Episode 187 - The Triathlete’s Guide to Thyroid Nutrition

The Triathlete’s Guide to Thyroid Nutrition

Nailing your training but can't shift those stubborn kilos? Maybe you’re battling gut issues despite a dialled-in nutrition plan or even dragging yourself through sessions after a solid 8 hours sleep. 

If this sounds all too familiar, it might be that your thyroid has been flying under the radar.

As a sports dietitian, I'm seeing more triathletes pushing through these warning signs – constant fatigue, resistant weight, bloating, and mysterious gut problems – not realising there's a tiny butterfly-shaped gland in their neck calling the shots. 

Thyroid health isn’t my area of specialty so today I’m joined by Registered Dietitian and Functional Practitioner, Alisha Knicely, to talk about about how this powerful gland affects everything from your race-day performance to your Monday morning motivation.

Diagnosed with an autoimmune thyroid disease in 2017 , Alisha’s drive to understand what was happening in her body was a turning point in her career. She now specialises in Hashimoto’s and Hypothyroidism and helps her clients to reverse the symptoms of thyroid dysfunction. 

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Alisha Knicely

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Episode Transcription

Episode 187: The Triathlete’s Guide to Thyroid Nutrition

Welcome to the Triathlon Nutrition Academy podcast. The show designed to serve you up evidence-based sports nutrition advice from the experts. Hi, I'm your host Taryn, Accredited Practicing Dietitian, Advanced Sports Dietitian and founder of Dietitian Approved. Listen as I break down the latest evidence to give you practical, easy-to-digest strategies to train hard, recover faster and perform at your best. You have so much potential, and I want to help you unlock that with the power of nutrition. Let's get into it.

[00:00:00] Taryn: Today we're diving into a topic that often flies under the radar, but can have a huge impact on your performance, which is thyroid health. Now, this is definitely not my area of expertise, so I've invited thyroid specialist dietician, Alicia, nicely to help us understand the connection between thyroid function and triathlon performance.

[00:00:20] So whether that is something that you are dealing with a thyroid condition personally, or you're just curious about how it affects your body and your health, then this episode's gonna provide some really valuable insights. In today's episode, we'll discuss why thyroid health is important, how to actually check your thyroid function and your thyroid health, and as always, some practical steps to optimize your thyroid function.

[00:00:44] So tune in to learn about how to keep your thyroid in check so you can train harder, recover faster, and perform at your best. Thank you so much for joining me on the podcast today, Alicia. I'm so excited to talk to you and pick your brain on an area of expertise that is definitely not my own but you're the expert. So we're gonna hear some great insights from you today.

[00:01:22] So welcome.

[00:01:23] Alisha: Yeah. Thank you so much, Tara, and I'm excited to be here. 

[00:01:26] Taryn: Can you kick us off by just introducing yourself a little bit and explaining how you became a thyroid specific dietician 

[00:01:33] Alisha: Yeah, absolutely. I've heard many stories similar to mine where it's a personal history, a personal story of my own diagnosis with autoimmune thyroid disease that happened back in 2017. So I've been practicing as a dietician for 10 years now. Just getting into my career, I was actually a dietician at a wellness center at the time.

[00:01:55] I had just moved out of the clinical atmosphere and I decided to [00:02:00] go in for a routine physical and did some more in-depth lab work to check on my own health. And I had the thought that everything was gonna come back great. And I was the picture of health and I. Exercise and ate well and everything. And to my surprise, my doctor's surprise.

[00:02:18] I had extremely elevated thyroid antibodies. My TSH was well above range in the forties, rock bottom, T four rock, bottom T three. My doctor truly made the comment. She was like, I don't know how you're like getting out of bed in the morning, um, how you're functioning. And I, I was just like, I don't, I don't know.

[00:02:38] This is just. How it's been, I didn't, I didn't really, I guess, realize the signs and the symptoms and normalized a lot of it, and it had been going on for a while and my body got like. Our bodies do get very good at adapting and compensating. So that was a huge turning point for me, what I understood health to be and what to look out for, and also my career.

[00:03:01] So I continued working at the wellness center and I saw a lot of thyroid patients and now had a personal attachment to it that I wanted to learn as much as I could to help my own body. And then also the patients I was seeing more than what we were already doing and. Through that I also got to experience the patient side of being referred to an endocrinologist and not getting any help, on lifestyle, none.

[00:03:24] And that was extremely frustrating because as a dietician I very much understood the importance of nutrition and, you can manage chronic diseases through lifestyle, but I wasn't being told that by my providers. So that went down the pathway of additional training, certifications, training in functional medicine where we look more at root cause approach, preventative versus symptom management.

[00:03:48] And over the years, I was able to reverse my symptoms, reduce my antibodies, get myself into a place of. Remission and really just understand how to live with [00:04:00] Hashimoto's, but also like to thrive with Hashimoto's. Um, like, truly feel like I don't have the condition most days. And it was such a. A passionate journey for me and I, I saw so many women and men go through the same, you know, run around with their doctors and not getting help and being told their labs are normal and having all of the symptoms and having nowhere to turn.

[00:04:23] So I just turned that into. This is what I wanna do. I want to educate, I want to support and advocate for this group, this population of people because I, I've been there and I can empathize and yeah, it's just something I'm, I love doing. And that's kind of how I got to specialize with thyroid patients.

[00:04:46] So personal journey, and then just really learning everything I could and now only taking on and working with thyroid patients. 

[00:04:54] Taryn: Lucky you were a dietician and you knew how to find the right information and do the research to

[00:04:59] like firstly help yourself and 

[00:05:01] then be able to share that knowledge with others. 'cause it is really frustrating. There's not a 

[00:05:05] lot of information out there and I've had the 

[00:05:07] same experience with regular doctors 

[00:05:10] as well.

[00:05:11] They just are like, fob you off as like, you know, you got little people and. It's normal to be that tired and whatever, 

[00:05:17] and you're like, no, no, no, no, no. Like there's definitely

[00:05:19] something going on here. I hate it. 

[00:05:21] Alisha: It's, it's not right. You take their word for medical advice or recommendations, and then you're stuck and it's, yeah. It's hard to see.

[00:05:30] Taryn: Yeah, we're, I think we're both aligned with the prevention rather than the cure space. And 

[00:05:34] there's so many things you can do before there's a problem to stop. There was a problem in the first place. 

[00:05:41] So for people that have no idea what the thyroid does and what its function is in the body, can you explain a little bit about that and how it does impact our metabolism and our energy levels?

[00:05:50] And I can help apply that then to the triathlete population.

[00:05:54] Alisha: Yeah, absolutely. So the thyroid gland is a gland, so it's part of the endocrine [00:06:00] system, and that means it secretes hormones. So hormones are these chemical messengers, they. You know, dictate a lot of processes in the body, and specifically with the thyroid, it is located in your neck. It's nicknamed the butterfly gland 'cause of its shape.

[00:06:13] It's not very big at all. I think it's about an ounce, but it's very important and very powerful and necessary. If you have your thyroid removed for whatever reason um, you do need to be on thyroid hormones. You cannot live without them. So Thyroid hormones do a lot of, huge involvement with the metabolism, your metabolic rate, which runs so many different processes in the body.

[00:06:34] And also how we, you know, basically obtain energy from our food and how well we do that, as well as utilizing fuel, but having healthy weight management. But it goes so far beyond that, which is why when you have a dysfunctional thyroid. Or low thyroid hormones are high.

[00:06:50] You experience symptoms systemically like head to toe. Thyroid hormones are involved in the brain. Which is why anxiety and depression and apathy are a symptom. And thyroid issues used to be screened with things like, do you have depression? Let's check your thyroid. That's not the case as much anymore.

[00:07:08] Same with cholesterol metabolism. You have high cholesterol. it used to be, again, a screening criteria for checking on the thyroid and it's, it's not anymore. And. A lot of reasons for that. But it's involved in sex hormones, fertility, so with productive health your ability to build muscle, your bone health, bi motility and how you generate heat, which is part of metabolism as well.

[00:07:30] So it really is, you know, hair, skin, nails, your appearance can change from, you know, low thyroid hormones. your ability to heal and recover, which is really important for athletes. I'm sure we'll talk about that too. So yeah, it's just, it's involved in every area. And, and to highlight that point, every cell in the human body has thyroid hormone cell receptors, meaning every cell for one reason or another, does require some level of thyroid hormones to function at an optimal level.

[00:07:59] Taryn: That's a lot, isn't [00:08:00] it? And easy to see why it being out of whack, everything can go awry. 

[00:08:05] Can you explain quickly the difference between hypothyroidism, hyperthyroidism, and then Hashimoto's?

[00:08:11] Alisha: Yeah. So that's a common question, especially because Hashimoto's and hypothyroidism sometimes are used 

[00:08:16] interchangeably, and sometimes even when the doctor's communicating to the patient, they might lump those terms together, but they really are separate conditions that do often go together. So hypothyroidism.

[00:08:30] Means low thyroid is a clinical term for like clinically low thyroid hormones in the body. The opposite being hyperthyroidism is high or elevated thyroid hormones in the body. Now the question in, in functional medicine is, is the why. Well, why do you have low thyroid hormones or why do you have elevated thyroid hormones?

[00:08:49] Most of the time for both states, it's autoimmunity. So with Hashimoto's, this is an autoimmune condition where the immune system becomes imbalanced and it creates autoantibodies towards your thyroid tissue. And I'm sure we'll talk about markers and, and lab tests that identify that. This is an autoimmune condition and it damages the thyroid gland to the point where it.

[00:09:13] Under produces thyroid hormones. So thus it leads to hypothyroidism over time. It can take years to get to that point, or it could be a lot faster depending on the severity of the disease and the inflammatory process. And then with hyperthyroidism, most often the root cause is grace disease, which is autoimmune hyperthyroidism, where the immune system is targeting different parts of the thyroid that cause more release of hormones and it becomes.

[00:09:42] Super high. And that can be dangerous too, if not managed. So that's, that's the difference. One is just describing the state or the level of hormones, and then the other is describing the autoimmune condition. And you can have, you can have hypothyroidism without Hashimoto's, although it is, Hashimoto's is the [00:10:00] most common cause for hypothyroidism, and it's much more common than Graves disease.

[00:10:04] And you can have hashimo without hypothyroidism. Like you can have the autoimmune condition without it. Impacting your thyroid hormone levels, and this is where it takes a skilled practitioner to, to look at your values and explain what's going on, and then also what to do about it depending on what stage you're in or where you're at.

[00:10:22] Taryn: And it's more common in females compared to males. Is that correct?

[00:10:26] Alisha: Yes, yes. Much more. Five to eight times more, I 

[00:10:29] Taryn: Wow. We always get the rough 

[00:10:31] end of the stick. 

[00:10:32] Alisha: yeah, yeah. And that's true from almost all autoimmune conditions. And, and from my understanding, they believe it has to do with our different hormonal profile, which can also influence our immune systems, which is directly linked to autoimmunity.

[00:10:45] So there's different theories and reasons as to why, but we are, different than men, so that's gonna leave us more vulnerable to certain things.

[00:10:54] Taryn: And so what are some of the symptoms that you might experience if your thyroid isn't functioning correctly?

[00:11:00] Alisha: Yeah, so we can start with low thyroid hormones, since that is definitely more common. 

[00:11:05] if you're hypothyroid, the symptoms you're gonna wanna be aware of uh, would be exhaustion and fatigue because these thyroid hormones are responsible again for metabolic rate and cellular energy production.

[00:11:16] So That's probably top and fatigue not restored from sleep or rest. This is like continued chronic fatigue. Weight gain and weight loss resistance. Again, going back to how hypothyroidism impacts the metabolism. Then we have GI issues, like constipation is very common. Heartburn and bloating can be pretty common.

[00:11:35] we Have hair thinning, hair loss weak nails, brit nails, dry skin. things like anxiety and depression and mood changes might come up. You might notice changes with your hormones, so that could look like changes with your menstrual cycle. It could look like a loss of your period as well. that's, you know, a huge indicator of women's health is the health of your menstrual cycle.

[00:11:57] It could look like high cholesterol [00:12:00] or cold extremities is the big one, so cold hands and feet and nose. So again, poor circulation, not able to generate body heat very well. It could be poor recovery. I. It could be the inability to build muscle. That one was, was one that I felt like I experienced. Even things like osteopenia and osteoporosis because they're involved in building strong bones too.

[00:12:25] those are kind of the top ones I would say. And then for hyper, we're kind of looking at. Basically the opposite of a lot of those things. So this could look like feeling really hot having a higher metabolic rate. So it's actually they might be thinner or unable to gain weight in a healthy way.

[00:12:42] Um, They could feel anxious, they could deal with insomnia, heart palpitations, thyroid hormones are involved in like heart rate as well. So these are, you know, and also with GI Health, it can be, instead of constipation, like loose stools, like rapid, you know, movement through the GI system. So those are some of the more common symptoms you'll see with excessive thyroid hormone levels.

[00:13:03] Taryn: I, a lot of those things are probably what triathletes feel like on the daily basis, 

[00:13:08] and some of it might even be confused with iron deficiency. So 

[00:13:11] one of the things we'll dive into later is how to actually check for it and, 

[00:13:15] and what we're looking for in our blood so that. You are not sitting there freaking out that you've got hypothyroidism right now.

[00:13:21] 'cause a, a, lot of that stuff can go hand in hand with being quite active, doing a lot of training, having a full night of sleep and still feeling tired when you wake up, 

[00:13:30] as well as, you know, the bowel type things. Either direction, it could go. 

[00:13:34] we'll jump into that a bit, a little bit later so that you can 

[00:13:37] calm down and just be at peace knowing that you're looking for the right things and getting the right answer when you go to the doctor.

[00:13:44] Before we dive into that though, like I did a deep dive on this as well myself, what are some of the key nutrients that we need for our thyroid to function optimally and make sure that we're not deficient in.

[00:13:55] Alisha: Yeah, that's a great question. So yes, the thyroid does require [00:14:00] micronutrients, these building blocks to create hormones. The one I think most people are aware of is iodine. So if you look at a lab test and you see like T four, T three, that's actually describing the number of iodine molecules attached to make that hormone.

[00:14:14] So iodine is important. The thing to know is it's this goldilocks kind of nutrient because you don't want too little and you don't want too much, especially in the case of Hashimoto's because it can actually exacerbate autoimmune activity. So we do need some, that, that it doesn't need too much. I think it's like 52 micrograms.

[00:14:33] I know we, it's recommended like 150 you know, for general health and then more if you're breastfeeding or pregnant. But that is definitely necessary for the thyroid. But if you have Hashimoto's, Sometimes we recommend restricting or going on a low iodine diet for autoimmune management. But iodine's one, and in developed countries, it's not so much of an issue like it is elsewhere in third world countries where they're actually iodine deficient and they develop goiters and things like that.

[00:14:59] And hence why we did iodized salt to prevent that. But now with. Our diets have plenty of iodine, and then it's added to the salt too, and in processed foods, so not so much of a concern. Then we have other nutrients like selenium and zinc are really helpful for thyroid hormone conversion. our thyroid produces mostly inactive thyroid hormone.

[00:15:21] And and our peripheral tissues, we do convert that to the active usable thyroid hormones. So certain nutrients are required for that. There's Also certain amino acids, like tyrosene that are used as the building blocks for thyroid hormones. But if you're getting adequate protein, You're gonna get enough of that amino acid um, where you don't need to supplement for anything like that. Really, it's um, looking at your overall dietary intake of protein. There's vitamin A is another great one. And then we can kind of get into like there's nutrients too specifically that can be helpful for Hashimoto's and immune modulation and inflammation management.

[00:15:56] Um, But those are some of the top ones that I think a lot of [00:16:00] people may have heard about or you might see and a thyroid complex support supplement or something like that. 

[00:16:06] Taryn: And is that something that you'd recommend people take? Is just a general thyroid support supplement?

[00:16:11] Alisha: It depends, you know, when I work with my clients, I really take a look at their nutrition and then their lab work and see if they need more, you know, maybe a therapeutic consistent dose through supplementation. Um, the fact is, is that our nutrition habits may not be great, but on top of that, you know, our food quality and mitten soils are depleted.

[00:16:31] Our food's more depleted than it used to be. So it does help to fill the gaps, but I do it on a more case by case basis. Supplements have a time in place, but not for everyone, for sure. certain things can deplete, you know, your ability to absorb or acquire nutrients, whether it's GI issues or stress.

[00:16:49] So all I take all of that into an account. Otherwise, you could be wasting money on a supplement that you don't need. If you could just focus on certain foods in your diet, you, you'd be 

[00:16:59] all right. 

[00:17:00] Taryn: Yeah, good answer. I like it. I'm glad we're on 

[00:17:02] the same page. 

[00:17:03] Alisha: yes.

[00:17:03] Taryn: And so what are some of your favorite foods then to help hit those big, big target nutrients?

[00:17:08] Alisha: Yeah. So this, I mean, this may not be popular, but I'm just gonna speak the truth. So Oregon Meats and Seafood are great sources of all of the things I just listed. So you get those minerals like copper, zinc, selenium protein. Of course you're gonna get iodine in seafood and sea vegetables. Again, being cautious with that.

[00:17:27] If you have Hashimoto's, nuts and seeds are gonna be sources of too, of like zinc and magnesium. Brazil nuts are a very rich source of selenium. And then I'm a huge fan of animal-based protein because it is very bioavailable, it's very nutrient dense, it's very easy for the body to get those nutrients.

[00:17:46] Not that you can't be plant-based. You can, you just have to usually be a little bit more on top of your nutrition um, making sure you're getting the right combinations and enough of, of. The food and you can digest that all very well. I'm a huge [00:18:00] fan of antioxidant rich foods.

[00:18:03] berries and your dark leafy greens and you know, omega threes as well. And that can be very therapeutic too, since most cases of hypothyroidism are Hashimotos. Not always, but it's a great thing to include in your diet. 

[00:18:18] Taryn: Yeah. Nice. I love that they're all whole foods. And they're all real foods

[00:18:21] too. 

[00:18:22] So from a training perspective. What are some signs and symptoms that a triathlete is, may be overdoing it with training if their thyroid's not working properly or some of the, some of the warning signs that they may be need to adjust their training a little bit or do something differently to help their overall health.

[00:18:38] Alisha: Yeah. Yeah, that's a really good question. I, I feel like most athletes kind of know, or they should, if they have the awareness there, they should know what their body feels like when they're performing and recovering well, like they're hitting ups, their times are better, they're lifting heavier, whatever it might look like for them.

[00:18:55] But when that starts to all. Feel like it's becoming compromised. So some classic signs of over training could be like insomnia, changes with your appetite, excessively sore muscles. Um, You just can't perform at a level that you maybe used to be. If you wanna compare that to like your baseline or like your peak level of performance, that is a big indicator that okay, something is up, whether it's stress on the body, inflammation, hormones are off, and it's definitely worth investigating.

[00:19:24] Taryn: I think a lot of triathletes have no idea. We just keep training 

[00:19:27] because it's on our program 

[00:19:28] and we do as we're told because we like training picks to go green or we like to, you know, 

[00:19:32] have the session achieved. So some of those things are good to look out for, 'cause your body will tell you what's wrong 

[00:19:38] if you can tune in and listen to it.

[00:19:41] Alisha: Oh, and I don't wanna forget this one 'cause it's probably the top of the list, but weight loss, resistance or continuing to gain weight despite not, maybe not changing anything. So that's a sign too, that stress hormones may be up, which can also, in parathyroid hormones inflammation might be up.

[00:19:56] You might feel puffier more achy or [00:20:00] swollen. Those are some key signs took out for, 

[00:20:03] Taryn: So if, if somebody's listening and they think, oh man, maybe my thyroid's not working properly. What are the tests we need to ask our doctor for to make sure we can assess that more accurately?

[00:20:13] Alisha: so typically your doctor, at the very least, will order TSH, what stands for Thyroid Stimulating Hormone, and this is gonna assess general thyroid hormone output. It is actually a hormone produced by the pituitary gland in your brain, so it's not really a thyroid hormone, it's a hormone used to communicate to your thyroid gland from the brain.

[00:20:34] When that becomes elevated, that's a, it's an inverse relationships. That's a sign of hypo or low thyroid hormones. When it becomes suppressed or low, that's a sign of hyper or excessive thyroid hormones. So at the very least, you're gonna get that. Some doctors may also test what's called free T four.

[00:20:49] This is the inactive thyroid hormone, and especially if you are on thyroid hormone replacement, like Synthroid, levothyroxine, cyrox, whatever it might be. Typically they check that as well, but for the most part, that's where a lot of conventional medicine will stop. I recommend more of a full panel to get a, a better picture of your thyroid function.

[00:21:10] So if you wanna test for Hashimoto's, we're looking at thyroid peroxidase antibodies or TPO antibodies, or the second one is th globulin antibodies. those are the ones that you're gonna wanna check to diagnose. Hashimoto's graves is different. See if it's TRAB antibodies and TSI, and I'll have to remember if I remember what those, I don't actively work with Graves clients, but.

[00:21:35] There's separate antibodies that you can request to screen for Graves disease, if that's a concern. And then I also like to look at T three levels. A lot of conventional doctors don't look at that, but it's helpful to see if those levels are optimal and if you're converting well from inactive to active because.

[00:21:52] It's very common, at least with my clients, I see that a lot is poor conversion. So like their TSH looks great, their T four looks [00:22:00] normal, but they're very symptomatic. They're not converting, so their cells aren't even getting the active thyroid hormone. So on paper, good, but the patient just feels awful.

[00:22:09] So that's worth looking into. And then with my clients, I also test what's called reverse T three, which oftentimes, if you're not converting. Inactive T four to active T three. Your body's converting it into reverse T three, which binds to the same cell receptor site as free T three, but it's not usable by the cell, so it kind of blocks it, and that's actually a protective mechanism by the body and the thyroid.

[00:22:33] So I like to view this as the thyroid's, a very sensitive gland. and It is going to perceive with the brain, obviously, but it's going to perceive in the environment the stressors and can you handle, you know, have you, have you surpassed that threshold of your personal stressors or stress load? If you have chronic, you know, overtraining, chronic undereating and whatever else life is throwing at you and you may have going on physiologically.

[00:22:57] Your body's gonna downshift to protect, for survival and if it doesn't have what it needs and if it doesn't feel safe or nourished or whatever that might be. So that's where I see reverse T three go up. It can also be for other reasons, illness, surgery, whatever. But that's really important to.

[00:23:14] See beyond the TSH and free T four because it can provide answers and at least a place to, to look and target you know, where to put your efforts essentially, and also help you not feel like you're going crazy because you do have some validity that can actually be shown in blood work.

[00:23:29] Taryn: Uh, Modern medicine,

[00:23:30] Alisha: Yeah.

[00:23:31] Taryn: so if somebody does have hypothyroidism or Hashimoto's, what do we do about it? What are the big rocks to 

[00:23:38] help support our thyroid function so that we can not feel so rubbish all the time?

[00:23:42] Alisha: I mean, they're all individual, so that's the tricky part. But the, the ones that I think almost everyone can work on optimizing that I talk to with all of my clients on social media is we wanna work on your nutrition. Um, There's almost always areas for improvement of the quality of [00:24:00] your diet, your meal timing, how well you're balancing your blood sugar levels.

[00:24:04] cause we're eating every day, multiple times a day. So it's a really good opportunity to work on improving. So nutrition is good. And, and with that I really like working on gut health, so that's a big one too, because it is very much connected to how well you're absorbing the nutrients from your diet, but also immune balance and regulation.

[00:24:24] I have a lot of, and this is kind of a two-way street, like thyroid function and autoimmunity impact gut health and vice versa. So we kind of how to put the flame out somewhere and, and it's a really good place to start. It's got health and nutrition and that can help calm inflammation and absorb micronutrients from your diet better.

[00:24:43] Metabolic health would look like blood sugar balance again, nutrition, but also the type of movement. I love the phrase the dose makes the poison. That's true for almost anything, whether it's your diet, your exercise, your recovery. So I keep that in mind for all of my clients of, you know, their personal stress buckets.

[00:25:01] And then, you know, how can we modify, mitigate things to help you feel better and help your body recover. better. So movement, you know, it's, it's a great therapeutic tool, but when it's underdone or overdone, it goes into that bucket of a negative stressor versus a positive stressor. So that's when I work with my clients on a lot, is making sure that works for them and for their bodies.

[00:25:24] And a lot of times it's, it's temporary too. It's not like. you're gonna, you know, scale back on exercising forever. Sometimes it's just in a short term to give your body a chance and a break and work on some other areas. And then another very big one would be stress management. So especially in the case of autoimmunity, You ask anyone who has an autoimmune condition and they're gonna tell you, stress is like probably at the top of their trigger. Because you know, the nervous system is gonna dictate if you're in a healing state or a fight or flight state. So learning how to address your stressors, identify them, coping mechanisms, [00:26:00] whatever it might be because the stress never stops coming, right?

[00:26:05] I mean, there's, there's so many things that really do impact, thyroid health, you know, and I mean, we could go on and on, but like, you can also make the argument of like how well you're detoxifying every day. You know, yes, we have a liver, yes, we have kidneys, but that becomes overburdened because we live in a toxic world.

[00:26:21] I don't care where you live or who you are. The fact is, is we are exposed to so many things that we, our bodies weren't really intended to. And that can build up. And then you throw in thyroid hormones and sluggish thyroid and, and things start to. Slow down and you see liver impairments and the liver's a big site for thyroid hormone conversion.

[00:26:40] So then again, it's this two-way street as is a lot of things in the body. and I, I always tell my clients like, let's take inventory of your life. What are your top three biggest areas that you know in your gut? And, you know, like be honest, that you could improve upon. You know, are you not getting outside or is your diet not great?

[00:27:00] You know, How is your emotional, mental health, that type of thing. And 

[00:27:04] when we started there, I mean, we really do see a lot of great progress and allowing the body to get into a better place of healing.

[00:27:12] Taryn: Yeah, so you mentioned detoxing. What are some of the key products in our lives 

[00:27:19] that we need to maybe switch to a different option? Because I see that that a lot with 

[00:27:23] thyroid nutrition is, is layering in the switching to low tox sort of products. What are some of the 

[00:27:28] big ticket things that we need to look for and ingredients that we wanna avoid?

[00:27:31] If thyroid health is something we wanna improve?

[00:27:34] Alisha: Yeah, I think first and foremost, like your air and your water quality is huge 'cause you're breathing air all the time. You're drinking water all the time. So we filter our air. Um, We have air filtration systems, we have like water filtration on our drinking water, and On our home as well. because you are gonna get things like chlorine and fluoride and, and things like that that can disrupt thyroid hormone production specifically fluoride is a big one [00:28:00] because it's in the same family and it can block iodine uptake into the thyroid.

[00:28:05] And some people are more sensitive to that. So those are two big ones. And then, yeah, when it comes to, especially women, if you are wearing makeup every day or perfume and things like that, it's, Really a great idea to, to look at how many products you're using and how many ingredients we're being exposed to.

[00:28:23] There's, there's so many things and they can also disrupt, you know, estrogen. you hear the term like endocrine disruptors or xeno estrogens, like they, they can mess with your fertility health and your estrogen balance. So, you know, like looking at. Your deodorant. I mean, as natural as you can get.

[00:28:39] There's some great companies out there now, which is great. whether it's your toothpaste, your deodorant, the makeup you're putting on your face, or the lotion you're using, or the sunscreen, especially talking about like athletes outside a lot, like if you're using that constantly, I try to look at the things that, what am I using on a regular basis and what's absorbing into my body, like what's going on my skin.

[00:29:01] Those are the products I tend to be a lot pickier about and with. I tell my clients too, like it can be a gradual swap out. It doesn't have to be all at once. 'cause that can get expensive and be very overwhelming and. 

[00:29:14] Also just the least, like the less products you can use overall.

[00:29:17] Like there's certain things I used to use that I never use now, you know, like perfumes and fragrances and hairspray. Like I don't, I don't really need any of that, you know, maybe once in a great while, but it's not really necessary. And also saves you some money now 

[00:29:32] Taryn: heaps of money. There's so much stuff that you can buy 

[00:29:35] that gets marketed to females, right?

[00:29:37] Alisha: Yes, exactly.

[00:29:38] Taryn: so on the female. path. For the female athletes that are listening, I know that postpartum thyroiditis is a, is a thing and can impact the first 12 months postpartum. Do 

[00:29:50] you know how common that is or how many people you see in that space?

[00:29:53] And then what? What are some tips for somebody that might be navigating that?

[00:29:57] Alisha: Great question. I dunno, the stats, like the updated [00:30:00] stats on how common it is, I actually, I. I think one of my clients has it right now, and we're trying to figure out, you know, because, well, yeah. What happens is, is after giving birth, there's a huge, almost immediate hormonal shift with the hormonal profile from being pregnant to no longer being pregnant.

[00:30:17] And that again, with the connection with the immune system, is a huge toll on the body. And anyone who's had a baby can testify to the, to the extreme night and day of change that that is. So, it can cause this transient inflammation of the thyroid gland that can last anywhere from six months to potentially 18 months.

[00:30:35] But 12 months is about the average and it will show up on lab work like Hashimoto. So sometimes it's hard to differentiate other than the timeline, like it happened postpartum. But postpartum is also a pretty common time for women to also develop Hashimoto's. So with postpartum thyroiditis, it does usually resolve on its own.

[00:30:55] Medication isn't usually warranted or, or your levels can be monitored, but you can kind of go back and forth from this hyper to this hypo and it, it doesn't help the craziness that postpartum is, but are, there are these kind of big fluctuations, but it does tend to even out. Now women who have positive thyroid antibodies prior to going into pregnancy and and postpartum are more likely to develop postpartum thyroiditis.

[00:31:21] So they're, they're at a higher risk. So women who have a history of thyroid disease, like get screened, get screened, but you know, before you even try to conceive too if you can. But having that knowledge since thyroid disease and autoimmunity is definitely, there's genetic components to it. If you have that knowledge in advance, then you can.

[00:31:38] At least prepare yourself and have your labs being monitored more often, especially during pregnancy, which is a very important time to monitor thyroid levels because it's, the fetus is dependent on the mother's thyroid hormones up through the middle of the second trimester. So it's, it's really crucial for the development of the baby, but things to kind of mitigate Yeah, the, that [00:32:00] time period.

[00:32:00] If someone is dealing with postpartum thyroiditis, again, we're kind of looking at ways to help with inflammation. Thyroiditis is inflammation of the thyroid gland, and for some people it does help for them to experiment with their nutrition and see what foods might be triggering more inflammation, whether that's gluten, processed foods, excessive sugar, excessive caffeine, or alcohol.

[00:32:20] nutrient void foods, like they're not getting enough micronutrients or antioxidants or polyphenols or enough protein. That type of thing can be really helpful. And then as much as possible, I mean, the stress piece is still gonna be huge um, as much as you can with a newborn trying to allow yourself to rest and, and recover and.

[00:32:38] I think it can be very helpful too to record your symptoms and record a timeline so you have more data to bring to your doctor as they are checking on your labs. They may want to do, depending on the case, an ultrasound of your thyroid gland to make sure that, you know, if, if they're swelling or something else that they can just keep an eye on it.

[00:32:57] But yeah, that's what I would recommend.

[00:32:59] Taryn: There's so much to unpack there isn't there? 

[00:33:01] And you know, for a new mom, or even the second or third time mom, like trying to keep stress levels 

[00:33:07] down through that 12 month postpartum window, then maybe wanting to return to training and trying to juggle all the 

[00:33:13] balls. It can be a lot. So little shout out to any moms out there just to look after you first.

[00:33:19] 'cause you're the bus driver, right? And if you go down, the whole shabam goes down.

[00:33:23] Alisha: Exactly. yeah, it's tough. I work with many moms and I'm a mom too, and it's like aspects that you do need to be selfish, but not in a selfish way. It's where you do have to make sure you care for yourself, care for yourself like you would one of your family members, you know? And a lot of times we don't do that or we do that very last.

[00:33:41] And we wonder why we're not thriving or we're not able to heal. It's like you gotta, you gotta give your body what it needs and, and not feel guilty about it, which is probably the hardest part, at least 

[00:33:52] for me, is like not feeling guilty for wanting to rest or 

[00:33:56] do whatever self-care thing needs to happen.

[00:33:58] Taryn: Yeah, I'm the same. I'm sure [00:34:00] a lot of people listening are the same. 

[00:34:01] So in terms of like ongoing management and long-term with thyroid things you hear about, you know, remission, you said it right in the 

[00:34:08] beginning. Is it possible to heal from Hashimoto's and and not have it anymore? Or do you mean just not having any markers in your biochem that are out of whack and you feel good on a daily basis?

[00:34:18] Alisha: there's no permanent cure. least I'm aware of for autoimmune conditions, there are a variety of therapies, whether you look at, you know, not so much for Hashimoto's, but whether it's like medications, like immunosuppressants, steroids, there's that, those options typically offered in conventional medicine for autoimmunity.

[00:34:36] More of the holistic, functional approach really is about remission as far as. Essentially keeping your immune system happy and balanced your lab work stable. And even, and when you have erratic lab work, like your TSH is bouncing all over, you're constantly having medication management, that's usually a sign of inflammation to the thyroid gland or an autoimmune flare.

[00:34:55] So that's important to kind of understand that. it's learning how to care for your body while living with Hashimoto's and. to no fault of your own 'cause life is gonna happen. But there can be periods where you, maybe you do reach a remission, your antibodies are low, your lab work's stable, your symptoms are resolved.

[00:35:12] You wor you've worked and address those root issues to help your body come back to a place of balance because this ambance does not happen overnight. It's years of. Dysfunction. It's years of environmental stressors. It's years. Whether you realize it or not, you're living out of alignment with your body, is the way that I like to think of it.

[00:35:31] so once we get to that good place and you, you've established those habits, there's gonna be times where, you know, an illness, a trauma, something may happen that may cause a flare or trigger the immune system. And it doesn't mean that you failed. I mean, your body is. Kind of just responding to that event or that circumstance.

[00:35:50] And I, I try to tell my clients that, you know, we, we know what to do. We can help the body. Maybe we don't know what the, the cause was, or maybe we do, but [00:36:00] the real, the goal is just understanding how to care for your unique needs in your body with, with your set of circumstances. 'cause everyone is different.

[00:36:08] I mean, when I work with my clients, they really just have Hashimoto's. They usually have hormonal imbalances and gut issues and this and that and the other thing. So it's a, it's the full picture. It's not just one thing, but I feel like the more, the closer you get to remission and you've worked on these different areas, the easier it does get because it does, you transform, you learn how to become that person to sustain, those healthy habits, and it becomes your new normal, which, which is the goal, you know, and, Life is gonna be life. And there's different seasons and, and especially for women, you know, we go through these significant hormonal periods too, with like puberty and, and pregnancies and postpartum and perimenopause and post menopause. So it's like we have to set our expectations accordingly, that things are gonna change and.

[00:36:55] and. You know, at least being aware of that and accepting of it can help too. So it doesn't catch you off guard like, oh, things were perfect and I just, you know, you don't reach remission and then stop doing all of the things that helped you get there. It's, it's 

[00:37:08] Taryn: Yep. Ongoing. 

[00:37:10] Is it possible to ever come off medication in your experience? Has that ever happened for anybody?

[00:37:16] Alisha: Yeah, so it is possible. depending on if you're able to identify what caused the dysfunction in the first place, 

[00:37:22] combined with how much of your thyroid gland can function, you know, sometimes for people, in my case, specifically when I was diagnosed, my thyroid, it had likely been going on for quite a while with, without really my knowledge of it.

[00:37:37] So I kind of explained to people that maybe your thyroid's working at 80%. It may never get back to a hundred. Maybe it will, but in that case, like hormone replacement therapy is, recommended because we don't want to be in a suboptimal place long term. We don't wanna chronically be in a hypothyroid 'cause that is damaging too. So I know there's cases of and and research to [00:38:00] support that excessive iodine. And once their nutrition was mitigated, they were able to get their Hashimoto's in remission. And maybe they didn't even need thyroid hormones in the first place, but they were placed on it.

[00:38:10] Inappropriately, right. 

[00:38:11] That can happen too, where the thyroid hormones are prescribed very quickly and very easily. Most, yeah, very. Like one of the most common prescribed prescription, you know, drugs. So that too is sometimes, and I've, I've had many clients, like over the years, who they They didn't need to go on medication. We had room to work on lifestyle things first. Their, their lab work didn't warrant it, but they were placed on it because they had symptoms. So their doctor said, okay, I'll 

[00:38:36] put you on this thyroid medication. But, but they never needed it in the first place. So yes, it's not as common, I will say.

[00:38:43] A lot of people who do go on medication if it's needed, it, it is a lifelong thing. But if that's the thing that helps you stay optimal in combination with everything else, then you know, it's, it's a small price to pay, I guess you could say. And but I'm, I'm hopeful for what the future has. There's so many cool things coming out with like peptide therapy and stuff for autoimmune, you know, patients that I 

[00:39:05] think is really promising.

[00:39:07] So I guess we'll just see what happens there. But, that's probably the number one question people ask. They're like, can I get off my thyroid medication? I'm like, I 

[00:39:14] don't, I don't know. Maybe like 

[00:39:16] in, you know? Right, right. And I I also try to explain like, it's, it's not a prescription drug. We are replacing hormones your body can't produce, and those hormones are very necessary, and if you're on the right dose, I'm kind of in the, the camp of the least effective dose is where you wanna be if it's needed.

[00:39:35] Taryn: And then how often are you checking that? So if you, if you're getting bloods done regularly, how often should you check in on your thyroid function?

[00:39:43] Alisha: the most often you can, if you have, if you start thyroid medication or if you change your dose, is every, like anywhere from four to eight weeks. The average is like six to eight weeks. If, or pregnancy or postpartum, you're gonna wanna be checking it probably that often for a little bit, especially if you are symptomatic.

[00:39:59] If you're in a [00:40:00] stable place and you're feeling good one to two times a year, but I am more of, if you are maybe starting off and, and not a great place and you're making changes and you wanna assess progress, then yeah, do it every two to two to three months, you know, because I, I do like data points.

[00:40:17] I like to see what changes are helping, you know, reach a certain outcome with your lab work and, and how 

[00:40:22] you feel. So it is, it is case by case, but, I do mine about twice a year, 

[00:40:28] Taryn: Yeah. Nice. Thank you. That was just a random question. 

[00:40:31] I know some people will probably think. Yeah. Well, thank you 

[00:40:34] so much. It's been so insightful into all things thyroid, where I know, I know a lot of triathletes that do struggle with it and they just have no idea 

[00:40:42] how to manage it, and it's hard to find the right advice in, modern medicine.

[00:40:46] Going to the doctor doesn't always help because they, they just. Hand you out a script, but maybe what's one piece of advice for a triathlete that does have some thyroid issues going on that you could give to help them through this?

[00:40:59] Alisha: that's hard. 'cause I know athletes, there's a, I feel like there's a certain mindset uh, maybe a competitive one and 

[00:41:04] and wanting to be Yeah. Like very high performing. And the thing about the thyroid gland and 

[00:41:10] autoimmunity is it's kind of, think of it as this is your ultra sensitive barometer.

[00:41:15] For stress and stress looks like many different things. Again, nutrition, recovery, all the things that we've been talking about. So, working on making yourself a more resilient person is the way I like to view it, because the more resilient you are, the more stressed you can handle and learning how to mitigate in the various stressors in your life, things you can control specifically, there's certain things you can't control.

[00:41:37] So don't focus on those so much. Focus on the things that you do have control over, like. your Sleep, schedule your recovery, schedule your nutrition, those types of things, and give yourself a lot of grace. you know, it's not your fault if something goes wrong, sometimes that's just gonna happen, but you can remain a high functioning athlete as long as you take all of that into consideration and truly learn your [00:42:00] body and, You know, have the awareness of what your body is telling you, learning the symptoms to look out for, staying on top of lab work dialing all of that in because as a LA athlete, I mean, you do have to have things styled in if you wanna perform at a certain level. I think that's just a requirement, but just understanding, you know, what is happening with your body being on the right type of medication for you, you know, can make a, a huge difference too.

[00:42:24] There's. There's different types, despite what your Dr. May say. There's a variety of different types that you can explore too. So in that case, I say if you can work with a functional medicine doctor or someone, you know, if you're seeking, maybe diving deeper and optimizing things, that, that could help too.

[00:42:40] If you're not getting the support you want through your endocrinologist or your primary doctor, there are options out there to help you, you know, achieve your goals for whatever that is.

[00:42:51] Taryn: Yeah. Thank you. That's really good advice. So, if somebody who does wanna dive deeper and wants to work with you and to support their thyroid, how do they go about doing that?

[00:43:00] Alisha: Yeah find me on Instagram. That's the 

[00:43:02] best way. I have all of my resources, free and paid, and courses and working with me. Everything's housed there. So that's at Leisha, LI, hha thyroid RD. send me a message. a follow and hoping to open up more services outside of the US as things become easier to do, whether that's testing and, and things like that.

[00:43:28] So hopefully I can't offer that to people who are listening in Australia or otherwise. 

[00:43:33] Taryn: Yeah. Thank you so much. That's been very eye opening and I hope everyone else has enjoyed it as much as I have.

[00:43:39] Alisha: Yeah.

[00:43:39] Thank you for having me. 

[00:43:40] This was great. I really enjoyed it. 

 

Thanks for joining me for this episode of the Triathlon Nutrition Academy podcast. I would love to hear from you. If you have any questions or want to share with me what you've learned, email me at [email protected]. You can also spread the word by leaving me a review and taking a screenshot of you listening to the show. Don't forget to tag me on social media, @dietitian.approved, so I can give you a shout out, too. If you want to learn more about what we do, head to dietitianapproved.com. And if you want to learn more about the Triathlon Nutrition Academy program, head to dietitianapproved.com/academy. Thanks for joining me and I look forward to helping you smashed in the fourth leg - nutrition!