasting diet from Michael Mosley? Fasting is no new concept either. it is an important practice in a number of religions (consider lent, Yom Kippur, Ramadan) carried out to fulfill a number of purposes that include practicing self-control and purifying oneself. In the early Christian church, Wednesdays and Fridays were traditionally fast days, and those partaking would abstain from meat, fish, eggs and butter. ‘i fast twice a week’ – Luke 18:12. “gluttony makes a man gloomy and fearful, but fasting makes him joyful and courageous” – Saint Nikolai of Zicha I have a nagging suspicion that there’s some wonderful underlying truth about improved health with fasting just waiting to be discovered. Does the 5:2 fasting diet work? Start – 4.3.13 – weight 127lbs; BMI 21.8 kg/m2; serum cholesterol 3.8mmol/l Finish – 12.4.13 – weight 127lbs; BMI 21.8kg/m2 This is interesting. My weight stayed stable. Admittedly, on a couple of occasions I cheated, going a little bit over the 500kcal allowance or being sneaky and ‘fasting’ from 2pm one day to 2pm the next day and still allowing myself 500kcal in between (and having a takeaway pizza for lunch at 1.30pm just before i started). Also, this period in my life has been one of celebration and freedom from structure and responsibility. Therefore I have been eating out, throwing dinner parties and having coffee dates much more frequently than usual. So what I have found is that this diet has allowed me to do is to maintain a happy weight whilst eating in a ridiculously undisciplined fashion 5 days a week. It has also shown me that I am disciplined enough to work around food all day (in a cafe on my days off) and not give in to temptation 2 days a week. It required effort in planning and calorie counting and commitment but it brought a sense of achievement and self-control when mastered. I am aware that lowered cholesterol and blood sugars are supposed to be the other health benefits in the fast diet. Prior to starting, and in the name of science I visited my GP to measure my blood sugar and cholesterol levels, but it turned out they only measured my cholesterol (as seen above). Because of this I did not return post fast period because my cholesterol was at a healthy level on starting and I had nothing to compare my sugars to! Not very scientific after all. For anyone else wanting to try out this diet, please make sure to get your bloods checked before and after! Did I over-compensate for my fast days? Yes. Definitely. However, I think that had I started the fast diet with a genuine desire to lose weight, I would easily have been able to refrain from over-compensating. in Mike Mosleys book, Dr Krista Varady carried out a study which showed people generally did not compensate for their fast days by having 175% on a feed day. personally, because I wanted to push boundaries with this diet, I think I have proven that to see all the results you need have a motivation and be very, very strict. What are the benefits of 5:2 fasting diet? Bearing in mind that there have been no long term studies carried out in humans, here is a list of some of the believed benefits of fasting: · longevity (in mice: lowered IGF-1*) · weight loss (i have spoken with a number of people who have lost between 8lbs and 21lbs) · improves learning and memory in mice (possibility of reduced risk of Alzheimer’s?*) · improves nutritional awareness (constantly reading labels) · reduced risk of cancer (due to weight loss and decreased % body fat*) · lowered blood sugar and cholesterol levels · choose your days/ make it suit you · improved self discipline *The science bits. 1) this is a quote from Mike Mosley’s book. “The IGF-1 hormone (insulin-like growth factor) is one of the drivers which keep our bodies in go-go mode, with cells driven to reproduce. This is fine when you are growing, but not so good later in life. There is now evidence suggesting that IGF-1 levels can be lowered by what you eat. Studies on calorie restrictors suggest that eating less helps, but it is not enough. As well as cutting calories you have to cut your protein intake. Not entirely – that would be a very bad idea. It’s about sticking to recommended guidelines, something most of us fail to do. The reason seems to be that when our bodies no longer have access
Workplace Nutrition
Answer the following to identify your workplace nutrition: Do you buy your food at work? Do you struggle to eat healthy choices at work? Do you find there is a lack of healthy options provided? Do you find healthier choices to be more expensive? Do you fail to drink enough fluids? Do you eat at your desk? If you answer yes to more than 3 of these questions then you need to read on to improve your workplace nutrition………. With over 29 million people working in the U.K and spending up to 60% of their waking hours in work it seems obvious that the eating decisions and habits we form at work could have a significant impact on our health. In 2006, the National Institute for Health and Clinical Excellence (NICE) recommend that workplaces have policies which encourage healthy eating and promote healthy choices. If you have answered mainly yes to the questions above you are not alone, despite the guidelines many people still feel it is difficult to make healthy choices in the workplace. The verdict by the Royal College of Physicians in 2011 that little action has been taken to promote healthy eating would come as no surprise then. Well 2 years on, has there been any improvement? A study on motivations and barriers to healthy eating in public sector workplaces was recently published in the Journal of Human Nutrition & Dietetics. It identified some important views from public sector workers. The article ‘A qualitative study to investigate the drivers and barriers to healthy eating in two public sector workplaces’ A Pridgeon & K Whitehead (2013) JHum Nutr Diet, 26, 85-95 can be accessed online using this link http://onlinelibrary.wiley.com/doi/10.1111/j.1365-277X.2012.01281.x/full . So should employers be doing more to improve workplace nutrition? Or should it be our own responsibility to tackle the obstacles in the way of making healthy choices in the workplace? Certainly here at 121 Dietitian we are of the opinion that employers should be doing more to promote healthy workplace nutrition choices, if they aren’t already. As a specialist nutritional team we are passionate about providing staff nutritional assessments and menu improvement, workshops etc. Our workplace nutrition programmes reduce absenteeism, improve moral and improve company finances. We also encourage staff to take responsibility, driving new ideas forward and to remain healthy outside the workplace. If you struggle to make healthy choices at work, find there is a lack of healthy options available at your work or feel that healthy options are too expensive, then preparation is the key. Boring you may yell, No, is our reply as with 121 Dietitian = Clever, quick and tasty. Just to wet your appetite!! Here are just a few popular tips on Workplace Nutrition to get you started…. If you’re always short on time why not cook an extra portion of dinner in the evening? The leftovers can be eaten for the next day’s lunch. Alternatively use the time while you’re in the kitchen anyway to prepare a tasty meal for the next evening. Stock up on lots of healthy ingredients such as salad vegetables and fruit, cooked fish, lean cooked unprocessed meats, wholegrain breads & pastas and dips. Having plenty of options will prevent you getting bored and help you resist the temptation of the canteen or vending machine. Fruit, vegetable sticks, yogurts, seeds & nuts are nutritious and great for snacking; keep these handy at your desk for when you are feeling peckish to tide you over until the next meal. If you are on a budget fresh fruit can be bought cheaper in bulk. You could buy a bag of fruit especially to keep in the workplace for snacking, remember to wash it well. How to improve Workplace Nutrition at your desk It is good to get away from the desk during your breaks for your body to relax, if you are eating at your desk; are you working through your break? This is not good for long term health or productive for your job. Bringing your own lunch can save you time rather than queuing in the canteen so push away when you can. It is important you maintain your energy to keep focused on your work. healthy snacks at your desk are recommended. Exercise is as important as eating right when wishing to maintain our health. We should be trying to get around 30 minutes exercise most days, so break the bad habits and start with manageable targets. 121 Dietitian’s are experts in diet and health and are leading the way in making positive changes in companies across Northern Ireland and saving their hard earned cash along the way. Why not find out how we can help you by getting in touch. We have a range of programmes to suit all requirements and budgets. Usage of KPI’s allowing success to be charted. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018.
Christmas Diet Dilemmas
The Christmas Diet Dilemmas. Many of us will gain unwanted extra weight this Christmas. Whether it is due to decreased exercise, attending more social occasions or an increased craving for comfort foods during the long, cold nights, weight gain is not inevitable. Here at 121 Dietitian we would like to share with you some tips for the festive season and hopefully save you making “must lose weight” resolutions as we enter the New Year. Christmas diet – Why do we gain weight during the festive period? Christmas is a time of celebration which can span from the 2 -3 weeks prior to the big day with Christmas parties followed by New Year celebrations and then continue into January with finishing the leftovers. This amounts to nearly a month of celebrating and for some of us who might normally resist temptation telling ourselves ‘it’s alright it’s a special occasion.’ These special occasions can easily mount up. Even something you consider to be a little treat can have a larger effect than you would realise. If you consume over 200 – 300 kcal ( mince pie or some buffet sausages, large glass of wine) or more each day over the course of 1 month you can expect to gain 4-8lb minimum if you are not actively exercising over and above your normal activity or having days where you keep control. Weight gain over the festive period is easy but it is not inevitable. You can be very clever with your food/kcal intake and still have fun. The right state of mind is often the major hurdle to compliance. A pre-party tip People live busy lives and are on the go the whole time. However take a little extra time to have a pre party planning stage for what you are going to wear, how you will travel and what you will eat during the day, and then at the party. This will see you through with a big smile and smaller bum, tum or hips!! Some good advice If going to a buffet eat well during the day. High fibre regular meals are good. Have a snack before you go out e.g. banana and wholemeal toast if in a rush, or some lean meat /fish and pasta/potato and vegetables. At the buffet try and fill most of your plate with raw vegetable sticks and fruit. What not to do instead of what not to eat! Avoidance is never the best long term plan. Usually it makes you want something more! It is better to teach ourselves to moderate rather than avoid. Often avoided foods will creep back into the diet and if you can’t control this then a yo-yo weight gain can occur. When out celebrating here are some don’ts. Don’t go hungry. Don’t stand near the food table as you will be tempted. Don’t get too tipsy early as this will reduce your willpower and the results could be bad! Watch the dips, go for the salad options, then you can add a few of the other items like goujons and crisps, enough variety to see you through. The worst high fat offenders are the sausage roll, vol au vents and depending on the quality deep fried chicken in breadcrumbs can be processed and fatty. Christmas diet – Being clever can save you calories! Your choice at the buffet table can mean you can make a difference of a clever 350 kcal intake for the night (not including alcohol) instead of 1200 kcal, almost a full extra days intake of junk and saturated fat. One last more sobering thought: Think ahead: how you are going to feel come January with a substantial food and drinks bill, clothes that are too tight and potential blood pressure, cholesterol, health problems. Do these treats seem so appealing? Enjoy, but have pride in resisting some temptation too! Happy Healthy Christmas, we look forward to hearing your success stories…. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018.
Irritable bowel syndrome IBS – patient’s perspective
1 year on since we commenced the Irritable bowel syndrome IBS Low FODMAP advice clinic we thought we would celebrate with some good news… This lovely lady attended clinic, miserable, frustrated and exhausted. Her Irritable bowel syndrome symptoms were severe, affecting her family, her work, going out… It had truly taken over and ruled their lives. She was worried that her symptoms meant something more sinister and really was in need of help and support. After Nutritional assessment and dietary analysis she commenced a personalised FODMAP elimination dietary programme designed by Gillian Killiner @ 121 Dietitian. Dear Gillian I am pleased to report all is going well from the IBS side of things. I appear to have it well under control from a diet point of view – I am eating well, sleeping well and bar the occasional flare up have stomach and bowels well under control. I had my scope back in June and the Consultant who did the procedure was happy that all was looking well. I wasn’t in any rush to see them as I was continuing to increase my intake of wheat and gluten without any difficulties. Gillian – I continue to steer completely clear of onions and garlic. I allow myself milk in tea and coffee but otherwise continue to enjoy the lacto free milk. Yes my diet is restricted but is healthy and varied and I am very happy with what I am eating. You have got me enjoying porridge – which is nothing short of a miracle. My Scottish father is delighted!!! Gillian I cannot thank you enough for all your advice – I continue to discuss the FODMAPS approach and your in-depth knowledge with other professional staff whenever I can…… A new beginning for this lady and for many more of our clients this year. If you suffer from IBS or know of someone who does give us a call so we can arrange to help you too. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018.
Men’s Health The Movember Movement – a great achievement
Men’s health – Movember already! Here at 121 Dietitian we can hardly believe how fast this Olympic year has raced by. The games are over but men now have something else to compete/chat about; moustaches! Pictures of sprouting moustaches are gracing the pages of social networking sites everywhere, a sure sign of a public health campaign gone right. It really is great to see a campaign which captures the imagination of so many, particularly since it is inspiring men to think about their health. On average men visit the GP half as often as women and there is a 4 year difference in life expectancy between men & women -with women living longer. This is why Movember aims to raise awareness of men’s health issues, in particular prostate and testicular cancers. Getting to know your body & looking after your health is important whether you are male or female and early detection of cancer can mean treatment is easier and more successful. More details on Movember can be found on their website uk.movember.com. Men’s health Regular exercise and a balanced diet are crucial for looking after your health. You probably already know you should include plenty of fruit and vegetables in your diet along with plenty of whole grains and water. But do you know why?? Well every year increasing research shows a clear association to health benefits, Cancer protection being one. To assist you further, foods which are high in saturated fat, sugars and salt should be kept to a minimum. So now you know that including plenty of plant foods in our diet may help to lower cancer risk, did you know they also contain many vitamins and minerals which help to strengthen immunity and keep the body healthy from inflammation, heart disease, diabetes and gut health …. They are also a great source of phytochemicals which can help to protect cells in the body from damage that may later cause cancer. Plant foods are also often low in energy/kcals, choosing these over high kcal/energy foods & snacks can help you to maintain a healthy weight. This is important since there is strong evidence to suggest being overweight can increase our risk of getting certain cancers. If you are struggling with your energy check out this blog on energy boosting foods. Top tip for the men out there….. Tomatoes are a plant food which you may wish to consider including in their diet. Research has shown that frequent consumption of tomato products is associated with a lower risk of prostate cancer. A compound called lycopenes which is found in tomatoes is thought to be the reason for this. Interestingly lycopenes are more available to us if we cook or process the tomatoes. Why not try a nice bowl of tomato soup if you fancy a lycopene rich dish? It’s a perfect for this colder weather too. If this Movember has inspired you to improve your diet 121 Dietitian is here to help. Please feel free to contact us for a consultation. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018.
