Podcast Episode #62: Vampire Hands, Thyroid, Binge Eating Recovery, Ex Vegan & Not Menstruating?

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Opening chat: Quick thoughts about the Western A. Price Foundation Wise Traditions Conference 

Topics:
1. Vampire hands [10:45] 2. Thyroid support [19:47] 3. Life long binge eating and drinking, can I recover while going through menopause? [33:10] 4. Ex raw vegan, Female MMA Fighter wants less body fat, more muscle, can’t poop, and is wary of cooked veggies. Help! [41:31] 5. I'm not menstruating [51:35]

Links:
Julia Ross' The Diet Cure & The Mood Cure

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LIZ WOLFE: Hey everyone, I'm Liz Wolfe. I'm a nutritional therapy practitioner and certified dark chocolate lover. And I’m here with Diane Sanfilippo, who's a certified holistic nutrition consultant and the woman behind Balanced Bites and the, what is it now? The 5 time New York Times Bestselling book Practical Paleo.

DIANE SANFILIPPO: Yep. 5 times.

LIZ WOLFE: Remember our disclaimer-that's amazing.. Remember our disclaimer: the materials and content contained in this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment.
Welcome to episode 62 of the Balanced Bites podcast.

DIANE SANFILIPPO: Woo hoo!

LIZ WOLFE: Woo hoo! So I want to give a quick shoutout to the first responders at the US Air Force Academy. I just came back from a really humbling and really fun few days doing some nutrition talking there. I was so just blessed to be invited out. I got to chat with some really lovely people. Not just the first responders, but a few others who also made it out. Jordan, who is a fellow nutritional therapist, the gals from CrossFit Continuum. I wanted to make it out for a workout, but considering that just talking at that altitude made me feel like I was going to pass out, I didn't think I'd be able to work out. And Julie of PaleOMG, who is definitely my long lost sister. She's awesome. I had a great time talking to her. We'll have to get her on the podcast one day. I know she's got a book coming out pretty soon. And before that, we had the Weston A. Price Foundation conference. Plenty of fish eggs eaten and kombucha drinking, or drank. I don't know. I'm drunk.

DIANE SANFILIPPO: [laughs] Drunk on kombucha.

LIZ WOLFE: I learned…okay, so what's the technical term? I learned my face off from Chris Masterjohn, as usual. From Stephanie Seneff, who is always a favorite of mine every year. She is not a woman who is afraid to postulate on what are probably pretty controversial topics to most people, but I'd say if you're an academically outfitted MIT, artificial intelligence fellow, you've probably got the brains to back up the stones and you can pretty much say whatever you want. So what else? So much good stuff. Not the least of which obviously was hanging out with good friends, making some new ones, and winning something at the final auction. I totally won a picture of sleeping pigs. So cute. And [laughs] I'll shut up because I feel like everything I just said was basically structured like a rap song. [laughs] Did I sound like I was rapping?

DIANE SANFILIPPO: Not even a little bit.

LIZ WOLFE: Okay.

DIANE SANFILIPPO: But I suppose if we had somebody like beatboxing, perhaps.

LIZ WOLFE: Put that it in the good idea folder.

DIANE SANFILIPPO: Okay. Yeah, I mean, I don't know. Do you want to talk a little bit more about some of the high level stuff we kind of took away from Weston Price? I can just drop a few things, I guess, that…

LIZ WOLFE: Drop a few things…drop it like it's hot.

DIANE SANFILIPPO: Drop a few knowledge bombs. No, I'm just kidding. I don't know. I mean, it was definitely like…okay, overarching things about the conference. Some things that were really different from some of the Paleo-oriented conferences we go to, like Ancestral Health or PaleoFX. You know, I think the sort of population that comes to the Weston Price Foundation conference…a lot more nutrition practitioners, at least from the population that I know. I ran into a lot of old classmates. My old instructors were both there, and it was pretty cool to see that everyone's kind of there to learn more. And you know, some of that could just be a little bit of a selection bias. We were in northern California, so there are just some people that I’ve known for years out there. But it seems like a little bit of a more user based group. You know what I mean? Like it's people who are really looking for the answers for themselves. Not to say that those who come to PaleoFX and Ancestral Health aren't, but you know, there's a lot of science in these talks and the people who are coming up to ask questions after, they're less asking questions about mechanisms and the research and all that, they're more asking very personal, specific questions about like how these ideas will help them.

LIZ WOLFE: Mm-hmm. People looking for healing, yeah, for sure.

DIANE SANFILIPPO: Yeah, so I think it's really cool that conferences like this make guys like Chris Masterjohn, Chris Kresser, Julia Ross…make all these people a little bit more accessible and get people in front of them asking questions, and it also keeps their…I think it keeps their research very practically focused.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: You know, it's not just like this intangible pie in the sky awesome research to do, but less, you know, practical. It's really like hands-on, so that was pretty cool.

LIZ WOLFE: You know, I was really excited to see Chris Kresser's talk because I've been working on this skincare guide for, you know, forever now, and I talk about it all the time, but it was cool to sit down and really get…I think I'm going to have ask Laura, our buddy Laura, who works for Chris, for his source list, but he really kind of confirmed a lot of the stuff that has worked for me, but I didn't necessarily have a good, you know, body of work to draw from, kind of proved scientifically what I've experienced just in healing my own skin. So that was great. It's definitely reflected in my skincare guide, and I’m so excited about that, so…loved that.

DIANE SANFILIPPO: Yeah, I thought, too, I thought Chris Masterjohn's talk on fat soluble vitamins was cool, and I thought part of what his..part of what the big takeaway for me on that one was, and, you know, you and I kind of are always trying to harp on people about eating organ meats and all of that, but he really always take it back to like, great, well, each of these nutrients is fantastic. We need them all, and what we get from food is really what we want.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: And obviously the Weston Price Foundation and all of its sort of contingency there, really into the fermented cod liver oil as a traditional food. A traditional super food. It's not a supplement. Like we say that all the time, and I think that that's really important to know, and I do think that, you know, it's made in a different way than a lot of other omega-3 supplements are made, but that's…the point is that people are still, I think, trying to come to terms with the fact that we're not recommending it as a major source of omega-3, and in fact, we don't even generally tell people to supplement with much omega-3 at all. Get it from your diet. We overall need a very low intake of polyunsaturated fats from the diet, so what we get from something like eating fish a few times a week, which that was the other really fun part was sampling all that awesome fish from Vital Choice.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: You know, I like that even though we get all this steeping in the science, the takeaway becomes real, whole foods as they occur in nature.

LIZ WOLFE: Yeah.

DIANE SANFILIPPO: You know, it's almost like we just always come back to those same themes.

LIZ WOLFE: And quite apologetically, organ meats and, you know, the odd bits, which I can get a little bit apologetic about, you know, when I'm working with clients, like, well, am I going to lose this person if I tell them to eat liver? You know, but it really is one of those things that you got to come around to or you have to be willing to really kind of look for those nutrients somewhere.

DIANE SANFILIPPO: Yeah, and even down to things like connective tissue, the skin, you know, chicken skin.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: Like one of slides Chris had up was showing like the amount of…was it glycine? What was it in muscle meat of chicken vs. the skin and the bones? And really recognizing the traditional value of foods and whole animal and, you know, we keep talking about broth and bone broth and not throwing away chicken skin and things like that, and that's really the value of it. It's not just because we want to be weird or make people eat things they don't want to eat. We really want to take people's brains out of this whole like, these are weird foods that, you know, I don't have to eat anymore because we have all these modern things, and I can just take a supplement. And the reality is, we don't know what happens with some of these nutrients when they're interacting with each other, all the synergies that we have there, and what happens really for healing in our bodies when we're doing that, and I think we go away from some of the performance orientation and we look at really the health and fertility and the, you know, hormonal balance, and, you know, all of that stuff. I think we can really focus a lot more on recognizing that real whole food carries that weight so much more than supplementation; even though we like supplementation for very specific purposes, we just can't undervalue real whole food.

LIZ WOLFE: Agreed. You can get as complicated as you want. You can talk about methylation, you know, what did he talk about? Tonic vs. phasic dopamine.

DIANE SANFILIPPO: That was interesting.

LIZ WOLFE: Regulation of, you know, methionine, glycine, B-12, and folate, but really you just back out and look at this, and say hey, these, you know, properly raised animal products are providing all of these things, and you don't even have to think about it.

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: It's true.

DIANE SANFILIPPO: Yeah, it's true.

LIZ WOLFE: Cool.

DIANE SANFILIPPO: True.

LIZ WOLFE: Okie dokie. So, let's start with some questions. First question. Wait, Diane? You are…oh, I already said, 5 time New York Times Bestseller. Congratulations. So exciting.

DIANE SANFILIPPO: Oh, well, thank you.

LIZ WOLFE: Practical Paleo's killing it.

DIANE SANFILIPPO: Oh, thanks. You know what? I forgot also to mention what…so this weekend coming up, if people catch this before the weekend, I'm in Tacoma, Seattle…teaching all day in Tacoma, have a special guest teacher with me, Anthony DiSarro. Obviously, you've had a bunch of stuff going on so weren't able to make it to this one. Kind of like a blip…blip in our little radar here, but you know. I'm going to be teaching most of that workshop, and Anthony is going to teach a bunch of cool stuff on like hormones and stress and how that affects your body, so that's going to be cool. And then Sunday signing books at Third Place Books in…I can't remember the name of the town right now. I don't have it in front of me. But in the Seattle area, let me take a look. Oh, Lake Forest Park, Washington. So Seattle area, that's a free event. So that's it, and we'll clue people in to what's going on for next year within the coming weeks here. Our upcoming workshops and everything.

LIZ WOLFE: All right, so we kind of psyched people out. Thought we were going to start with questions, but I had to throw in something else. So here we go. Right about 10 minutes in, hopefully if you hate our banter, you've fast forwarded to ten minutes and now we're ready to go.

DIANE SANFILIPPO: [laughs]

LIZ WOLFE: [laughs] Number one. “Vampire hands.”
Lauren says: “What are your recommendations (if any) for diet and Reynaud’s syndrome (aka my hands turn white and numb in the cold)?” I think she must know my affinity for vampire fiction and that's why she entitled this “vampire hands.” So we would read it.
“I am easing my way into the Paleo diet. I was vegetarian (with occasional seafood) for many years, but I have started eating more seafood, as well as plenty of eggs. The meat is coming (it’s more of a mental block for me, but I’ve tried bites here and there recently). Other than that, I have cut out all grains, beans, legumes, and limit nuts.
When it is cold (or even just chilly like in the fall) out, my fingertips and sometimes my whole fingers turn white and lose circulation. It’s obviously worse in the winter (aka 6 months of the year in New England), but if I’m cold other times of the year, it happens as well. When it gets really bad, I have to run my hands under hot water for several minutes. Otherwise, I just wear gloves (which doesn’t always help). The one time it doesn’t happen is when I go running in the cold – my hands stay perfectly normal. If there are any supplements or diet recommendations, that would be great, so my hands don’t look like weird, white, vampire hands all winter long.”
And I'll just throw in here…Reynaud’s can be worse in shifting temperatures. What happens is the vasculature constricts, and even spasms and reduces circulation, so that's what's going on with Lauren. There's primary Reynaud’s and there's later onset Reynaud's, and it can also be brought on, I believe, by things like beta blockers or any vasoconstrictor like caffeine or tobacco, or even stress. I've done a little reading about birth control pills worsening those symptoms, so there are kind of a lot of inputs here to think about, but just wanted to give that context. Diane, what are your thoughts?

DIANE SANFILIPPO: So, you know, she's saying that she was a vegetarian. We know that Reynaud’s has some autoimmune underpinnings, so obviously a Paleo diet is a really great start. As we know how much grains, legumes, pasteurized dairy affect our digestive function and how much that affects things like autoimmunity. But that said, you know, she may be eating a lot of other really commonly irritating foods. Things like nightshades and eggs. So I would definitely focus less on mentally, emotionally, on the fact that she needs to be eating all this meat and she may not be eating enough meat or whatever it is, and more on the fact that we want to get rid of the gut irritants. So she's already started to omit things like grains, legumes, nuts. Unfortunately, the eggs may not be the most helpful food item for her to be adding in, and I would omit nightshades pretty strictly as well for a couple of weeks to see if you can get some remission from these symptoms. So I would pretty carefully examine things like condiments, sauces, spices, looking for hidden gluten because if you think you're doing this thing totally perfectly, but you're getting an exposure from some kind of hot sauce or some kind of other condiment or spice blend that you just haven't looked at or re-looked at, then that could be a pretty, pretty big exposure, and I would guess too that in this type of situation, gluten is going to have the most severe effect on promoting the leaky gut.
So what's happening when we're looking at autoimmunity and how we affect that with diet is that we're always looking to heal leaky gut. We're always looking to pull out anything that's irritating that. Maybe add in some-excuse me-some supplementation to support the healing. So I would use the Guide to Gluten. See if you can find anything. Play detective. See if you can find something you just didn't realize you were eating. I would also again watch the nightshades and the eggs. And I would do that for like, depending on how long you've been eating Paleo. So did she say-I'm trying to remember if she said how long she's been doing this?

LIZ WOLFE: Mmm-I think she just got started. She's easing into it.

DIANE SANFILIPPO: Yeah. So I mean, I would give it a month on like a basic Paleo diet, but I would cut the eggs and the nightshades for at least 2 weeks. What's cool about like once you're already eating Paleo to get yourself off of things like nightshades and eggs, you can do that for two weeks, and that's enough time to really see some help. It normally takes about 2 weeks for the gut lining to start to heal or even to fully heal, so it’s not like you need to do a whole months without eggs to really see some kind of effect from it. So that's what I would say there. You know, play detective, see what you're eating. Do some food logging. See if you're eating the same things over and over again, especially again, eggs and nightshades, since she's already said that she's cut out nuts and seeds. Trying to see what else here…are there any other notes?
Obviously, there's, you know, it wouldn't be a complete answer if I didn't also recommend the kind of typical things that I'll recommend for gut healing. Things like l-glutamine, which is known as somewhat of an adaptogenic amino acid. It can kind of become different amino acids that we need that are essential for us to be getting in to heal the gut lining and sort of rebuild those cells. Bone broth as well also again for gut healing. And then probably fermented cod liver oil, potentially with the butter oil blend for the immune support of the vitamins A and D, less than for something like the omega-3, which is anti-inflammatory. I'm looking more at the immune modulation of vitamin D and really vitamin A as well. That was something we kind of covered a lot last weekend at the conference. That vitamin D is great, but without vitamin A, it's almost like it's not really going to work. So the beauty of that supplement is that we're getting both of those nutrients in. We're getting them undamaged as they naturally occur. They're not synthetic, they're not added back in. And the thing about autoimmunity to think about leaky gut is that you have seemingly like, you know, unlocalized non-central like symptoms. It's not gut symptoms, it's what's happening in your hands, but what you need to fix is what's happening in your gut so that your body can allow the rest of its systems to work. This is kind of the part of inflammation that when I explain this to people that inflammation can be pain, heat, redness, swelling or loss of function, so if something in your body is not functioning properly, you always have to look back to gut health, what's happening there.

LIZ WOLFE: I like it. I'll just make one or two remarks about something that we learned actually at the Weston Price conference was this idea anyway that egg protein is actually very poorly absorbed, which is part of the reason I really just don't like egg white protein shakes and stuff like that. There are a couple problems with that, but folks that do think hey, I need to supplement a little bit of protein. In a former recovering vegetarian diet, you may not be getting the protein that you think that you're getting from those eggs. So it's not so much what you're eating, it's what your body is able to do with it, which really circles back around to what Diane was saying about digestion and healing that and making sure that whole process is supported from top to tail.
There's also…it seems to me that there’s also an association with chronically high blood sugar and Reynaud's, Reynaud’s-I don't know which one it is. But I think, you know, my hunch is we see that a lot with vegetarian diets because they just tend to include a higher proportion of calories from carbohydrate, and as you kind of recover from that, and you engage in a plan like Diane described for awhile, the symptoms will subside from, you know, the chronically high blood sugar as well. As long as she's implementing the lifestyle as is most optimal, and what I mean by that, she's getting to the point where she's eating grass-fed beef, getting those really important nutrients in, being a nutrient seeker, like we like to talk about and not just, you know, sticking with what you may be comfortable with: you know, chicken, broccoli, and coconut oil. That type of stuff. But getting those real healthy fats in from pastured animals. I think those are important steps and things to kind of hold as a goal down the road. I think for blood sugar recovery and for curbing that vasoconstriction that we talked about, it might be worth seeking good sources of magnesium. Bone broth may be good. Other than that, you know, maybe some magnesium glycinate on a temporary basis while everything comes together, but none of that without what Diane has already said. Don't try to supplement, you know, without covering the important bases that Diane already mentioned. So I think that's all I had to say about that.
All right, next question. “Thyroid support.”
Mary says: “Hey gals, LOVE your podcast! So engaging, informative and fun!
On to the serious stuff, I had a thyroid nodule biopsied and the pathology results came back as “inconclusive, but suspicious as cancer.” Of course I am stunned, frightened and in total denial. My endo recommended a partial or full thyroidectomy dependent upon the ENT doc. My TSH and free T-3 are in normal ranges, according to what Chris Kresser indicates as normal, so that’s why this is all the more baffling, but I suppose one is not necessarily related to the other…?
I will obviously have to take some kind of thyroid medication for the rest of my (hopefully very long) life, and would love to get your advice on nutrition support as well. I am considering taking a desiccated thyroid as I’m not jazzed about taking synthetic hormone, but will do whatever I need to in order to maintain proper thyroid levels once the thyroid gland is no more. What kinds of foods should I avoid, add and what kind of supplements will best support my thyroid?
Any thoughts on thyroid meds would be helpful as well!
Bedtime.” This is her routine. “Bedtime: 9pm, Wake: 5am to exercise which includes walking, 30-minute interval sessions on an elliptical or spin bike, weight training, sometimes weight training with cardio bursts (jump rope, spin bike or elliptical), core work and stretching. I typically exercise 60 minutes 5 days/week and change up the routine regularly. I take a week every few weeks to recover (light walking and yoga).
Supplements: 1 Tablespoon Lewis Labs Brewer's Yeast, 2 Green Pastures Cod Liver Oil/Butter Oil blend capsules, 6 Enerprime capsules by IMP, 4000 IU Bioletics Vitamin D NonoSpray, 4 Jigsaw Magnesium w/SRT tablets, 500 milligrams Rainbow Light Food-based Calcium, ginkgo biloba, taurine, methionine and N-Acetyl Cysteine for liver detox, 1 packet of Tianchi (Chinese adaptogenic herbs) and finally DIM. Diindolymethane. I also take 25 mg of Spironolactone per day for acne. Whew!” Yes, whew. I can't believe I got through that. I probably stumbled a little bit there.
“Food: All fruits (limited) and veggies are organic and all meats are organic and/or grass-fed. I do eat a lot of organic, full-fat dairy which I intend to drop after surgery. 2 cups of coffee/day with raw milk, breakfast is eggs and some kind of organic grass-fed meat or liver on the weekends, but during the week I tend to eat either kefir or cottage cheese. Lunch is chicken breast, sardines or tuna with carrots, jicama, guacamole or hummus (I know). ” What, is there something wrong with hummus? It's not Paleo, but it's not…Diane…I can see Diane in video chat smiling at me right now. She's like, just finish the question. All right.
“I eat a lot of seaweed. I use it as a wrap for tuna or salmon salads, and dinner is more of the same. I do eat night shades and sweet potatoes and use coconut oil to cook with and snack on organic peanut butter, almond butter or coconut manna (heaven in a jar) in limited amounts. I have a glass of red wine 2-4 times per week. I don’t do any gluten and the only grains I have are the occasional rice crackers. Thank you for your words of wisdom!”
Diane, go.

DIANE SANFILIPPO: All right, well, a couple of things before I get into her question. I love that we have this huge amount of additional information and every time we get it, it tells us so much about what the person's doing and also about the person. You know, just like how detailed they are in describing things and how much they put in there because we know some people like write like 3 lines and some people fill the whole thing in. It's a box that doesn't really tell you how much to write, you know, so it just kind of like gives people a blank piece of paper and it's almost like a…almost a little like a psychological test as well. I know it sounds kind of crazy, but it's like let's see what you're going to say. Let's just see what comes out here.
So a couple of things before I get into the nutritional and the ideas about the thyroid hormones. First off, the exercise she's describing. It sounds way too intense for somebody with a thyroid condition and someone who potentially could be dealing with having their thyroid removed. Maybe it's not as intense as it sounds, but exercising 60minutes 5 days a week, that sounds like too much to me. And the big thing that I always tell people is like, big secret is doing less is better and is more. Like more is not better. It's just more. And so when you're pushing the stress response that comes from exercise, if you're doing less work, and you're getting the right kind of response, the right kind of adaptive stress response from the exercise, again the short burst and a lot of rest, but when you’re pushing, and I say pushing it like we've got so many people listening with hypothyroidism and all kinds of thyroid concerns, anything that is like borderline where you are…anything you feel like you're doing that's not just bare minimum, like I feel like I do bare minimum of exercise most of the time, especially when I'm traveling.

LIZ WOLFE: I do bare minimum-er. [laughs]

DIANE SANFILIPPO: When I'm home, it's not bare minimum. I’m way more rested, I’m trying to train several days a week and really going at it, but otherwise, bare minimum, just to get that like appropriate response with your muscles, what you don't want to do when you're exercising with a thyroid condition is put yourself in that stress response, fight or flight situation for long periods of time. Because if your thyroid is stressed, it means that your whole body is stressed. Your adrenals have already been taxed, and your thyroid is sort of next in line. Now it doesn't mean, you know, I can say what's causing it for every person, but I do know that if somebody exercises like mad crazy for years and years and it's you know, an hour every day for 5 days, and often people say, well, I used to be able to do this. I did this for forever, and it's like, that's exactly what happens. You weren't really able to do it, but you did it anyway, and then it all comes to a screeching halt when your thyroid gives out. And I'm not trying to tell, what's her name here…

LIZ WOLFE: Mary?

DIANE SANFILIPPO: I'm not trying to tell Mary that she's like caused her problem, that she's caused this potential cancer, but the reality is, we know what stress does to the body. We know it's not good, and we know that if you're doing things that are chronically stressing your system, it's not supporting thyroid health. So number one, I would tell her to scale back on that exercise. I might tell her…I don't know where she's located, but I might even tell her to look for like a CHEK practitioner, who's going to help her do what we calling “working in” vs. working out. Doing things that build energy within and, you know, it gets a little hippie dippy, but I'm all about that stuff. You've got some really serious conditions to deal with here. That's one thing I would really recommend. You could even just get Paul Chek's book How to Eat, Move, and Be Healthy, and you really need to find a way to exercise less to keep your body less stressed. It's about the hormones here. It's not about burning calories. It's not about any of that. So when you're dealing with healing, we don't want to you to be thinking, well, I need to burn all these calories. We want you to be thinking, what can I do to give my body the best environment possible to heal in.
The other thing is the coffee. Two cups a day with raw milk? I don't know how much the milk may or may not be affecting her system. Dairy can be, obviously, really irritating to the gut. It can be an immune upregulator for people who don't tolerate it well. We don't know what's happening here. I would pull back on all of that stuff. I would definitely try and quit the caffeine because again, if you're pushing stress at all, you're pushing your adrenals around and your thyroid is getting beat up as well. Just this whole endocrine cascade. So, you know, I'd become this bad cop over here talking about all these things that she's doing that she really shouldn't be doing. The reality is, you know, who knows? Maybe if you change your lifestyle for like a month or 3 months, you really put yourself first, you really reduce your stress, and reduce some of this stuff, and maybe get this whole thing tested again and see what's happening. I'm not saying you're going to reverse the whole thing, but it's absolutely possible that you could change this inconclusive but suspicious result for the better if you change your mind set. You get things really thinking in a different way. So that's kind of the lifestyle, stress, caffeine issue.
So shifting back to kind of her actual question, the thyroid health meal plan in my book outlines foods that are important to avoid as well those that are important to simply not overdo. Things like cruciferous vegetables that are rich in goitrogens, especially in a raw or fermented form. They're usually not that big of a deal when cooked and this is something that I've learned from Chris Kresser, that, you know, appropriate iodine supplementation, which I’d say, work with your endocrinologist. I think Chris has some recommendations on dosages for that. It's not something I feel comfortable telling people dosages on at this point in time. At some point maybe I will, but getting proper iodine supplementation if you're dealing with a thyroid issue pretty much mitigates any negative effects of goitrogenic like foods. So it's not something you need to be that worried about it. It’s just more an awareness to have. Most people also in this country who have thyroid conditions, it's autoimmune. It's not from an iodine deficiency, which is commonly a cause in other countries, so dealing with the autoimmunity, dealing with stress largely with autoimmunity, and stress coming from, again, exercise, caffeine, and also food related stressors. Things that your body doesn't tolerate, that you may or may not even recognize.

LIZ WOLFE: And would you say, Diane, there's definitely, you know, there is reason to believe in the connection between, for example, cancer and autoimmunity? Uncontrolled growth in your body's inability to handle it.

DIANE SANFILIPPO: Yeah, absolutely. I mean, that's kind of another big point that we try and drive home at the workshops, too, and you know, people are always so fearful of all these diseases that happen, and the reality is we need to…we need to work on immunity. We need to work on gut health and all of that, and that is our best possible chance at preventing this stuff. It's the best thing we can do. It's the best thing we know how to do. We can't control everything else. And then she did ask about thyroid meds, and I've said this probably roughly about 1 million times before, so I'm just going to repeat myself.

LIZ WOLFE: Roughly.

DIANE SANFILIPPO: Roughly, I mean, I know that people who listen all the time are like, we've heard this before. And she can go back and listen. We've answered questions about thyroid countless, countless times. Please use the podcast archive page. Do a little search on that page. You'll find some other good answers on thyroid health. But the reality with thyroid meds is that they're not medications in the way that other medications are. They don't up or downregulate a normal body function. They replace something that is no longer produced. So they're absolutely critical. You need them, whether they're synthetic or, you know, bio-identical or whatever's happening with them. I don't know. I can't make that call for you. I don't know which hormones are going to work best for you. I do know that if your labs come back seemingly normal, the issue is not likely as much as just a thyroid issue, it's an autoimmune issue. So I've already beat that one over the head. Beat that dead horse, whatever. That's really what we're looking at here is dealing with this autoimmunity and stress in the system. So I don't…I don't ever tell anyone to like stop taking thyroid meds. I always encourage people to make sure they're getting the right dose, to, you know, talk to their endocrinologist if they're feeling too jittery or still feeling too lethargic on whatever dose they have, to make sure that they get that dose appropriate because it's really…it's regulating so many things in the body and we can't know…we can't know how well you respond to a lot of different changes, lifestyle, dietary, what have you, if you don't get the right dosage to kind of feel normal again on that thyroid hormone.

LIZ WOLFE: Cool. So as kind of transition into this next question, which is going to ask a little bit about kind of dealing with the aftereffects of lifelong behaviors, that I think this applies to Mary as well. It may not be what you're doing now. You may feel like your workouts and everything is something you should be able to handle, or, you know, you may feel like you're doing the right things with your workouts and exercise and diet, but we do have to look at the environment you've created in your life for sometimes decades leading up to the manifestation of health problems. I know that's certainly the case with me reversing many years of, you know, nutritional deficiencies just stressing my body with various things. So a lot of times, you know, once we change our diet, we do have to face kind of that harsh reality of maybe you can't work out all the time, even though you feel that much better or maybe you need to look at these things that, you know, like Diane says, she's the bad cop. Like sometimes the hard truth is, you're going to need to give up things that you don't want to give up just because of other things that have led up to that circumstance.
So we're going to talk about that here in this question from Trisha. Question is “Lifelong binge eating and drinking. Can I recover while going through menopause?”
Trisha says: “Your podcast is an inspiration and has helped me tremendously in getting through the 21 Day Sugar Detox. Your work is helping so many. Where were you when I was struggling as a young woman? Oh. You were in diapers.” [laughs] “Anyway, I am currently doing the 21 Day Sugar Detox and have had an epiphany that I am very sugar addicted and a long time over-drinker. Once off the wagon with these 2 substances it’s hard to control my intake. I would love to continue to live without these substances after the 21 Day Sugar Detox. So, my question is this; what nutritional/supplement advice would you give to repair the damage done from years of disordered binge eating as well as years of over-drinking and to control the cravings for them? I am 50 years old and going through menopause too so I’ve got THAT going for me, which is nice. Main problem” [laughs] “Just envision Bill Murray going, So I've got that going for me. [laughs] I hope that was an intentional Caddyshack quote. That's awesome. “Main problem with that: hot flashes and brain fog. I was bulimic as a teenager/young adult. Also binge eater, with weight as high as 220. Currently 155 and feel best at 140. Finally not so worried about my body composition for vanity purposes but rather to be fit and strong and healthy as I age.
Currently Paleo for a couple of months and currently half way through the 21 Day Sugar Detox. Prior to that, diet was ok albeit uninformed and I always struggled with refined carbs, sugar binges, and alcohol. I’m somewhat an all-or-nothing person but getting better. For exercise I hike in the hills and do yoga and want to add some weight lifting at some point. I have recently started fermented cod liver oil but no real supplements. Sleep is not ideal. I work 3 night shifts per week at a stressful job but can sleep at work approx 50% of the time. The other 50% is interrupted sleep with the occasional up all night. On my days off I sleep well, 8 hours a night.”
Diane, what do you think?

DIANE SANFILIPPO: So I think this is a perfect case for some help from Julia Ross's work in the Mood Cure. Maybe even the Diet Cure? When we're dealing with addictions and behaviors that seem nearly impossible to break away from, often our brain is simply lacking in some deeper amount of specific amino acids or maybe a combination of a couple of them. And supplementation may be, you know, the correct…may be able to correct it, you know, quite simply. Like it's not something that we know…it's sort of like a chicken or an egg thing here. Julia's books have questionnaires and pretty solid protocols of items you can pick up in a place like Whole Foods or online, maybe Amazon. Amino acid therapies, so things like l-tryptophan and that kind of thing. I would want to ask the hard questions about her lifestyle, like what about moving away from that night shift eventually? You know? On days you're trying to sleep at work, you know, is there something you can take that can help the sleep be more restful, like an herbal supplements, some adaptogens or something like that. I don't know. She didn't say what her work is. I'm guessing she needs to be able to wake up, so I wouldn’t say to take some melatonin while you're on a shift. It is a hormone and it's pretty potent, but sleep is going to go a long way to helping you repair the brain. So in this situation, as I was saying, like we don't know if it's a chicken or an egg thing here. We don't know. You know, if we get you on some supplementation that could help you sleep better, that might help. The big issue to remember here is that, you know, with the diet, with whatever else is going on stress wise, 95% of serotonin is made in your gut, so feeling good, having even moods, reducing cravings, etc., can all be helped tremendously by something like amino acid therapy, but your diet is what really drives the boat to keep you in line. Too much sugar, too many carbs, too much alcohol can create gut dysbiosis or bacterial imbalance by feeding in way too much sugar, so that's going to throw off that whole serotonin production. You need serotonin to make melatonin for adequate sleep, so this whole thing is like really interconnected. So there's a motivation for keeping out the sugar, refined carbs, etc. It's knowing that your brain health, your serenity, your ability to kind of be calm and not have cravings and not have that anxiety around food really is rooted in your gut health, and your gut health means not getting in too much sugar, refined carbs, and alcohol. But I think that perhaps doing some kind of protocol with amino acid therapy, it can really just quite literally change your brain. It changes and calms down some of these moods or these excited states we get into to where you can no longer…you know, you may no longer be interested in that thing that you were just constantly thinking about. Maybe you've moved through the day constantly thinking about candy bars or whatever kind of carbs are sitting around, but it's amazing what happens when you get in these amino acids. You just don't think about them, and it almost makes you realize that to some degree, it's not really your fault. There's something going on, we don't know what. It could have been years of not enough protein. We don't know what caused it. It could just be stress, and the lack of sleep that's depleting all these nutrients, but that might be really helpful, and I would definitely say to check out those books. I'll put a link to them in the show notes. I would say maybe if it's dealing with a lot of the binge eating and drinking, I'd sort of…it's almost an addictive nature to food. I might say the Diet Cure is a good place to start with that.

LIZ WOLFE: Okie doke. So my biggest flag on this one, and I wanted to say besides the usual words on patience, stress relief, doing everything Diane says, and forgiving yourself anything that came to define you at any point in your life is also I like liver support in these types of situations. I do think that some supplements that support the liver can be helpful in turning around the physical damage of years of these types of issues, particularly with addiction and especially when alcoholism is involved. It can be a long road, but I think it's worth considering, and I'm not a doctor, so obviously, this is not medical advice. I'm not, you know, making prescriptive suggestions, especially since we don't know for sure whether Trisha is on any other meds that could interact, and this is important to remember: anything that detoxifies or helps heal or regenerates the liver is also going to change the way your body clears medications. This is why more holistic liver support can manipulate the way other medications work in your body because the liver is really the distributor of those meds. It's kind of the governor with regards to how that works in your body, so while I do think you can get good mileage out of supporting your liver with foods like liver because the nutrients your organs need are present, TADA! in those same organs, so eating beef liver can help support your own liver. Eating beef heart, which is rich in CoQ10 can support your own heart, which needs CoQ10. But to take the support one step further, where it's indicated, I do like a few supplements, like alpha lipoic acid and silymarin with milk thistle. Alpha lipoic acid is really a master anti-oxidant. But I also have to say that I don't know that it's indicated where there's any depressed thyroid function, but I could be wrong on that. I also want to say, Trisha, good on you for moving forward like this and please be assured that you're going to do great. Your mind and self-awareness are dialed in, you're making changes, and you're moving forward, so keep in touch on all that stuff. We like to hear back from folks.
Good?

DIANE SANFILIPPO: Good.

LIZ WOLFE: All right, next question. “Ex-raw vegan female MMA fighter wants less body fat, more muscle, can't poop and is wary of cooked veggies. Help!”
Okay, this is from Ana. “I’m training as an MMA fighter and would like to go pro, but I'm having three big issues. One, despite training 3 to 6 times per week, I'm barely putting on muscle. Two, my body fat percentage is way too high for a fighter. I don't stand a chance against someone in my weight class because they will have much more muscle than me, and three, I have severe constipation issues.” She's female, 25 years old, 5'5 and 125 pounds. Started Paleo 7 months ago. “Before Paleo I was raw vegan, eating 90% fresh fruit, maybe 1800 calories a day. I started raw vegan to try and cure my lifelong constipation problems and gravitated toward basically fruitarianism because I could finally go to the bathroom normally. However, after a couple years, the constipation came back even on all fruit. I began to have low energy and had more trouble building muscle than I already had, even on Zone. For the last 7 months, an average day's food looks like one quart lemon water, breakfast a whole pineapple, kombucha, lunch, 800 to 1000 calories of fresh or dry fruit, lots of water and/or unsweetened ginger and/or chamomile tea and/or water kefir. Dinner, 12 to 16 ounces of raw wild fish or shellfish or grass-fed beef or venison, one to two tablespoons coconut oil, fermented carrots or raw sauerkraut, seaweed and/or greens and/or other fresh veggies. Sometimes a raw egg yolk or two. Homemade bone broth, a cup or more per day usually.
I bought your book, but I'm scared to eat cooked veggies, especially starchy veggies like you recommend because of how much raw helped me, at least initially, and also because bananas constipate me terribly even when covered in spots. I take a tablespoon of magnesium citrate in hot water, plus one cup of coconut water before bed each night, and I take a good probiotic every day.” Are you waving at me right now?

DIANE SANFILIPPO: No.

LIZ WOLFE: Oh. I'll cut that out. “I had a colonoscopy a week ago, trying to figure out the cause to constipation, and the doctor said I have a very twisty colon, and to just take Miralax for the rest of my life, and to eat immense amounts of fiber. I do not want to start taking Miralax or anything like that, and I tend to find I do better on less fiber, 25 to 40 grams rather than 60 plus, which is easy to get in my diet. I never take fiber supplements. I sleep 7 to 9 hours per night, train hard for an hour or less, 4 to 6 times per week, and take rest days when I feel I need them. I hope to increase my training eventually, but I'm trying to work with my body and not stress it out. Before this, I ate mostly raw fruit for 3 years. Every time I tried other raw vegan foods, I got seriously constipated. And before that, I ate a more varied, raw vegan diet for 2years. Prior to the raw veganism, I ate Zone, lots of canned tuna and lunch meat, olive oil, apples, things like that. I had a horrendous constipation and had some trouble building muscle even then, but not as bad as now.”
Diane, I'm going to jump in and just say a few things. There's a lot going on here, but one of the things I'm hearing is that potentially that vegan diet was used really maybe exclusively for its supposed constipation fighting effects. I didn't really hear any kind of moral imperative in there or anything like that. So I'm going to kind of address it that way. What I see is that maybe fiber's effects or the temporary effects from raw veganism masking an underlying problem. I think it's possible that, you know, when we talk about a lot of these gut issues, irritable bowel issues, whether constipation, diarrhea, whatever, we may also be talking about a potential serotonin issue. Serotonin does play a role in motility and quite frankly, this is just me talking out of my you know, rear end, but if there's been no substrate for serotonin or there's been a breakdown in that feedback loop in the long term or over several years or if there's been a breakdown in whatever process is being mediated by serotonin with regards to bowel motility or if there's a problem with serotonin reuptake. I honestly don't know enough to describe it more clearly than that. I do think that could lead to chronic constipation. I know that there are other neurotransmitters involved in regulating peristalsis, which is basically intestinal contractions, but I'm really just not well informed enough on that to speak on it in more detail. I just think it may be worth looking at.
There's also the possibility of trying some biofeedback, which has actually been studied. It's been used with the type of constipation that's caused by something called Dyssynergia, which basically means your pelvic floor fails to relax, so a couple of ideas there. What else did you have to say on this, Diane?

DIANE SANFILIPPO: So like I guess, you know, I had one note about like, you were talking about the substrate for serotonin and generally we're talking about protein to be able to make serotonin to make neurotransmitters like that and hormones. But I think she's eating enough of it enough. Obviously she probably was not for many years. I wonder if she's really digesting and absorbing food properly.

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: At this point, it seems like digestive support might be really helpful. You know, hydrochloric acid…she's been away from animal foods for a really long time. Perhaps some other enzymatic support, and you know, all that stuff can really help to increase motility. If you don't have sufficient stomach acid…first of all, if you're stressed mentally, you won't produce enough stomach acid. So this is where that whole digestion starts in the brain thing, you know, comes from. If you have inadequate stomach acid, what happens to the bolus of food, whatever it is that you eat that moves through the rest of your system, it's simply not acidic enough to trigger the appropriate digestive enzymes and bile support that you need for gut motility the rest of the way. So you need hydrochloric acid to support all of that. I think what happens in a very strongly plant-based diet is that there is so much fiber that the real reasons we have motility, perhaps the serotonin, perhaps bile flow, which is something else that, you know, I was really stressed on, that was stressed upon me at one of the lectures this weekend, and I just can't remember whose lecture it was at the conference, but that bile flow is absolutely critical to motility as well. We don't know every intricate role that some of these digestive enzymes and secretions play in this process, but we know they're supposed to be there in adequate amounts, and we're living in a way that doesn't support that, we know that we're fouling up the works. We know that something is happening that's not working right. We talked about HCL a lot, and I think…I think that could be one of the big issues here.
So this whole idea of gut motility…you know, she needs to make sure she's getting enough fat in her diet to promote bile flow. If you don't eat fat, your body doesn't demand the secretion of bile, so that's something I would be really concerned with. I wouldn't say to all of a sudden chug 4 extra tablespoons of coconut oil, but I would definitely look into upping that. And you know, she may need to take some supplementation for all of this stuff along the way because it's interesting. As much as we talk about nutrient deficiencies that can result from a plant-based diet, we often don't delve into the downregulation of these normal body functions with regards to specifically to things like the digestive juices and things outside of HCL. To me, this is a huge concern. So everyone knows by now my two big soapboxes are blood sugar regulation and digestive health, so for eating in ways that are imbalanced and not naturally supportive of those two things, we're not setting ourselves up for long term success. So, you know, whenever we can talk about our views of a largely plant-based diet, and you and I, I think, have both come to terms with the fact that like plants are fine. They're cool, they add some interest, but where we get a huge amount of nutrient density is from animal foods. But if we aren't getting in animal foods, or we're not digesting and absorbing them well, doesn't really matter. We're not really getting what we need.
I think her fear of the cooked vegetables. I think all of these fears…I do think she kind of needs to kind of just step into it. Maybe ease into it. Maybe it's one meal a day you get some cooked veggies. They have some fat on them. Trust that your body will come around, but perhaps stock up on some of those digestive support supplements, so in the event you don't feel it, you've got some HCL, you've maybe got a combination of digestive enzymes. Usually one supplement will have digestive enzymes to support fat, carbohydrate, and protein digestion. And then perhaps some ox bile. And that's really what I would focus on for her, is really kind of like, reducing her stress and starting to get in more real foods. And even, you know, you've talked about this before, Liz, the idea of like raw foods and how quickly some of that moves through. We might not be digesting and absorbing most of the nutrition from that, so, you know, sometimes that's why people can't gain weight. They lose it. Sometimes they needed to lose it, but in this case, you know, she wants to gain some muscle mass. If you're not digesting and absorbing protein, you can't do it. It's impossible. So this is really what, you know, what I would have her focus on is getting that digestion optimized so that what she puts in actually gets used properly.

LIZ WOLFE: Maybe some Cal-Teen bars while she's at it?

DIANE SANFILIPPO: [laughs]

LIZ WOLFE: Just kidding. A little Mean Girls reference.

DIANE SANFILIPPO: A little Mean Girls, yeah.

LIZ WOLFE: Strike that from the record. [laughs] All right.

DIANE SANFILIPPO: No, I'm not waving…I'm touching my head. My hair is being adjusted here.

LIZ WOLFE: We're deleting all of this. Okay. Next question.

DIANE SANFILIPPO: Don't delete any of it.

LIZ WOLFE: I won't. Too lazy. All right.”I'm not menstruating.” This is a long one, but I think the information that Michelle gives is really interesting and it's well spoken, so I’m going to go ahead and read the whole thing. I think this has the potential to really help people so…
Michelle says: “My question is about how to safely regain a normal, regular menstruation cycle and how concerned I should be that I’m not menstruating.
I’m 30 years old, almost 31, and weigh about 118 lbs. I lost my period in Jan 2012, which is also when I adopted a paleo diet (following the template provided by the Whole30). [Side note – I actually had light spotting in January for 1 day, which was 2.5 weeks after the previous cycle ended in Dec 2011.] At that point, I’d been CrossFitting 3-5x per week for about 7 months and weighed 125lbs. I was generally happy with my health and wanted to give paleo a try which I’d learned about via the CrossFit community. My goals were to improve my overall health and see how my body would feel after cutting out gluten and sugar. So after the holidays, I started eating paleo and cut out dairy, sugar, gluten, and grains and ate a lot more meat, fats, and nuts. In about 1-2 months, I’d lost weight, with a low of around 115lbs. Over a few months, I dropped my pant size from 4 to 0. I certainly felt like I was eating more food, especially meat, and weight lost was totally unexpected. I now hover around 118lbs, plus a few when I’m traveling and have less control over my food choices. I never try to limit how much I eat and basically eat when hungry and until I’m full.
I saw a gynecologist in June and she did some labs (I think just blood work and a pregnancy test), which all came out normal. She gave me a prescription for medroxyprogesterone and after 10 pills, I had my period. However, after nearly 4 months it’s not come back again. I don’t think the doctor ran any thyroid panels or tested hormone levels. I’ve never been on birth control. I think my loss of my period came with my weight loss. Even though I lost maybe 7 lbs, it was probably a significant amount given my starting weight.
Now that I haven’t had my period for a few months, what should I do to get it back? Should I adjust my diet or my workout routine? Should I get another Rx to medroxyprogesterone? How concerned should I be? definitely want to stay away from birth control. Anything else I should stay clear of? Should I get a thyroid panel? If I were anywhere near a Paleo physician, I’d go see him or her because I really don’t want to just take drugs to relieve symptoms and I feel like they’d understand and work with my lifestyle rather than look for a standard quick fix solution.
I'm generally very laid back and hard to stress out. I keep a very even temperament and don't have highs or lows in terms of emotion. If I were to try and think about sources of stress, one possibility could be a latent source of stress, which is living with my mom for 6 months now, the longest since I was a teenager, and trying to sort out business and personal matters for my parents. Long story short, my father passed away in July unexpectedly and I'm sorting out a lot of personal and business matters since my father hadn't communicated much information to any of my family members. It's sort of a mess anyway, and my mom was totally dependent on my dad for everything. So I bet if I actually saw a therapist who got to my inner core, I'd probably break down and release a lot of pent up emotion, especially since I’m fairly reserved emotionally by nature. But this is a whole other side point, which may or may not be contributing to my lack of period.”
Now, I can skip over the rest of the stuff. It looks like…well, I'll read this about sleep. “I sleep about 8 to9 hours per night. I feel like I'm getting enough sleep, since I wake up naturally most days, but that could also be to do with not having…” Oh, I'm sorry. “with not having blackout curtains. But sometimes I do feel drowsy all day. My eyelids will feel heavy, but my body won't feel physically tired. I keep thinking it's a sleep issue, but I think I'm getting enough sleep. When I'm listening to your podcast, I sometimes wonder if I’m suffering from adrenal fatigue or something else, but I don't think I have any other symptoms that would lead me to think I have any issues.”
So food looks good. We can kind of skip over that, I think. She was eating about 1300 to 1600 calories per day, which seems really low. She's not tracking calories any more, tries to have meat with every meal, don't worry about eating too much. My only concern's about overeating to avoid getting a stomach cramp. CrossFit 4 to 5 times week, 2 or 3 days on, 1 to 2 days off. Now, okay, so this is why I wanted to read a lot of that stuff because I really saw kind of some of myself in this person, and before I turn this over to Diane, see what she has to say, I wanted to zero in on the therapist suggestion. I personally tend to minimize whatever it is I'm going through at the time. I tend to think, you know, gosh, there are people in the world that are dealing with so much, and they're stressed out. You know, I'm not stressed, and I kind of look at the way I am poised, the way I conduct myself, you know, in polite company to be a direct read on how much stress I’m under. So what I mean by that is if I can keep my composure, you know, if I can minimize whatever it is I'm dealing with, then I must be okay. Then whatever level of stress I'm dealing with must be minimal compared to what other people deal with who are just, you know, completely on the floor all the time. And I don't really think that's the truth for people like this podcast question and, you know, myself and probably a lot of women who don't really realize how much they're dealing with until they really have to force themselves to dig into it.
So there's a lot going on foodwise here, but, and this isn't to say that men aren't dealing with the same issues, but this is something that I see a lot in women, and just because I'm a woman and Michelle is a woman, I connect with this state of affairs in women. Again, I see women not fully realizing the volume of their stress load. Michelle has put together her thoughts so well in writing, it seems to me that she's a very together person from the outside, but she's struggling with some physical problems and we absolutely can't ignore what's happening from a mental or emotional perspective when it comes to physical manifestations of that stress. If she feels like she's reserved emotionally by nature as she says, whether or not her lack of a period is directly involved with what she's dealing with from a mental or emotional perspective, and, you know, she's open to saying, well, a therapist would probably identify some deep-seated issues, and so, you know, I think Michelle should explore that. I went through a very difficult time in my life at one point, and I did manage to pull myself out of it, kind of bootstraps style, and I finally got to this point where like, hey, I'm coming out of this. I’m going to be okay, I'm eating healthy, I'm living like I'm supposed to. I'm in a great relationship. I'm on solid ground again. Yet, even though I was fully poised from the outside, I still felt like there was something else I needed to deal with. I couldn't put my finger on it, and it felt strange because I felt like, you know, I'm a collected person otherwise. But I decided to go for it and do something I'd never considered doing in my entire life, and I went to see a therapist. I just went to talk to somebody. I was fortunate that I chose the right therapist and I had a great experience. I don't know if I can say that I did open up fully, but the willingness to go and see if I could dig a little deeper really did help in a lot of ways, mental and physical.
And as far as the hormonal balance, again, I'll repeat, as I have been lately, take a look at Taking Charge of Your Fertility and see if you can, you know, take control of some of this with your own knowledge of yourself and your cycle or what’s going on with your hormones. At the very least it will be empowering and potentially give a clue as to where to go from here. So short story, long, that's what I got. What do you think, Diane?

DIANE SANFILIPPO: I think all of that is more important than anything I'm going to say because this stuff is way more…it just seems like, okay, it started when she first went on like a really strict Paleo approach, and I think that, so that was January of this year. It's been almost a year now.

LIZ WOLFE: Kind of undereating with a calories, I think, in there.

DIANE SANFILIPPO: Yeah, I mean, the big thing is here, we don't know how tall she is, but her body weight sounds definitely really low. I mean, yeah, again, I don't know how tall she is, but she's stressing it, so she's saying that that's low, hovering around 118. I just would be really concerned with her undereating, and looking into that calorie intake of 1300 to 1600, it's funny, Julia Ross was saying, you know, anything less than 2300 a day might not be enough. And that number might freak some people out, but I think the important thing to remember when we talk about calories is it's nutrition, it's substrate for life. It's the substrate of the vitamins and minerals that we need, not just the macronutrients to build your entire body, hormones included. And so when you lose body fat, especially through dieting, you've not given your body enough substrate in the first place to build those hormones. Low body weight for women is a really dangerous thing, and I think, you know, we've heard it before too where some women are like, well, if I don't want to have babies, why does it matter that I worry about fertility? Fertility is a sign of health. You know, it doesn't mean that every person who gets pregnant is the healthiest person there is, but it absolutely means that if you don't have that ability, and it's something that can be affected by diet and lifestyle as you know.
Obviously, there's extenuating circumstances or other things going on with a lot of people. I don't want people to start feeling guilty about these issues, but if they've got a diet and lifestyle that is not optimal, there is always something that can be done or doing less. You know, sometimes it's a matter of doing less, stressing less about your food, and making sure you’re eating enough and just focusing on nourishing your body. You know, giving your body all of those nutrient dense foods, that sort of more Weston Price-oriented approach. If it helps you to say that like you have that focus, rather than a Paleo focus. Basically, I think with Paleo, what we do, and I do it, too, and it is what I promote largely, it's about what we're…what we are excluding and the way that we break our diet down within what we include is sort of less important and it's very specific to the person, which is legitimate. You know, we're avoiding sugars and grains, seed oils, etc. And the Weston Price-orientation is pretty similar, but I think that as a collective group, they have this idea more about nutrient density and supporting fertility than most other groups we see. And so if that's, you know, if that's what you're noticing is changing, you have to change your mind set to okay, well, what is it going to take for my body to be healthy and fertile and focusing only on that.
I think the rest of what's happening with your body will be healthier, and I think the mental health…the mental stress cannot be undervalued or underestimated, even if one thing promoted the loss of the period in the first place, this mental stress could be perpetuating that to a very large degree. One of the big things that happens with mental stress that people don't think about, especially in underweight people is it's promoting leaky gut. When you've got leaky gut, when your digestive system, your small intestinal lining is not intact, you're not able to digest and absorb nutrients the same way you would if it were not leaky, if it were intact, working appropriately, I have clients and friends and colleagues and all kinds of people I've seen who are just really stressed out, whether it's internally or externally visible, and they're just not able to put healthy weight on. I can't help them do that until they work on that mental stress, the emotional stuff, all of that stuff needs to change because it's like this old expression, I can't remember who it is, the terrain is everything. You know, it's not just what you put in, it's what the terrain is that it's going into, and that's really what's critical. So I like Liz's focus on the mental health, and I think that will help bring you around to eating more food, to recognizing how you need to nourish your body and to kind of supporting that with some more mental, emotional help.

LIZ WOLFE: The terrain is everything. That's a…I totally thought I said that. Did I steal that from somebody?

DIANE SANFILIPPO: Yeah, you stole it.

LIZ WOLFE: [laughs] Shoot. All right, well, we're rounding out an hour, so let's cut it off there. That's everything we had for today. We will be back next week as usual with more of your questions. Until then, you can find Diane at www.blog.balancedbites.com. You can grab her book, Practical Paleo, from Amazon. You can find me, Liz, at www.cavegirleats.com or www.lizwolfentp.com, or you can pre-order my book, Modern Cave Girl, on Amazon. Thanks everybody for listening. We'll be back next week.

Cheers!
Diane & Liz